Recent publications
Background and Purpose
Chlormadinone acetate (CMA) is a synthetic progestin for which cases of intracranial meningioma have been reported following prolonged exposure.
Method
An observational cohort study was conducted based on the French national health data system. Women aged 10‐70 years and who started CMA between 2007 and 2017 were included. Participants were considered to be exposed if they had received a cumulative dose >360 mg of CMA during the first 6 months and very slightly exposed (control group) when they had received a cumulative dose ≤360 mg. The outcome was surgery or radiotherapy for one or more intracranial meningioma(s). Poisson models assessed the relative risk (RR) of meningioma.
Results
In total, 828,499 women were included: 469,976 in the exposed group (mean age 39.1 years, SD 10.1) and 358,523 in the control group (38.3 years, SD 11.0). Surgery or radiotherapy for intracranial meningioma between 2007 and 2017 was recorded for 164 and 104 women in the exposed and control groups, respectively. The incidence of meningioma was 18.5 and 6.8 per 100,000 person‐years for the exposed and control groups respectively (crude RR = 2.7, 95% confidence interval [CI] 2.1–3.5; age‐adjusted RR = 3.1, 95% CI 2.4–4.0). Meningioma incidence reached almost 47 cases/100,000 person‐years in the most exposed group (>8.64 g), giving an age‐adjusted RR of 6.9, 95% CI 5.1–9.2, relative to the control group.
Conclusions
A strong dose–effect relationship was observed between prolonged use of CMA and risk of meningiomas. As with other progestogens, meningiomas associated with CMA are more likely to be found at the base of the skull.
This contribution is dedicated to the analysis of the size and interaction parameters effects on the thermal properties of square‐shaped cross‐spin transition core‐shell nanoparticles. The present study is carried out by varying the shell size at fixed core size and vice versa. In this problem, the core and shell are active from the spin transition point of view, while having different properties in terms of ligand field (transition temperatures) and interactions. The resulting nanoparticle is described by an Ising‐type model including the three interaction parameters JCC, JSS and JCS coupling core‐core, shell‐shell and core‐shell sites, respectively. The thermodynamic investigations have been carried out in 3 different ways: (i) by Monte Carlo Entropic Sampling (MCES) for small size nanoparticles ( N×N≤92 ) (ii) by usual Monte Carlo Metropolis for higher dimensions (iii) by an analytical method deducing the equilibrium temperature of the system from the various local environments. We demonstrate that, as long as a clear plateau region occurs in the thermal‐dependence of the high‐spin fraction, an excellent agreement is obtained, allowing to predict analytically the evolution of the transition temperatures. The limitations of the method are discussed in the case of strong interference between the thermal dependences of the core and shell.
In this paper, we examine the discretionary uses of documentation in the implementation of naturalisation through a comparative perspective focusing on Belgium, France and the United Kingdom. We investigate the organisational and professional factors that are likely to impact variation in the uses of discretion based on documentation. Belgium, France and the United Kingdom represent three interesting case studies involving different actors with different mandates. In Belgium, municipal agents are responsible for a mandatory check of applicants' documents before transferring the naturalisation application to public prosecutors. While only the latter have the mandate to check that the legal requirements are met, most municipal agents are involved in the examination of the requirements. In France, before the digitisation of nationality acquisition in 2023, the initial acceptance of an application involved prefectural agents who had the power to refuse application registration if the documentation was deemed insufficient or ‘non‐compliant’. In the United Kingdom, ‘Nationality Checking Services’ (NCS) were available until 2019 in local register offices for an optional check of the application before the transfer to the Home Office, which remains the decision‐making body on nationality applications. As United Kingdom law regulates strictly immigration advice, NCSs were often unwilling to express themselves on the chances of an application. Drawing on ethnographic fieldwork consisting of interviews with implementation agents in the three countries and observations of their interactions with applicants, this paper contributes to shedding light on what drives variations in the governance of access to nationality through paperwork.
Purpose
Onco-nephrology is an emerging subspecialty aiming to better understand and prevent renal events in cancer patients. We assessed patients’ knowledge about (1) oncological/hematological treatments induced renal toxicity and (2) kidney protective measures.
Methods
Adult patients receiving systemic anti-tumor treatments in multiple day hospital units in France answered a self-administered questionnaire about their knowledge and expectations related to treatment-associated renal toxicity.
