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The objectives of this work were (a) to adopt the Active Healthy Kids Global Alliance Report Card methodology to evaluate the state of physical activity (PA) for French children and adolescents with disabilities (CAWD) and (b) to identify the strengths, weaknesses, opportunities, and threats (SWOT) perceived by French PA experts for promoting PA among CAWD. The harmonized Active Healthy Kids Global Alliance Report Card development process was used to assign a grade to the 10 common PA indicators. SWOT templates were completed by PA experts and then collapsed in a summary figure. Despite increasing efforts to provide active opportunities to CAWD, concerning low grades were assigned to behavioral indicators. SWOT analysis provided important insights for the promotion of PA in CAWD. This work highlighted the need for the inclusion of CAWD in a comprehensive national PA surveillance system and for more efficient strategies promoting PA specifically targeting CAWD in France. [ABSTRACT FROM AUTHOR]

Data on retrospective compensation claims for injuries caused by pharmaceutical drugs are prone to selection and reporting biases. Nevertheless, this case study of the antidiabetic drug benfluorex shows that such data can be used to estimate the cumulative incidence of drug‐related injury, and to provide insights into its epidemiology. To this end, we develop a modelling framework for under‐reporting of retrospective claims for compensation arising from drug damage. The model involves a longitudinal component related to attrition of cases over time, and a cross‐sectional component related to incomplete reporting. We apply this model to cardiac valve surgery necessitated by exposure to benfluorex. Benfluorex was marketed in France between 1976 and 2009, when it was withdrawn because it caused valvular heart disease. A scandal erupted in 2010 over the scale of the damage caused by the drug. Since then, no further estimates of cumulative incidence have been published, though thousands of claims for compensation have been processed. The analysis combines compensation claims data and sociological survey data on benfluorex users, together with data on benfluorex sales and duration of treatment. We find a threshold of toxicity at about 6 months' exposure, and that at least 1690 individuals (95% CI 1290 to 2320) needed heart surgery to replace or repair valves damaged by exposure to benfluorex in France: a cumulative incidence of 3.68 per 10,000 (95% CI 2.68 to 5.34) benfluorex users or 3.22 per 10,000 (95% CI 2.48 to 4.39) person‐years at risk above the exposure threshold. While these findings are tentative, they are consistent with those obtained previously using very different methods. [ABSTRACT FROM AUTHOR]

Burnout and absenteeism are prevalent among healthcare workers, reflecting prolonged work-related stress and dissatisfaction with their job. Identifying poor sleep as a contributing factor can assist in developing targeted interventions. This study explored the relationship between burnout, absenteeism, and sleep among healthcare workers. A nationwide online cross-sectional study was conducted among healthcare professionals in France during the third wave of COVID-19, from May 2021 to June 2021. Recruitment strategies included outreach through social and professional networks and email invitations. Burnout was assessed using the Maslach Burnout Inventory, absenteeism through self-reported days absent in the preceding 12 months, and sleep quality using the Pittsburgh Sleep Quality Index. The association between burnout, absenteeism, and poor sleep was analyzed using multivariate logistic regression, accounting for individual and professional variables. The study also explored various sleep dimension abnormalities. Of 10,087 healthcare workers, 55.2 % reported burnout, 20.5 % absenteeism, and 64.8 % poor sleep. Burnout and absenteeism were more frequent in individuals with poor sleep compared to those with good sleep (74.2 % vs. 25.8 % and 75.6 % vs. 24.4 %, respectively). The multivariate analyses confirmed the associations between burnout, absenteeism, and poor sleep (Adjusted Odds Ratio [aOR] = 2.15, 95 % CI [1.97–2.35], p < 0.001; and aOR = 1.49, 95 % CI [1.32–1.67], p < 0.001, respectively). The study highlighted the intricate relationship between burnout, absenteeism, and poor sleep among healthcare professionals, informing workforce management and policy decisions to foster a supportive work environment and enhance their well-being. • Out of 10,087 healthcare professionals, a concerning 55.2% reported experiencing burnout, with 20.5% indicating absenteeism. • Multivariate analyses confirmed the links between burnout, absenteeism, and sleep disturbances. • Poor sleep was associated with burnout (aOR = 2.15, 95% CI [1.97-2.35]) and absenteeism (aOR = 1.49, 95% CI [1.32-1.67]). • This research sheds light on the intricate ties between burnout, sleep quality, and absenteeism. [ABSTRACT FROM AUTHOR]

• Two years after its discovery in 1798, the smallpox vaccine was introduced in France. • A privately funded vaccine committee was established in 1800 to evaluate its value. • An official vaccine society was established in 1804 to distribute the vaccine in France. • Vaccination activities were supported by Napoleon Bonaparte. • Different medals and tokens were issued to commemorate vaccine introduction. The smallpox vaccine developed by Jenner in 1798 was successfully introduced in France in 1800 with the support of Napoleon Bonaparte. The medals and tokens (coin-like medals) issued to encourage early-day vaccination activities are described in the context of the changing political situation in that country. In 1800 a private society of subscribers, led by the Duke of La Rochefoucauld-Liancourt was created, along with a Vaccine Committee charged with evaluating the safety and efficacy of vaccination before deciding if vaccination should be extended to the entire population. The Vaccine Committee published a positive report in 1803, and in 1804, the Ministry of the Interior established the "Society for the extinction of smallpox in France by means of the propagation of the vaccine". The creation of the Society made smallpox vaccination an official activity of the empire, facilitating collaboration between government agencies. The vaccine institution, established by Napoleon in 1804, continued its functions until 1820 when the Royal Academy of Medicine was created and took over those functions. This case exemplifies the collaboration that was needed between science and politics to rapidly bring the recently developed smallpox vaccine to the needed population. [ABSTRACT FROM AUTHOR]

France and Germany agree on the need to further European defence-industrial cooperation, but boast radically different preferences on how to structure such cooperation. Why? To answer this question, we introduce the distinction between the two faces of market size – the first exclusively related to defence, the second including the broader commercial-industrial base. Since Germany is, overall, more competitive than France in the commercial sector but less competitive in the defence one, it will advocate for a full-fledged integration of the European defence market but seek to protect its less competitive defence industry from France by championing autonomy in ad-hoc arms programmes. In turn, France would prefer to leverage its defence-industrial advantage by injecting efficiency on arms programmes but resist pan-EU initiatives to integrate the defence market, which would benefit Germany more over the long-term. To test our argument, we examine French and German preferences towards the European Defence Fund and the Future Combat Air System. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to contribute to an understanding of the role deployment of advanced practice nurses (APNs) in French healthcare settings. Introduction: The introduction of APNs was formalised in France by the decrees issued on 18 July 2018, which described the areas, activities and training of APNs. Background: A qualitative study on the role implementation of APNs was conducted between July 2021 and May 2022 following a call for projects launched by the Île‐de‐France Regional Health Agency to evaluate the deployment of APNs in the area. Methods: Data were collected through field observations and semi‐structured interviews in order to explore both the APNs deployment processes in nine healthcare structures and the roles played by APN networks and associations with regard to the deployment of APN activities in their working environments. Results: The projects proved to be evolutionary, and their development was marked by various forms of APN isolation and multiple obstacles that were specific to their professional practice settings. Some APNs relied on a variety of forms of mutual assistance and advocacy deployed throughout APN networks and associations. Discussion: The deployment of APNs' role was impacted by diverse configurations of professional power relations and the nature of the obstacles that were structural for APNs in primary care. Their experience of isolation derived from the novelty of their role, the challenge they posed to the cohesion of the nursing profession and a lack of supportive policies for their deployment. Their participation in APN networks and associations enabled them to access advocacy and manage the uncertainties and unknowns related to the deployment of their activities. Conclusion: The results suggest that the formalisation of schemes for mutual assistance among APNs and advocacy should be integrated into the guidelines for the implementation of their role. Implications for nursing policy: APN policy should strengthen a bottom‐up approach, relying in particular on the development of different forms of collaboration and communication between APN networks and associations on the one hand and the public authorities on the other. [ABSTRACT FROM AUTHOR]

