Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths

Publisher Copyright: © 2021 The Authors, some rights reserved.Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-alpha and/or IFN-omega are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-alpha and/or IFN-omega (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-beta. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-alpha and/or IFN-omega are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-beta do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases.Peer reviewe

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

SignificanceThere is growing evidence that preexisting autoantibodies neutralizing type I interferons (IFNs) are strong determinants of life-threatening COVID-19 pneumonia. It is important to estimate their quantitative impact on COVID-19 mortality upon SARS-CoV-2 infection, by age and sex, as both the prevalence of these autoantibodies and the risk of COVID-19 death increase with age and are higher in men. Using an unvaccinated sample of 1,261 deceased patients and 34,159 individuals from the general population, we found that autoantibodies against type I IFNs strongly increased the SARS-CoV-2 infection fatality rate at all ages, in both men and women. Autoantibodies against type I IFNs are strong and common predictors of life-threatening COVID-19. Testing for these autoantibodies should be considered in the general population

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection fatality rate (IFR) doubles with every 5 y of age from childhood onward. Circulating autoantibodies neutralizing IFN-α, IFN-ω, and/or IFN-β are found in ∼20% of deceased patients across age groups, and in ∼1% of individuals aged 4% of those >70 y old in the general population. With a sample of 1,261 unvaccinated deceased patients and 34,159 individuals of the general population sampled before the pandemic, we estimated both IFR and relative risk of death (RRD) across age groups for individuals carrying autoantibodies neutralizing type I IFNs, relative to noncarriers. The RRD associated with any combination of autoantibodies was higher in subjects under 70 y old. For autoantibodies neutralizing IFN-α2 or IFN-ω, the RRDs were 17.0 (95% CI: 11.7 to 24.7) and 5.8 (4.5 to 7.4) for individuals <70 y and ≥70 y old, respectively, whereas, for autoantibodies neutralizing both molecules, the RRDs were 188.3 (44.8 to 774.4) and 7.2 (5.0 to 10.3), respectively. In contrast, IFRs increased with age, ranging from 0.17% (0.12 to 0.31) for individuals <40 y old to 26.7% (20.3 to 35.2) for those ≥80 y old for autoantibodies neutralizing IFN-α2 or IFN-ω, and from 0.84% (0.31 to 8.28) to 40.5% (27.82 to 61.20) for autoantibodies neutralizing both. Autoantibodies against type I IFNs increase IFRs, and are associated with high RRDs, especially when neutralizing both IFN-α2 and IFN-ω. Remarkably, IFRs increase with age, whereas RRDs decrease with age. Autoimmunity to type I IFNs is a strong and common predictor of COVID-19 death.The Laboratory of Human Genetics of Infectious Diseases is supported by the Howard Hughes Medical Institute; The Rockefeller University; the St. Giles Foundation; the NIH (Grants R01AI088364 and R01AI163029); the National Center for Advancing Translational Sciences; NIH Clinical and Translational Science Awards program (Grant UL1 TR001866); a Fast Grant from Emergent Ventures; Mercatus Center at George Mason University; the Yale Center for Mendelian Genomics and the Genome Sequencing Program Coordinating Center funded by the National Human Genome Research Institute (Grants UM1HG006504 and U24HG008956); the Yale