Results
In total, 621 questionnaires were collected in 8 units from November 2021 to January 2022. Among respondents, 84.5% were treated for a solid tumor. Overall, 34.3% (n = 208) patients reported they had some knowledge about potential renal adverse events related to their anticancer treatment, and 38.5% (n = 234) about kidney protection measures. Their referring oncologist or hematologist represented the commonest source of knowledge (67.8%). Sufficient hydration was cited as a kidney protection measure by 93.2% (n = 218) of patients declaring some knowledge about renal toxicity; prevention of nausea/vomiting by 52.6% (n = 123). Consumption of still and alkaline water was chosen by respectively 64.4% (n = 400) and 16.8% (n = 104) of participants to correct dehydration. A majority of patients expressed strong interest for receiving more information about renal toxicity and prevention: median Likert scale score was 10/10 (Q1–Q3, 5–10), with online resources mentioned as the most desired source of information.
Conclusion
One-third of patients declared they had some knowledge about potential renal toxicity of their oncologic treatment and the ways to prevent them, especially regarding hydration. However, a majority expressed interest for dedicated information, which conducted to the elaboration of free online educational sheets for patients.
Follicular lymphoma (FL) is the second most common type of lymphoma (20% of all non‐Hodgkin lymphomas), derived from germinal centre (GC) B cells, and is characterised by its significant clinical, prognostic and biological heterogeneity, leading to complexity in management. Despite significant biological investigation and indisputable clinical progress since the advent of the immunotherapy era more than 20 years ago, much remains to be done to understand and cure this lymphoma. Today, FL is metaphorically a giant puzzle on the table with patches of sky, landscape and foliage clearly appearing. However, many of the remaining pieces are held by various stakeholders (e.g. clinicians, pathologists, researchers, drug developers) without global agreement on what the gaps are, or any clear blueprint on how to solve the puzzle of understanding the heterogeneity of this disease and create curative and tailored therapies. With the advent of new investigation and drug technologies, together with recent advances in our capacity to manage big data, the time seems ripe for a change of scale. More than ever, this will require collaboration between and within all stakeholders to overcome the current bottlenecks in the field. As for every investigator, we acknowledge that this first draft is necessarily biased, incomplete and some FL expert readers might recognise some remaining gaps not addressed. We hope they will reply to make this effort a collaborative one to assemble all the pieces in the most ideal fashion. As such, this review intends to be a first step and an interactive platform to a collaborative roadmap towards better understanding and care of FL.
This study introduces a novel approach for chloride recognition utilizing multifunctional naphthalene‐based receptors. By strategically modifying the substitution patterns on tetrafluoropyridines, a series of new receptors with customized cavities and enhanced binding capabilities were developed. Density functional theory (DFT) calculations and experimental studies combining NMR spectroscopy and mass spectrometry confirmed the efficacy of these receptors in capturing chloride ions. The relative chloride affinity order determined experimentally is in agreement with DFT predictions. The synergistic effect of anion‐π and C‐H…Cl interactions, mediated by the TFP groups, played a crucial role in achieving high binding affinity. This work provides valuable insights for designing future anion receptors with improved performance.
Background
Transmission of SARS-CoV-2 highlighting the importance of social distancing guidelines. Following a series of lockdowns and the widespread vaccination of the European population, many countries began to lift these restrictions. During this period, while some parents yearned for emotional support and family presence, others found that the solitude facilitated by the restrictions was beneficial for bonding and breastfeeding. In France, postnatal stays are generally longer than in other countries, and the limited availability of home-based follow-up care, combined with pandemic isolation measures, further complicated perspectives on visitation restrictions. Therefore, the objective of this study was to assess the satisfaction of mothers and caregivers regarding these visit restrictions in French maternity settings during the COVID-19 pandemic.
Methods
We conducted two multicentre descriptives surveys across five French maternity wards (three in Paris and two in Lyon) from June 1st to July 15th, 2021. Participants included mothers, selected based on criteria such as French-speaking, at-term birth (≥ 37 weeks), and hospitalisation with their newborn, as well as caregivers working in the postpartum units. Satisfaction with visitation restrictions was assessed using a four-point Likert scale, which was then dichotomised into “mostly satisfied” versus “mostly dissatisfied” for the analysis. Multivariable logistic regression models were used to identify factors associated with satisfaction.
Results
We analysed complete responses from 430 of the 2,142 mothers (20.1%) and 221 of the 385 caregivers (57.4%) who participated during the study period. The majority of mothers (68.8%, n = 296/430) and caregivers (90.5%, n = 200/221) declare themselves satisfied with the policy of restricting visits to maternity wards. The main source of mother’s satisfaction came from a quieter stay, but they regretted the absence of their other children.
Conclusions
Maternity visit restriction policies were largely supported by mothers and caregivers, especially when partners and siblings were allowed. Revisiting these policies, along with the postpartum stay length, may improve care, though further evaluation in non-pandemic settings is needed.
