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Simple Summary: The quality of resection after unplanned excision of soft tissue sarcoma (STS) performed outside of a reference center or at second resection potentially impacts local and metastatic recurrence and survival. The French cohort NETSARC prospectively collected data from patients with unplanned excision outside reference centers from 2010 to 2019 and reported survival in patients reexcised (RE) or not (No-RE). Patients who would most benefit from RE need to be identified. A total of 2371 patients had unplanned excision for STS outside reference centers, including 1692 patients with no multidisciplinary board review (RE: 913; No-RE: 779). Discrepancies in RE/No-RE subgroups were observed regarding age, tumor site, size, depth, grade and histotype. R0 final resection associated with better MFS; R1 initial resection showed better MFS than R0 initial resection. The study identified RE as an independent favorable factor for MFS (HR 0.7, 95% CI 0.53–0.93; p = 0.013). All subgroups except patients > 70 years, and patients with large tumors (>10 cm) showed better MFS with RE. RE in patients with STS of limb or trunk after macroscopic complete resection out of NETSARC reference center, and also in R0 resections to improve LRFS and MFS. Systematic RE should not be advocated for patients ≥ 70 years, or tumor size ≥ 10 cm. Background: Whether re-excision (RE) of a soft tissue sarcoma (STS) of limb or trunk should be systematized as adjuvant care and if it would improve metastatic free survival (MFS) are still debated. The impact of resection margins after unplanned macroscopically complete excision (UE) performed out of a NETSARC reference center or after second resection was further investigated. Methods: This large nationwide series used data from patients having experienced UE outside of a reference center from 2010 to 2019, collected in a French nationwide exhaustive prospective cohort NETSARC. Patient characteristics and survival distributions in patients reexcised (RE) or not (No-RE) are reported. Multivariate Cox proportional hazard model was conducted to adjust for classical prognosis factors. Subgroup analysis were performed to identify which patients may benefit from RE. Results: Out of 2371 patients with UE for STS performed outside NETSARC reference centers, 1692 patients were not reviewed by multidisciplinary board before treatment decision and had a second operation documented. Among them, 913 patients experienced re-excision, and 779 were not re-excised. Characteristics were significantly different regarding patient age, tumor site, size, depth, grade and histotype in patients re-excised (RE) or not (No-RE). In univariate analysis, final R0 margins are associated with a better MFS, patients with R1 margins documented at first surgery had a better MFS as compared to patients with first R0 resection. The study identified RE as an independent favorable factor for MFS (HR 0.7, 95% CI 0.53–0.93; p = 0.013). All subgroups except older patients (>70 years) and patients with large tumors (>10 cm) had superior MFS with RE. Conclusions: RE might be considered in patients with STS of limb or trunk, with UE with macroscopic complete resection performed out of a reference center, and also in originally defined R0 margin resections, to improve LRFS and MFS. Systematic RE should not be advocated for patients older than 70 years, or with tumors greater than 10 cm. [ABSTRACT FROM AUTHOR]

Background: Following the results of randomized controlled trials on levosimendan, French health authorities requested an update of the current use and side-effects of this medication on a national scale. Method: The France-LEVO registry was a prospective observational cohort study reflecting the indications, dosing regimens, and side-effects of levosimendan, as well as patient outcomes over a year. Results: The patients included (n = 602) represented 29.6% of the national yearly use of levosimendan in France. They were treated for cardiogenic shock (n = 250, 41.5%), decompensated heart failure (n = 127, 21.1%), cardiac surgery-related low cardiac output prophylaxis and/or treatment (n = 86, 14.3%), and weaning from veno-arterial extracorporeal membrane oxygenation (n = 82, 13.6%). They received 0.18 ± 0.07 µg/kg/min levosimendan over 26 ± 8 h. An initial bolus was administered in 45 patients (7.5%), 103 (17.1%) received repeated infusions, and 461 (76.6%) received inotropes and or vasoactive agents concomitantly. Hypotension was reported in 218 patients (36.2%), atrial fibrillation in 85 (14.1%), and serious adverse events in 17 (2.8%). 136 patients (22.6%) died in hospital, and 26 (4.3%) during the 90-day follow-up. Conclusions: We observed that levosimendan was used in accordance with recent recommendations by French physicians. Hypotension and atrial fibrillation remained the most frequent side-effects, while serious adverse event potentially attributable to levosimendan were infrequent. The results suggest that this medication was safe and potentially associated with some benefit in the population studied. [ABSTRACT FROM AUTHOR]

This article concentrates on the policy reforms of schools in England, Germany, France and Italy, from 1988 to 2009, with a focus on the introduction of market accountability. Pressing demands for organisational change in schools, shaped by the objectives of "efficiency" and competition, which were introduced in England in the 1980s, have been adopted in other European countries, albeit at a slower pace and within the continuing need for domestic institutional conformity. How does the increasing predominance of market accountability in state schools change traditional bureaucratic and professional accountability relationships between politicians, managers, professionals and users? The article argues that despite some evidence of convergence between different education systems, England remains the outlier and continental European countries have been much more reluctant to adopt choice and competition policies. (Contains 4 tables and 7 notes.)