High Performance Computing Center (Grant S10OD018521); the Fisher Center for Alzheimer’s Research Foundation; the Meyer Foundation; the JPB Foundation; the French National Research Agency (ANR) under the “Investments for the Future” program (Grant ANR-10-IAHU-01); the Integrative Biology of Emerging Infectious Diseases Laboratory of Excellence (Grant ANR-10-LABX-62-IBEID); the French Foundation for Medical Research (FRM) (Grant EQU201903007798); the French Agency for Research on AIDS and Viral hepatitis (ANRS) Nord-Sud (Grant ANRS-COV05); the ANR GENVIR (Grant ANR-20-CE93-003), AABIFNCOV (Grant ANR-20-CO11-0001), CNSVIRGEN (Grant ANR-19-CE15-0009-01), and GenMIS-C (Grant ANR-21-COVR-0039) projects; the Square Foundation; Grandir–Fonds de solidarité pour l’Enfance; the Fondation du Souffle; the SCOR Corporate Foundation for Science; The French Ministry of Higher Education, Research, and Innovation (Grant MESRI-COVID-19); Institut National de la Santé et de la Recherche Médicale (INSERM), REACTing-INSERM; and the University Paris Cité. P. Bastard was supported by the FRM (Award EA20170638020). P. Bastard., J.R., and T.L.V. were supported by the MD-PhD program of the Imagine Institute (with the support of Fondation Bettencourt Schueller). Work at the Neurometabolic Disease lab received funding from Centre for Biomedical Research on Rare Diseases (CIBERER) (Grant ACCI20-767) and the European Union's Horizon 2020 research and innovation program under grant agreement 824110 (EASI Genomics). Work in the Laboratory of Virology and Infectious Disease was supported by the NIH (Grants P01AI138398-S1, 2U19AI111825, and R01AI091707-10S1), a George Mason University Fast Grant, and the G. Harold and Leila Y. Mathers Charitable Foundation. The Infanta Leonor University Hospital supported the research of the Department of Internal Medicine and Allergology. The French COVID Cohort study group was sponsored by INSERM and supported by the REACTing consortium and by a grant from the French Ministry of Health (Grant PHRC 20-0424). The Cov-Contact Cohort was supported by the REACTing consortium, the French Ministry of Health, and the European Commission (Grant RECOVER WP 6). This work was also partly supported by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases and the National Institute of Dental and Craniofacial Research, NIH (Grants ZIA AI001270 to L.D.N. and 1ZIAAI001265 to H.C.S.). This program is supported by the Agence Nationale de la Recherche (Grant ANR-10-LABX-69-01). K.K.’s group was supported by the Estonian Research Council, through Grants PRG117 and PRG377. R.H. was supported by an Al Jalila Foundation Seed Grant (Grant AJF202019), Dubai, United Arab Emirates, and a COVID-19 research grant (Grant CoV19-0307) from the University of Sharjah, United Arab Emirates. S.G.T. is supported by Investigator and Program Grants awarded by the National Health and Medical Research Council of Australia and a University of New South Wales COVID Rapid Response Initiative Grant. L.I. reports funding from Regione Lombardia, Italy (project “Risposta immune in pazienti con COVID-19 e co-morbidità”). This research was partially supported by the Instituto de Salud Carlos III (Grant COV20/0968). J.R.H. reports funding from Biomedical Advanced Research and Development Authority (Grant HHSO10201600031C). S.O. reports funding from Research Program on Emerging and Re-emerging Infectious Diseases from Japan Agency for Medical Research and Development (Grant JP20fk0108531). G.G. was supported by the ANR Flash COVID-19 program and SARS-CoV-2 Program of the Faculty of Medicine from Sorbonne University iCOVID programs. The 3C