Quand l’innovation sociale réoriente l’innovation technologique dans les systèmes agroalimentaires : le cas des chaînes locales autour des blés

International audienceIn recent years, the technological lock-in of the wheat industry has led to the emergence of alternatives which are now taking on a new dimension with regard to consumer concerns about gluten. Based on a research-intervention in Occitanie and a national survey, this article proposes an interdisciplinary and systemic approach to the development of local wheat chains. It shows how farmers and artisans are carrying out social innovations that reorient technological innovation towards a new agri-food system taking into account new indicators of wealth. While taking part in the work on the scaling up of short food chains, it thus calls to study further the coupling between social innovation and technological innovation in the history and transition of agri-food systems.Le verrouillage technologique des filières blés a suscité, dans la période récente, l’émergence d’alternatives qui prennent aujourd’hui une nouvelle dimension au regard des préoccupations des consommateurs vis-à-vis du gluten. Basé sur une recherche-intervention en Occitanie et une étude menée à l’échelle nationale, cet article propose une approche interdisciplinaire et systémique du développement des chaînes locales autour des blés. Il montre comment des agriculteurs et des artisans portent des innovations sociales qui réorientent l’innovation technologique vers un nouveau système agroalimentaire prenant en compte de nouveaux indicateurs de richesse. Tout en prenant place dans les travaux sur le changement d’échelle des circuits courts alimentaires, il appelle ainsi à approfondir le couplage entre innovation sociale et innovation technologique dans l’histoire et la transition des systèmes agroalimentaires

Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies.

AIMS: There is debate about the optimum algorithm for cardiovascular disease (CVD) risk estimation. We conducted head-to-head comparisons of four algorithms recommended by primary prevention guidelines, before and after 'recalibration', a method that adapts risk algorithms to take account of differences in the risk characteristics of the populations being studied. METHODS AND RESULTS: Using individual-participant data on 360 737 participants without CVD at baseline in 86 prospective studies from 22 countries, we compared the Framingham risk score (FRS), Systematic COronary Risk Evaluation (SCORE), pooled cohort equations (PCE), and Reynolds risk score (RRS). We calculated measures of risk discrimination and calibration, and modelled clinical implications of initiating statin therapy in people judged to be at 'high' 10 year CVD risk. Original risk algorithms were recalibrated using the risk factor profile and CVD incidence of target populations. The four algorithms had similar risk discrimination. Before recalibration, FRS, SCORE, and PCE over-predicted CVD risk on average by 10%, 52%, and 41%, respectively, whereas RRS under-predicted by 10%. Original versions of algorithms classified 29-39% of individuals aged ≥40 years as high risk. By contrast, recalibration reduced this proportion to 22-24% for every algorithm. We estimated that to prevent one CVD event, it would be necessary to initiate statin therapy in 44-51 such individuals using original algorithms, in contrast to 37-39 individuals with recalibrated algorithms. CONCLUSION: Before recalibration, the clinical performance of four widely used CVD risk algorithms varied substantially. By contrast, simple recalibration nearly equalized their performance and improved modelled targeting of preventive action to clinical need