We assessed the associations of substance (alcohol, tobacco, cannabis, and other illicit drugs) use of adolescents with that of their family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers, and the mediating role of school and mental difficulties (SMDs) which remained insufficiently addressed. This cross-sectional population-based study included 1,559 middle-school adolescents in France (mean age = 13.5 ± 1.3, 778 boys, 781 girls). They completed a questionnaire including socioeconomic features (nationality, family structure and parents' education, occupation, and income), substance use, cumulative number of substance use of family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers (noted familySUcn and peerSUcn), SMDs (grade repetition, suffered physical/verbal violence, sexual abuse, lack of family/peer support, depressive symptoms, suicide attempt, and age at onset). Data were analyzed using logistic regression models and Kaplan–Meier estimates. Most adolescents had familySUcn 1–2, 3–5, and ≥ 6 (39.1%, 23.0%, and 4.5%, respectively) and peerSUcn 1–2 and ≥ 3 (36.1% and 13.0%, respectively). Strong dose–effect associations were found between all substance use and familySUcn and peerSUcn (odds ratio adjusted for sex, age, and socioeconomic features reaching 13.44 and 9.90, respectively, most with p <.001). SMDs explained more the associations of all substance use with familySUcn than with peerSUcn (contributions reaching 69% and 34%, respectively). The proportion of subjects without each substance use decreased with age more quickly among the adolescents with higher familySUcn or peerSUcn. Early prevention reducing familySUcn, peerSUcn and SMDs among adolescents and their families may reduce efficiently initiation and regular use of substances during adolescents' life course. Many adolescents had a high cumulative number of family members' and peers' substance (alcohol, tobacco, cannabis, or other illicit drugs) use (familySUcn and peerSUcn) Strong dose–effect links of substance use with familySUcn and peerSUcn (odds ratio up to 13) School and mental difficulties explained up to 69% of the link of substance use with familySUcn and up to 34% of that of substance use with peerSUcn The proportion of subjects without each substance use decreased with age more quickly among the adolescents with higher familySUcn/peerSUcn than among the others Our results may help implementing prevention to reduce substance use [ABSTRACT FROM AUTHOR]

Food Recommender Systems (RecSys) are innovative knowledge systems that inform consumers of food choices according to criteria, including nutritional content, health concerns, production method, carbon footprint or other social and ethical considerations. They raise important questions at the intersection of technology accuracy and today evolving consumers' knowledge seeking behaviours, which implies to unpack the epistemic value of food RecSys. This study investigates the drivers of the perceived value of food RSs consumption by proposing a model that establishes via PLS-SEM (n = 253) a positive relationship between the Yuka company's food RecSys' epistemic value and its perceived value. The model demonstrates that Yuka RecSys' epistemic value relies on the disciplinary drivers of compatibility, self-confidence, and consumer innovativeness, and the problematising drivers of memory and learning, which come from using the application. The perceived value of food RecSys is found to relate to RecSys epistemic value beyond the functional accuracy aspects of recommendation algorithms. Results highlight the importance of developing a refined understanding of epistemic value considering the consumption of RecSys. RecSys' developers, retailers, food manufacturers and policy makers must work on better mapping and adjusting information through consumers socialised RecSys' usage to shape the design of the next generation RecSys. [ABSTRACT FROM AUTHOR]

Background: GPP is a rare, chronic, neutrophilic skin disease, with limited real‐world data characterizing patients with flares and the impact of flares on disease progression and morbidity. Objective: Describe the clinical characteristics of patients with GPP, comorbidities, disease epidemiology and frequency and severity of flares, and compare patients with GPP with a matched severe psoriasis population. Methods: In this population‐based real‐world cohort study an algorithm was developed to identify patients with GPP flares. Three cohorts were identified using the Système National des Données de Santé (SNDS) database covering almost the entire French population; a prevalent cohort (2010–2018), an incident cohort (2012–2015). A severe psoriasis cohort was compared with the GPP incident cohort using propensity score matching. Results: The prevalent and incident cohorts comprised 4195 and 1842 patients, respectively. In both cohorts, mean age was 58 years; 53% were male. Comorbidities were significantly more common in the incident cohort versus matched psoriasis cohort, respectively, including hypertension (44% vs. 26%), ischaemic heart disease (26% vs. 18%) and hyperlipidaemia (25% vs. 15%). In the incident cohort, the flare rate was 0.1 flares/person‐year and 0.4 flares/person‐year among the 569 out of 1842 patients hospitalized with flares. These patients had a mean (±SD) stay of 11.6 ± 10.4 days; 25% were admitted to the intensive care unit. In 2017, the cumulative incidence and cumulative GPP age–sex standardized prevalence were 7.1 and 45.2 per million, respectively. Conclusions: Patients with GPP had a distinct comorbidity profile compared to patients with severe psoriasis, and GPP flares were associated with long hospitalizations. [ABSTRACT FROM AUTHOR]

Purpose Recommendations to improve therapeutics are proposals made by pharmacists during the prescription review process to address suboptimal use of medicines. Recommendations are generated daily as text documents but are rarely reused beyond their primary use to alert prescribers and caregivers. If recommendation data were easier to summarize, they could be used retrospectively to improve safeguards for better prescribing. The objective of this work was to train a deep learning algorithm for automated recommendation classification to valorize the large amount of recommendation data. Methods The study was conducted in a French university hospital, at which recommendation data were collected throughout 2017. Data from the first 6 months of 2017 were labeled by 2 pharmacists who assigned recommendations to 1 of the 29 possible classes of the French Society of Clinical Pharmacy classification. A deep neural network classifier was trained to predict the class of recommendations. Results In total, 27,699 labeled recommendations from the first half of 2017 were used to train and evaluate a classifier. The prediction accuracy calculated on a validation dataset was 78.0%. We also predicted classes for unlabeled recommendations collected during the second half of 2017. Of the 4,460 predictions reviewed, 67 required correction. When these additional labeled data were concatenated with the original dataset and the neural network was retrained, accuracy reached 81.0%. Conclusion To facilitate analysis of recommendations, we have implemented an automated classification system using deep learning that achieves respectable performance. This tool can help to retrospectively highlight the clinical significance of daily medication reviews performed by hospital clinical pharmacists. [ABSTRACT FROM AUTHOR]

We examined the cognitive processes underlying the comprehension of reduced word pronunciation variants in natives and advanced learners of French. In a passive listening visual world task, participants heard sentences containing either a reduced or a full form and saw pictures representing the target word, a phonological competitor and two neutral distractors. After each sentence they saw a picture and had to decide whether it matched the content of that sentence. Eye movements and EEG were recorded simultaneously. Because the two recordings offer complementary information about cognitive processes, we developed methods for analysing the signals in combination. We found a stronger effect of reduction on phonetic processing and semantic integration in learners than in natives, but the effects are different from the N100/N400 and P600 effects found in previous research. Time-locking EEG signals on fixation moments in the eye movements offers a window onto the time course of semantic integration. [ABSTRACT FROM AUTHOR]

Grainger et al. examined flanker effects in an experiment where target words could be morphologically complex (e.g. farmer), have a pseudo-morphological structure (e.g. corner), or have no morphological structure (e.g. cashew). Target words were flanked on both sides by the left-aligned embedded word in the related flanker condition (e.g. farm farmer farm; corn corner corn; cash cashew cash). Effects of related flankers were compared with matched unrelated flankers (e.g. book farmer book). Significantly greater effects of flanker relatedness were found with morphologically related flankers compared with both pseudo-morphological flankers and non-morphological embedded word flankers. However, more recent work in Spanish has failed to replicate this specific pattern. We therefore sought to replicate our findings in French, while increasing experimental power and modifying the nonword targets. The results of the present study successfully replicate the findings of Grainger et al. [(2021). Morphological processing in the flankers task. Language, Cognition and Neuroscience, 36(3), 288–295. ]. [ABSTRACT FROM AUTHOR]

This paper investigates the infrastructure projects undertaken for the event initially known as the Semaine des sports d'hiver, which took place in Chamonix, France, from 25 January to 4 February 1924 and was later recognized as the first Winter Olympics. Although the already famous resort town was able to use its existing hotels to accommodate visitors and athletes, it also made a considerable investment in the construction of new sports infrastructure. Following an agreement signed just 9 months before the Games, these facilities included a large ice rink, a bobsleigh run and a ski jump. The project was entrusted to the Ponts et Chaussées engineers, who encouraged local firms to help with the construction. Archival analysis will be used to examine the relationship between the project and the changing environment. Our aim is to show how the work in Chamonix modified the environment by exploiting certain natural elements (e.g. water, soil and forests) and, conversely, how the natural (in particular, the geological and climatic) and historical (notably land ownership) components of the environment affected the execution of these works. [ABSTRACT FROM AUTHOR]

