Pertinence of Off-label Prescriptions of Innovating and Expensive Drugs in a University Hospital

International audienceObjectives. Pertinence of off-label prescriptions of innovative and expensive drugs needs a strict scientific appraisal to prevent adverse reaction risks and financial drift. Methods. Pertinence of such prescriptions has been analyzed in a University Hospital by bibliometric methods. Scientific publications issued from this clinical activity have been also evaluated. Results. Oncology differed from other clinical specialties by a better pertinence in justifying off-label prescriptions (good evidence level in 46% vs. 21%, scientific publications issued from A/B ranked journals: 51% versus 41%). Quality of scientific production from oncologists was also better (publication impact factor [IF] mean: 4.571 versus 2.245). Conclusions. The better pertinence of off-label prescriptions by oncologists in comparison to others clinicians' ones was mainly due to a shorter field of indications but also to a more efficient organisation such as systematic prescription by seniors, dedicated computerized provider order entry, multidisciplinary team meetings and collaborative culture

New datings of Amudian layers at Qesem Cave (Israel): results of TL applied to burnt flints and ESR/U-series to teeth

International audienc

Dating the Lower to Middle Paleolithic transition in the Levant: A view from Misliya Cave, Mount Carmel, Israel

International audienc

Absence of acute inhibitory effect of insulin on chylomicron production in type 2 diabetes

International audienceObjective-Overproduction of intestinally derived apoB-48-containing triglyceride-rich lipoproteins (TRLs) (chylomicrons) has recently been described in type 2 diabetes, as is known for hepatic TRL-apoB-100 (very-low-density lipoprotein) production. Furthermore, insulin acutely inhibits both intestinal and hepatic TRL production, whereas this acute inhibitory effect on very-low-density lipoprotein production is blunted in type 2 diabetes. It is not currently known whether this acute effect on chylomicron production is similarly blunted in humans with type 2 diabetes. Methods and Results-We investigated the effect of acute hyperinsulinemia on TRL metabolism in 18 type 2 diabetic men using stable isotope methodology. Each subject underwent 1 control (saline infusion [ SAL]) lipoprotein turnover study followed by a second study, under 1 of the 3 following clamp conditions: (1) hyperinsulinemic-euglycemic, (2) hyperinsulinemic-hyperglycemic, or (3) hyperinsulinemic-euglycemic plus intralipid and heparin. TRL-apoB-48 and TRL-apoB-100 production and clearance rates were not different between SAL and clamp and between the different clamp conditions, except for significantly lower TRL-apoB-100 clearance and production rates in hyperinsulinemic-euglycemic plus intralipid and heparin clamp compared with SAL. Conclusion-This is the first demonstration in individuals with type 2 diabetes that chylomicron production is resistant to the normal acute suppressive effect of insulin. This phenomenon may contribute to the highly prevalent dyslipidemia of type 2 diabetes and potentially to atherosclerosis. Clinical Trial Registration-URL: http:// www.clinicaltrials.gov. Unique identifier: NCT00950209. (Arterioscler Thromb Vasc Biol. 2012; 32: 1039-1044.

Carbonyl sulfide (COS) emissions in two agroecosystems in central France

International audienceCarbonyl sulfide (COS) fluxes simulated by vegetation and soil component models, both implemented in the ORCHIDEE land surface model, were evaluated against field observations at two agroecosystems in central France. The dynamics of a biogenic process not yet accounted for by this model, i.e., COS emissions from croplands, was examined in the context of three independent and complementary approaches. First, during the growing seasons of 2019 and 2020, monthly variations in the nighttime ratio of vertical mole fraction gradients of COS and carbon dioxide measured between 5 and 180 m height (Grad COS / Grad CO2), a proxy of the ratio of their respective nocturnal net fluxes, were monitored at a rural tall tower site near Orle ´ans (i.e., a "profile vs. model" approach). Second, field observations of COS nocturnal fluxes, obtained by the Radon Tracer Method (RTM) at a suburban site near Paris, were used for that same purpose (i.e., a "RTM vs. model" approach of unaccounted biogenic emissions). This site has observations going back to 2014. Third, during the growing seasons of 2019, 2020 and 2021, horizontal mole fraction gradients of COS were calculated from downwind-upwind surveys of wheat and rapeseed crops as a proxy of their respective exchange rates at the plot scale (i.e., a "crop based" comparative approach). The "profile vs. model" approach suggests that the nocturnal net COS uptake gradually weakens during the peak growing season and recovers from August on. The "RTM vs. model" approach suggests that there exists a biogenic source of COS, the intensity of which culminates in late June early July. Our "crop based" comparative approach demonstrates that rapeseed crops shift from COS uptake to emission in early summer during the late stages of growth (ripening and senescence) while wheat crops uptake capacities lower markedly. Hence, rapeseed appears to be a much larger source of COS than wheat at the plot scale. Nevertheless, compared to current estimates of the largest COS sources (i.e., marine and anthropogenic emissions), agricultural emissions during the late stages of growth are of secondary importance