The objectives of this study are to characterize the input signal of a shallow carbonate aquifer in northeastern France and to clarify the recharge and groundwater mineralization processes, by analysing the chemical and isotopic (δ18O, δ2H) composition of rain and groundwater. The groundwater isotopic signature was very close to the calculated local meteoric water line and showed a narrow range, which is explained by the buffer effect of the matrix-dominated chalk aquifer. Nevertheless, intensive fracture networks can exist at local scale and lead to rapid aquifer response to rainfall, as attested by observed large variations in groundwater isotopic and chemical signatures at one specific site. Main factors controlling the groundwater mineralization are highlighted, including the input signal, water-rock interactions and human activities. Moreover, groundwater isotopic signatures are related to groundwater ages and historical climate conditions, showing that groundwater isotopic signal could also be used as a record of climate changes. [ABSTRACT FROM AUTHOR]

• Evaluation of local void effect with deterministic calculation is very challenging. • An original 2-steps deterministic scheme is proposed using APOLLO3® code. • The subgroup selfshielding method gives the most accurate void effect estimation. • A combination of finestructure and Tone's selfshielding methods is calibrated. • A Local Flux Volume normalization of SPH equivalence coefficients is proposed. In some countries, as France, plutonium is used in industrial Pressurized Water Reactors (PWRs), using Mixed Oxides (MOX) fuels. To avoid a reactivity increase during a loss of coolant accident, the plutonium content in a PWR is limited at 12 wt%. This limit, that have been determined in the early 1990 s using a very conservative approach, is a strong constraint on the possibility to stabilize the plutonium inventory. Thus, further studies are now conducted to refine the plutonium limit content in the fuel. One interesting case is the local moderator voiding, which could for instance occurs at the beginning of a core depressurization accident. To study this phenomenon, a 2-steps neutronic deterministic scheme is proposed in this paper, using the APOLLO3® code. It is shown that the choice of the selfshielding method to use at the lattice step has a strong influence on the precision of the calculation. It is shown that, as expected, the subgroup formalism is the more precise to cope with both nominal and voided configurations. However, methods relying on this formalism are numerically costly. The use of a method relying on the finestructure formalism allow to conserve a satisfying estimation of the void effect on the reactivity or the spatial distribution of energy-integrated reaction rates. Unfortunately, we show that those good results are due to compensation of large energetic biases in the nominal case. A combination of Tone's and finestructure selfshielding methods is presented. This method permit to strongly improve per-energetic-groups precision in the voided configuration compared to the method solely relying on the finestructure formalism, while drastically decreasing the numerical cost and duration compared to the subgroup method. The necessity to perform environed lattice calculation is demonstrated in the case of the voiding of a single assembly. A Local Flux Volume normalization of SPH coefficients is proposed to run equivalence calculation on this heterogeneous geometry. A method of characteristic solver is used for the flux calculation at the lattice step, while a S 8 transport calculation is performed at the core level, using pin-by-pin discretization and a 26-groups energy mesh. Finally, the precision of the calculation scheme is assessed by comparison to Monte Carlo calculation ran with TRIPOLI–4® on a two-dimensional clusters of assemblies. [ABSTRACT FROM AUTHOR]

B Correction: Annals of Intensive Care (2023) 13:69 b https://doi.org/10.1186/s13613-023-01164-3 In the original publication of the article [[1]], ARCOTHOVA study group Collaborators' member name Nicolas Nesseler was incorrectly written as Nicolas Nessler. Reference 1 Cholley B, Bojan M, Guillon B, Besnier E, Mattei M, Levy B, Ouattara A, Tafer N, Delmas C, Tonon D, Rozec B, Fellahi J-L, Lim P, Labaste F, Roubille F, Caruba T, Mauriat Pfor the ARCOTHOVA study group. The original article can be found online at https://doi.org/10.1186/s13613-023-01164-3. [Extracted from the article]

Mkrtich Portukalian is one of the most significant figures in the Armenian revolutionary movement, but there is a general lack of knowledge about his activities and work. This applies to the famous journal of "Armenia" published in Marseille from 1885 to 1923 by Portukalian in Armenian. In this paper, the period under research especially entailsthe years 1914, 1918, 1919, 1921, 1922 and 1923. We will try to convey Portukalian's personality by referring to various sources. In the second and third section, we will address the "Armenia" journal by frequently reminding that the revolutionist's personality identifies with his journal. [ABSTRACT FROM AUTHOR]

This article concentrates on the policy reforms of schools in England, Germany, France and Italy, from 1988 to 2009, with a focus on the introduction of market accountability. Pressing demands for organisational change in schools, shaped by the objectives of ‘efficiency’ and competition, which were introduced in England in the 1980s, have been adopted in other European countries, albeit at a slower pace and within the continuing need for domestic institutional conformity. How does the increasing predominance of market accountability in state schools change traditional bureaucratic and professional accountability relationships between politicians, managers, professionals and users? The article argues that despite some evidence of convergence between different education systems, England remains the outlier and continental European countries have been much more reluctant to adopt choice and competition policies. [ABSTRACT FROM PUBLISHER]

In the historical development of the relationship between education and society, primary education in France has played a central role. The French educational system is one of the most stable public institutions, given its constitutional significance and relevance for the embodiment of the republican virtues. Its organisational structure has remained almost unchanged since the Loi Goblet, enacted on 30 October 1886. The principles of universalism, uniformity and equality of opportunity have marked over time that policy developments in France aimed at fighting inherited disadvantage and lifting children above the poverty line through state-based education. The scholarly focus on the institutional and administrative dimension of the French system of education has helped illuminate some of the difficulties associated with the implementation of change, including the disappointing experience with the introduction of positive discrimination in the 1980s. However, to date, the empirical evidence of the effects of educational reforms that were implemented remains unfortunately secondary to the conventional wisdom of the 'politics of non-reform' and institutional inertia. Governmental initiatives have concentrated on tackling educational under-achievements in basic literacy and numeracy in primary schools. The empirical findings in this article point not only to the general deterioration of educational achievements, but also to a persisting gap between pupils from different social background. The article will document how educational inequalities driven by different social economic groups have increased, despite government efforts and new policy initiatives in the 1980s and 1990s. [ABSTRACT FROM AUTHOR]

The present study evaluates the concentrations of arsenic (As) and antimony (Sb) in the intestine, liver, muscle, gonads, gills, and kidney of Salmo trutta subsp. from the Presa River in Corsica (France; n = 10), which crosses an abandoned arsenic mine, and from the Bravona River (reference site; n = 10). Both metalloids were analyzed by means of ICP-MS. The relationships between fish size (length and weight) and metalloid concentrations in their tissues were investigated by linear regression analysis. In all fish samples concentrations of As and Sb (expressed as micrograms per gram fresh weight) were highest in the kidney. Lowest Sb concentrations were found in the muscle, whereas lowest As concentrations were found in the gonads of S. trutta. Two organotropisms were revealed: one for As—kidney (21.4656) > intestine (3.9535) > gills (3.0404) > liver (1.1743) > muscle (0.9976) > gonads (0.8081); and the other for Sb—kidney (0.70067) > gills (0.6181) > intestine (0.2576) > gonads (0.1673) > liver (0.9625) > muscle (0.0753). Results of linear regression analysis in most cases showed a significant negative correlation between metalloid concentration and fish size. Highly significant ( p < 0.05) negative correlations were found between fish length and As concentration in the gonads, as well as between fish length and Sb concentrations in the gills. Arsenic concentrations in female fish were significantly higher than those in males in the kidney, gonads, gills, and liver. The same results were found for Sb, except in the liver, where the tendency was reversed. [ABSTRACT FROM AUTHOR]

Discusses whether there is a ruling class in France. Criteria that should be adopted for testing the hypotheses of a ruling class; Argument on the transmission of elite positions; Social origins of ministers; Members of corporate boards in parliament and government.

