Le moment du choix : l’indécision politique. Avant le premier tour de l’élection présidentielle

Rapport réalisé dans le cadre du Panel électoral français 2007 (vague 1- panel 1, 29 mars-21 avril 2007

L’(in)décision électorale et la temporalité du vote:le moment du choix pour le premier tour de l'élection présidentielle 2007

Cet article propose une analyse de l’(in)décision électorale dans le contexte de l’élection présidentielle de 2007. Une réflexion théorique et méthodologique sur la mesure de l’indécision électorale est tout d’abord proposée car le concept peut recouvrir plusieurs sens : absence de fermeté de l’intention de vote, cristallisation tardive du choix, arbitrages entre divers possibles. Nous mesurons ici l’(in)décision par le moment du choix ; puis nous distinguons trois types : les « convaincus » de longue date, les récemment « conquis » et enfin les « circonspects » tardifs. Nous utilisons les données du Panel électoral français de 2007 réalisé par le Cevipof pour dresser le portrait de ces trois types d’électeurs.This article proposes an analysis of electoral (in)decision in the context of the presidential election of 2007. First of all, a theoretical and methodological reflection on the measure of the electoral indecision is proposed because the concept can take several meanings : absence of firmness of the vote intention, late crystallization of the choice, hesitations between different potential votes. We measure here (in)decision by the moment of choice ; then we distinguish three types of voters : those « convinced » for a long time, those recently « conquered » and finally those still « circumspect » late in the campaign. We use the data of the 2007 Panel électoral français realized by the Cevipof to portray these three types of (in)decided voters

A Translational Metabonomic Assessment of Aristolochic Acid- Induced Nephropathies

Aristolochic acid nephropathy (AAN) is a global term including any form of toxic interstitial nephropathy that is caused either by the ingestion of plants containing aristolochic acids (AA) as part of traditional phytotherapies or by the environmental contaminants in food. Originally, AAN was reported in Belgium in individuals having ingested slimming pills containing powdered root extracts of a Chinese herb, Aristolochia fangchi. However, it is estimated that exposure to AA affects thousands of people all over the world, particularly in the Balkans, Taiwan and China. Despite warnings from the Regulatory Agencies regarding the safety of products containing AA, many AAN cases remain frequently described worldwide. This chapter aims at giving a global picture of AAN through the descriptions of clinical cases and animal models, which were developed to better understand the mode of action of AA when inducing acute/chronic kidney diseases. Major advances in the translational research on biomarkers of AAN are reviewed, with an intended emphasis on the “omics” assessment of this nephrotoxicity

EFFECTS OF INOS INHIBITION IN HIGH FAT DIET-INDUCED OBESITY

Introduction and Aims: Obesity is aworldwide problem caused by caloric excess promoting deleterious cellular responses in organs. Endothelial dysfunction, impaired vasodilation and insulin resistance are considered as key features of obesity. Interactions between metabolic and hemodynamic factors activate intracellular signalling pathways, leading to the production of oxidative stress, pro-inflammatory cytokines and fibrotic factors. Among vasoactive factors, nitric oxide (NO) has been determined as playing acritical role in the pathogenesis of metabolic diseases. The aim of this study isto investigate the involvement of inducible nitric oxide synthase (iNOS) in the development of progressive renal dysfunction leading to obesity-induced kidney disease as well as in liverand adipose tissue. Methods: Todo so, C57BL/6 male micewererandomized to a low fat diet (LFD) ora high fat diet (HFD) and treated with pharmacological agent, L-NIL (iNOS inhibitor; 0.1 % in drinking water), for 16 weeks. Results: We have demonstrated thatiNOS inhibition with L-NIL prevented several changes in mice fed a HFD: increase of body weight, fasting blood glucose level and plasma levels of triglyceride, non-esterified fattyacids and insulin. Interestingly, the increase in albuminuria and mesangial matrix expansion were not ameliorated with L-NIL, while therewas a significant improvement in glycosuria and proteinuria. Moreover, the urinary hydrogen peroxidelevel, a stable product of ROS production, significantly higher in mice fed a HFD, wasreduced with L-NIL. To evaluate the beneficial effect of L-NIL in the development of insulin resistance, liverand peri-renal white adipose tissuewere also investigated. Histological analysis revealed an increasing size of adipocytes and an accumulation of lipid vacuoles into hepatocytes of mice fed a HFD along with increased liver triglyceride levelwhich were significantly decreased with L-NIL treatment. However, inflammation, as attested by macrophage infiltration and enhanced MCP-1 level, was only prevented by L-NIL in the adipose tissue but not in the liver. Conclusions: These results suggestthatinhibition of iNOS leadsto beneficial effects in kidney, especially in regard to tubular function. We also observed afavourable role of L-NIL administration in liverand adipose tissue of mice fed a HFD. However, further investigations are needed to better determine the role of iNOS in the targeted organ