Study was conducted under a partnership agreement between INSERM, Victor Segalen Bordeaux 2 University, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study was also supported by the Caisse Nationale d’Assurance Maladie des Travailleurs Salariés, Direction générale de la Santé, Mutuelle Générale de l’Education Nationale, Institut de la Longévité, Conseils Régionaux of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research–INSERM Program “Cohortes et collections de données biologiques.” S. Debette was supported by the University of Bordeaux Initiative of Excellence. P.K.G. reports funding from the National Cancer Institute, NIH, under Contract 75N91019D00024, Task Order 75N91021F00001. J.W. is supported by a Research Foundation - Flanders (FWO) Fundamental Clinical Mandate (Grant 1833317N). Sample processing at IrsiCaixa was possible thanks to the crowdfunding initiative YoMeCorono. Work at Vall d’Hebron was also partly supported by research funding from Instituto de Salud Carlos III Grant PI17/00660 cofinanced by the European Regional Development Fund (ERDF/FEDER). C.R.-G. and colleagues from the Canarian Health System Sequencing Hub were supported by the Instituto de Salud Carlos III (Grants COV20_01333 and COV20_01334), the Spanish Ministry for Science and Innovation (RTC-2017-6471-1; AEI/FEDER, European Union), Fundación DISA (Grants OA18/017 and OA20/024), and Cabildo Insular de Tenerife (Grants CGIEU0000219140 and “Apuestas científicas del ITER para colaborar en la lucha contra la COVID-19”). T.H.M. was supported by grants from the Novo Nordisk Foundation (Grants NNF20OC0064890 and NNF21OC0067157). C.M.B. is supported by a Michael Smith Foundation for Health Research Health Professional-Investigator Award. P.Q.H. and L. Hammarström were funded by the European Union’s Horizon 2020 research and innovation program (Antibody Therapy Against Coronavirus consortium, Grant 101003650). Work at Y.-L.L.’s laboratory in the University of Hong Kong (HKU) was supported by the Society for the Relief of Disabled Children. MBBS/PhD study of D.L. in HKU was supported by the Croucher Foundation. J.L.F. was supported in part by the Evaluation-Orientation de la Coopération Scientifique (ECOS) Nord - Coopération Scientifique France-Colombie (ECOS-Nord/Columbian Administrative department of Science, Technology and Innovation [COLCIENCIAS]/Colombian Ministry of National Education [MEN]/Colombian Institute of Educational Credit and Technical Studies Abroad [ICETEX, Grant 806-2018] and Colciencias Contract 713-2016 [Code 111574455633]). A. Klocperk was, in part, supported by Grants NU20-05-00282 and NV18-05-00162 issued by the Czech Health Research Council and Ministry of Health, Czech Republic. L.P. was funded by Program Project COVID-19 OSR-UniSR and Ministero della Salute (Grant COVID-2020-12371617). I.M. is a Senior Clinical Investigator at the Research Foundation–Flanders and is supported by the CSL Behring Chair of Primary Immunodeficiencies (PID); by the Katholieke Universiteit Leuven C1 Grant C16/18/007; by a Flanders Institute for Biotechnology-Grand Challenges - PID grant; by the FWO Grants G0C8517N, G0B5120N, and G0E8420N; and by the Jeffrey Modell Foundation. I.M. has received funding under the European Union’s Horizon 2020 research and innovation program (Grant Agreement 948959). E.A. received funding from the Hellenic Foundation for Research and Innovation (Grant INTERFLU 1574). M. Vidigal received funding from the São Paulo Research Foundation (Grant 2020/09702-1) and JBS SA (Grant 69004). The NH-COVAIR study group consortium was supported by a grant from the Meath Foundation.Peer reviewe