Background
Immunosuppressive therapies are associated with a risk of infections. Nevertheless, their incidence in this population remains unclear. This study aims to determine the incidence of serious respiratory tract infections (SRI) in a population exposed to immunosuppressive therapies.
Methods
Data from a representative sample of the French healthcare claims from 01/01/2014 to 12/31/2019 were analyzed. Exposure to immunosuppressive therapy was defined by the dispensation of drugs through community pharmacies or in hospitals. SRI diagnosis was based on ICD-10 codes from hospitalization records. A cohort analysis was performed to estimate standardized SRI incidence rates. A nested case-control analysis within this cohort was used to study the characteristics associated with SRI.
Results
We identified 24,122 individuals exposed to immunosuppressive therapies, among which 1,559 developed SRI, resulting in a standardized incidence rate of 1,398 per 100,000 person-years. In this population, the risk of SRI was associated with a history of cancer (OR 2.68, 95% Confidence Intervals (CI) 2.24–3.21; p < 0.001), chronic respiratory disease (2.62, 95%CI 2.17–3.16; p < 0.001), end-stage renal failure (2.38, 95%CI 1.37–4.13; p = 0.003), neurodegenerative diseases (1.52, 95%CI 1.07–2.17; p = 0.026), diabetes (1.44, 95%CI 1.14–1.82; p < 0.001), psychiatric diseases (1.27, 95%CI 1.06–1.52; p < 0.001), and cardiovascular diseases (1.26, 95%CI 1.04–1.52; p = 0.002). Compared to corticosteroids alone, the risk of SRI was lower in individuals treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARD) only (0.44, 95%CI 0.25–0.78; p < 0.001).
Conclusion
In the population exposed to immunosuppressive therapies, a history of chronic disease is associated with an increased risk of SRI. This risk is lower in those receiving csDMARD alone than corticosteroids alone.
Background
BK-polyomavirus (BKpyV) nephropathy (BKVN) is associated with end-stage kidney disease in kidney and non-kidney solid organ transplantation, with no curative treatment.
Case presentation
A 45-year-old woman with a past medical history of double lung transplantation subsequently developed end-stage kidney disease, of undetermined origin. One month after receiving a kidney transplant, a diagnosis of early BKVN was suspected, and in retrospect was a reasonable cause for the loss of her native kidneys. Minimisation of immunosuppression, achieved through extracorporeal photopheresis, allowed clearance of BKpyV and so prevented nephropathy. Both lung and kidney grafts had a satisfactory and stable function after one year of follow-up, with no rejection.
Conclusions
Extracorporeal photopheresis may have facilitated minimisation of immunosuppression and BKpyV clearance without lung allograft rejection.
This article analyses the effect of women's political empowerment on child undernourishment for a sample of 87 developing countries over the period 2001–2021. We provide evidence through various empirical approaches that women's political empowerment reduces undernourishment. Examination of transmission channels indicates that women's political empowerment improves nutrition through its effects on public health spending, public education spending and governance. This result remains robust when we: (i) decompose the women's political empowerment index; (ii) control for income level, natural resource dependency, civil and political liberties, and religious predominance; and (iii) control for endogeneity using methods with external instrumental variables, namely two-stage least squares (2SLS) and Lewbel's ordinary least squares method. This article contributes to the literature by demonstrating the fundamental role of women’s political empowerment in achieving sustainable development goals, in particular improving the food and nutritional status of children.
Cognitive decline is common in patients with acute or chronic kidney disease. Several areas of brain function can be affected, including short and long-term memory, attention and inhibitory control, sleep, mood, eating control and motor function. Cognitive decline in kidney disease shares risk factors with cognitive dysfunction in people without kidney disease, such as diabetes, high blood pressure, sedentary lifestyle and unhealthy diet. However, additional kidney-specific risk factors may contribute, such as uremic toxins, electrolyte imbalances, chronic inflammation, acid-base disorders or endocrine dysregulation. Traditional and kidney-specific risk factors may interact to cause damage to the blood-brain barrier, induce vascular damage in the brain, and cause neurotoxicity or neuroinflammation. Here, we discuss recent insights into the pathomechanisms of cognitive decline from animal models and novel avenues for prevention and therapy. We focus on a several areas that influence cognition: blood-brain barrier disruption, the role of skeletal muscle, physical activity and the endocrine factor irisin, and the emerging therapeutic role of sodium-glucose transporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists. Taken together, these studies demonstrate the importance of animal models in providing a mechanistic understanding of this complex condition and their potential to explain the mechanisms of novel therapies.