This paper considers the urban consequences of failing to host Olympic Games. Using the example of Paris and its unsuccessful bids to hosts the Olympic Games of 1992, 2008 and 2012, the paper analyses the pre- and post-bid status of key projected 'Olympic' sites within the context of urban plans and aspirations of the city of Paris. The French capital attracts special attention because of the rapid succession of submissions that proved to be outbid by those presented to the IOC by the cities of Barcelona (1992), Beijing (2008) and London (2012). The paper will briefly outline the reasons for failing to attract the Games but will devote most of its space for an analysis of the siting of the planned Olympic Villages, which often form the most lasting of legacies of Olympic Games in host cities. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this work is to evaluate the real-world outcomes of the reinforced treat-and-extend (RTE) protocol for the treatment of exudative age-related macular degeneration with intravitreal injections of aflibercept or ranibizumab (anti-vascular endothelial growth factor therapies). Methods: This was a retrospective review of patients from two tertiary ophthalmology centers in France initiating the RTE protocol between February 2018 and June 2021. The primary outcome was change in best-corrected visual acuity (BCVA) after 24 months. Secondary outcomes were change in central retinal thickness (CRT), recurrence, and management-related factors (injection interval, number of injections/consultations). Outcomes were additionally evaluated after protocol changes (strict versus modified RTE protocol groups). Results: Sixty-eight patients (72 eyes) were included (68% females; mean age 82.2 ± 7.8 years). After 24 months, mean BCVA significantly improved (65.22 ± 14 vs. 71.96 ± 13 Early Treatment Diabetic Retinopathy Study letters; p < 0.001) and CRT significantly decreased (388.6 ± 104 vs. 278.8 ± 51 μM; p < 0.001) with 21% of eyes showing signs of exudation. Over the 24 months, a mean total of 14.9 ± 4.0 injections and 8.6 ± 1.4 consultations were performed. Mean 24-month injection interval was 7.9 ± 2.3 weeks. Initial and 24-month ophthalmic outcomes for eyes in the strict (47%) versus modified (53%) groups were not significantly different, but mean time interval to first recurrence of disease activity was significantly shorter for the modified group (7.3 ± 2.4 vs. 9.9 ± 2.5 weeks; p < 0.001). Patients in the strict RTE group received significantly less injections (13.9 ± 3.6 vs. 16.5 ± 3.9; p = 0.006) and mean 24-month injection interval was significantly longer (9.5 ± 2.7 vs. 6.5 ± 2.1 weeks; p < 0.001). Consultation number was similar (8.5 ± 1.9 vs. 8.8 ± 1.6; p = 0.93). Treatment with aflibercept versus ranibizumab did not influence ophthalmic or management outcomes. Conclusions: The RTE protocol, even when modified, reduced consultations but improved ophthalmic outcomes. The RTE protocol could reduce hospital visits and overall burden while also encouraging better patient compliance. Video Abstract available for this article. 87UXnuCLS6rE_gv6c9Xvtc VIDEO ABSTRACT: Vincent Soler and François-Philippe Roubelat summarize the Reinforced Treat-and-Extend Protocol and main results (MP4 225022 KB) [ABSTRACT FROM AUTHOR]

Introduction: Even though the local tolerance of prostaglandin (PG) analogues has improved drastically since the introduction of preservative-free (PF) eye drops, prescription patterns still vary widely among practitioners and between countries and could have an impact on the ocular surface of treated patients and, in consequence, their adherence. The aim of this study is to explore the prescribing patterns of PG analogues monotherapy in France and to evaluate their impact on ocular surface status. Methods: This was a national multicenter cross-sectional observational study that was conducted by 18 glaucoma experts in France. Patients over 18 years of age and receiving monotherapy with topical PG analogues for the treatment of ocular hypertension and/or glaucoma, with no history of prior glaucoma surgery, were consecutively selected from the glaucoma outpatient clinics of participating physicians and underwent an ocular surface examination. Results: A total of 344 eyes of 344 patients were enrolled between November 2022 and November 2023. Prescribed PG monotherapy was PF in 271 (78.7%) patients. Clinical history and ocular surface evaluation indicated that 79.4% of the study population (n = 273) presented with at least one symptom or clinical sign of dry eye and that three patients out of four had an unstable tear film. Subgroup analysis comparing preserved and PF PG analogues showed a higher prevalence of conjunctival hyperemia and corneal staining in the preserved group. Multivariate analysis identified conjunctival hyperemia as consistently associated with preservative use (odds ratio = 7.654; p = 0.003 for moderate conjunctival hyperemia). Conclusions: This study highlights the growing trend toward PF PG analogue prescriptions by specialists in France. However, ocular surface issues remain prevalent, impacting patient adherence and treatment efficacy. Comprehensive ocular surface examinations are crucial in glaucoma management to enhance long-term tolerance, compliance, and overall treatment success. [ABSTRACT FROM AUTHOR]

Advanced practice nurses constitute a new professional group within the French health care system. Advanced practice nurses specialise in one of five disciplines including Psychiatry/Mental‐Health. This specific discipline is strongly marked by stigmatising representations by healthcare users and other health professionals (including other advanced practice nurses), whose consequences have a deleterious effect. The aim was to highlight all advanced practice nurses representation of Psychiatry/Mental‐Health advanced practice nurses. An observational descriptive survey, based on an anonymous online questionnaire was conducted in April 2022 among qualified and student advanced practice nurses from the five specialist disciplines. Overall, 356 advanced practice nurses completed the survey questionnaire. No significant difference in stigmatising representations of Psychiatry/Mental‐Health advanced practice nurses versus other advanced practice nurses was observed. Only 3.3% of other advanced practice nurses thought that Psychiatry/Mental‐Health advanced practice nurses are often 'strange'. Psychiatry/Mental‐Health advanced practice nurses and other advanced practice nurses appeared to have similar representations of the professional roles of advanced practice nurses in general and of advanced practice nurses APN specifically. Unlike other professionals in the psychiatric field (e.g. medical interns, nurses), very little stigmatisation of Psychiatry/Mental‐Health advanced practice nurses by their colleagues (i.e. other advanced practice nurses) was observed. This could be partly due to the fact that advanced practice nurses professional identity appeared to be built collectively around the concept of advanced practice. Advanced practice nurses constitute a professional group that is fully involved in contemporary transformations in care and organisational innovation. The very low level of stigmatisation of Psychiatry/Mental‐Health advanced practice nurses by other advanced practice nurses in our study suggests that these new healthcare actors could play a crucial role in the improvement of professional health practices, particularly in terms of improved coordination between psychiatric‐care and physical‐care. [ABSTRACT FROM AUTHOR]

Background: External ear canal exostoses are usually bilateral and broad-based, secondary to external ear canal chronic cold exposure, especially water. Objectives: The objectives were to analyze the influence of the surgeon's experience on the 3-year recurrence and on the complication. We also studied the influence of prolonged exposure to cold water on the incidence of recurrence. Material and Methods: This monocentric retrospective study included 98 ears operated for canalplasty between 2009 and 2016 by nine different operators including one senior, a junior, and seven beginner surgeons. Senior, Junior, and Beginner groups were compared. Results: 3-year recurrence rate was higher in the Beginner and Junior groups than in the Senior group (69% and 38% vs 18%, P =.001). Although there was a difference between the Beginner (69%) and Junior (38%) groups, it was not significant (P =.407). Among the recurrences, 48% had continued exposure to cold water while only 7% of the ears without recidivism were still exposed (P <.001, OR = 1.25 [4.4; 36.1]). The complication rates were similar between groups, concerning pain (8% vs 30% vs 12%), per procedure perforation (17% vs 10% vs 16%), scarring disorders (25% vs 20% vs 13%), and osteitis (8% vs 0% vs 1%). Hearing was unaffected. Conclusions: This is the first study evaluating the risk of recurrence of external ear canal exostoses after canalplasty based on the surgeon's experience. This risk of recurrence seems to decrease with the surgeon's experience. There was no difference in complication rates. [ABSTRACT FROM AUTHOR]