EVOLUTION MORPHOLOGIQUE DES NANOSTRUCTURES Si1-xGex PENDANT LA CROISSANCE PAR EJM

The heterostructures based on Silicium Germanium (SiGe) alloy are used in certain transistors since the end of the years '90. New very promising components for the nanoelectronics could be manufactured by using the quantum properties of low dimensionality objects containing SiGe. For that, the size and the organization of these objects must be controlled perfectly on a nanometric scale. The goal is to reach dots sizes of ~20 nm and a density ~1011/cm2. A simple and cheep way for the realization of such nanostructures is the natural self-organization of Ge quantum dots growth by Molecular Beam Epitaxy (MBE). Actually, the three problems which persist to carry out this type of structures are: 1) the interdiffusion between Ge and substrate; 2) the average size of the dots which is very inhomogenous and always higher than 70 nm; 3) the organization of the nanometric dots, impossible to realize on a large scale by local techniques. In this work we studied the Ge dots self-organization on vicinal Si substrates nanostructured by using a two stages process which consists of: i) substrate natural self-structuration and ii) Ge dots preferential nucleation on the created patterns. In the first three chapters we presented some bibliographical recalls on the growth mechanisms, self-organization, growth instabilities and Monte Carlo simulations. The theoretical and experimental results of this work, let us to evidence an implicit inverse Ehrlich-Schwoebel pseudo-barrier at the origin of the kinetic instability which develops during the homoepitaxy Si/Si(001). The scaling exponents describing the evolution of this instability were extracted from experiments and are in good agreement with the theory. Instabilities which appear during the SiGe/Si growth have complex origins dependent on a coupling of the stress and kinetics. In addition, we evidenced an important reduction of the elastic energy of a system including a Ge dot, a Ge wetting layer and a patterned Si substrate (where each pattern is represented by steps) when the pattern is constituted of three steps at least.Les hétérostructures à base d'alliage Silicium Germanium (SiGe) sont utilisées dans certains transistors depuis la fin des années '90. De nouveaux composants très prometteurs pour la nanoélectronique pourraient être fabriqués en utilisant les propriétés quantiques d'objets de basse dimensionalité à base de SiGe. Pour cela, la taille et l'organisation de ces objets doivent être parfaitement contrôlées à l'échelle nanométrique. Le but est d'atteindre des tailles d'îlots de ~20 nm et une densité ~1011/cm2. Une voie simple et peu coûteuse pour la réalisation de telles nanostructures est l'auto-organisation naturelle d'îlots quantiques de Ge par la croissance par épitaxie par jets moléculaires (EJM). Les trois problèmes qui persistent à l'heure actuelle pour réaliser ce type de structures sont : 1) l'interdiffusion entre le Ge et le substrat ; 2) la taille moyenne des îlots qui est très inhomogène et toujours supérieure à 70 nm; 3) l'organisation des îlots de taille nanométrique, impossible à réaliser à grande échelle par des techniques locales. Dans ce travail nous avons étudié l'auto-organisation d'îlots de Ge sur des substrats vicinaux de Si nanostructurés, en utilisant un processus à deux étapes qui consiste en : i) l'auto-structuration naturelle du substrat et ii) la nucléation préférentielle des îlots de Ge sur les motifs créés. Dans les trois premiers chapitres des rappels bibliographiques sur les mécanismes de croissance et d'auto-organisation, sur les instabilités de croissance et sur les simulations Monte Carlo sont présentés. Les résultats, à la fois théoriques et expérimentaux de ce travail, ont permis de mettre en évidence une pseudo-barrière Ehrlich-Schwoebel inverse implicite à l'origine de l'instabilité cinétique qui se développe durant l'homoépitaxie Si/Si(001). Les exposants critiques de l'évolution de cette instabilité ont été extraits expérimentalement et sont en bon accord avec la théorie. Les instabilités qui apparaissent durant la croissance SiGe/Si ont des origines complexes liées à un couplage de la contrainte et de la cinétique. Par ailleurs, nous avons mis en évidence une réduction importante de l'énergie élastique d'un système comprenant un îlot de Ge, une couche de mouillage de Ge et un substrat à motifs de Si (où chaque motif est représenté par des marches) lorsque le motif présente au moins trois marches

