Management des connaissances : quels dispositifs pour quels objectifs ?

Cet article examine les questions de recherche suivantes : quels sont les objectifs du management des connaissances et les dispositifs mis en place dans les organisations ? Peut-on établir des relations spécifiques entre objectifs et dispositifs ? Et, enfin, peut-on identifier des facteurs de contingence ? L’approche méthodologique retenue s’appuie sur une étude quantitative par questionnaire menée auprès d’une centaine d’entreprises. D’un point de vue théorique, les résultats de cette recherche montrent, en accord avec la littérature, l’existence de groupes d’objectifs distincts – à visée interne et externe –, et de groupes de dispositifs – organisationnels, techniques, humains. Nous avons alors cherché à montrer l’existence de liens directs entre objectifs et dispositifs. Or, nous constatons une quasi absence de liens significatifs. Ainsi, les choix des dirigeants en matière d’objectifs et de dispositifs sont dissociés, et ne font pas apparaître de combinaison significative : les acteurs disposent d’un portefeuille de dispositifs KM sans caractérisation a priori sur l’atteinte d’objectifs internes ou externes. Par ailleurs, l’étude de la contingence fait apparaître des résultats contrastés. Une étude typologique des dirigeants a enfin été menée et a fait apparaître trois profils comportementaux : les convaincus, les modérés et les sceptiques. D’un point de vue pratique et managérial, cette recherche caractérise les objectifs et les dispositifs afin de permettre une meilleure compréhension des mécanismes en œuvre

Fish Hydrolysate Supplementation Containing n-3 Long Chain Polyunsaturated Fatty Acids and Peptides Prevents LPS-Induced Neuroinflammation

Neuroinflammation constitutes a normal part of the brain immune response orchestrated by microglial cells. However, a sustained and uncontrolled production of proinflammatory factors together with microglial activation contribute to the onset of a chronic low-grade inflammation, leading to neuronal damage and cognitive as well as behavioral impairments. Hence, limiting brain inflammatory response and improving the resolution of inflammation could be particularly of interest to prevent these alterations. Dietary n-3 long chain polyunsaturated fatty acids (LC-PUFAs) and low molecular weight peptides are good candidates because of their immunomodulatory and proresolutive properties. These compounds are present in a fish hydrolysate derived from marine-derived byproducts. In this study, we compared the effect of an 18-day supplementation with this fish hydrolysate to a supplementation with docosahexaenoic acid (DHA) on lipopolysaccharide (LPS)-induced inflammation in mice. In response to peripherally injected LPS, the fish hydrolysate supplementation decreased the hippocampal mRNA expression of the proinflammatory cytokines IL-6 (p < 0.001), IL-1β (p = 0.0008) and TNF-α (p < 0.0001), whereas the DHA supplementation reduced only the expression of IL-6 (p = 0.004). This decline in proinflammatory cytokine expressions was associated with an increase in the protein expression of IκB (p = 0.014 and p = 0.0054 as compared to the DHA supplementation and control groups, respectively) and to a modulation of microglial activation markers in the hippocampus. The beneficial effects of the fish hydrolysate could be due in part to the switch of the hippocampal oxylipin profile towards a more anti-inflammatory profile as compared to the DHA supplementation. Thus, the valorization of fish byproducts seems very attractive to prevent and counteract neuroinflammation

MAREA PROJECT : MEDISEH (Mediterranean Sensitive Habitats) specific contract no 2 (SI2.600741)