Introduction: Second-generation basal insulins like glargine 300 U/mL (Gla-300) have a longer duration of action and less daily fluctuation and interday variability than first-generation ones, such as glargine 100 U/mL (Gla-100). The EF-BI study, a nationwide observational, retrospective study, was designed to compare persistence, acute care complications, and healthcare costs associated with the initiation of such basal insulins (BI) in a real-life setting in France. Methods: This study was conducted using the French healthcare claims database (SNDS). Adult patients living with type 1 or type 2 diabetes mellitus (T1DM or T2DM) initiating Gla-300 or Gla-100 ± other hypoglycemic medications between January 1, 2016 and December 31, 2020, and without any insulin therapy over the previous 6 months were included. Persistence was defined as remaining on the same insulin therapy until discontinuation defined by a 6 month period without insulin reimbursement. Hospitalized acute complications were identified using ICD-10 codes. Total collective costs were established for patients treated continuously with each basal insulin over 1–3 years. All comparisons were adjusted using a propensity score based on initial patient/treatment characteristics. Results: A total of 235,894 patients with T2DM and 6672 patients with T1DM were included. Patients treated with Gla-300 were 83% (T1DM) and 44% (T2DM) less likely to discontinue their treatment than those treated with Gla-100 after 24 months (p < 0.0001). The annual incidence of acute hospitalized events in patients with T2DM treated with Gla-300 was 12% lower than with Gla-100 (p < 0.0001) but similar in patients with T1DM. Comparison of overall costs showed moderate but statistically significant differences in favor of Gla-300 versus Gla-100 for all patients over the first year, and in T2DM only over a 3-year follow-up. Conclusion: Use of Gla-300 resulted in a better persistence, less acute hospitalized events at least in T2DM, and reduced healthcare expenditure. These real-life results confirmed the potential interest of using Gla-300 rather than Gla-100. [ABSTRACT FROM AUTHOR]

This paper analyses the potential impacts of a hypothetical implementation of the Income Stabilisation Tool (IST) in France for the field crops sector. The IST is a risk management tool available within the 2014–2020 Common Agricultural Policy (CAP) to support farmers facing a severe drop in their incomes. This analysis was conducted using a farm‐level model relying on expected utility theory and based on positive mathematical programming with risk. The model was applied to a sample of 1375 field crop farms in France derived from Farm Accountancy Data Network (FADN) data. Simulation results show that the uptake rate of the tool is relatively low, less than 37% in all scenarios. It is strongly dependent on CAP public support and on how much premium farmers have to pay. Highest uptake rates are observed in farms specialising in Other Field Crops, such as potatoes, pulses and sugar beet, and farms located in regions highly exposed to climatic risks. Previous experience with insurance favours the acceptance of the IST. Model results also show that the IST improves adopters' income and reduces income inequality. However, its impacts on crop diversity, measured by the Shannon index, are negative. [ABSTRACT FROM AUTHOR]

To reduce total test time and increase the efficiency of statistical analysis of a life-testing experiment adaptive progressive Type-II censoring scheme has been proposed. This paper addresses the statistical inference of the unknown parameters, reliability, and hazard rate functions of logistic exponential distribution under adaptive progressive Type-II censored samples. Maximum likelihood estimates (MLEs) and maximum product spacing estimates (MPSEs) for the model parameters, reliability, and hazard rate functions can not be obtained explicitly, hence these are derived numerically using the Newton–Raphson method. Bayes estimates for the unknown parameters and reliability and hazard rate functions are computed under squared error loss function (SELF) and linear exponential loss function (LLF). It has been observed that the Bayes estimates are not in explicit forms, hence an approximation method such as Markov Chain Monte Carlo (MCMC) method is employed. Further, asymptotic confidence intervals (ACIs) and highest posterior density (HPD) credible intervals for the unknown parameters, reliability, and hazard rate functions are constructed. Besides, point and interval Bayesian predictions have been derived for future samples. A Monte Carlo simulation study has been carried out to compare the performance of the proposed estimates. Furthermore, three different optimality criteria have been considered to obtain the optimal censoring plan. Two real-life data sets, one from electronic industry and other one from COVID-19 data set containing the daily death rate from France are re-analyzed to demonstrate the proposed methodology. [ABSTRACT FROM AUTHOR]

Beyond cardiovascular disease protection, the health consequences of very low concentrations of low-density lipoprotein-cholesterol (LDL-C) remain a matter of debate. In primary hypobetalipoproteinemia (HBL), liver steatosis and cirrhosis have occasionally been reported. Here, we aimed to investigate the association between HBL and the risk of hepatic complications (cirrhosis complications and/or primary liver cancer) in the general population. A cohort study was conducted in the French population-based cohort CONSTANCES. Participants with primary HBL (LDL-C <5th percentile for age and sex, [HBL]) were compared with those with normal LDL-C concentrations (40th-60th percentile, [Control]). Participants on lipid-lowering therapies were excluded. For hepatic complications, follow-up events were compared by calculating the incidence density ratio (IDR). The same analyses were replicated in the UK Biobank (UKBB) cohort. In the CONSTANCES and UKBB cohorts, 34,653 and 94,666 patients were analyzed, with median ages of 45 and 56 years, mean LDL-C concentrations (HBL vs. control) of 71 vs. 128 mg/dl and 86 vs. 142 mg/dl, and mean follow-up durations of 5.0 and 11.5 years, respectively. The HBL group presented a higher incidence of hepatic complications than the control group: 0.32/ vs. 0.07/1,000 person-years (IDR = 4.50, 95% CI 1.91-10.6) in CONSTANCES, and 0.69/ vs. 0.21/1,000 person-years (IDR = 3.27, 95% CI 2.63-4.06) in the UKBB. This risk proved to be independent of classic risk factors for liver disease (obesity, alcohol consumption, diabetes, viral hepatitis), including in a 5-year landmark analysis excluding early events. Sensitivity analyses based on apoliprotein-B levels (instead of LDL-C levels) or genetically defined HBL showed similar results. HBL is associated with a markedly increased risk of hepatic complications. HBL must be considered as a substantial independent risk factor for liver diseases which justifies specific prevention and screening. Hypobetalipoproteinemia (HBL) is a lipid disorder characterized by permanent, inherited low levels (below the 5th percentile) of low-density lipoprotein-cholesterol. While HBL is associated with a lower risk of cardiovascular events, some studies suggest that it may be associated with a potential risk of hepatic steatosis and hepatic complications. Here, we studied the association between HBL and hepatic complications (defined as cirrhosis complications and/or primary liver cancer) in two populations of several hundred thousand people, both in France (CONSTANCES cohort) and the United Kingdom (UKBB). The results show that HBL is associated with a significant and independent excess risk of hepatic complications, including primary liver cancer. Thus, in people with HBL, the value of regular liver monitoring must be studied. [Display omitted] • Hypobetalipoproteinemia is defined by permanent, inherited low LDL-cholesterol levels. • In two large population cohorts, hypobetalipoproteinemia increased the risk of cirrhosis complications and/or liver cancer. • This risk was observed independently of classical risk factors for liver disease (obesity, alcohol, diabetes, viral hepatitis). • Hypobetalipoproteinemia is a risk factor for liver disease complications that requires appropriate monitoring. [ABSTRACT FROM AUTHOR]

Perioperative anaphylaxis is rare but is associated with significant morbidity. This complication has been well described in France by the GERAP (Groupe d'Etude des Réactions Anaphylactiques Périopératoires), a network focused on its study. The epidemiology of perioperative anaphylaxis is evolving, influenced by environmental factors and clinical practice. The aim of this study was to update the epidemiology of perioperative anaphylaxis in France. This multicentre retrospective study was performed in 26 allergy clinics of the GERAP network in 2017–8. There were 765 patients with perioperative anaphylaxis included. Most cases were severe, with 428 (56%) reactions graded as 3 or 4 according to the Ring and Messmer classification. Skin test results were available for 676 patients, with a culprit agent identified in 471 cases (70%). Neuromuscular blocking agents were the main cause of perioperative anaphylaxis (n =281; 60%), followed by antibiotics (n =118; 25%) and patent blue dye (n =11; 2%). Cefazolin was the main antibiotic responsible for perioperative anaphylaxis (52% of antibiotic-related reactions). Suxamethonium and rocuronium were the main neuromuscular blocking agents responsible for perioperative anaphylaxis with 7.1 (6.1–8.4) and 5.6 (4.2–7.4) reactions per 100,000 vials sold, respectively, whereas cefazolin-related cases were estimated at 0.7 (0.5–0.9) reactions per 100,000 vials sold. Our results confirm that most commonly identified triggering agents remain neuromuscular blocking agents. Reactions to antibiotics, particularly cefazolin, are becoming increasingly frequent. The origin of sensitisation to cefazolin is unknown, as no cross-sensitisation has been described, and it should be the subject of further study. Perioperative anaphylaxis should be followed over the years and understood given the changing triggers. ClinicalTrials.gov (NCT 04654923). [ABSTRACT FROM AUTHOR]