EVOLUTION MORPHOLOGIQUE DES NANOSTRUCTURES Si1-xGex PENDANT LA CROISSANCE PAR EJM

The heterostructures based on Silicium Germanium (SiGe) alloy are used in certain transistors since the end of the years '90. New very promising components for the nanoelectronics could be manufactured by using the quantum properties of low dimensionality objects containing SiGe. For that, the size and the organization of these objects must be controlled perfectly on a nanometric scale. The goal is to reach dots sizes of ~20 nm and a density ~1011/cm2. A simple and cheep way for the realization of such nanostructures is the natural self-organization of Ge quantum dots growth by Molecular Beam Epitaxy (MBE). Actually, the three problems which persist to carry out this type of structures are: 1) the interdiffusion between Ge and substrate; 2) the average size of the dots which is very inhomogenous and always higher than 70 nm; 3) the organization of the nanometric dots, impossible to realize on a large scale by local techniques. In this work we studied the Ge dots self-organization on vicinal Si substrates nanostructured by using a two stages process which consists of: i) substrate natural self-structuration and ii) Ge dots preferential nucleation on the created patterns. In the first three chapters we presented some bibliographical recalls on the growth mechanisms, self-organization, growth instabilities and Monte Carlo simulations. The theoretical and experimental results of this work, let us to evidence an implicit inverse Ehrlich-Schwoebel pseudo-barrier at the origin of the kinetic instability which develops during the homoepitaxy Si/Si(001). The scaling exponents describing the evolution of this instability were extracted from experiments and are in good agreement with the theory. Instabilities which appear during the SiGe/Si growth have complex origins dependent on a coupling of the stress and kinetics. In addition, we evidenced an important reduction of the elastic energy of a system including a Ge dot, a Ge wetting layer and a patterned Si substrate (where each pattern is represented by steps) when the pattern is constituted of three steps at least.Les hétérostructures à base d'alliage Silicium Germanium (SiGe) sont utilisées dans certains transistors depuis la fin des années '90. De nouveaux composants très prometteurs pour la nanoélectronique pourraient être fabriqués en utilisant les propriétés quantiques d'objets de basse dimensionalité à base de SiGe. Pour cela, la taille et l'organisation de ces objets doivent être parfaitement contrôlées à l'échelle nanométrique. Le but est d'atteindre des tailles d'îlots de ~20 nm et une densité ~1011/cm2. Une voie simple et peu coûteuse pour la réalisation de telles nanostructures est l'auto-organisation naturelle d'îlots quantiques de Ge par la croissance par épitaxie par jets moléculaires (EJM). Les trois problèmes qui persistent à l'heure actuelle pour réaliser ce type de structures sont : 1) l'interdiffusion entre le Ge et le substrat ; 2) la taille moyenne des îlots qui est très inhomogène et toujours supérieure à 70 nm; 3) l'organisation des îlots de taille nanométrique, impossible à réaliser à grande échelle par des techniques locales. Dans ce travail nous avons étudié l'auto-organisation d'îlots de Ge sur des substrats vicinaux de Si nanostructurés, en utilisant un processus à deux étapes qui consiste en : i) l'auto-structuration naturelle du substrat et ii) la nucléation préférentielle des îlots de Ge sur les motifs créés. Dans les trois premiers chapitres des rappels bibliographiques sur les mécanismes de croissance et d'auto-organisation, sur les instabilités de croissance et sur les simulations Monte Carlo sont présentés. Les résultats, à la fois théoriques et expérimentaux de ce travail, ont permis de mettre en évidence une pseudo-barrière Ehrlich-Schwoebel inverse implicite à l'origine de l'instabilité cinétique qui se développe durant l'homoépitaxie Si/Si(001). Les exposants critiques de l'évolution de cette instabilité ont été extraits expérimentalement et sont en bon accord avec la théorie. Les instabilités qui apparaissent durant la croissance SiGe/Si ont des origines complexes liées à un couplage de la contrainte et de la cinétique. Par ailleurs, nous avons mis en évidence une réduction importante de l'énergie élastique d'un système comprenant un îlot de Ge, une couche de mouillage de Ge et un substrat à motifs de Si (où chaque motif est représenté par des marches) lorsque le motif présente au moins trois marches

"Delhis City Makers"

