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201. Heat inactivation of the Severe Acute Respiratory Syndrome Coronavirus 2

Author: Jean-Claude Manuguerra, India Leclercq, Quentin Grassin, Christophe Batéjat, Cellule d'Intervention Biologique d'Urgence (Centre National de Référence) - Laboratory for Urgent Response to Biological Threats (National Reference Center) (CIBU), Université Paris Cité (UPCité)-Environnement et Risques infectieux - Environment and Infectious Risks (ERI), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité)-Institut Pasteur [Paris] (IP), Cellule Pasteur, and Université Paris Diderot - Paris 7 (UPD7)-PRES Sorbonne Paris Cité
Subjects: 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), QH301-705.5, SARS-CoV-2, business.industry, Short Communication, [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), viruses, fungi, General Medicine, Virology, Heat, Inactivation, Virus, respiratory tract diseases, Microbiology, Heat inactivation, body regions, Biosafety, Medicine, Biology (General), Covid-19, business, skin and connective tissue diseases
Abstract: Supernatants of cells infected with SARS-CoV-2, nasopharyngeal and sera samples containing SARS-CoV-2 were submitted to heat inactivation for various periods of time, ranging from 30 seconds to 60 minutes. Our results showed that SARS-CoV-2 could be inactivated in less than 30 minutes, 15 minutes and 3 minutes at 56°C, 65°C and 95°C respectively. These data could help laboratory workers to improve their protocols with handling of the virus in biosafety conditions.
Published: 2020
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202. Gender differences in the association between socioeconomic status and hypertension in France: A cross-sectional analysis of the CONSTANCES cohort

Author: Lola Neufcourt, Olivier Grimaud, Sahar Bayat, Marie Zins, Séverine Deguen, Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Santé Environnement Travail et Génie Sanitaire (DSETGS), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Descartes, Sorbonne Paris Cité, French Ministry of Health / Region Bretagne, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and EHESP, SCD
Subjects: Male, Cross-sectional study, Physiology, Secondary hypertension, Social Sciences, Blood Pressure, 030204 cardiovascular system & hematology, Vascular Medicine, 0302 clinical medicine, 5. Gender equality, Sociology, Medicine and Health Sciences, Prevalence, Public and Occupational Health, 030212 general & internal medicine, 10. No inequality, Multidisciplinary, Relative index of inequality, 1. No poverty, Middle Aged, Socioeconomic Aspects of Health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiological Parameters, Cohort, Hypertension, Medicine, Educational Status, Female, Research Article, Adult, Science, Social class, 03 medical and health sciences, Sex Factors, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine, Adults, Humans, Social Stratification, Obesity, Socioeconomic status, Aged, business.industry, Body Weight, Biology and Life Sciences, medicine.disease, Health Care, Blood pressure, Cross-Sectional Studies, Social Class, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Age Groups, People and Places, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Population Groupings, Secondary Hypertension, business, Demography
Abstract: BackgroundHypertension prevalence increases when socioeconomic status decreases but gender differences in the relationship between socioeconomic status and hypertension have been less studied. This work aimed to explore the pattern of associations between three indicators of socioeconomic status at individual, household, and municipal levels with hypertension across genders in a large sample of French adults from the CONSTANCES cohort.MethodsUsing data at inclusion from 59 805 participants (52% women) aged 25-69 years and recruited between 2012 and 2015, multilevel log-Poisson regressions with robust variance estimates were used to assess the associations of Relative Index of Inequality in education, monthly income per consumption unit and residential deprivation with hypertension. Modifying effects of gender and age in those associations were tested.ResultsHypertension prevalence was higher in men than in women. Steep socioeconomic gradients of hypertension were observed for the three socioeconomic indicators in both genders and from the youngest to the oldest age class. Socioeconomic inequalities, especially educational inequalities, were larger among women than men: Relative Index of Inequality for highest versus lowest education among the 25-34 years were 0.43 [95%-confidence interval = 0.28-0.67] in women and 0.70 [95%-confidence interval = 0.53-0.92] in men. With increasing age, socioeconomic gradients of hypertension eased in men and even more in women so that gender differences decreased.ConclusionsIn this cross-sectional analysis of a large sample of adults, prevalence of hypertension was higher in men than in women. Moreover, socioeconomic status and especially education displayed a stronger association with hypertension prevalence in women compared to men. Reducing inequalities in hypertension may require gender-specific approaches.
Published: 2020
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203. Impact of alcohol marketing on drinkers with Alcohol use disorders seeking treatment: a mixed-method study protocol

