A Random Field Model and its Application in Industrial Production

International audienceWe propose a new tool of decision support in front of a globally unknown phenomenon which is modeled by a random field representing simultaneously our knowledge and our lack of information.This tool is the distribution of a random variable called failure risk probability. Before giving the precise definition of this object, we describe an industrial context in which the decision problem occurs and we discuss Bayesian random field model constructions

Oc031--Generic Substitution Of Antiepileptic Drug (Aed) And Loss Of Seizure Control: A Population-Based Case-Crossover Study

Open access CC-BYInternational audienceThere are still controversies over pill substitution among AEDs: some studies claimed that switching between brand and generic AED (generic substitution) can lead to breakthrough seizures; other studies have refuted these concerns. France and some US states recommend limiting substitution of generic AED. We aimed at further estimating the association between generic substitution and loss of seizure control

An extension of chronicles temporal model with taxonomies: Application to epidemiological studies

International audienceMedico-administrative databases contain information about patients’ medical events, i.e. their care trajectories. Semantic Web technologies are used by epidemiologists to query these databases in order to identify patients whose care trajectories conform to some criteria. In this article we are interested in care trajectories involving temporal constraints. In such cases, Semantic Web tools lack computational efficiency while temporal pattern matching algorithms are efficient but lack of expressiveness. We propose to use a temporal pattern called chronicles to represent temporal constraints on care trajectories. We also propose an hybrid approach, combining the expressiveness of SPARQL and the efficiency of chronicle recognition to query care trajectories. We evaluate our approach on synthetic data and real large data. The results show that the hybrid approach is more efficient than pure SPARQL, and validate the interest of our tool to detect patients having venous thromboembolism disease in the French medico-administrative database

085: Heart failure with preserved ejection fraction: changes in clinical parameters between acute presentation and subsequent follow-up

PurposeIn the prospective KaRen registry of heart failure with preserved ejection fraction (HFPEF), changes in clinical and biological parameters and medications were assessed between acute presentation and out-patient follow-up in stable state.MethodsThe KaRen study included patients presenting with acute heart failure (HF) according to inclusion criteria: Framingham criteria for HF, left ventricular ejection fraction > or=45% and brain natriuretic peptide (BNP)>100pg/mL or NT-proBNP>300pg/mL. Once stabilized, 4-8 weeks after the index presentation, patients returned as out-patients for repeat assessment. Changes in clinical and biological parameters and medications between inclusion and follow-up were assessed with Students t-test and Chi-square testsResults577 patients were recruited and 458 returned for the 4-8 weeks visit. 56% were women. The median [25-75pctl] age was 79 [72-84] years. Medical history included 78% hypertension, 58% atrial arrhythmia, 26% type II diabetes and 27% serum creatinin >100 micromol/l. The table provides inclusion and follow-up dataConclusionsPatients presenting with HFPEF are elderly and a majority are women, with a high rate of hypertension and atrial arrhythmias. Blood pressure is incompletely controlled. At follow-up, blood pressure and NT-proBNP were reduced, but patients remain symptomatic. Still, efforts are needed to improve symptoms in HFPEF.Table (abstract 85) – Inclusion and follow-up data.Variable Mean (IQR)NYHA I / II / III / IVSBPCreatinineNT-proBNPACEI /ARBB-blockerANTICOAGInclusion0.8 / 9.4 / 40 / 49.8%148 [130-170]93 [74-128]2433 [1272-4790]60%65%41%Follow-up13 / 62.5 / 22.2 / 2.3140 [120-150]95 [75-129]1409 [514-2641]68%67.5%51.3%p<0.00010.003<0.000

Electrocardiographic correlates of mechanical dyssynchrony in recipients of cardiac resynchronization therapy devices

SummaryBackgroundThe relationship between electrical and mechanical indices of cardiac dyssynchronization in systolic heart failure (HF) remains poorly understood.ObjectivesWe examined retrospectively this relationship by using the daily practice tools in cardiology in recipients of cardiac resynchronization therapy (CRT) systems.MethodsWe studied 119 consecutive patients in sinus rhythm and QRS≥120ms (mean: 160±17ms) undergoing CRT device implantation. P wave duration, PR, ePR (end of P wave to QRS onset), QT, RR–QT, JT and QRS axis and morphology were putative predictors of atrioventricular (diastolic filling time [DFT]/RR), interventricular mechanical dyssynchrony (IVMD) and left intraventricular mechanical dyssynchrony (left ventricular pre-ejection interval [PEI] and other measures) assessed by transthoracic echocardiography (TTE). Correlations between TTE and electrocardiographic measurements were examined by linear regression.ResultsStatistically significant but relatively weak correlations were found between heart rate (r=−0.5), JT (r=0.3), QT (r=0.3), RR–QT intervals (r=0.5) and DFT/RR, though not with PR and QRS intervals. Weak correlations were found between: (a) QRS (r=0.3) and QT interval (r=0.3) and (b) IVMD>40ms; and between (a) ePR (r=−0.2), QRS (r=0.4), QT interval (r=0.3) and (b) LVPEI, though not with other indices of intraventricular dyssynchrony.ConclusionsThe correlations between electrical and the evaluated mechanical indices of cardiac dyssynchrony were generally weak in heart failure candidates for CRT. These data may help to explain the discordance between electrocardiographic and echocardiographic criteria of ventricular dyssynchrony in predicting the effect of CRT

Cytoplasmic PAR-3 protein expression is associated with adverse prognostic factors in clear cell renal cell carcinoma and independently impacts survival.

