Gender- and age-related differences in clinical presentation and management of outpatients with stable coronary artery disease

<br>Introduction: Contemporary generalizable data on the demographics and management of outpatients with stable coronary artery disease (CAD) in routine clinical practice are sparse. Using the data from the CLARIFY registry we describe gender- and age-related differences in baseline characteristics and management of these patients across broad geographic regions.</br> <br>Methods: This international, prospective, observational, longitudinal registry enrolled stable CAD outpatients from 45 countries in Africa, Asia, Australia, Europe, the Middle East, and North, Central, and South America.</br> <br>Results: Baseline data were available for 33 280 patients. Mean (SD) age was 64 (10.5) years and 22.5% of patients were female. The prevalence of CAD risk factors was generally higher in women than in men. Women were older (66.6 vs 63.4 years), more frequently diagnosed with diabetes (33% vs 28%), hypertension (79% vs 69%), and higher resting heart rate (69 vs 67 bpm), and were less physically active. Smoking and a history of myocardial infarction were more common in men. Women were more likely to have angina (28% vs 20%), but less likely to have undergone revascularization procedures. CAD was more likely to be asymptomatic in older patients perhaps because of reduced levels of physical activity. Prescription of evidence-based medication for secondary prevention varied with age, with patients ≥ 75 years treated less often with beta blockers, aspirin and angiotensin-converting enzyme inhibitors than patients < 65 years.</br> <br>Conclusions: Important gender-related differences in clinical characteristics and management continue to exist in all age groups of outpatients with stable CAD.</br&gt

Images and imagination : automated analysis of priming effects related to autism spectrum disorder and developmental language disorder

Different aspects of language processing have been shown to be sensitive to priming but the findings of studies examining priming effects in adolescents with Autism Spectrum Disorder (ASD) and Developmental Language Disorder (DLD) have been inconclusive. We present a study analysing visual and implicit semantic priming in adolescents with ASD and DLD. Based on a dataset of fictional and script-like narratives, we evaluate how often and how extensively, content of two different priming sources is used by the participants. The first priming source was visual, consisting of images shown to the participants to assist them with their storytelling. The second priming source originated from commonsense knowledge, using crowdsourced data containing prototypical script elements. Our results show that individuals with ASD are less sensitive to both types of priming, but show typical usage of primed cues when they use them at all. In contrast, children with DLD show mostly average priming sensitivity, but exhibit an over-proportional use of the priming cues

Constitution d'un corpus de dialogue oral pour l'évaluation automatique de la compréhension hors- et en- contexte du dialogue

Colloque avec actes et comité de lecture. internationale.International audienceThis paper presents and reports on the progress of the EVALDA/MEDIA project, focusing on the recording protocol of the reference dialogue corpus. The aim of this project is to define and test an evaluation methodology that assess and diagnose the contextsensitive understanding capability of spoken language dialogue systems. Systems from both academic organizations (CLIPS, IRIT, LIA, LIMSI, LORIA, VALORIA) and industrial sites (FRANCE TELECOM R et D, TELIP) will be evaluated. ELDA is the coordinator of the Technolangue/EVALDA multicampaign evaluation project, a national initiative sponsored by the French government, of which MEDIA is a sub-campaign. MEDIA began in January 2003. VECSYS provides the recording platform for the project

Slow learning of feeding skills in a nocturnal extractive forager

A long developmental period in animals is often needed to learn skills for adult reproduction and survival, including feeding behaviour. The nocturnal Javan slow loris, Nycticebus javanicus, is unusual in that it consumes a specialized diet of difficult to extract resources, as well as disperses up to a year after sexual maturity. Here, we examined the ontogeny of its feeding behaviour to understand whether learning to feed on difficult resources, including by co-feeding, is related to delayed dispersal. We collected feeding and proximity data on developing and adult wild slow lorises at a long-term field site in Cipaganti, West Java from 2012 to 2018. To determine whether acquisition of insects, exudates, nectar and flowers varied by age, we ran logistic generalized additive mixed models. We found that intake of insects and exudates occurred significantly more in the early stages, and feeding on nectar significantly more in the later stages, of development. Co feeding occurred for all food types, with insects showing the most co-feeding events during early development, and co-feeding on exudates remaining high throughout development. Social learning via co-feeding is a potentially important factor in transmission of dietary information from older individuals, including siblings and parents, to young slow lorises. Differences between immature and adult diets levelled off after sexual maturity and before average dispersal. Together these factors suggest that the period required to learn to forage on difficult items could help explain the delayed dispersal patterns seen in mammals with similar foraging strategies

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

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Questions à intonation descendante: un exemple d'isolat corse?

International audienceIl apparaît que la mélodie des questions totales (appelant une réponse en oui/non) différencie le corse (ainsi que le français de Corse, avec tous deux des tons hauts en début de question suivis de descentes mélodiques finales) et le français « standard » (avec des tons hauts en fin de question). Des expériences perceptives ont été menées, montrant en particulier que les questions en corse et en français de Corse sont souvent prises pour des assertions par les Parisiens, alors qu’elles sont bien identifiées par les Corses. En Corse, les questions à intonation descendante observées en lecture se retrouvent bien en parole spontanée

Repérage des entités nommées pour l'arabe : adaptation non-supervisée et combinaison de systèmes

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