Author: Karine Gallopel-Morvan, Marie Grall-Bronnec, Jean Yves Le Reste, Antoine Dany, Morgane Guillou-Landreat, Delphine Le Goff, Amine Benyamina, Soins Primaires, Santé Publique, Registre des cancers de Bretagne Occidentale (SPURBO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Hôpital Paul Brousse, Centre hospitalier universitaire de Nantes (CHU Nantes), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre de recherche en économie et management (CREM), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), French National Cancer InstituteInstitut National du Cancer (INCA) France [DEPREV 2018-110], Brest University Hospital, Soins Primaires, Santé Publique, Registre des cancers de Bretagne Occidentale (EA7479 SPURBO), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN)-Université de Tours (UT), and Jonchère, Laurent
Subjects: Adult, Male, Adolescent, Alcohol Drinking, Population, Information Seeking Behavior, Psychological intervention, Poison control, Counter-marketing, Alcohol use disorder, 03 medical and health sciences, Study Protocol, Young Adult, 0302 clinical medicine, Advertising, Risk Factors, Intervention (counseling), Injury prevention, mental disorders, Medicine, Humans, 030212 general & internal medicine, Marketing, education, Health behavior, health care economics and organizations, Qualitative Research, education.field_of_study, business.industry, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, Human factors and ergonomics, lcsh:RA1-1270, Middle Aged, medicine.disease, Alcoholism, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Research Design, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, Biostatistics, business, Alcohol, 030217 neurology & neurosurgery
Abstract: Background The marketing of alcohol influences patterns of alcohol consumption. Existing studies have focused, for the most part, on adolescents and the links between exposure to marketing and alcohol initiation. In France, the Evin law, a French exception, was set up in 1991 with the aim of regulating this exposure to marketing, but since 2009 it has been severely compromised. Alcohol consumption causes severe damage, which may be seenfrom 1 standard unit per day and mostly among adults who are regular users of alcohol. In this at-risk population, studies analysing the impact of marketing are sparse. The specific objectives include (i) the evaluation of the perception of alcohol marketing by patients with an AUD (ii) gaining understanding of the links between alcohol marketing and patients with AUD behaviours (iii) the development of alcohol demarketing strategy in patients receiving AUD coaching. Methods Our main objective isto evaluate the impact of marketing on a population with an AUD. The methodology was in 4 steps: step 1 is a pre-test (N = 100) selecting type of alcohol consumed and type of marketing stimuli identified by patients aged 18 + with an AUD. Step 2 is a qualitative study (N = 20), with in-depth interview, to understand links between alcohol marketing and patients with AUD behaviours. Step 3 is a quantitative study(N = 600) to confirm these links and the impact of alcohol marketing on patients with AUD behaviours. Step 4 is an interventional step, including and testing the impact of demarketing intervention on patients with AUD while using the results of the three first steps (N = 120). Discussion This study will contribute to a better definition of the impact of alcohol marketing on patients with AUD and will enable identification of the determinants of this impact. These data will inform the development of interventions that take into account demarketingstrategies on patients under AUD management. Trial registration The Trial registrationregistration number is NCT03876132, and it was registered on the 15th march 2019.
Published: 2020
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204. High urinary ferritin reflects myoglobin iron evacuation in DMD patients