Indien hat die wichtigsten UN-Menschenrechtspakte unterzeichnet, ist Mitglied des Menschenrechtsrates und verfügt über eine demokratische Verfassung. Trotzdem werden grundlegende Menschenrechte marginalisierter Bevölkerungsgruppen – wie es beispielsweise die Obdachlosen von Delhi sind – praktisch täglich verletzt. Es scheint vor allem, dass das Menschenrecht auf Wohnen missachtet wird. Der Rights-Based Approach (RBA) stellt einen eventuellen Lösungsansatz innerhalb des Entwicklungsdiskurses dar, welcher die Grund- und Menschenrechte marginalisierter Bevölkerungsgruppen sichern kann und obendrein zu einem Empowerment der Zielgruppe führen kann. Diese Diplomarbeit widmet sich insbesondere der Frage ob Projekte in der Entwicklungszusammenarbeit durch den RBA maßgeblich zu Empowerment und zur Einhaltung der Grund- bzw. Menschenrechte von Randgruppen, wie beispielsweise den Obdachlosen in Delhi, beitragen können. Die zugehörige Hypothese lautet: „RBA-Projekte können bis zu einem gewissen Grad zu einem Empowerment von Randgruppen beitragen, weißen aber auch erhebliche Schwierigkeiten im Hinblick auf die Reichweite auf.“ Im Zuge einer Projektanalyse wird diese Hypothese überprüft. Im ersten Teil der Arbeit wird ein Überblick über Obdachlosigkeit sowie über die obdachlose Bevölkerung Delhis gegeben. Weiters werden theoretische Ansätze dargestellt und dabei insbesondere der Rights-Based Approach näher betrachtet. Auch der Zusammenhang von Entwicklung und Menschenrechten wird in diesem Teil der Arbeit abgehandelt. Daran anschließend erfolgt im zweiten Teil der Arbeit eine Projektanalyse eines konkreten urbanen Projekts zum Rights-Based Approach, welches als Zielgruppe Delhis Obdachlose umfasst. Im Zuge der Arbeit konnte festgestellt werden, dass Indien und insbesondere Delhis Regierung die menschenrechtspolitische Selbstverpflichtung größtenteils nicht einhält und der Pflicht Grund- und Menschenrechte der Bevölkerung zu sichern (wie etwa das Recht auf Wohnen), weitestgehend nicht nachkommen. Die Projektanalyse hat verdeutlicht, dass die Zusammenarbeit mit der Regierung bzw. Administration und mit anderen NGOs unabdingbar für den Erfolg eines RBA-Projekts ist. Weiters konnte aufgezeigt werden, dass Interventionen innerhalb des RBA-Ansatzes jedenfalls auf „Grassroots“-Ebene statt finden müssen, denn nur so kann der Blick auf die verletzten Grund- und Menschenrechte geschärft werden. Darüber hinaus konnte aufgezeigt werden, dass der vom Projekt umfasste Teil der Obdachlosen aufgrund des RBA-Ansatzes empowert (dies wird etwa durch die Ermöglichung des Zugangs zu Wahlen deutlich) und nicht mehr nur als klassische HilfsempfängerInnen betrachtet wurde. Ob dies jedoch ausreicht, um einen Prozess in Gang setzen zu können, welcher die PflichtenträgerInnen zur Rechenschaft zieht, damit diese die Grund- und Menschenrechte sichern, bleibt fraglich. Auch die mit dem gegenständlichen Projekt einhergehende eingeschränkte Reichweite lässt Rückschlüsse auf die Bestätigung meiner Hypothese zu, dass der Ansatz des RBA erhebliche Schwierigkeiten in seiner Reichweite aufweist. Entwicklung auf Grundlage von Rechten zu betrachten, deutet jedenfalls auf eine funktionierende Strategie hin, welche gerade für ein Land wie Indien eine Alternative im Entwicklungsdiskurs darstellen kann.India has ratified the most important UN Conventions of Human Rights, is member of the Human Rights Council and has a democratic constitution. However, in practice violation of human rights is on the daily agenda, especially regarding the rights of marginalised population groups, like the homeless people of Delhi. It seems that particularly the right to housing is being ignored. The Rights-Based Approach (RBA) could be a solution method within the development discussion, securing basic and human rights of marginalised parts of population, and leading to an empowerment process. This thesis is devoted to the question, if the Rights-Based Approach in development projects could contributes to an empowerment process of marginal groups like the homeless people of Delhi and to compliance with basic and human rights. The respective hypothesis: “RBA-projects can contribute to an empowerment process of marginal groups to a certain degree, but have also difficulties regarding their coverage.” This hypothesis will be verified in the course of an analysis of a specific project. The first part of the thesis covers an overview of homelessness and in particular the homeless population of Delhi. Furthermore some theoretical approaches are described, especially the Rights-Based Approach. Also the relation between development and human rights is discussed in this part of the thesis. The second part of the thesis covers an analysis of an urban RBA-project of homeless people of Delhi. In the course of this thesis, it has been found out that India’s and especially Delhi’s government does not meet their commitment regarding their human rights policy, and furthermore does not secure the basic and human rights of their population (like the right to housing). The analysis of the project has illustrated, that the cooperation with the government and also with like minded NGOs is essential for the success of a RBA-project. Furthermore it has been pointed out, that interventions within a Rights-Based Approach should be on a “grassroots”level, because only by that the violation of human rights can be clearly identified. In addition it has been found, that the homeless persons which are covered by the project, have been empowered in the process of the RBA (they got access to polls) and not seen as classical aid recipients anymore. It remains questionable, if this is enough to start up a process which holds the duty bearers accountable, so that they secure basic and human rights. The limited coverage which goes hand in hand with the project leads to conclusion regarding the confirmation of my hypothesis. It is also indicated that development on basis of rights seems to be an efficient strategy, which could be an alternative in the common debate of development in particularly for a country like India