Lithium–Sulfur (Li–S) batteries are promising energy storage devices due to their high theoretical energy density. However, challenges such as the shuttling effect and volume expansion have significantly hindered their cycle life and capacity retention. Furthermore, the complex kinetic pathways in Li–S batteries call for advanced characterization techniques to unravel underlying mechanisms. In this study, a hollow porous carbon (HPC) is used as a microreactor, where inverse vulcanization occurs between 1,3‐diisopropylbenzene (DIB) and sulfur (S8), resulting in the creation of three‐dimensionally interconnected and well‐distributed S‐DIB in carbon frameworks. As a result, the dual confinement strategy imparts Li–S coin cells with remarkable cycling stability and capacity retention, exhibiting an impressive capacity of 866 mAh g⁻¹ when returning to 0.1 C after 100 cycles of rate capability tests. Particularly, the Energy‐selective Backscattered (EsB) assisted Scanning Electron Microscope (SEM) technique as a novel approach is introduced to distinguish different lengths of polysulfides. Their distribution is visualized in the cross‐section view of the electrode in a micrometer range. These EsB images provide concrete indications of the sulfur evolution process and explain the capacity degradation during cycling.
We investigate the static properties of a new class of 1D Ising‐like Hamiltonian for binuclear spin‐crossover materials accounting for two‐, three‐, and four‐body short‐range interactions between binuclear units of spins (s1A,s1B) and (s2A,s2B) . The following 2‐, 3‐, and 4‐body J1(s1A+s1B)(s2A+s2B) , K1s1As1B(s2A+s2B) , and K2(s1As1B)(s2As2B) terms are considered, in addition to intra‐binuclear interactions, such as effective ligand‐field energy and exchange‐like coupling. An exact treatment is carried out within the frame of the transfer matrix method, leading to a 4×4 matrix from which, we obtained the thermal evolution of the thermodynamic quantities. Several situations of model parameter values were tested, among which that of competing intra‐ and inter‐molecular interactions, leading to the occurrence of (i) one‐step spin transition, (ii) two‐, three‐, and four‐step transitions, obtained with a reasonable number of parameters. To reproduce first‐order phase transitions, we accounted for inter‐chains interactions, treated in the mean‐field approach. Hysteretic multi‐step transitions, recalling experimental observations, are then achieved. Overall, the present model not only suggests new landscapes of interaction configurations between SCO molecules but also opens new avenues to tackle the complex behaviors often observed in the properties of SCO materials.
This paper introduces a novel control algorithm leveraging artificial intelligence to address the key defects of Direct Power Control (DPC) via Grid Voltage Modulation (GVM) strategy enhanced by Neural Network Control (NNC) for a three-phase inverter in a photovoltaic generation system. Conventional DPC-GVM techniques face major constraints due to the need for accurate tuning of gains (KP and Ki) in three PI controls, which affects the system's robustness, reliability, and stability. Besides, these conventional techniques suffer from incomplete decoupling between active and reactive powers, direct interdependence between the DC-link voltage and active power reference, elevated harmonic distortion, and suboptimal transient response. This paper introduces a progressive NNC-based algorithm, termed GVM-NNC (Grid Voltage Modulated-Neural Network Control), to overcome these issues. The proposed strategy effectively decouples the active and reactive power control, mitigates the dependence between DC-link voltage and active power reference, diminishes harmonic distortion, and improves transient response. The innovations and contributions of the GVM-NNC strategy include decoupling of active and reactive power for improved control precision, robust adaptability to sudden changes and external disturbances guaranteeing excellent dynamic response, enhanced stability and reliability by eliminating the need for precise tuning of PI controller gains, reduced harmonic distortion for cleaner power output, where the proposed algorithm reduces the THD until 0.98% compared to the THD of conventional DPC-GVM 1.20%. Numerical simulations executed in MATLAB Simulink demonstrate that the GVM-NNC method achieves superior comportment in each steady-state and transient state compared to the conventional DPC-GVM strategy.
PAX6-related congenital aniridia is a genetic pan-ocular disease characterized by a partial or total absence of the iris and foveal hypoplasia. The mechanisms involved in the development of ocular hypertension and glaucoma in patients with congenital aniridia are still unknown. Many hypotheses have been proposed and the advent of new anterior segment imaging techniques has allowed the identification of various potential mechanisms: congenital trabecular dysfunction, progressive closure of the iridocorneal angle, postoperative ocular hypertension. The diagnosis must take into account the various obstacles to clinical examination (corneal opacity, obturating cataract, foveolar aplasia, significant nystagmus) and is often considered only upon detection of ocular hypertension. Glaucoma remains, along with limbal insufficiency, one of the major causes of blindness in congenital aniridia. The treatment of glaucoma in congenital aniridia is primarily medical. The benefit/risk ratio of a surgical intervention should always be thoroughly evaluated in order to not underestimate the postoperative complications associated with congenital aniridia.
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