Author: Jeremy Rouillon, Hervé Puy, Katell Peoc'h, Thomas Voit, Brenda Wong, Thibaud Lefebvre, Jérôme Ausseil, Vincent Puy, Laurent Servais, Aleksandar Zocevic, Paul Fogel, Fedor Svinartchouk, Zoubida Karim, Jérôme Denard, Raed Daher, Centre de recherche et d'applications sur les thérapies géniques (CRATG), Université d'Évry-Val-d'Essonne (UEVE)-Centre National de la Recherche Scientifique (CNRS)-Généthon, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Université de Picardie Jules Verne (UPJV), Laboratory of Excellence GR-Ex ' The red cell : from genesis to death ', PRES Sorbonne Paris Cité, CHU Amiens-Picardie, Service de Biochimie et de Biologie moléculaire, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Faculté de Pharmacie, Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center, Service of Clinical Trials and Databases, Institut de Myologie, Thérapie des maladies du muscle strié, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Diderot - Paris 7 (UPD7), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Faculté de Pharmacie-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Université d'Évry-Val-d'Essonne (UEVE)-GENETHON 3-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier universitaire d'Amiens (CHU Amiens-Picardie), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Faculté de Pharmacie
Subjects: 0301 basic medicine, Male, Antibody microarray, Duchenne muscular dystrophy, Urinary ferritin, Urine, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Antibody array, MESH: Child, Child, Genetics (clinical), Kidney, MESH: Cytokines, MESH: Iron, biology, Myoglobin, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, 3. Good health, medicine.anatomical_structure, Neurology, MESH: Young Adult, Child, Preschool, Biomarker (medicine), Cytokines, Dystrophin, musculoskeletal diseases, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, Adolescent, MESH: Myoglobin, Urinary system, Iron, MESH: Ferritins, 03 medical and health sciences, Young Adult, Internal medicine, medicine, MESH: Muscular Dystrophy, Duchenne, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, MESH: Adolescent, MESH: Humans, business.industry, MESH: Child, Preschool, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, MESH: Male, Ferritin, Muscular Dystrophy, Duchenne, 030104 developmental biology, Endocrinology, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Pediatrics, Perinatology and Child Health, Ferritins, biology.protein, MESH: Biomarkers, Neurology (clinical), business, 030217 neurology & neurosurgery, Biomarkers
Abstract: International audience; Duchenne muscular dystrophy (DMD) is an X-linked disease caused by mutations in the dystrophin gene leading to the absence of the normal dystrophin protein. The efforts of many laboratories brought new treatments of DMD to the reality, but ongoing and forthcoming clinical trials suffer from absence of valuable biomarkers permitting to follow the outcome of the treatment day by day and to adjust the treatment if needed. In the present study the levels of 128 urinary proteins including growth factors, cytokines and chemokines were compared in urine of DMD patients and age related control subjects by antibody array approach. Surprisingly, statistically significant difference was observed only for urinary ferritin whose level was 50 times higher in young DMD patients. To explain the observed high urinary ferritin content we analysed the levels of iron, iron containing proteins and proteins involved in regulation of iron metabolism in serum and urine of DMD patients and their age-matched healthy controls. Obtained data strongly suggest that elevated level of urinary ferritin is functionally linked to the renal management of myoglobin iron derived from leaky muscles of DMD patients. This first observation of the high level of ferritin in urine of DMD patients permits to consider this protein as a new urinary biomarker in muscular dystrophies and sheds light on the mechanisms of iron metabolism and kidney functioning in DMD.
Published: 2020
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205. Impact of alcohol marketing content regulation on consumers’ responses and warnings’ visibility