The purpose of this article is to provide an overview of the present situation and the development of English in France during the past 25 years. After reviewing the expansion of English in pre‐university and higher education, and its spread in the press (Anglicisms), workplace and daily life, we come to the conclusion that English has made steady progress, in particular in the area of language education, but that its use for communicative purposes remains limited to international contexts. In most other fields, English is used for its connotative value, to evoke modernity, technological advances, coolness, educational pretense and sophistication. [ABSTRACT FROM AUTHOR]

Background: Limitation of mouth opening, widely known as trismus, is a major symptom altering quality of life in individuals presenting from temporomandibular joint disorder or head and neck cancer. A French‐language instrument addressing jaw opening limitation following treatment for head and neck cancer (HNC) or temporomandibular joint disorder (TMD) is lacking. Objective: The aim of this study was to translate and validate the Gothenburg Trismus Questionnaire‐2 (GTQ‐2) into French. Methods: A French translation of the GTQ‐2 was performed according to established international guidelines, leading to the French‐GTQ‐2 (F‐GTQ‐2). The validation study included 154 participants with trismus (minimum interincisal opening of ≤35 mm) following treatment for TMD or HNC and 149 age‐matched participants without trismus. All participants completed the F‐GTQ‐2 and participants with trismus completed additional health‐related quality of life questionnaires to allow for analysis of convergent validity. Results: The F‐GTQ‐2 demonstrated retained psychometric properties with Cronbach's alpha values above 0.70 for the domains, jaw‐related problems, eating limitations, facial pain and somewhat lower for muscular tension (0.60). Mainly moderate correlations were found when comparing the F‐GTQ‐2 to other instruments, which was in line with the pre‐specified hypotheses, indicating satisfactory convergent validity. Discriminant validity was found with statistically significant differences in all domains of the F‐GTQ‐2 between trismus and non‐trismus participants. Conclusion: The F‐GTQ‐2 can be considered a reliable and valid instrument to assess jaw‐related difficulties in individuals with trismus due to HNC or TMD. [ABSTRACT FROM AUTHOR]

This paper examines The diary from the border: Ventimiglia, an auto‐ethnographic comic based on intensive fieldwork in the Italian border city of Ventimiglia from September to December 2018. The primary objective of my empirical research was to explore the socio‐spatial effects of France's reintroduction of border controls in the area since 2015, mainly targeting irregular mobilities within the European Union (EU). This study presents the auto‐ethnographic comic by delving into two crucial aspects. Firstly, it illuminates the rationale behind utilising an auto‐ethnographic comic as a research output, shedding light on the creative process involved in its conception. Secondly, it explores its composite narrative plot, encompassing three key elements: 'me' (the researcher's personal experiences extending beyond the fieldwork), 'me in Ventimiglia' (the researcher's encounters during the fieldwork), and 'Ventimiglia itself' (the French‐Italian border regime). By fostering a trans‐disciplinary dialogue encompassing migration issues, comics and life course theory, this paper enriches the geographical debate in three significant ways. It recognises the profound impact of the researcher's life events in shaping both research experiences and outcomes within and beyond the fieldwork. Additionally, it underscores the importance of auto‐ethnographic comics in challenging dominant narratives and visually portraying the multifaceted experiences of migration. Lastly, it contributes to the ongoing discussion on visual methods within geography and advocates for using comics as a compelling tool to disseminate research findings, fostering empathy and a comprehensive understanding of migration experiences. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to suggest a new method to calculate the intraocular lens (IOL) power in paediatric cataracts targeting emmetropia at the age of 15 years. Methods: Data of children younger than 15 years who underwent cataract surgery with IOL implantation between 2005 and 2020 in the ophthalmological department of Marseille (South of France) was collected retrospectively. A logarithmic regression model was used to predict the axial length growth of the included eyes between implantation and 15 years. The predicted myopic shift served as target refraction to calculate a theoretical IOL power aiming for emmetropia at 15 years. Refractive error with the theoretical lens power was estimated as the spherical equivalent at the last follow‐up minus the difference of target refractions between the implanted IOL and the theoretical one. Refractive errors using Dahan, Enyedi and Trivedi guidelines were also estimated and compared to the logarithmic model. Results: Thirty‐five eyes of 26 children were analysed. At the last follow‐up, the median age of children was 10 years old and the median spherical equivalent was −1.88 dioptres (D) (IQR −3.81, −0.75). The estimated median refractive errors were 0.18 D (IQR −1.11, 1.42) with the logarithmic formula, −1.47 D (IQR −3.84, −0.65) with Dahan formula, −0.63 D (IQR −2.15, 0.32) with Enyedi formula and 0.38 D (IQR −1.58, 1.07) with Trivedi formula. Conclusion: The estimated refractive error with the new logarithmic formula is the closest to emmetropia at the last follow‐up. [ABSTRACT FROM AUTHOR]

Objective: To describe the management of diabetic macular oedema (DME) patients from the entire French population between 2012 and 2018. Methods: In this retrospective longitudinal study, we identified adults treated for DME from the French population using the exhaustive French National Health Information database (SNDS), and an algorithm based on diagnosis and procedure codes, and reimbursed treatments. Results: Between 2012 and 2018, we identified 53 584 treated DME patients, who were followed for up to 7 years from DME treatment initiation. Optical coherence tomography (OCT) became the predominant imaging tool to diagnose DME. Only 14% of patients consulted a diabetologist or endocrinologist in the 3 months prior to initiating DME treatment, whereas 84% consulted a general practitioner. The percentage of patients consulting an ophthalmologist declined over time, from 97% of patients in Year 1 (median of 9 consultations), to 46% in Year 7 (median of 7 consultations). The median DME treatment duration with an anti‐VEGF and/or dexamethasone implant treatment was 9 months; 54% of patients had a treatment duration less than 1 year. First‐line treatment was more common with ranibizumab (55% of patients) than with aflibercept (30%), or dexamethasone implant (15%). About 25% of patients who initiated anti‐VEGF treatment switched treatment at least once, while 30% of patients who initiated dexamethasone implant switched to anti‐VEGF treatment at least once. Conclusions: French DME patients seem well‐monitored by their ophthalmologist, but median DME treatment duration was just 9 months. These results emphasise the challenge to manage and treat patients with DME over the long term. [ABSTRACT FROM AUTHOR]

Intimate partner sexual violence (IPSV) is a common form of intimate partner violence (IPV). This study aimed to (a) identify a typology of intimate partner sexual victimization among French women victims of IPV on the basis of the frequency of various forms of sexual violence and (b) evaluate whether these profiles differ in several clinical characteristics. A total of 93 women consulting a specialized hospital service were recruited. Cluster analyses suggested four profiles: highly frequent rapes (5.4%), predominant sexual coercion (20.4%), medium frequency of all forms (20.4%), and low frequency of all forms (19.4%). Further person-centered research focusing on IPSV is warranted. [ABSTRACT FROM AUTHOR]

Background: Schistosomiasis affects approximately 230 million people worldwide. There is an increased incidence of schistosomiasis cases in France acquired from outside the country. This increases the risk of schistosomiasis outbreaks as observed in Corsica. Clinicians from non-endemic regions are not accustomed to diagnosing and managing this pathology. The objective of this study is to provide a better description of the clinical and paraclinical characteristics and disease evolution of affected children. Methods: Through the French Pediatric Nephrology Society and the Pediatric Infectious Pathology Group, we contacted all French pediatric centers that may have treated children with urinary schistosomiasis between 2013 and 2019. Age, sex, comorbidities, and clinical, biological, and radiological data (at discovery and follow-up) were collected retrospectively. Results: A total of 122 patients from 10 different centers were included. The median age was 14 years and the sex ratio M/F was 4:1. Hematuria was present in 82% of the patients while urinary tract abnormality was found in 36% of them. Fourteen patients (11%) displayed complicated forms of urinary schistosomiasis including 10 patients with chronic kidney disease. A total of 110 patients received treatment with praziquantel, which was well-tolerated and led to clinical resolution of symptoms in 98% of cases. Conclusion: Patients with schistosomiasis present frequent kidney, urinary, or genital involvement. Systematic screening of patients returning from endemic areas is therefore recommended, especially since treatment with antiparasitic drugs is effective and well-tolerated. Enhancing medical knowledge of this pathology among all practitioners is essential to improve care and outcomes. [ABSTRACT FROM AUTHOR]