Based on the following Terms of Reference (TOR) of the content of the European Commission DG MARE request Ares (2011)665688: “Compile information supporting the identification and location of nursery areas (juveniles in their first and, if appropriate, second year of life) and spawning aggregations. This information, which is to be collated and archived in formats adequate for GIS rendering, shall refer to all the demersal and small pelagic species in the Mediterranean included in Appendix VII of Council Regulation (EC) No 199/2008 as well as for the species subject to minimum size (Council Regulation (EC) No 1967/2006-Annex III). In addition, ecological characterisation of these areas, both in terms of biological community (assemblage) and habitats therein, must be provided.” The technical tender form of the Specific Contract 2 (MEDISEH) defined the following objectives: Review of historical and current data on the locations and the status of seagrass beds, coralligenous and mäerl beds in different GSAs (Geographical Sub-Areas amending amending the Resolution GFCM/31/2007/2) all over the Mediterranean basin. Transform the information into a digitilized format within the framework of a geodatabase Review and map of all existing specific Marine Protected Areas (MPAs) in the Mediterranean area as well as areas that are under any form of national or international regulation. Identify and map suitable areas for Posidonia, coralligenous and mäerl communities by developing habitat distribution models at different spatial scales. Review and map all existing information on historical and current data of nurseries and spawning grounds of certain small pelagic (i.e., Engraulis encrasicolus, Sardina pilchardus, Scomber spp., Trachurus spp.) and demersal species (i.e., Aristaeomorpha foliacea, Aristeus antennatus, Merluccius merluccius, Mullus barbatus, Mullus surmuletus, Nephrops norvegicus, Parapenaeus longirostris, Pagellus erythrinus, Galeus melastomus, Raja clavata, Illex coindetti, Eledone cirrosa) that are included in the Data Collection Framework for the Mediterranean and subjected to minimum landing size based on Council Regulation No 1967/2006-Annex II. Analyze existing survey data and apply spatial analysis techniques in order to identify locations that are more likely to be density hot spot areas or are being more suitable for fish nurseries and spawning grounds for Engraulis encrasicolus, Sardina pilchardus, Scomber spp., Trachurus trachurus, Aristaeomorpha foliacea, Aristeus antennatus, Merluccius merluccius, Mullus barbatus, Mullus surmuletus, Nephrops norvegicus, Parapenaeus longirostris, Pagellus erythrinus, Galeus melastomus, Raja clavata, Illex coindetti, Eledone cirrosa These areas will also be characterized from an environmental and ecological perspective upon data availability. Integrate and present the aforementioned information through a Web-based GIS viewer with an associated geo-referenced database that will operate as a consulting tool for spatial management and conservation planning. Following the revision of the knowledge base, to identify gaps and suggest future research priorities. In order to meet these objectives, an expert team was composed within the MAREA Consortium from scientists with established expertise in the different topics required, and working in different areas of the Mediterranean basin. The team formed to execute the project includes the main Institutes of EU countries in the Mediterranean, all having solid reputations in the fields covered. The participating Institutes/Entities operate in the Western, Central and Eastern parts of the Mediterranean basin, and this ensures familiarity with the geographical areas that are related to the specific tendering. Moreover, a large number of scientists outside of the MAREA Consortium collaborated on a volunteer basis with data and other input. Details on the list of experts and external collaborators can be found in each Work Package in the present report. For CV details, check the MAREA expert web-site http://www.mareaproject.net/.peer-reviewe

The genetic landscape and clinical spectrum of nephronophthisis and related ciliopathies

Nephronophthisis (NPH) is an autosomal-recessive ciliopathy representing one of the most frequent causes of kidney failure in childhood characterized by a broad clinical and genetic heterogeneity. Applied to one of the worldwide largest cohorts of patients with NPH, genetic analysis encompassing targeted and whole exome sequencing identified disease-causing variants in 600 patients from 496 families with a detection rate of 71%. Of 788 pathogenic variants, 40 known ciliopathy genes were identified. However, the majority of patients (53%) bore biallelic pathogenic variants in NPHP1. NPH-causing gene alterations affected all ciliary modules defined by structural and/or functional subdomains. Seventy six percent of these patients had progressed to kidney failure, of which 18% had an infantile form (under five years) and harbored variants affecting the Inversin compartment or intraflagellar transport complex A. Forty eight percent of patients showed a juvenile (5-15 years) and 34% a late-onset disease (over 15 years), the latter mostly carrying variants belonging to the Transition Zone module. Furthermore, while more than 85% of patients with an infantile form presented with extra-kidney manifestations, it only concerned half of juvenile and late onset cases. Eye involvement represented a predominant feature, followed by cerebellar hypoplasia and other brain abnormalities, liver and skeletal defects. The phenotypic variability was in a large part associated with mutation types, genes and corresponding ciliary modules with hypomorphic variants in ciliary genes playing a role in early steps of ciliogenesis associated with juvenile-to-late onset NPH forms. Thus, our data confirm a considerable proportion of late-onset NPH suggesting an underdiagnosis in adult chronic kidney disease

Efficacy of vinblastine in central nervous system Langerhans cell histiocytosis: a nationwide retrospective study

<p>Abstract</p> <p>Background</p> <p>Vinblastine (VBL) is the standard treatment for systemic Langerhans cell histiocytosis (LCH), but little is known about its efficacy in central nervous system (CNS) mass lesions.</p> <p>Methods</p> <p>A retrospective chart review was conducted. Twenty patients from the French LCH Study Group register met the inclusion criteria. In brief, they had CNS mass lesions, had been treated with VBL, and were evaluable for radiologic response.</p> <p>Results</p> <p>The median age at diagnosis of LCH was 11.5 years (range: 1-50). Intravenous VBL 6 mg/m²was given in a 6-week induction treatment, followed by a maintenance treatment. The median total duration was 12 months (range: 3-30). Eleven patients received steroids concomitantly. Fifteen patients achieved an objective response; five had a complete response (CR: 25%), ten had a partial response (PR: 50%), four had stable disease (SD: 20%) and one patient progressed (PD: 5%). Of interest, four out of the six patients who received VBL without concomitant steroids achieved an objective response. With a median follow-up of 6.8 years, the 5-year event-free and overall survival was 61% and 84%, respectively. VBL was well-tolerated and there were no patient withdrawals due to adverse events.</p> <p>Conclusion</p> <p>VBL, with or without steroids, could potentially be a useful therapeutic option in LCH with CNS mass lesions, especially for those with inoperable lesions or multiple lesions. Prospective clinical trials are warranted for the evaluation of VBL in this indication.</p

How to follow the guidelines, when the appropriate fluid is missing?

Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. Recently paediatric societies have produced evidence-based practice guidelines that recommend the use of balanced isotonic fluid when prescribing IV-MFT in both acute and critical paediatric care. Unfortunately, the applicability of these guidelines could be called into question when a ready-to-use glucose-containing balanced isotonic fluid is not available. The main objective of this study was to describe the availability of glucose-containing balanced isotonic fluids in European and Middle Eastern paediatric acute and critical care settings. This work is an ancillary study of the survey dedicated to IV-MFT practices in the paediatric acute and critical care settings in Europe and Middle East, a cross-sectional electronic 27-item survey, emailed in April–May 2021 to paediatric critical care physicians across 34 European and Middle East countries. The survey was developed by an expert multi-professional panel within the European Society of Peadiatric and Neonatal Intensive Care (ESPNIC). Balanced isotonic fluid with glucose 5% was available for only 32/153 (21%) responders. Balanced isotonic fluid with glucose 5% was consistently available in the UK (90%) but not available in France, Greece, The Netherlands and Turkey.    Conclusion: Ready-to-use isotonic balanced IV solutions containing glucose in sufficient amount exist but are inconsistently available throughout Europe. National and European Medication Safety Incentives should guarantee the availability of the most appropriate and safest IV-MFT solution for all children. What is Known:• Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care.• Balanced isotonic fluid is recommended when prescribing IV-MFT in both acute and critical paediatric care. What is New:• Balanced isotonic fluid with glucose 5% is available for less than 25% of the prescribers in Europe and the Middle East. Availability of balanced isotonic fluid with glucose 5% varies from one country to another but can also be inconsistent within the same country.• Clinicians who have access to a ready-to-use balanced isotonic fluid with glucose 5% are more likely to consider its use than clinicians who do not have access to such an IV solution

ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis

PURPOSE Intravenous maintenance fluid therapy (IV-MFT) prescribing in acute and critically ill children is very variable among pediatric health care professionals. In order to provide up to date IV-MFT guidelines, the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) undertook a systematic review to answer the following five main questions about IV-MFT: (i) the indications for use (ii) the role of isotonic fluid (iii) the role of balanced solutions (iv) IV fluid composition (calcium, magnesium, potassium, glucose and micronutrients) and v) and the optimal amount of fluid. METHODS A multidisciplinary expert group within ESPNIC conducted this systematic review using the Scottish Intercollegiate Guidelines Network (SIGN) grading method. Five databases were searched for studies that answered these questions, in acute and critically children (from 37 weeks gestational age to 18 years), published until November 2020. The quality of evidence and risk of bias were assessed, and meta-analyses were undertaken when appropriate. A series of recommendations was derived and voted on by the expert group to achieve consensus through two voting rounds. RESULTS 56 papers met the inclusion criteria, and 16 recommendations were produced. Outcome reporting was inconsistent among studies. Recommendations generated were based on a heterogeneous level of evidence, but consensus within the expert group was high. "Strong consensus" was reached for 11/16 (69%) and "consensus" for 5/16 (31%) of the recommendations. CONCLUSIONS Key recommendations are to use isotonic balanced solutions providing glucose to restrict IV-MFT infusion volumes in most hospitalized children and to regularly monitor plasma electrolyte levels, serum glucose and fluid balance

Challenges of Harmonizing 40 Years of AVHRR Data: The TIMELINE Experience

Earth Observation satellite data allows for the monitoring of the surface of our planet at predefined intervals covering large areas. However, there is only one medium resolution sensor family in orbit that enables an observation time span of 40 and more years at a daily repeat interval. This is the AVHRR sensor family. If we want to investigate the long-term impacts of climate change on our environment, we can only do so based on data that remains available for several decades. If we then want to investigate processes with respect to climate change, we need very high temporal resolution enabling the generation of long-term time series and the derivation of related statistical parameters such as mean, variability, anomalies, and trends. The challenges to generating a well calibrated and harmonized 40-year-long time series based on AVHRR sensor data flown on 14 different platforms are enormous. However, only extremely thorough pre-processing and harmonization ensures that trends found in the data are real trends and not sensor-related (or other) artefacts. The generation of European-wide time series as a basis for the derivation of a multitude of parameters is therefore an extremely challenging task, the details of which are presented in this paper

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy