Spatial Point Pattern Analysis of the Unidentified Aerial Phenomena in France

We model the unidentified aerial phenomena observed in France during the last 60 years as a spatial point pattern. We use some public information such as population density, rate of moisture or presence of airports to model the intensity of the unidentified aerial phenomena. Spatial exploratory data analysis is a first approach to appreciate the link between the intensity of the unidentified aerial phenomena and the covariates. We then fit an inhomogeneous spatial Poisson process model with covariates. We find that the significant variables are the population density, the presence of the factories with a nuclear risk and contaminated land, and the rate of moisture. The analysis of the residuals shows that some parts of France (the Belgian border, the tip of Britany, some parts in the SouthEast , the Picardie and Haute-Normandie regions, the Loiret and Corr eze departments) present a high value of local intensity which are not explained by our model

L’embolisation préalable de l’artère mésentérique inférieure prévient l’augmentation du diamètre aortique après traitement par endoprothèse des anévrysmes de l’aorte abdominale

Introduction: Endoleaks are the most frequently encountered complications after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA), and in particular type II endoleaks. Some studies have demonstrated the value of preventive embolization of the inferior mesenteric artery (IMA), but controversy persists as to its effectiveness and profitability. The aim of this retrospective study was to evaluate the efficiency of this practice in the prevention of aneurysmal sac’s expansion during follow-up.Material and method: All patients treated with EVAR between November 2007 and June 2016 were included. We then excluded symptomatic aneurysms, branched endoprostheses and patients with occluded, stenotic or <3 mm diameter AMI. The remaining population was divided into 2 groups: a group that had an embolization of the AMI before EVAR and a non-embolized (control) group. We then analyzed the diameter evolution of the aneurysmal sac, the rate of endoleaks and reoperation, and the cost of the two groups.Results: 224 patients were included. After exclusion we selected a group of 37 embolized patients and a control group of 46 patients. The technical success of embolization was 100% and we observed no complications. The incidence of increased diameter of the aneurysmal sac was significantly higher in the control group at 2 years (27.9% vs 4.3%, p = 0.025). The type II endoleak rate at 1 year was significantly higher in the control group (65% vs 15.2%, p <0.001) as well as the rate of reoperation related to the aneurysm (31.1% vs 8.1%, p = 0.013). Multivariate analysis confirmed the results obtained for diameter increase and type II endoleak. At 3 years of follow-up, the cost of the total care per patient was 13016 euros in the embolized group and 13135 euros in the control group.Conclusion: Preventive embolization of AMI is an effective, reliable and cost-effective technique that reduces the rate of increase in diameter of the aneurysmal bag, type II endoleak and re-intervention after EVAR.Introduction : les endofuites sont les complications les plus fréquemment rencontrées après traitement endovasculaire (EVAR) des anévrysmes de l’aorte abdominale (AAA), et en particulier les endofuites de type II. Certaines études ont démontré l’intérêt de l’embolisation préventive de l’artère mésentérique inférieure (AMI) mais des controverses persistent quant à son efficacité et sa rentabilité. L’objectif de cette étude rétrospective était d’évaluer l’efficacité de cette pratique sur l’augmentation du diamètre du sac anévrysmal au cours du suivi.Matériel et méthode : tous les patients traités par EVAR entre novembre 2007 et juin 2016 ont été inclus. Nous avons ensuite exclu les anévrysmes symptomatiques, les endoprothèses branchées et les patients porteurs d’une AMI occluse, sténosée ou d’un diamètre < 3 mm. La population restante a été divisée en 2 groupes : un groupe ayant bénéficié d’une embolisation de l’AMI avant EVAR et un groupe non embolisé (contrôle). Nous avons alors analysé l’évolution de diamètre du sac anévrysmal, le taux d’endofuite et de ré intervention, et le coût des différents groupes.Résultats : 224 malades ont été inclus. Après exclusion nous avons retenu un groupe de 37 patients embolisés et un groupe contrôle de 46 patients. Le succès technique de l’embolisation était de 100% et nous n’avons observé aucune complication. L’incidence de l’augmentation de diamètre du sac anévrysmal était significativement plus élevée dans le groupe contrôle à 2 ans (27.9% vs 4.3%, p=0.025). Le taux d’endofuite de type II à 1 an était significativement plus élevé dans le groupe contrôle (65% vs 15.2%, p<0.001) de même que le taux de ré interventions lié à l’anévrysme (31.1% vs 8.1%, p=0.013). L’analyse multivariée confirmait les résultats obtenus concernant l’augmentation de diamètre et le taux d’endofuite de type II. A 3 ans de suivi le coût de la prise en charge globale par patient était de 13016 euros dans le groupe embolisé et de 13135 euros dans le groupe contrôle. Conclusion : l’embolisation préventive de l’AMI est une technique efficace, fiable et rentable qui permet de diminuer le taux d’augmentation de diamètre du sac anévrysmal, d’endofuite de type II et de ré intervention après EVAR