Given the consequences for the climate and human well-being, there is unquestionable universal fear about the ecological impact of socioeconomic activity. Therefore, this research aims to investigate the effects of carbon tax and resource efficiency on environmental sustainability while controlling economic growth and total energy supply in France between 1995 and 2020. As a result, the empirical findings would shed light on ecological sustainability in France and spark new debate. This study employs a novel Fourier autoregressive distributed lag cointegration method for cointegration and a nonlinear autoregressive distributed lag approach for long-run estimation. The empirical outcomes show that resource efficiency is negatively connected to environmental pollution. Moreover, the impact of a carbon tax on environmental pollution is negative. Lastly, energy use and economic growth positively influence environmental pollution. The study concludes that carbon taxes can help to achieve sustainable development goals and resource efficiency. [ABSTRACT FROM AUTHOR]

This article explores the social processes of solidarities under pressure and their articulation with food in migratory contexts, in both urban and rural settings around Bordeaux (Gironde, South-West France). It is based on the actual experiences of vulnerable individuals in migration situations (the Outsiders) and “the Established” (cf. Elias and Scotson), who engage in various actions for, and sometimes with, the former. Our methodology included observing participants in several dwelling places and food-aid initiatives, as well as conversations with adults, unaccompanied minors, and families. Adopting an “embedded” anthropology approach (Dubey; Lewis and Russell), we followed long-term residents and new arrivals in their interactions. We conducted a multi-level analysis of the different approaches and positions adopted by the protagonists providing and receiving assistance, sometimes both at once, exerting their agency in order to create spaces of freedom within structural constraints, thus expressing their participation in society. One of the aims was to contribute to a situational anthropology approach that ultimately challenged the position of foreigners in our societies. [ABSTRACT FROM AUTHOR]

Background: Tick-borne encephalitis (TBE) is a severe human neuroinfection caused by TBE virus (TBEV). TBEV is transmitted by tick bites and by the consumption of unpasteurized dairy products from infected asymptomatic ruminants. In France, several food-borne transmission events have been reported since 2020, raising the question of the level of exposure of domestic ungulates to TBEV. In this study, our objectives were (i) to estimate TBEV seroprevalence and quantify antibodies titres in cattle in the historical endemic area of TBEV in France using the micro virus neutralisation test (MNT) and (ii) to compare the performance of two veterinary cELISA kits with MNT for detecting anti-TBEV antibodies in cattle in various epidemiological contexts. A total of 344 cattle sera from four grid cells of 100 km² in Alsace-Lorraine (endemic region) and 84 from western France, assumed to be TBEV-free, were investigated. Results: In Alsace-Lorraine, cattle were exposed to the virus with an overall estimated seroprevalence of 57.6% (95% CI: 52.1–62.8%, n = 344), varying locally from 29.9% (95% CI: 21.0–40.0%) to 92.1% (95% CI: 84.5–96.8%). Seroprevalence did not increase with age, with one- to three-year-old cattle being as highly exposed as older ones, suggesting a short-life duration of antibodies. The proportion of sera with MNT titres lower than 1:40 per grid cell decreased with increased seroprevalence. Both cELISA kits showed high specificity (> 90%) and low sensitivity (less than 78.1%) compared with MNT. Sensitivity was lower for sera with neutralising antibodies titres below 1:40, suggesting that sensitivity of these tests varied with local virus circulation intensity. Conclusions: Our results highlight that cattle were highly exposed to TBEV. Screening strategy and serological tests should be carefully chosen according to the purpose of the serological study and with regard to the limitations of each method. [ABSTRACT FROM AUTHOR]

Purpose: The recent epidemiology of Pneumocystis pneumonia (PCP) requiring intensive care unit (ICU) admission and the associated spectrum of immunocompromising conditions are poorly described. Methods: We analyzed all adult PCP cases admitted to French ICUs via the French medical database system (PMSI), over the period from 2013 to 2019. Results: French ICUs admitted a total of 4055 adult patients with PCP. Among all hospitalized PCP cases, the proportion requiring ICU admission increased from 17.8 in 2014 to 21.3% in 2019 (P < 0.001). The incidence of severe PCP rose from 0.85 in 2013 to 1.32/100,000 adult inhabitants in 2019 (P < 0.0001), primarily due to the proportion of HIV-negative patients that increased from 60.6% to 74.4% (P < 0.0001). Meanwhile, the annual number of severe PCP cases among patients with HIV infection remained stable over the years. In-hospital mortality of severe PCP cases was 28.5% in patients with HIV infection and 49.7% in patients without. Multivariable logistic analysis showed that patients with HIV infection had a lower adjusted risk of death than patients without HIV infection (Odds Ratio [OR]: 0.30, 95% confidence interval [95CI]: 0.17–0.55). Comorbidities or conditions strongly associated with hospital mortality included the patient's age, Simplified Acute Physiologic Score II, congestive heart failure, coagulopathy, solid organ cancer, and cirrhosis. A vast array of autoimmune inflammatory diseases affected 19.9% of HIV-negative patients. Conclusions: The number of PCP cases requiring ICU admission in France has risen sharply. While the yearly count of severe PCP cases in HIV-infected patients has remained steady, this rise predominantly affects cancer patients, with a recent surge observed in patients with autoimmune inflammatory diseases, affecting one in five individuals. [ABSTRACT FROM AUTHOR]

• The 7C psychological antecedents are known to relate to vaccine intention. • Here, 7C antecedents were also related to COVID-19 vaccine status and uptake speed. • 7C antecedents explained a large portion of variance in vaccine status. • Calculation, collective responsibility, and capacity for reactance stood out. • Vaccine promotion should take into account 7C psychological antecedents. Widely documented psychological antecedents of vaccination are confidence in vaccines, complacency, convenience, calculation, collective responsibility (5C model) with the recent addition of confidence in the wider system and social conformism. While the capacity of these seven antecedents (7C) to explain variance in COVID-19 vaccine intentions has been previously documented, we study whether these factors also are associated with vaccine behaviours , beyond intentions. From February to June 2022, we recruited a sample of adults in France, including persons with notified recent SARS-CoV-2 infection, along with relatives and randomly selected non-infected persons. Participants completed self-administered questionnaires assessing COVID-19 vaccination history and the 7C antecedents. We defined vaccination behaviours as three outcomes: at-least-one-dose vaccine status by 2022 (N = 49,019), up-to-date vaccination status (N = 46,566), and uptake speed of first dose (N = 25,998). We conducted multivariable logistic regressions and Cox models. Among the 49,019 participants, 95.0% reported receipt of at least one dose and 89.8% were up to date with recommendations. All 7C antecedents were significantly associated with the outcomes, although effects were weaker for up-to-date vaccination status and uptake speed. The strongest effects (most vs. least vaccine-favourable attitude level, at-least-one-dose vaccination status) were observed for collective responsibility (OR: 14.44; 95%CI: 10.72–19.45), calculation (OR: 10.29; 95%CI: 7.53–14.05), and confidence in the wider system (OR: 8.94; 95%CI: 6.51–12.27). This study demonstrates that the 7C not only explain vaccine intention, but also vaccine behaviours, and underpins the importance of developing vaccine promotion strategies considering the 7C antecedents. [ABSTRACT FROM AUTHOR]

Background. Poor glycemic control in patients with type 1 diabetes (T1D) is associated with greater social deprivation. However, the evidence is inconsistent in terms of the type of social deprivation (individual-level or area-level) and whether glycemic control changes over time. Here, we investigated the impacts of individual-level and area-level social deprivation on the glycated hemoglobin (HbA1c) trajectory from the time of T1D diagnosis. Materials and Methods. We retrospectively analyzed a cohort of children who were diagnosed with T1D between 2017 and 2020 at Bordeaux University Hospital. Social deprivation was assessed using both parental individual indicator (EPICES score) and ecological indicator (European Deprivation Index (EDI) score). Piecewise linear mixed-effects models were used to estimate the effects of social deprivation on HbA1c trajectory. Results. We included 168 patients. The most-deprived group included 29% and 22% of all patients, as revealed by the respective EPICES and EDI scores. The two indicators were poorly correlated. The short-term decrease in HbA1c level tended to be smaller in the most-deprived patients over the first 4 months after diagnosis than in other patients (slope difference of 2.68% per year compared with the slope among the least-deprived patients, P = 0.056). The long-term trajectory was influenced by area-level deprivation (EDI score); the least-deprived patients (quintile 1) exhibited more stable mean HbA1c levels. Conclusions. Social deprivation may partially explain poor glycemic control in some patients; both short-term individual deprivation and long-term area-level deprivation may be involved. Further research is needed to determine how to integrate this information into a therapeutic strategy. [ABSTRACT FROM AUTHOR]

