Epidémiologie de la sclérose en plaques en France

En Europe, la France est située entre des zones à haut et bas risque de Sclérose en Plaques (SEP).Nous avons estimé la prévalence de la SEP en France au 31 octobre 2004 et l incidence entre 2000 et 2007 à partir des données de la Caisse Nationale d Assurance Maladie des Travailleurs Salariés (CNAMTS) qui assure 87 % de la population. La SEP, comme d autres maladies chroniques, fait partie des affections de longue durée (ALD). Les variations géographiques de la prévalence et de l incidence ont été analysées par un modèle Bayesien.La prévalence standardisée sur l âge était de 94,7 pour 100 000 ; 130,5 pour les femmes ; 54,8 pour les hommes. Le taux de notification de SEP (2000-2007) standardisé sur la population Européenne était de 6,8 pour 100 000 ; 9,8 parmi les femmes et 3,7 parmi les hommes. Avec le modèle Bayesien, la prévalence était plus forte au nord-est et plus faible dans la région parisienne et sur la Côte d Azur. L incidence était également plus forte au nord-est mais plus faible sur la côte atlantique et de part et d autre du Rhône.A partir des autres ALD, les comorbidités survenant avant l ALD SEP ont été étudiées. Elles étaient rares et essentiellement représentées par les troubles psychiatriques (40,2%) et le diabète (20,3%). Cette étude a été réalisée parmi une population représentative avec une seule et même méthodologie. Le modèle Bayesien prenant en compte l hétérogénéité et l auto-corrélation spatiales ne confirme pas l existence d un gradient net mais des zones à sur ou sous risque. La meilleure connaissance de l épidémiologie de la SEP permettra d avancer sur ses facteurs étiologiques.In Europe, France is located between high and low risk areas of Multiple Sclerosis (MS). We estimated the national prevalence of MS in France on 31st October 2004 and the incidence between 2000 and 2007 based on data from the Caisse Nationale d Assurance Maladie des Travailleurs Salariés which insures 87% of the population. MS like other chronic diseases is one of the 30 long-term illnesses (Affections de Longue Durée, ALD). We analysed geographic variations in the prevalence and incidence of MS in France using the Bayesian approach.Total MS prevalence in France standardised for age was 94.7 per 100,000; 130.5 in women; 54.8 in men. The notification rate for MS (2000-2007) after age-standardisation according to the European population was 6.8 per 100,000; 9.8 in women and 3.7 in men. With a Bayesian approach, the prevalence of MS was higher in northeast and lower in the Paris area and on the Mediterranean coast. The notification rate was higher in northeast and lower on the Atlantic coast and in the Alps as well as on both sides of the Rhône River.The study of other chronic diseases for which ALD status was registered before MS revealed that comorbidities were rare, essentially represented by psychiatric diseases (40.2%) and diabetes (20.3%).This study is performed among a representative population using the same method throughout. The Bayesian approach which takes into account spatial heterogeneity and spatial autocorrelation did not confirm the existence of a clear gradient but only higher or lower areas of MS. The better knowledge of MS epidemiology will allow to venture hypothesis its etiological factors.DIJON-BU Doc.électronique (212319901) / SudocSudocFranceF

A Review of Pneumatic Actuators Used for the Design of Medical Simulators and Medical Tools

International audienc

Role of the liver in splanchnic extraction of atrial natriuretic factor in the rat

Mesenteric, hepatic and splanchnic extraction of C-terminal and N-terminal atrial natriuretic factor was investigated in male Sprague-Dawley rats. Plasma concentrations (mean ± S.E.M.) of C-terminal atrial natriuretic factor were 55.0 ± 6.1 fmol/ml, 31.2 ± 4.0 fmol/ml and 23.5 ± 3.3 fmol/ml (n = 12) in the abdominal aorta, the portal vein and the hepatic vein, respectively. N-terminal atrial natriuretic factor plasma levels in these vessels were 3031 ± 756 fmol/ml, 2264 ± 661 fmol/ml and 1618 ± 496 fmol/ml (n = 6), respectively. Although the mesenteric extraction ratio was higher (p < 0.05) for C-terminal atrial natriuretic factor (42% ± 6%) than for N-terminal atrial natriuretic factor (28% ± 4%), there were no significant differences in the hepatic extraction ratio (41% ± 5% vs. 39% ± 6%) and the splanchnic extraction ratio (56% ± 5% vs. 50% ± 7%). These data suggest a major role of the liver in the splanchnic extraction of C-terminal and of N-terminal atrial natriuretic factor in the rat. (HEPATOLOGY 1992;16:790-793