Author: Diouf, Jacques-François, Gallopel-Morvan, Karine, École des Hautes Études en Santé Publique [EHESP] (EHESP), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Institut du Management (IDM), ASAFE (INCa_11913), and Financé par l'institut national du cancer. Responsable scientifique Karine Gallopel-Morvan
Subjects: Alcohol marketing regulation, [SHS.GESTION]Humanities and Social Sciences/Business administration, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Alcohol
Abstract: International audience; Study objectives:Our research tackles the effectiveness of alcohol marketing regulation. More precisely, this researchexamines how content-regulated (CR) marketing as proposed in the French Evin law (that mandates ads andpackaging to convey only factual information and objective qualities of alcohol products) compared to nonregulated marketing - and particularly “limited edition” (LE) ads and packs (with novel designs orinnovations) - can influence perceptions, attitude, desire to consume alcohol and the noticeability ofwarnings displayed in ads to inform about risks.Methods and material:A between-subject designed experiment was conducted on 696 individuals aged 15-30 with an onlinequestionnaire. Twelve stimuli were used: 3 (alcohol brands: Absolut Vodka, Hennessy cognac and Moet &Chandon champagne) x 2 (CR packs presented in regulated ads vs. LE packs presented in non-regulated ads)x 2 (warning format: less vs. more prominent). Each participant was exposed to 3 stimuli of 3 the differentbrands. The LE pack (and ad) of Absolut was designed by a fashion designer, the LE of Hennessy by an artistand the LE Moet was a golden LE launched for the New Year.Results:Results show that CR packs and ads, compared to LE ones, reduce attractiveness of the ad, products’ appealand desire to consume alcohol. While prominence enhances warning’s attentional processing, none of thetested ad types influenced its noticeability.Conclusion:Content-regulated laws such as the Evin law in France are effective way to reduce alcohol appeal amongyoung adults.
Published: 2020

206. How Can Warning Be Displayed on Alcohol advertisement to impact youth consumption?

Author: Dossou, Gloria, Gallopel-Morvan, Karine, Lacoste-Badie, Sophie, Centre de recherche en économie et management (CREM), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), Lille économie management - UMR 9221 (LEM), Université d'Artois (UA)-Université catholique de Lille (UCL)-Université de Lille-Centre National de la Recherche Scientifique (CNRS), ASAFE (INCa_11913), Financé par l'institut national du cancer. Responsable scientifique Karine Gallopel-Morvan, Université de Caen Normandie (UNICAEN), and Normandie Université (NU)-Normandie Université (NU)-Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)
Subjects: pictograms, Youth, Warning, prevention, Consumption, [SHS.GESTION]Humanities and Social Sciences/Business administration, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Social marketing, Alcohol, Avertissement, Consommation, Alcool, Jeunes
Abstract: International audience; Study objectives:Warnings are one of the measures recommended by health policymakers to reduce alcohol misuse. Incountries that have adopted them, alcohol warnings seem not to be effective enough to influence people.This exploratory research investigates the effect of different warnings content (short/long-term risks;health/other risks) and formats (text-only vs. combined text and pictogram) on the variables of persuasion:attention, comprehension, credibility, intention to drink less.Methods and material:Semi-structured interviews were conducted with 25 young French people aged 18-25. This target is relevantas there has been an increase in “binge drinking” in recent decades. Data were analysed using thematicanalysis.Results:Some warning content may increase knowledge, awareness and susceptibility (social risks, short-term risks,accurate risks) among young people. In addition, larger warnings and combined text and pictogrammessages increase visibility, noticeability and message comprehension. However, alcohol warnings aloneseem insufficient to influence behavioural intentions.Conclusion:Our research is the first one, to our knowledge, that compare health risks, social risks and other risks(environmental, calorie intake, etc.) in order to find the most suitable and effective topic to convince youngpeople. Regarding public health, these findings can help health policymakers to increase the effectiveness ofalcohol warnings displayed on ads. This is true not only for France but also for the other 55 countries thatrequired warning on alcohol advertisements. This research remains limited due to its exploratory nature.Declarative methods are prone to social-desirability bias, denial, etc
Published: 2020

207. Les parcours de soins pré-dialyse des insuffisants rénaux chroniques terminaux : quels types de parcours et déterminants d’un démarrage de la dialyse en urgence ?