Lenin lives ! : analysis of creative reinvestments of Lenin Monument in Bishkek (Kyrgyzstan)

In the wake of the dissolution of the USSR, not all statues and other monuments dedicated to Lenin have suffered the same fate in the former Soviet republics. In Ukraine, for example, the “decommunisation” of the country meant that almost all the Soviet emblems were lost as collateral victims of the struggle to free themselves from the influence of the imposing Russian neighbour. In Central Asia, too, statues of Lenin have often been replaced by monuments to the new leaders, establishing their own cult of personality. In Kyrgyzstan, however, the memory of Lenin and his most famous statuary representation - the Lenin statue on Ala-Too Square in the centre of the city of Bishkek - has had a special destiny: untouched for over a decade after the collapse of communism, the monument was protected by a decree as a national heritage in 2000. And finally, when, in 2003, the government after all decided to remove the monument, it was then relocated only several meters from its original location. Far from signing its death, this relocation led to a re-reading of the monument and took on a plurality of uses in an unofficial register of representation. As symbols of a potentially controversial memory, the statues have regularly aroused strong “heritage emotions” (Fabre, 2013). In the wake of the claims expressed by the “Black Lives Matters” movement, this project proposes to examine the circumstances and forms of reappropriation of this particular statuary heritage. The importance of the monument as a referent in the rhetorical confrontations around power cannot be reduced to a clear-cut alternative between construction and destruction. From graffiti to decapitation and hijacking, citizens intervene in the public space to make claims, denounce, support or ignore. In the light of these repertoires of actions, we will analyse what the statues “say” or, rather, what they are made to say. 

Evolution morphologique des nanostructures Si(1-x)Ge(x) pendant la croissance par EJM

Dans ce travail nous avons étudié l'auto-organisation d'îlots de Ge sur des substrats vicinaux de Si nanostructurés en utilisant un processus à deux étapes qui consiste en :1) l'auto-structuration naturelle du substrat et 2) la nucléation préférentielle des îlots de Ge sur les motifs créés.Après des rappels bibliographiques dans les trois premiers chapitres, nous présentons les résultats, à la fois théoriques et expérimentaux, dans les deux derniers chapitres. En particulier, nous avons mis en évidence : a) une pseudo-barrière Ehrlich-Schwoebel inverse implicite à l'origine de l'instabilité cinétique qui se développe durant l'homoépitaxie Si/Si(001), avec des exposants critiques en bon accord avec la théorie et b) une réduction importante de l'énergie élastique d'un système comprenant un îlot de Ge, une couche de mouillage de Ge et un substrat à motifs de Si (où chaque motif est représenté par des marches) lorsque le motif possède au moins trois marches.In this work we studied the Ge dots self-organization on vicinal Si substrates nanostructured by using a two stages process which consists of: i) substrate natural self-structuration and ii) Ge dots preferential nucleation on the created patterns. After bibliographical recalls in the first three chapters, we present the theoretical and experimental results in the two last chapters. In particular, we have evidenced: a) an implicit inverse Ehrlich-Schwoebel pseudo-barrier at the origin of the kinetic instability which develops during the homoepitaxial growth Si/Si(001), with scaling exponents in good agreement with the theory and b) an important reduction of the elastic energy of a system including a Ge dot, a Ge wetting layer and a Si patterned substrate (where each pattern is represented by steps) when the pattern is constitued of three steps at least.AIX-MARSEILLE2-BU Sci.Luminy (130552106) / SudocSudocFranceF