Preoperative Inferior Mesenteric Artery Embolization is a Cost-effective Technique that May Reduce the Rate of Aneurysm Sac Diameter Enlargement and Reintervention After EVAR

International audienceBACKGROUND:Type II endoleaks are the most common complications after endovascular repair of abdominal aortic aneurysms (EVARs). Some studies have shown the benefit of preventive inferior mesenteric artery (IMA) embolization, but its efficacy and cost-effectiveness continue to be controversial. The aim of this study was to evaluate the efficacy of this procedure on the increase in aneurysmal sac diameter during follow-up.MATERIALS AND METHODS:All consecutive patients who underwent the embolization of the IMA before EVAR in our center, between January 2014 and July 2016, were included. We retrospectively compared the diameter of the aortic aneurysm sac, the rate of endoleak and reinterventions, and the theoretical cost of management between these patients (group 2) and a historical cohort of patients treated for EVAR before January 2014 who did not undergo prior IMA embolization (group 1).RESULTS:Two hundred twenty-four patients were retrospectively analyzed. After exclusion, we compared a group of 37 embolized patients with a control group of 46 patients. The rate of enlargement in the aneurysmal sac diameter was significantly higher in the control group at 2 years (27.9% vs. 4.3%, P = 0.025). The type II endoleak rate at 2 years was significantly higher in the control group (53.1% vs. 18.2%, P = 0.012), as was the aneurysm-related reintervention rate (31.1% vs. 8.1%, P = 0.013). Multivariate analysis confirmed these results. At 2 years of follow-up, there was no difference in the overall cost of patient management between the 2 groups.CONCLUSIONS:Preventive IMA embolization is an effective, reliable, and cost-effective technique that seems to reduce the rate of the aneurysmal sac diameter enlargement, type II endoleak, and reinterventions after EVAR

Bi-directional characteristics of leaf reflectance and transmittance: measurement and influence on canopy bi-directional reflectance

National audienc

Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee

International audienceUpper urinary tract urothelial carcinoma (UTUC) is an uncommon disease and its gold-standard treatment is radical nephroureterectomy (RNU). Distal ureterectomy (DU) might be an alternative for tumors of the distal ureter but its indications remain unclear. Here, we aimed to evaluate the oncological outcomes of DU for UTUC of the pelvic ureter. We performed a multicenter retrospective analysis of patients with UTUC who underwent DU. The primary endpoint was 5-year cancer-specific survival (CSS), followed by overall survival (OS), intravesical recurrence-free (IVR) and homolateral urinary tract recurrence-free (HUR) survivals as secondary endpoints. Univariate and multivariate Cox regressions were performed to assess factors associated with outcomes. 155 patients were included, 91% of which were high-risk. 5-year CSS was 84.4%, OS was 71.9%, IVR-free survival was 43.6% and HUR-free survival was 74.4%. Multifocality, high grade and tumor size were the most significant predictors of survival endpoints. Of note, neither hydronephrosis nor pre-operative diagnostic ureteroscopy/JJ stent were associated with any of the endpoints. Perioperative morbidity was minimal. In conclusion, DU stands as a possible alternative to RNU for UTUC of the pelvic ureter. Close monitoring is mandatory due to the high risk of recurrence in the remaining urinary tract

Desenvolvimento Profissional de Docentes Iniciantes na Educação Especial

The professional development of novice teachers in the profession and in special education is poorly understood, despite its relevance to the improvement of teaching. This study analyzes the challenges faced by such teachers with a view to understanding their professional development. The participants in the research were teachers of classrooms equipped with multifunctional resources (SRM) in state schools. The research follows a critical-dialectic approach and a qualitative focus. The results indicate deficiencies in the professional development of novices, who experience difficulties related to teaching and bureaucracy, despite having specific training in the area. They also feel alienated in the schools and seek alternatives to fill existing gaps related to their professional practice.O desenvolvimento profissional de docentes iniciantes na profissão e na educação especial é pouco compreendido, mesmo sendo ele relevante para a prática docente e sua melhoria. Neste estudo analisam-se os desafios vivenciados por esses professores, tendo em vista compreender seu desenvolvimento profissional. Participaram da pesquisa professores de Salas de Recursos Multifuncionais (SRM) de escolas estaduais. A pesquisa tem abordagem crítico-dialética e enfoque qualitativo. Os resultados indicam fragilidades no desenvolvimento profissional dos iniciantes, que sentem dificuldades relacionadas à prática pedagógica e à burocracia, mesmo tendo formação específica na área. Sentem-se também estranhos à escola e buscam alternativas para suprir as lacunas existentes em relação à prática profissional