Author: Cécile Vigneau, Adélaïde Pladys, Sahar Bayat, Cécile Couchoud, F. Gao, M. Raffray, Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Agence de la biomédecine [Saint-Denis la Plaine], CHU Pontchaillou [Rennes], EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: 030505 public health, Dialyse, Appariement, Epidemiology, Public Health, Environmental and Occupational Health, SNDS, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Parcours de soins, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine, Insuffisance rénale chronique terminale, 0305 other medical science
Abstract: International audience; IntroductionEn France en 2017, d’après les données du registre Réseau épidémiologique et information en néphrologie (REIN), 30 % des patients atteints d’insuffisance rénale chronique terminale (IRCT) avaient démarré l’hémodialyse en urgence. Le démarrage en urgence de la dialyse augmente le risque de morbidité et de mortalité et diminue la qualité de vie des patients. L’objectif était de décrire des types de parcours de soins pré-dialyse et d’identifier les facteurs associés au démarrage en urgence.MéthodesL’étude a été menée à partir des données du registre REIN appariées à celles du Système national des données de santé (SNDS). Les patients âgés de 18 ans et plus ayant démarré la dialyse en 2015 en France ont été inclus. Le parcours de soins deux ans avant le démarrage de la dialyse a été défini par huit variables clés du parcours de l’IRC. Une analyse des composantes multiples (ACM) sur ces variables a précédé une classification ascendante hiérarchique (CAH) afin de générer des types de parcours. Une régression logistique intégrant les caractéristiques des patients et les variables clés du parcours a été utilisée pour identifier les facteurs associés au démarrage en urgence.RésultatsParmi les 8856 patients inclus (taux d’appariement SNDS de 90,2 %), 2681 (30,3 %) avaient démarré la dialyse en urgence. La CAH a permis d’identifier huit types de parcours de soins différents, dont les taux de démarrage en urgence variaient de 11 % à 62 % et qui incluaient des patients de profils différents, notamment en âge et comorbidités (22 % à 56 % de diabétiques). Contrairement à l’absence de suivi néphrologique, l’absence de suivi avec le médecin généraliste n’était pas significativement associée au démarrage en urgence (OR=1,83 et 0,79, IC95 % [1,58–2,13] et [0,61–1,04] respectivement).Discussion/ConclusionEn croisant des données de registre et de recours aux soins, notre étude montre la diversité de parcours de soins des patients IRC que les caractéristiques de ces derniers expliquent en partie. Certains types de parcours suggèrent un besoin accru de dépistage de l’IRC et d’adressage au néphrologue plus précoces.
Published: 2020
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208. L’appariement des données de registres avec le Système national des données de santé: exemple du registre du Réseau épidémiologique et information en néphrologie

Author: Mathilde Lassalle, Cécile Couchoud, M. Raffray, Sahar Bayat, Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Agence de la biomédecine [Saint-Denis la Plaine], and Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)
Subjects: 030505 public health, Appariement, Epidemiology, Données, Public Health, Environmental and Occupational Health, Registres, 3. Good health, Réseau épidémiologique et information en néphrologie (REIN), 03 medical and health sciences, 0302 clinical medicine, Système national des données de santé, Insuffisance rénale chronique, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine, France, 0305 other medical science
Abstract: International audience; IntroductionL’appariement de bases de données massives et à échelle individuelle est de plus en plus utilisé, en particulier dans la recherche en santé. Dans un enjeu de transparence, certaines recommandations internationales invitent les chercheurs à décrire leurs méthodes d’appariement sur lesquelles de nombreuses études se basent. Le registre du Réseau épidémiologique et information en néphrologie (REIN) enregistre et suit tous les cas d’Insuffisance rénale chronique terminale traitée (IRCT) en France. Ce registre utilise depuis peu les données du Système national des données de santé (SNDS). L’objectif est de décrire et présenter la méthode d’appariement utilisée.MéthodesUne approche déterministe itérative a été développée pour apparier les patients ayant démarré un traitement de suppléance rénale (TS) entre 2014 et 2015. L’algorithme comprend 24 étapes successives et inclut comme variables d’appariement: l’âge, le sexe, la commune de résidence du patient au démarrage du TS, le centre du TS et les dates du premier TS et de décès. Une première validation de l’algorithme a été menée en croisant le statut diabétique des patients dans les deux bases et en examinant les caractéristiques des patients non appariés.RésultatsParmi les 22 073 patients ayant démarré un traitement de suppléance rénale entre 2014 et 2015, 19 223 (87,1 %) ont été appariés au SNDS. Les taux de concordance du statut diabétique des patients entre les deux bases étaient de 92 % pour les diabétiques et 89,4 % pour les non diabétiques. Les caractéristiques des patients non appariés étaient similaires à celles des appariés. On notait cependant une surreprésentation de patients non appariés qui avaient démarré le traitement de suppléance par dialyse péritonéale (18,4 % versus 9,2 % des patients appariés).Discussion/ConclusionPar rapport à une méthode probabiliste, cette méthode d’appariement, qui utilise des variables habituelles de registre, est plus rapide en temps de calcul et peu consommatrice en ressources. Malgré l’absence de validation par « gold-standard », elle ouvre de nouvelles perspectives de recherche sur l’insuffisance rénale chronique, notamment l’étude des parcours de soins.
Published: 2020
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209. Promouvoir la qualité de vie au travail : comment l’EHESP forme les managers de demain ?