Background: Diabetes self-management (DSM) helps people with diabetes to become actors in their disease. Deprived populations are particularly affected by diabetes and are less likely to have access to these programmes. DSM implementation in primary care, particularly in a multi-professional primary care practice (MPCP), is a valuable strategy to promote care access for these populations. In Rennes (Western France), a DSM programme was designed by a MPCP in a socio-economically deprived area. The study objective was to compare diabetes control in people who followed or not this DSM programme. Method: The historical cohort of patients who participated in the DSM programme at the MPCP between 2017 and 2019 (n = 69) was compared with patients who did not participate in the programme, matched on sex, age, diabetes type and place of the general practitioner's practice (n = 138). The primary outcome was glycated haemoglobin (HbA1c) change between 12 months before and 12 months after the DSM programme. Secondary outcomes included modifications in diabetes treatment, body mass index, blood pressure, dyslipidaemia, presence of microalbuminuria, and diabetes retinopathy screening participation. Results: HbA1c was significantly improved in the exposed group after the programme (p < 0.01). The analysis did not find any significant between-group difference in socio-demographic data, medical history, comorbidities, and treatment adaptation. Conclusions: These results, consistent with the international literature, promote the development of DSM programmes in primary care settings in deprived areas. The results of this real-life study need to be confirmed on the long-term and in different contexts (rural area, healthcare organisation). [ABSTRACT FROM AUTHOR]

Projects such as the European Covid-19 Forecast Hub publish forecasts on the national level for new deaths, new cases, and hospital admissions, but not direct measurements of hospital strain like critical care bed occupancy at the sub-national level, which is of particular interest to health professionals for planning purposes. We present a sub-national French framework for forecasting hospital strain based on a non-Markovian compartmental model, its associated online visualisation tool and a retrospective evaluation of the real-time forecasts it provided from January to December 2021 by comparing to three baselines derived from standard statistical forecasting methods (a naive model, auto-regression, and an ensemble of exponential smoothing and ARIMA). In terms of median absolute error for forecasting critical care unit occupancy at the two-week horizon, our model only outperformed the naive baseline for 4 out of 14 geographical units and underperformed compared to the ensemble baseline for 5 of them at the 90% confidence level (n = 38). However, for the same level at the 4 week horizon, our model was never statistically outperformed for any unit despite outperforming the baselines 10 times spanning 7 out of 14 geographical units. This implies modest forecasting utility for longer horizons which may justify the application of non-Markovian compartmental models in the context of hospital-strain surveillance for future pandemics. Author summary: The US and European Covid-19 Forecast Hubs focus on metrics such as deaths, new cases, and hospital admissions, but do not offer measurements of hospital strain like critical care bed occupancy, which was essential for the provisioning of healthcare resources during the COVID-19 pandemic. Furthermore, forecasting support was only guaranteed on the national level leaving many countries to look elsewhere for valuable sub-national forecasts. In France statistical modelling approaches were proposed to anticipate hospital stain at the sub-national level but these were limited by a two-week forecast horizon. We present a sub-national French modelling framework and online application for anticipating hospital strain at the four-week horizon that can account for abrupt changes in key epidemiological parameters. It was the only publicly available real-time non-Markovian mechanistic model for the French epidemic when implemented in January 2021 and, to our knowledge, it still was at the time it stopped in early 2022. Further adaptations of this surveillance system can serve as an anticipation tool for hospital strain across sub-national localities to aid in the prevention of short-noticed ward closures and patient transfers. [ABSTRACT FROM AUTHOR]

Simple Summary: Assessments of invasive species are of particular relevance in the Iberian Peninsula, where the endemic fish fauna is highly important for conservation. Parasites of invasive fish can vary substantially because of the seasonal variability in freshwater habitats. The study species was the invasive Languedoc minnow, native to France. Fish organs and parasites were assessed across seasons in a Mediterranean stream, which has a wide range of habitat variability throughout the year. Autumn was the most 'benign' season in the study area, with minnows displaying a better health status and a lower parasite burden. This information is relevant to understanding the effects of seasonal variation on parasites of invasive fish. Also, these data could assist environmental managers in controlling the spread of this non-native fish in Mediterranean streams. Biological invasions are of special conservation concern in the Iberian Peninsula and other regions with high levels of endemism. Environmental variability, such as the seasonal fluctuations of Mediterranean streams, is a key factor that affects the spread of aquatic species in novel habitats. Fish parasites have a great potential to reflect such changes in the habitat features of freshwater ecosystems. The aim of this study consisted of seasonally analysing the health status and parasitological traits of non-native fish in Iberian waters. In particular, a strongly invasive population of Languedoc minnow Phoxinus septimaniae (leuciscid species native to south-east France) was assessed in Tordera Stream (north-eastern Iberian Peninsula, Mediterranean conditions). Fish were sampled in April, July, and October 2023 by electrofishing. Health status (external/internal organs) was significantly better in autumn (HAI = 28.8) than spring (HAI = 35.6). Life-cycle complexity was higher in spring (LCI = 1.98), whereas parasite abundance and Shannon diversity were significantly lower in autumn (TA = 19.6 and H' = 2.15, respectively). In October (more 'benign' environmental conditions in Iberian streams), minnows could display elevated foraging activity, with fish increasing their health condition and level of parasite resistance/tolerance. Overall results showed a particular seasonal profile of health and parasite infra-communities that allow this minnow species to thrive under highly fluctuating habitat conditions. This information could help environmental managers to control non-native fish in Mediterranean streams. [ABSTRACT FROM AUTHOR]

The emerging heteropathotype shigatoxigenic (STEC) and extra-intestinal pathogenic Escherichia coli (ExPEC) O80:H2 has been the second leading cause of pediatric HUS in France since the mid-2010s. In contrast with other highly pathogenic STEC serotypes, for which ruminants have clearly been identified as the main human infection source, this heteropathotype's reservoir remains unknown. In this context, we describe for the first time the isolation of seven STEC O80:H2 strains from healthy cattle on a single cattle farm in France. This study aimed at (i) characterizing the genome and (ii) investigating the phylogenetic positions of these O80:H2 STEC strains. The virulomes, resistomes, and phylogenetic positions of the seven bovine isolates were investigated using in silico typing tools, antimicrobial susceptibility testing and cgMLST analysis after short-read whole genome sequencing (WGS). One representative isolate (A13P112V1) was also subjected to long-read sequencing. The seven isolates possessed ExPEC-related virulence genes on a pR444_A-like mosaic plasmid, previously described in strain RDEx444 and known to confer multi-drug resistance. All isolates were clonally related and clustered with human clinical strains from France and Switzerland with a range of locus differences of only one to five. In conclusion, our findings suggest that healthy cattle in France could potentially act as a reservoir of the STEC-ExPEC O80:H2 pathotype. [ABSTRACT FROM AUTHOR]

Background: Severe overcrowding of emergency departments (EDs) affects the quality of healthcare. One factor of overcrowding is precariousness, but it has rarely been considered a key factor in designing interventions to improve ED care. Health mediation (HM) aims to facilitate access to rights, prevention, and care for the most vulnerable persons and to raise awareness among healthcare providers about obstacles in accessing healthcare. The primary aim was to determine whether HM intervention for frequent users of EDs (FUED) living in precarious conditions could reduce the readmission rate at 90 days. Methods: Between February 2019 and May 2022, we enrolled and interviewed 726 FUED in four EDs of southeastern France in this randomised controlled trial. The HM intervention started in the ED and lasted 90 days. In addition to the primary endpoint (first readmission at 90 days), secondary endpoints (readmission at 30 and 180 days, number of hospitalisations at 30, 90, 180 days, admissions for the same reasons as the first admission) were also studied. The outcomes were measured in the ED information systems. Statistical methods included an intention-to-treat analysis and a per-protocol analysis. Comparisons were adjusted for gender, age, ED, and health mediator. Results: 46% of patients reported attending the ED because they felt their life was in danger, and 42% had been referred to the ED by the emergency medical dispatch centre or their GP; 40% of patients were considered to be in a serious condition by ED physicians. The proportion of patients who were readmitted at 90 days was high but did not differ between the control and the HM intervention groups (31.7% vs. 36.3%, p = 0.23). There was no significant difference in any of the secondary outcome measures between the control and HM intervention groups. Per-protocol analysis also showed no significant difference for the primary and secondary endpoints. Conclusions: This randomised controlled trial did not show that our health mediation intervention was effective in reducing the use of emergency services by FUED living in precarious conditions. Some limitations are discussed: the duration of the intervention (90 days), the long-term effects (> 6 months), the involvement of the ED staff. Trial registration: Registered on clinicaltrials.gov as NCT03660215 on 4th September 2018. [ABSTRACT FROM AUTHOR]

