Guillain-Barré Syndrome, Greater Paris Area

We studied 263 cases of Guillain-Barré syndrome from 1996 to 2001, 40% of which were associated with a known causative agent, mainly Campylobacter jejuni (22%) or cytomegalovirus (15%). The cases with no known agent (60%) peaked in winter, and half were preceded by respiratory infection, influenzalike syndrome, or gastrointestinal illness

Asymmetrical Bi-RNNs (U-RNNs), 2nd place solution at the Trajnet++ Challenge for pedestrian trajectory forecasting

International audienc

Asymmetrical Bi-RNNs, 3rd place solution at the ICCV Trajnet++ Challenge

International audienc

Asymmetrical Bi-RNN for Pedestrian Trajectory Encoding

International audiencePedestrian motion behavior involves a combination of individual goals and social interactions with other agents. In this article, we present an asymmetrical bidirectional recurrent neural network architecture called U-RNN to encode pedestrian trajectories and evaluate its relevance to replace LSTMs for various forecasting models. Experimental results on the Trajnet++ benchmark show that the U-LSTM variant yields better results regarding every available metrics (ADE, FDE, Collision rate) than common trajectory encoders for a variety of approaches and interaction modules, suggesting that the proposed approach is a viable alternative to the de facto sequence encoding RNNs. Our implementation of the asymmetrical Bi-RNNs for the Trajnet++ benchmark is available at: github.com/JosephGesnouin/Asymmetrical-Bi-RNNs-toencode-pedestrian-trajectories

Asymmetrical Bi-RNN for pedestrian trajectory encoding

Pedestrian motion behavior involves a combination of individual goals and social interactions with other agents. In this article, we present a non-symmetrical bidirectional recurrent neural network architecture called U-RNN as a sequence encoder and evaluate its relevance to replace LSTMs for various forecasting models. Experimental results on the Trajnet++ benchmark show that the U-LSTM variant can yield better results regarding every available metric (ADE, FDE, Collision rate) than common LSTMs sequence encoders for a variety of approaches and interaction modules. Our implementation of the asymmetrical Bi-RNNs for the Trajnet++ benchmark is available at: github.com/JosephGesnouin/Asymmetrical-Bi-RNNs-to-encode-pedestrian-trajectoriesComment: 7 page

Influence of ultrasound determination of fetal head position on mode of delivery: A pragmatic randomized trial

International audienceObjective To evaluate the influence of ultrasound determination of fetal head position on mode of delivery. Methods This was a pragmatic open-label randomized controlled trial that included women with a singleton pregnancy in the vertex presentation at ≥ 37 weeks' gestation, cervical dilation ≥ 8 cm and who received epidural anesthesia. Women were assigned randomly to undergo either digital vaginal examination (VE group) or both digital vaginal and ultrasound examinations (VE+US group) to determine fetal head position. When the ultrasound and digital vaginal findings were inconsistent in the VE+US group, the ultrasound result was used for clinical management. The primary outcome assessed was operative delivery (Cesarean or instrumental vaginal delivery), and maternal and fetal morbidity were also assessed. Results The VE and VE+US groups included 959 and 944 women, respectively. The overall rate of operative delivery was significantly higher in the VE+US group than in the VE group: 33.7% vs 27.1%, respectively (relative risk (RR), 1.24 (95% CI, 1.08-1.43)), as was the rate of Cesarean delivery: 7.8% vs 4.9%, respectively (RR, 1.60 (95% CI, 1.12-2.28)). The rate of instrumental vaginal delivery was also higher, albeit not significantly: 25.8% in the VE+US group vs 22.2% in the VE group (RR, 1.16 (95% CI, 0.99-1.37)). Neonatal outcomes did not differ between the two groups. When analysis was restricted to instrumental vaginal deliveries only, maternal and neonatal morbidity outcomes were similar in both groups. Conclusion Correction of fetal occiput position, determined initially by digital vaginal examination, using systematic ultrasound examination did not improve management of labor and increased the rate of operative delivery without decreasing maternal and neonatal morbidity. Copyrigh

Guillain-Barré syndrome and influenza virus infection.

International audienceBACKGROUND: In Western countries, the cause of 60% of all Guillain-Barré syndrome (GBS) cases remains unidentified. The number of cases of unidentified cause peaks in winter, and these cases are commonly preceded by respiratory tract infection or influenza-like illness. We investigated the triggering role of influenza virus infection. METHODS: Of 405 patients with GBS who were admitted to a French reference center during 1996-2004, 234 had cases caused by an unidentified agent. We used time-series methods to study the correlation between the monthly incidence of such cases and influenza-like illnesses reported by the Sentinelles surveillance network. We analyzed anti-influenza antibodies using complement fixation testing and hemagglutination-inhibition assays. We studied etiological subgroups using Wilcoxon and Fisher's exact tests. RESULTS: We found a positive association between the monthly incidence of GBS caused by an unidentified agent and reported influenza-like illnesses. Of 73 patients whose cases occurred during periods in which there was a possible link to influenza, 10 (13.7%) had serological evidence of recent influenza A, and 4 (5.5%) had serological evidence of influenza B. Eight of 10 influenza A-related cases occurred during "major" influenza seasons, and antibodies specific to the current epidemic strain were found in 9 cases. Most patients with influenza A-related cases were aged < 65 years, and none had antiganglioside antibodies. Influenza-related cases differed both from Campylobacter jejuni-related cases, with regard to the lack of need for mechanical ventilation (P = .014), and from the cases caused by an unidentified agent, with regard to the presence of preceding influenza-like illness or respiratory tract infection (P = .015) and longer time from the infectious event to GBS onset (P = .04). CONCLUSIONS: Influenza viruses are infrequent triggering agents of GBS but may play a significant role during major influenza outbreaks. Influenza-related GBS displays specific features and is not associated with antiganglioside antibody response, which suggests the presence of underlying immune mechanisms