Author: Cristofalo, Paula, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), and Institut du Management (IDM)
Subjects: Qualité de vie au travail, [SHS.GESTION]Humanities and Social Sciences/Business administration, EHESP, Compétence, Management
Abstract: National audience; La qualité de vie au travail est au cœur de l’activité de tout dirigeant. L’EHESP propose une formation transversale et interdisciplinaire « Qualité de vie au travail, compétence en pilotage stratégique ».
Published: 2020

210. Prominence of ileal mucosa-associated microbiota to predict postoperative endoscopic recurrence in Crohn’s disease

Author: Philippe Seksik, Xavier Treton, Mathurin Fumery, Claire Auzolle, Nicolas Barnich, Lionel Le Bourhis, Benjamin Pariente, Anthony Buisson, Loic Brot, Stéphane Nancey, Harry Sokol, Carmen Stefanescu, Matthieu Allez, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte - Clermont Auvergne (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), INSERM, U1160, Département de Gastroentérologie, Université Paris Diderot - Paris 7 (UPD7), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Clermont-Ferrand, CHU Amiens-Picardie, Hôpital Claude Huriez [Lille], CHU Lille, Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Autophagie infection et immunité - Autophagy Infection Immunity (APY), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), INSERM UMR-S 606, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, PRES Sorbonne Paris-Cité, and Université Paris Denis Diderot, This study has been supported by grants from MSD France, Association Francois Aupetit, the Helmsley Charitable Trust and Inserm., Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AgroParisTech, Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de la Recherche Agronomique (INRA), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), Centre Hospitalier Universitaire Clermont Ferrand, Centre hospitalier universitaire d'Amiens (CHU Amiens-Picardie), Hôpital Claude Huriez, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Autophagie infections immunité – Autophagy Infection Immunity, École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7), and Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: Adult, Male, medicine.medical_specialty, Firmicutes, Disease, Gut flora, Gastroenterology, digestive system, Endoscopy, Gastrointestinal, Ileal resection, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Crohn Disease, Ileum, Recurrence, Risk Factors, Internal medicine, Proteobacteria, medicine, microbiota, Humans, Postoperative Period, Prospective Studies, Intestinal Mucosa, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, 0303 health sciences, Crohn's disease, biology, business.industry, Lachnospiraceae, Healthy subjects, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, mucosa-associated, Middle Aged, biology.organism_classification, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Gastrointestinal Microbiome, Cohort, 030211 gastroenterology & hepatology, Female, business, Ileal mucosa
Abstract: ObjectiveFollowing ileal resection for Crohn’s disease (CD), recurrence is very frequent. Although several clinical risk factors of recurrence have been identified, predicting relapse remains challenging. Performing an ileocolonoscopy within the first year after surgery is currently recommended to assess endoscopic recurrence and to adjust the treatment. We took advantage of a large prospective multicentric cohort to investigate the role of the ileal mucosa-associated microbiota in postoperative endoscopic recurrence.Patients and methodsIleal mucosa-associated microbiota was analysed by 16S sequencing at the time of surgery and/or of endoscopic evaluation in 201 patients (288 samples in total) prospectively recruited in France.ResultsIleal mucosa-associated microbiota exhibits profound changes following surgery in CD. Compared with non-recurrence setting, endoscopic recurrence is associated with strong changes in ileal mucosa-associated microbiota that are highly reminiscent of those observed generally in ileal CD compared with healthy subjects with a reduction in alpha diversity, an increase in several members of the Proteobacteria phylum and a decrease in several members of the Lachnospiraceae and the Ruminococcaceae families within the Firmicutes phylum. At the time of surgery, we identified several bacterial taxa associated with endoscopic recurrence and that can better predict relapse than usual clinical risk factors.ConclusionSurgery has an important impact on ileal mucosa-associated microbiota. Postoperative endoscopic recurrence is associated with changes in microbiota composition and alpha diversity. The gut microbiota has the potential to predict postoperative evolution and recurrence.
Published: 2020
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211. Cost-Effectiveness of Lifestyle-Related Interventions for the Primary Prevention of Breast Cancer: A Rapid Review