Background and Objectives: Meningioma is one of the most common neoplasm of the central nervous system. To describe the epidemiology of meningioma operated in France and, to assess grading and histopathological variability among the different neurosurgical centres. Methods: We processed the French Brain Tumour Database (FBTDB) to conduct a nationwide population-based study of all histopathologically confirmed meningiomas between 2006 and 2015. Results: 30,223 meningiomas cases were operated on 28,424 patients, in 61 centres. The average number of meningioma operated per year in France was 3,022 (SD ± 122). Meningioma was 3 times more common in women (74.1% vs. 25.9%). The incidence of meningioma increased with age and, mean age at surgery was 58.5 ± 13.9 years. Grade 1, 2, and 3 meningiomas accounted for 83.9%, 13.91% and, 2.19% respectively. There was a significant variability of meningioma grading by institutions, especially for grade 2 which spanned from 5.1% up to 22.4% (p < 0.001). Moreover, the proportion of grade 2 significantly grew over the study period (p < 0.001). There was also a significant variation in grade 1 subtypes diagnosis among the institutions (p < 0.001). 89.05% of the patients had solely one meningioma surgery, 8.52% two and, 2.43% three or more. The number of surgeries was associated to the grade of malignancy (p < 0.001). Conclusion: The incidence of meningioma surgery increased with age and, peaked at 58.5 years. They were predominantly benign with meningothelial subtype being the most common. However, there was a significant variation of grade 1 subtypes diagnosis among the centres involved. The proportion of grade 2 meningioma significantly grew over the study time, on contrary to malignant meningioma proportion, which remained rare and, stable over time around 2%. Likewise, there was a significant variability of grade 2 meningioma rate among the institutions. [ABSTRACT FROM AUTHOR]

AbstractInternational students’ contact and engagement with various cultures has received increased scholarly attention. This scholarship tends to either celebrate students’ cosmopolitanism or highlight their difficulties ‘adapting’ in their receiving countries. In this paper, we examine students’ own perceptions of and engagement with their sending and receiving countries’ cultures through the dialectic of distance and proximity, gleaned from mobilities studies. Based on 20 in-depth online interviews with Vietnamese nationals studying in Vancouver and Paris, our analysis highlights how these students construct or deconstruct notions of distance and proximity between Vietnam and their receiving countries (i.e. France and Canada), as well as between themselves and each of these countries. First, we examine how, before their departure, students cultivate a sense of cultural proximity to their geographically distant countries of destination, through studying and consuming media in French or English. Second, we address students’ rapport with French and Canadian societies as well as their sense of proximity to or distance from Vietnamese culture while studying in France and Canada. We examine how these (de-)constructions of distance can be related to students’ cosmopolitanism. We argue that notions of distance and proximity help foster a nuanced understanding of international students’ mobilities and cosmopolitanism. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the cost-effectiveness of avelumab first-line (1L) maintenance therapy plus best supportive care (BSC) versus BSC alone for adults with locally advanced or metastatic urothelial carcinoma (la/mUC) that had not progressed following platinum-based chemotherapy in France. Methods: A three-state partitioned survival model was developed to assess the lifetime costs and effects of avelumab plus BSC versus BSC alone. Data from the phase 3 JAVELIN Bladder 100 trial (NCT02603432) were used to inform estimates of clinical and utility values considering a 10-year time horizon and a weekly cycle length. Cost data were estimated from a collective perspective and included treatment acquisition, administration, follow-up, adverse event–related hospitalization, transport, post-progression, and end-of-life costs. Health outcomes were measured in quality-adjusted life-years (QALYs) and life-years gained. Costs and clinical outcomes were discounted at 2.5% per annum. Incremental cost-effectiveness ratios (ICERs) were used to compare cost-effectiveness and willingness to pay in France. Uncertainty was assessed using a range of sensitivity analyses. Results: Avelumab plus BSC was associated with a gain of 2.49 QALYs and total discounted costs of €136,917; BSC alone was associated with 1.82 QALYs and €39,751. Although avelumab plus BSC was associated with increased acquisition costs compared with BSC alone, offsets of −€20,424 and −€351 were observed for post-progression and end-of-life costs, respectively. The base case analysis ICER was €145,626/QALY. Sensitivity analyses were consistent with the reference case and showed that efficacy parameters (overall survival, time to treatment discontinuation), post-progression time on immunotherapy, and post-progression costs had the largest impact on the ICER. Conclusions: This analysis demonstrated that avelumab plus BSC is associated with a favorable cost-effectiveness profile for patients with la/mUC who are eligible for 1L maintenance therapy in France. [ABSTRACT FROM AUTHOR]

Background: Next-generation sequencing liquid biopsy (NGS-LB) for colorectal cancer (CRC) detection and surveillance remains an expensive technology as economies of scale have not yet been realized. Nevertheless, the cost of sequencing has decreased while sensitivity has increased, raising the question of whether cost-effectiveness (CE) has already been achieved from the perspective of European healthcare systems. Objectives: This health economic (HE) modeling study explores the CE of NGS-LB for CRC based on direct treatment costs compared to standard care without liquid biopsy in Spain, France, and Germany. Methods: A structured literature search was used to collect evidence from 2009 to 2020 on the stage-dependent quality of life (quality-adjusted life-years, QALY), efficacy, and total direct treatment costs (TDC) of NGS-LB. A decision-analytic Markov model was developed. Over the remaining lifetime, cumulative life expectancy (LE), TDC, and QALYs were calculated for 60-year-old men and women in CRC stage III with different assumed effects of NGS-LB of 1% or 3% on improved survival and reduced stage progression, respectively. Results: The use of NGS-LB increases LE by 0.19 years in Spanish men (France: 0.19 years, Germany: 0.13 years) and by 0.21 years in Spanish women (France: 0.21 years, Germany: 0.14 years), respectively. The 3% discounted cost per QALY gained was 35,571.95 € for Spanish men (France: 31,705.15 €, Germany: 37,537.68 €) and 35,435.71 € for Spanish women (France: 31,295.57 €, Germany: 38,137.08 €) in the scenario with 3% improved survival and reduced disease progression. Compared to the other two countries, Germany has by far the highest TDC, which can amount to >80k euros in the last treatment year. Conclusion: In this explorative HE modeling study, NGS-LB achieves generally accepted CE levels in CRC treatment from the health system perspective in three major European economies under assumptions of small improvements in cancer recurrence and survival. Confirmation of these findings through clinical trials is encouraged. Plain language summary: Is it worthwhile to use next generation liquid biopsy for cancer recurrence detection on patients with colorectal cancer? Colon cancer is common. Worldwide, almost one million people die from it every year. Next Generation Sequencing Liquid Biopsy is a very sensitive technology for detecting cancer cells and their genetic information in the blood. Therefore, it is a good way to detect cancer and to detect early recurrence of a previously treated tumor. This test procedure is not yet used very often. Therefore, it is still expensive. Furthermore, there are still no studies that have demonstrated that and how liquid biopsy can aid doctors and patients after initial treatment. The research team of this study has developed an analytical model to investigate what performance liquid biopsy should have to demonstrate an affordable patient benefit in terms of quality of life, survival and cost per additional quality-adjusted life year gained. To do this, they studied the existing medical literature and many cost studies on colorectal cancer for the countries of Spain, France and Germany to feed their model. Then, they made different assumptions about the performance of liquid biopsy and did calculations. In the process, they also particularly examined the significance of specific influencing factors such as costs or disease progression in so-called sensitivity analyses. As a result, the authors found that there are large differences in treatment costs for colorectal cancer between the three countries Spain, France and Germany. Furthermore, even small improvements in the progression of cancer and the survival of cancer patients lead to the economic efficiency of liquid biopsy for the health care system. However, these are still thought experiments, so the research team of this study says that there should be further clinical trials to assess the impact of liquid biopsy on cancer progression and patient survival by using this technology. By this, one could confirm or contradict the authors' educated assumptions and possibly pave a new way towards medical progress for people with colorectal cancer. [ABSTRACT FROM AUTHOR]