Rituels, territoires et pouvoirs dans les marges sino-indiennes

Faisant suite à l’idée de Paul Mus de l’existence d’une « religion cadastrale » constitutive de l’organisation socioreligieuse du « socle asien », ce volume propose une approche comparative des rituels liés à la prospérité du territoire des populations vivant en marge des mondes chinois, indien et sud-est asiatique, ce que nous appelons ici les « marges sino-indiennes ». Il rassemble des études ethnographiques inédites menées dans différents pays (Népal, Inde, Chine, Thaïlande, Laos), qui éclairent les spécificités de chaque configuration locale tout en révélant une logique globale, liée aux enjeux que ces rituels révèlent. En légitimant l’occupation d’un territoire et en favorisant sa fertilité, ces rituels sont en effet le lieu de cristallisation de nombreux enjeux imbriqués qui impliquent tout à la fois les rapports au territoire, les sources de la subsistance, mais aussi les formes d’appartenance et l’exercice du pouvoir, au sein de ces groupes comme dans leurs relations avec leurs voisins. Ces rites liés au territoire, expression du local, ne seraient pas à percevoir comme des résidus d’un ancien état de culture resté à l’écart des civilisations, mais comme le résultat de processus qui se construisent dans l’interaction – à la fois entre groupes et avec les centres de pouvoir régionaux – processus d’interactions qui, sur le long terme, ont contribué à façonner le fond de culture commun de ces régions périphériques de l’Asie

Evaluation of the usefulness of ultrasound measurement of the lower uterine segment before delivery of women with a prior cesarean delivery: a randomized trial

International audienceBackground: The main reason to avoid trial of labor after cesarean delivery is the possibility of uterine rupture. Identifying women at risk is thus an important aim, for it would enable women at low risk to proceed with a secure planned vaginal birth. bjective: To evaluate the impact of proposing mode of delivery based on the ultrasound measurement of the lower uterine segment thickness on a composite outcome of maternal-fetal mortality and morbidity, compared with usual management, among pregnant women with a previous cesarean delivery.Study Design: This multicenter, randomized, controlled, parallel-group, unmasked trial was conducted at 8 referral university hospitals with a neonatal intensive care unit and enrolled 2948 women at 36 weeks 0 days to 38 weeks 6 days of gestation with 1 previous low transverse cesarean delivery and no contraindication to trial of labor. Women in the study group had their lower uterine segment thickness measured by ultrasound. Those with measurements >3.5 mm, were encouraged to choose a planned vaginal delivery, and those with measurements ≤3.5 mm, were encouraged to choose a planned repeat cesarean delivery. This measurement was not taken in the control group; their mode of delivery was decided according to standard management. The primary outcome was a composite criterion comprising maternal mortality, uterine rupture, uterine dehiscence, hysterectomy, thromboembolic disease, transfusion, endometritis, perinatal death, or neonatal encephalopathy. Prespecified secondary outcomes were repeat cesarean deliveries, elective or after trial of labor.Results: The study group included 1472 women, and the control group included 1476 women. These groups were similar at baseline. The primary outcome occurred in 3.4% of the study group and 4.3% of the control group (relative risk, 0.78; 95% confidence interval, 0.54–1.13: risk difference, −1.0%; 95% confidence interval, −2.4 to 0.5). The uterine rupture rate in the study group was 0.4% and in the control group 0.9% (relative risk, 0.43; 95% confidence interval, 0.15–1.19). The planned cesarean delivery rate was 16.4% in the study group and 13.7% in the control group (relative risk, 1.21; 95% confidence interval, 1.00–1.47), whereas the rates of cesarean delivery during labor were 25.1% and 25.0% (relative risk, 1.01; 95% confidence interval, 0.89–1.14) in the study and control groups, respectively.Conclusion: Ultrasound measurements of lower uterine segment thickness did not result in a statistically significant lower frequency of maternal and perinatal adverse outcomes than standard management. However, because this study was underpowered, further research should be encouraged

High levels of antibodies against merkel cell polyomavirus identify a subset of patients with merkel cell carcinoma with better clinical outcome.

International audiencePURPOSE: A new human polyomavirus, Merkel cell polyomavirus (MCV), was identified in 2008 in tumor tissue of patients with Merkel cell carcinoma (MCC), a relatively rare human skin cancer. In this study, we investigated patients with MCC and controls for the presence of antibodies against MCV and their association with clinical characteristics. PATIENTS AND METHODS: Antibodies against MCV were investigated by enzyme-linked immunosorbent assay in 68 patients with MCC and 82 controls using VP1 virus-like particles produced in insect cells. RESULTS: Antibodies against MCV were detected in all patients with MCC and in 85% of controls. However, high antibody titers (> 10,000) were rarely observed in controls (7.3%) and they were detected in 64.7% of patients with MCC (P < .001) in contrast to the absence of VP1 expression in tumor samples. In addition, the geometric mean titer of anti-MCV in patients with MCC was around 14 times higher than that observed in MCV-positive controls (P < .001) and was not correlated with tumor viral load. High antibody titers were not found to be associated with any subject or tumor characteristics, but better progression-free survival was observed in patients with high antibody titers (hazard ratio, 4.6; 95% CI, 1.7 to 12.2; P = .002). CONCLUSION: High titers of MCV antibodies in a much higher proportion of patients with MCC than in controls confirmed the association between MCV infection and MCC. The findings also indicated that a better progression-free survival occurred in patients with high MCV antibody titers and suggested that there are at least two distinct etiologic causes of MCC