Carbonyl sulfide (COS) emissions in two agroecosystems in central France

International audienceCarbonyl sulfide (COS) fluxes simulated by vegetation and soil component models, both implemented in the ORCHIDEE land surface model, were evaluated against field observations at two agroecosystems in central France. The dynamics of a biogenic process not yet accounted for by this model, i.e., COS emissions from croplands, was examined in the context of three independent and complementary approaches. First, during the growing seasons of 2019 and 2020, monthly variations in the nighttime ratio of vertical mole fraction gradients of COS and carbon dioxide measured between 5 and 180 m height (Grad COS / Grad CO2), a proxy of the ratio of their respective nocturnal net fluxes, were monitored at a rural tall tower site near Orle ´ans (i.e., a "profile vs. model" approach). Second, field observations of COS nocturnal fluxes, obtained by the Radon Tracer Method (RTM) at a suburban site near Paris, were used for that same purpose (i.e., a "RTM vs. model" approach of unaccounted biogenic emissions). This site has observations going back to 2014. Third, during the growing seasons of 2019, 2020 and 2021, horizontal mole fraction gradients of COS were calculated from downwind-upwind surveys of wheat and rapeseed crops as a proxy of their respective exchange rates at the plot scale (i.e., a "crop based" comparative approach). The "profile vs. model" approach suggests that the nocturnal net COS uptake gradually weakens during the peak growing season and recovers from August on. The "RTM vs. model" approach suggests that there exists a biogenic source of COS, the intensity of which culminates in late June early July. Our "crop based" comparative approach demonstrates that rapeseed crops shift from COS uptake to emission in early summer during the late stages of growth (ripening and senescence) while wheat crops uptake capacities lower markedly. Hence, rapeseed appears to be a much larger source of COS than wheat at the plot scale. Nevertheless, compared to current estimates of the largest COS sources (i.e., marine and anthropogenic emissions), agricultural emissions during the late stages of growth are of secondary importance

Carbonyl sulfide (COS) emissions in two agroecosystems in central France

Carbonyl sulfide (COS) fluxes simulated by vegetation and soil component models, both implemented in the ORCHIDEE land surface model, were evaluated against field observations at two agroecosystems in central France. The dynamics of a biogenic process not yet accounted for by this model, i.e., COS emissions from croplands, was examined in the context of three independent and complementary approaches. First, during the growing seasons of 2019 and 2020, monthly variations in the nighttime ratio of vertical mole fraction gradients of COS and carbon dioxide measured between 5 and 180 m height (GradCOS/GradCO2), a proxy of the ratio of their respective nocturnal net fluxes, were monitored at a rural tall tower site near Orléans (i.e., a “profile vs. model” approach). Second, field observations of COS nocturnal fluxes, obtained by the Radon Tracer Method (RTM) at a sub-urban site near Paris, were used for that same purpose (i.e., a “RTM vs. model” approach of unaccounted biogenic emissions). This site has observations going back to 2014. Third, during the growing seasons of 2019, 2020 and 2021, horizontal mole fraction gradients of COS were calculated from downwind-upwind surveys of wheat and rapeseed crops as a proxy of their respective exchange rates at the plot scale (i.e., a “crop based” comparative approach). The “profile vs. model” approach suggests that the nocturnal net COS uptake gradually weakens during the peak growing season and recovers from August on. The “RTM vs. model” approach suggests that there exists a biogenic source of COS, the intensity of which culminates in late June early July. Our “crop based” comparative approach demonstrates that rapeseed crops shift from COS uptake to emission in early summer during the late stages of growth (ripening and senescence) while wheat crops uptake capacities lower markedly. Hence, rapeseed appears to be a much larger source of COS than wheat at the plot scale. Nevertheless, compared to current estimates of the largest COS sources (i.e., marine and anthropogenic emissions), agricultural emissions during the late stages of growth are of secondary importance

Soil wetness index (SWI) for the Ile-de-France region.

The SWI is a soil moisture index documented in the scientific literature. It represents, over a depth of about two meters, the state of the water reserve of the soil in relation to the useful reserve (water available for plant nutrition). Plots downloaded from https://donneespubliques.meteofrance.fr/?fond=produit&id_produit=129&id_rubrique=29. First, we selected Bulletin climatique mensuel régional (à partir de janvier 2020), then Ile-de-France region from the drop-down menu, then we downloaded reports for the months of July 2020 and July 2021, then compared graphs entitled “Indice d’humidité des sols” in page 4 of 5). Upper panel: March 1st to July 31st, 2020. Lower panel: March 1st to July 31st, 2021. Refer only to the purple curves. (PDF)</p

Hourly variations in COS mixing ratio at the GIF (7m agl) and TRN (5m agl) sites.

The mini-QCL remained operative at TRN during the French lockdown while GC measurements at GIF were stopped for about two months. (PDF)</p

Analysis precision for COS measurements from flask-air samples collected upwind and downwind of selected crops.

Left box plot: difference in COS (ppt dry air) between two consecutive analyses of each flask content (n = 58). Right box plot: difference in COS (ppt dry air) between flasks of the same pair (n = 29). Shown are10th, 25th, median, 75th and 90th percentile. Circles correspond to outliers. The study period extends from late March to late July 2021.</p