Objectives. We aimed to evaluate the effectiveness of a multifaceted procedure in improving pneumococcal and influenza vaccinations 6 months after an emergency department (ED) visit among patients aged 65 years and older. Methods. We conducted a cluster-randomized, controlled, parallel-group, open-label implementation trial in 18 EDs in France and Monaco. Participants were recruited from November 2015 to September 2016. EDs were randomly assigned with a 1:1 ratio to provide either a multifaceted procedure that combined structured information about pneumococcal and influenza vaccines and three text message reminders sent to patients every two weeks (intervention arm) or nonstructured information only (control arm). The outcomes were self-reported pneumococcal vaccination and influenza vaccination rates within 6 months of enrollment. Results. A total of 9 EDs were randomized to the intervention arm (n = 780 patients) and 9 to the control arm (n = 695 patients). The median age for all enrolled patients was 74 years (25–75th percentiles, 69 to 82): 50.1% were male, 34.9% had at least one underlying condition, and 30.7% were at risk for invasive pneumococcal infection. In the intention-to-treat analysis, the multifaceted intervention did not alter the pneumococcal vaccination rate (6.4% versus 4.6%, absolute difference: 1.8; 95% CI: [−0.9 to 4.4]; p = 0.19), whereas it improved the influenza vaccination rate (52.1% versus 40.0%, absolute difference: 12.1; 95% CI: [2.4 to 21.8]; p = 0.01). At 12 months, mortality did not differ between the intervention (9.7%) and control (11.2%) arms (p = 0.35). Conclusions. A multifaceted intervention based on text message reminders provides an opportunity to increase anti-influenza vaccination among elderly patients visiting the ED. Efforts are warranted to provide better information on pneumococcal diseases and the benefits of pneumococcal vaccines, especially in the elderly. [ABSTRACT FROM AUTHOR]

Copyright of International Political Science Review is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Française de Sociologie is the property of Presses de Sciences Po and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVES: To assess the impact of a screening programme for haemoglobinopathies which was organised from 1978 to 1985 in high secondary schools of the Marseille region. METHODS: Several variables that reflected the influence of this preventive programme on the uptake of prenatal diagnosis were investigated. To evaluate the partner’s uptake for the testing, a letter was sent, together with an anonymous questionnaire, to all the haemoglobin carriers detected in this programme. To evaluate the number of prenatal diagnoses, the charts of all couples from the Marseille area who underwent genetic counselling for haemoglobinopathies were compiled. The number of affected children born between 1980 to 2000 was recorded, and the cases in which one of the parents had previously been screened at school were noted. RESULTS: Half of the carriers replied to the questionnaire: 86% knew that they have to test their partner. Six carrier couples were identified, four asked for genetic counselling and requested eight prenatal diagnoses, two couples did not request genetic couselling and have had two affected children. CONCLUSIONS: Despite the time lapse between screening, informing, and pregnancy (mean 15 years), the information was well conserved and resulted in testing of the partner. The screening programme was effective in motivating requests for prenatal diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Notre objectif était de rechercher si l’institution d’un traitement par pompe chez des patientes diabétiques de type 1 (DT1) au cours d’une grossesse n’entraînait pas plus de complications maternelles et/ou fœtales que chez les patientes déjà traitées par pompe depuis plusieurs mois. Patients et méthodes: Nous avons étudié 71 DT1 ayant mené une grossesse à terme sous pompe à insuline, suivis dans 6 centres initiateurs du Réseau Diabète-Provence entre 2008 et 2010. Avant la grossesse, 39 patientes étaient sous pompe à insuline (groupe pompe) et 32 sous multi-injections (groupe multi-injections). Les données ont été colligées à l’aide de la grille simplifiée du groupe Diabète et Grossesse de la SFD. Résultats: Les patientes du groupe pompe avaient des caractéristiques initiales comparables à celle sous injections (âge : 30,6+/-4,6 vs 28,5 +/-5,8 ; ancienneté diabète : 15+/-7,6 vs 12,7 +/-7,5 ; rétinopathie 13 % vs 7 % ; néphropathie 2 % vs 3 %). Dans le groupe pompe, le taux de programmation était de 77 %. Les HbA1c de début (7,2 % +/-1 vs 7,3 % +/-1,3) et fin de grossesse (6,6 % +/-0,7 vs 6,4 % +/-0,9) n’étaient pas significativement différentes entre les deux groupes. La fréquence des complications métaboliques aigues diffère dans les 2 groupes (NS) (3 hypoglycémies sévères dans le groupe pompe) ainsi que le taux d’aggravation des néphropathies (16 % d’aggravation vs 2 % dans le groupe pompe). Dans notre population totale, le taux de macrosomie était élevé (35 %), alors que les complications fœtales étaient peu fréquentes (prématurité 28 %, malformation congénitale 2,82 %, détresse respiratoire 7 %). Conclusion: Au sein du Réseau Diabète-Provence les patientes présentent un taux remarquablement bas de complications maternofoetales et il n’y a pas plus de risques à instituer un traitement par pompe après le début de la grossesse. Cependant, le taux de programmation reste insuffisant et malgré un bon équilibre glycémique, le taux de macrosomie est élevé. La poursuite du travail en Réseau pourra permettre d’améliorer ces résultats. [Copyright &y& Elsevier]