Viral markers of hepatitis B, C and D and HB vaccination status of a health care team in a rural district of Cameroon

UNLABELLED: Ninety-three health care workers (HCW) in the Tokombere sahelian district volunteered to participate in a trial to investigate viral markers of hepatitis B, C, and D and HB vaccination status. METHODS: . Sera were tested using the Vikia HBsAg kit followed by CMIA for detection of HBsAg, anti-HBs, anti-HBc, and anti-HCV. HBsAg-positive HCW were tested for HBV-DNA, anti-HDV, and, if positive for anti-HDV, HDV-RNA.RESULTS: Analysis of anti-HBc positivity indicated that 91% of HCW had been infected by HBV, regardless of vaccination history. Vikia HBsAg results were confirmed by chemiluminescent microparticle immunoassay (CMIA) in all HCW and were positive in 17 HCW with virus load &gt;2000 IU/mL in 6 and HDV co-infection in 6. Anti-HCV was found in 6 HCW. Among the 55 HCW that had not been vaccinated, only 3 needed vaccination because of anti-HBc negativity. Among HCW considered for HBV treatment, one patient presenting HBV/HDV co-infection was excluded after diagnosis of hepatocarcinoma. CONCLUSION: Systematic HB vaccination of new HCW appears unnecessary in this rural region of Africa. Anti-HBc screening is cost-effective for identifying HCW requiring vaccination. Vikia HBsAg is effective for point-of-care screening. We underline the need for universal early (preferably neonatal) HB vaccination and for availability of anti-HBV drug in limited-resource countries

Is attention to bounding boxes all you need for pedestrian action prediction?

The human driver is no longer the only one concerned with the complexity of the driving scenarios. Autonomous vehicles (AV) are similarly becoming involved in the process. Nowadays, the development of AV in urban places underpins essential safety concerns for vulnerable road users (VRUs) such as pedestrians. Therefore, to make the roads safer, it is critical to classify and predict their future behavior. In this paper, we present a framework based on multiple variations of the Transformer models to reason attentively about the dynamic evolution of the pedestrians' past trajectory and predict its future actions of crossing or not crossing the street. We proved that using only bounding-boxes as input to our model can outperform the previous state-of-the-art models and reach a prediction accuracy of 91% and an F1-score of 0.83 on the PIE dataset up to two seconds ahead in the future. In addition, we introduced a large-size simulated dataset (CP2A) using CARLA for action prediction. Our model has similarly reached high accuracy (91 %) and F1-score (0.91) on this dataset. Interestingly, we showed that pre-training our Transformer model on the simulated dataset and then fine-tuning it on the real dataset can be very effective for the action prediction task

Lamination and folding in electromagnetically driven flows of specified geometries

Accepted versio

Ultraviolet astronomical spectrograph calibration with laser frequency combs from nanophotonic waveguides

Astronomical precision spectroscopy underpins searches for life beyond Earth, direct observation of the expanding Universe and constraining the potential variability of physical constants across cosmological scales. Laser frequency combs can provide the critically required accurate and precise calibration to the astronomical spectrographs. For cosmological studies, extending the calibration with such astrocombs to the ultraviolet spectral range is highly desirable, however, strong material dispersion and large spectral separation from the established infrared laser oscillators have made this exceedingly challenging. Here, we demonstrate for the first time astronomical spectrograph calibrations with an astrocomb in the ultraviolet spectral range below 400 nm. This is accomplished via chip-integrated highly nonlinear photonics in periodically-poled, nano-fabricated lithium niobate waveguides in conjunction with a robust infrared electro-optic comb generator, as well as a chip-integrated microresonator comb. These results demonstrate a viable route towards astronomical precision spectroscopy in the ultraviolet and may contribute to unlocking the full potential of next generation ground- and future space-based astronomical instruments