Restored nitric oxide bioavailability reduces the severity of acute-to-chronic transition in a mouse model of aristolochic acid nephropathy.

peer reviewedAristolochic Acid (AA) nephropathy (AAN) is a progressive tubulointerstitial nephritis characterized by an early phase of acute kidney injury (AKI) leading to chronic kidney disease (CKD). The reduced nitric oxide (NO) bioavailability reported in AAN might contribute to renal function impairment and progression of the disease. We previously demonstrated that L-arginine (L-Arg) supplementation is protective in AA-induced AKI. Since the severity of AKI may be considered a strong predictor of progression to CKD, the present study aims to assess the potential benefit of L-Arg supplementation during the transition from the acute phase to the chronic phase of AAN. C57BL/6J male mice were randomly subjected to daily i.p. injections of vehicle or AA for 4 days. To determine whether renal AA-induced injuries were linked to reduced NO production, L-Arg was added to drinking water from 7 days before starting i.p. injections, until the end of the protocol. Mice were euthanized 5, 10 and 20 days after vehicle or AA administration. AA-treated mice displayed marked renal injury and reduced NO bioavailability, while histopathological features of AAN were reproduced, including interstitial cell infiltration and tubulointerstitial fibrosis. L-Arg treatment restored renal NO bioavailability and reduced the severity of AA-induced injury, inflammation and fibrosis. We concluded that reduced renal NO bioavailability contributes to the processes underlying AAN. Furthermore, L-Arg shows nephroprotective effects by decreasing the severity of acute-to-chronic transition in experimental AAN and might represent a potential therapeutic tool in the future

Prevention of ventilator‑associated pneumonia by noble metal coating of endotracheal tubes: a multi‑center, randomized, double‑blind study

BACKGROUND: Ventilator-associated pneumonia (VAP) causes increased mortality, prolonged hospital stay and increased healthcare costs. Prevention of VAP in intensive care units (ICUs) is currently based on several measures, and application of noble metal coating on medical devices has been shown to inhibit the bacterial adherence of microorganisms to the surface. The objective of this study was to evaluate the potential benefit of noble metal coating of endotracheal tubes for the prevention of VAP. METHODS: This was a multi-center, randomized, controlled, double-blind, prospective study including ventilated patients from nine ICUs from four hospital sites in Belgium. Patients were randomly intubated with identical appearing noble metal alloy (NMA) coated (NMA-coated group) or non-coated (control group) endotracheal tubes (ETT). Primary endpoint was the incidence of VAP. Secondary endpoints were the proportion of antibiotic days during ICU stay and tracheal colonization by pathogenic bacteria. RESULTS: In total, 323 patients were enrolled, 168 in the NMA-coated group and 155 in the control group. During ventilation, VAP occurred in 11 patients (6.5%) in the NMA-coated group and in 18 patients (11.6%) in the control group (p  = 0.11). A higher delay in VAP occurrence was observed in the NMA-coated group compared with the control group by Cox proportional hazards regression analysis (HR 0.41, 95% CI 0.19–0.88, p  = 0.02). The number of antibiotic days was 58.8% of the 1,928 ICU days in the NMA-coated group and 65.4% of the 1774 ICU days in the control group (p  = 0.06). Regarding tracheal colonization, bacteria occurred in 38 of 126 patients in the NMA-coated group (30.2%) and in 37 of 109 patients in the control group (33.9%) (p  = 0.57). CONCLUSIONS: This study provides preliminary evidence to support the benefit of noble metal coating in the prevention of VAP. A confirmatory study in a larger population would be valuable. Trial registration: Clinical trial number: NCT04242706 (http://www.clinicaltrials.gov