International audienceClear cell renal cell carcinomas (ccRCCs) represent 70% of renal cancers, and several clinical and histolopathological factors are implicated in their prognosis. We recently demonstrated that the overexpression of PAR-3 protein encoded by the PARD3 gene could be implicated in renal oncogenesis. The object of this work was to study the association of intratumoral PAR-3 expression with known prognostic parameters and clinical outcome. In this aim, PAR-3 expression was assessed by immunohistochemistry in ccRCC tumors of 101 patients from 2003 to 2005. The immunostaining of PAR-3 was scored either as membranous (mPAR-3) or as both membranous and cytoplasmic (cPAR-3). Cytoplasmic PAR-3 was significantly associated with worse histopathological and clinical prognostic factors: Fuhrman grades 3 and 4, tumor necrosis, sarcomatoid component, adrenal invasion, renal and hilar fat invasion, eosinophilic component, a noninactivated VHL gene, higher tumor grade, lymph node involvement, metastasis, and worse clinical Eastern Cooperative Oncology Group and S classification scores. After multivariate analysis, 2 parameters were independently associated with cPAR-3: necrosis and eosinophilic components. In addition, cPAR-3 patients had shorter overall and progression-free survivals independently from strong prognostic validated factors like metastases. A cytoplasmic expression of PAR-3 is therefore implicated in worse clinical and pathological cancer features in ccRCC and could be useful to identify patients with high-risk tumors

IA et données de santé : regards croisés sur les droits, devoirs et responsabilités des personnes publiques

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Simultaneous eradications of Black Rat (Rattus rattus) and Ice plants (Carpobrotus spp.) on Bagaud Island (Port-Cros National Park, Provence, France): preliminary results on their impacts on Athropods communities

Les invasions biologiques sont reconnues comme l’une des principales menaces pour la conservation de la biodiversité, et de nombreux travaux ont été conduits à travers la planète pour restaurer la biodiversité insulaire par des programmes d’éradication d’espèces invasives. Cependant, peu d’études scientifiques post-éradication ont été conduites notamment pour l’évaluation de la biodiversité des communautés d’Arthropodes. L’île de Bagaud, située dans l’archipel des îles d’Hyères (Var, France), est une réserve intégrale du Parc national de Port-Cros (PNPC) qui a notamment été soumise à deux perturbations majeures d’origine anthropique au cours des derniers siècles : l’invasion du Rat noir (Rattus rattus) et celle des Griffes de sorcière (Carpobrotus spp.). Ces espèces allochtones engendrent des effets particulièrement néfastes sur la flore et la faune des écosystèmes insulaires méditerranéens, notamment sur les Arthropodes. Le PNPC a ainsi lancé un programme décennal de restauration écologique qui implique l’éradication de ces deux taxons invasifs. La communauté des Arthropodes de l’île a fait l’objet d’un état initial au printemps 2011, les éradications ont été effectuées entre septembre 2011 et janvier 2013, et la première campagne d’échantillonnage post-éradication a été réalisée au printemps 2013. L’échantillonnage de la faune épigée a été réalisé au moyen de quatre transects fixes de pièges Barber répartis dans différents milieux écologiques de l’île. Cette première étude post-éradication révèle une augmentation de l’abondance des Arthropodes piégés entre 2011 (4868 individus dans 74 pièges) et 2013 (6892, n = 60). Les effectifs moyens par piège augmentent significativement dans les zones où les Carpobrotus spp. ont été arrachés, mais chutent dans la zone de maquis qui abritait une forte densité de R. rattus. La richesse spécifique reste globalement stable (220 morpho-espèces en 2011, 216 en 2013), cependant les communautés de décomposeurs explosent a contrario des populations de prédateurs. Les suivis doivent être poursuivis afin de mieux déterminer les impacts directs et indirects à long terme de ces éradications s’exerçant sur la biodiversité des communautés d’Arthropodes de l’île.Biological invasions are recognized as one of the major threats to island biodiversity conservation, and numerous studies have been conducted around the world to restore the biodiversity of islands submitted to invasive species impacts. However, few scientific post-eradication studies were piloted notably for the biodiversity assessment of Arthropod communities. Bagaud Island is an integral reserve of the Port-Cros National Park (PNPC), located in the îles d’Hyères Archipelago (Var, France). In the last centuries, it has undergone two major anthropogenic disturbances: the invasion of the Black Rat (Rattus rattus) and the Ice plants (Carpobrotus spp.), two alien taxa known for their particularly negative effects on the flora and fauna of the Mediterranean island ecosystems, including Arthropods. PNPC has launched a ten-year program of ecological restoration that involves the eradication of these two invasive taxa. The Arthropod communities of the island have been analysed in their initial state in spring 2011, eradications were conducted between September 2011 and January 2013, and the first post-eradication campaign began in spring 2013. The ground fauna was sampled using four transects of Barber traps distributed in different ecological contexts of the island. This first post-eradication study reveals an increase in the abundance of arthropods trapped between 2011 (4868 individuals in 74 traps) and 2013 (6892, n = 60). The average number of trapped Arthropods was significantly higher in areas where Carpobrotus spp. have been eradicated, but declined in the bush area that housed a high density of R. rattus. The communities of decomposers explode, in contrast to predator populations. However, the global specific richness remains stable (220 morphospecies in 2011, 216 in 2013). Scientific monitoring by the PNC must be continued to better determine the direct and indirect long-term impacts of these eradications upon the structure and the functioning of the Arthropods communities of the Bagaud Island