Author: Martine Bellanger, Katharine Barry, Juwel Rana, Jean-Philippe Regnaux, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Département des sciences humaines et sociales (SHS), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, University of Massachusetts [Amherst] (UMass Amherst), University of Massachusetts System (UMASS), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Epidemiology of Ageing and Neurodegenerative diseases [Paris] (EpiAgeing), and Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Healthy behavior, medicine.medical_specialty, lifestyle, Cost effectiveness, Mini Review, Psychological intervention, MEDLINE, Societal level, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, breast cancer, Primary prevention, Medicine, 030212 general & internal medicine, health care economics and organizations, lcsh:R5-920, Behavior, business.industry, Behavior change, General Medicine, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Family medicine, Cost-effectiveness, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, lcsh:Medicine (General)
Abstract: International audience; Background: In 2018, the global estimate of newly diagnosed breast cancer cases among women totaled 2.1 million. The economic and social burden that breast cancer places on societies has propelled research that analyzes the role of modifiable risk factors as the primary prevention methods. Healthy behavior changes, moderated alcohol intake, healthy body weight, and regular physical activity may decrease the risk of breast cancer among women. This review aimed to synthesize evidence on the cost-effectiveness of lifestyle-related interventions for the primary prevention of breast cancer in order to answer the question on whether implementing interventions focused on behavior changes are worth the value for money. Methods: A rapid review was performed using search terms developed by the research team. The articles were retrieved from MEDLINE and the Tufts Medical Center Cost-Effectiveness Analysis Registry, with an additional web search in Google and Google Scholar. Comparisons were performed on the cost-effectiveness ratio per quality-adjusted life-year between the interventions using a league table, and the likelihood of cost-effective interventions for breast cancer primary prevention was analyzed. Results: Six studies were selected. The median cost-effectiveness ratio (in 2018 USD) was $24,973, and 80% of the interventions had a ratio below the $50,000 threshold. The low-fat-diet program for postmenopausal women was cost-effective at a societal level, and the physical activity interventions, such as the Be Active Program in the UK, had the best cost saving results. A total of 11 of the 25 interventions ranked either as highly or very highly likely to be cost-effective for breast cancer primary preventions. Conclusion: Although the review had some limitations due to using only a few studies, it showed evidence that diet-related and physical-activity-related interventions for the primary prevention of breast cancer were cost-effective. Many of the cost-effective interventions aimed to reduce the risk of non-communicable diseases alongside breast cancer.
Published: 2020
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212. Pour qu’acheter du tabac ne soit plus un jeu d’enfant !