Evaluation of inducible nitric oxide synthase inhibition on kidney function and structure in high-fat diet-induced kidney disease

peer reviewedBACKGROUND: Central obesity is related to caloric excess promoting deleterious cellular responses in targeted organs. Nitric oxide (NO) has been determined as a key player in the pathogenesis of metabolic diseases. Here, we investigated the implication of inducible NO synthase (iNOS) in the development of obesity-induced kidney disease. MATERIALS AND METHODS: C57Bl/6 male mice were randomized to a low-fat diet (LFD) or a high-fat diet (HFD) and treated with L-NIL, a specific iNOS inhibitor for 16 weeks. RESULTS: Mice fed a HFD exhibited a significant increase in body weight, fasting blood glucose, plasma levels of NEFA, triglyceride and insulin. iNOS inhibition prevented these changes in mice fed a HFD. Interestingly, the significant increase in albuminuria and mesangial matrix expansion were not ameliorated with L-NIL whereas a significant decrease in proteinuria, NAG (N-acetyl-ß-D-glucosaminidase) excretion and renal triglycerides content were found, suggesting that iNOS inhibition is more suitable for tubular function than glomerular function. The urinary hydrogen peroxide level, a stable product of ROS production, that was found to be increased in mice fed a HFD, was significantly reduced with L-NIL. Finally, despite a moderate effect of L-NIL on inflammatory process in the kidney, we demonstrated a positive impact of this treatment on adipocyte hypertrophy and on adipose tissue inflammation. CONCLUSIONS: These results suggest that inhibition of iNOS leads to a moderate beneficial effect on kidney function in mice fed a HFD. Further studies are needed for better understanding of the role of iNOS in obesity-induced kidney disease. This article is protected by copyright. All rights reserved

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

L’(in)décision électorale et la temporalité du vote: le moment du choix pour le premier tour de l'élection présidentielle 2007

This article proposes an analysis of electoral (in)decision in the context of the presidential election of 2007. First of all, a theoretical and methodological reflection on the measure of the electoral indecision is proposed because the concept can take several meanings : absence of firmness of the vote intention, late crystallization of the choice, hesitations between different potential votes. We measure here (in)decision by the moment of choice ; then we distinguish three types of voters : those « convinced » for a long time, those recently « conquered » and finally those still « circumspect » late in the campaign. We use the data of the 2007 Panel électoral français realized by the Cevipof to portray these three types of (in)decided voters.Cet article propose une analyse de l’(in)décision électorale dans le contexte de l’élection présidentielle de 2007. Une réflexion théorique et méthodologique sur la mesure de l’indécision électorale est tout d’abord proposée car le concept peut recouvrir plusieurs sens : absence de fermeté de l’intention de vote, cristallisation tardive du choix, arbitrages entre divers possibles. Nous mesurons ici l’(in)décision par le moment du choix ; puis nous distinguons trois types : les « convaincus » de longue date, les récemment « conquis » et enfin les « circonspects » tardifs. Nous utilisons les données du Panel électoral français de 2007 réalisé par le Cevipof pour dresser le portrait de ces trois types d’électeurs