Author: Elharrar, X, Beguinot, E., Gallopel-Morvan, Karine, Ben Lakhdar, C., Martinet, Y., Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), Comité National Contre le Tabagisme (CNCT), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), Lille économie management - UMR 9221 (LEM), Université d'Artois (UA)-Université catholique de Lille (UCL)-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre de recherche en économie et management (CREM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Minors, Jurisprudence, Smoke-Free Policy, Adolescent, Smoking, Tobacco, Legislation, Commerce, Humans, Smoking Prevention, France, [SHS.ECO]Humanities and Social Sciences/Economics and Finance
Abstract: National audience; Preventing tobacco sales to minors. Since 2009, selling tobacco products in France to minors less than 18 years of age is forbidden by law, but this law is poorly enforced even though tobacco use mainly begins at adolescence. The aim of this study was to identify measures implemented by foreign countries leading to a better enforcement of tobacco sale ban to minors. The main measures are: organizing tobacco retailers training programs; using automated age-verification systems; requiring a valid photo ID from anyone who looks under the age of 25; developing communication campaigns directed to the general public in order to explain and promote age control for customers. Furthermore, in all studied countries, the only effective controls rely on "mystery shopping" with underage shoppers accompanied by dedicated inspectors, attempting to purchase tobacco products. In case of non-compliance with the law, these controls must lead to dissuasive financial as well as administrative penalties. In all studied countries, an efficient implementation of these measures has led to reduced tobacco sales to minors, and thus contributed to bring down underage smoking.Pour qu’acheter du tabac ne soit plus un jeu d’enfant ! En France, la vente de tabac est interdite aux moins de 18 ans depuis 2009, mais la loi est peu respectée alors que la plupart des nouveaux fumeurs commencent leur consommation à l’adolescence. Cette étude a pour objectif d’identifier les mesures mises en œuvre par des pays tiers permettant une meilleure application de l’interdiction de vente de tabac aux mineurs. Parmi ces mesures : la formation des détaillants de tabac ; l’utilisation dans les points de vente de systèmes de vérification automatisée de l’âge ; une vérification de l’âge de toute personne ayant l’apparence d’avoir moins de 25 ans ; le développement de campagnes de communication grand public pour expliquer et promouvoir le contrôle de l’âge des clients. Par ailleurs, les inspections « clients mystères » apparaissent dans tous les pays étudiés comme le seul moyen de contrôle efficace. En cas de non-respect de la loi, ces inspections doivent donner lieu à des sanctions réelles et dissuasives, financières et administratives. Dans les pays étudiés, la mise en place conjointe de ces différentes mesures a permis de réduire la vente de tabac aux mineurs et de contribuer ainsi à diminuer le tabagisme des adolescents.; Pour qu’acheter du tabac ne soit plus un jeu d’enfant ! En France, la vente de tabac est interdite aux moins de 18 ans depuis 2009, mais la loi est peu respectée alors que la plupart des nouveaux fumeurs commencent leur consommation à l’adolescence. Cette étude a pour objectif d’identifier les mesures mises en œuvre par des pays tiers permettant une meilleure application de l’interdiction de vente de tabac aux mineurs. Parmi ces mesures : la formation des détaillants de tabac ; l’utilisation dans les points de vente de systèmes de vérification automatisée de l’âge ; une vérification de l’âge de toute personne ayant l’apparence d’avoir moins de 25 ans ; le développement de campagnes de communication grand public pour expliquer et promouvoir le contrôle de l’âge des clients. Par ailleurs, les inspections « clients mystères » apparaissent dans tous les pays étudiés comme le seul moyen de contrôle efficace. En cas de non-respect de la loi, ces inspections doivent donner lieu à des sanctions réelles et dissuasives, financières et administratives. Dans les pays étudiés, la mise en place conjointe de ces différentes mesures a permis de réduire la vente de tabac aux mineurs et de contribuer ainsi à diminuer le tabagisme des adolescents.
Published: 2020

213. Development of ASAS quality standards to improve the quality of health and care services for patients with axial spondyloarthritis

Author: J. Brandt, Pedro Machado, Karin Niederman, Uta Kiltz, Victoria Navarro-Compán, Juergen Braun, Laure Gossec, Salima van Weely, Dieter Wiek, Robert Landewé, Michael H. Weisman, Maxime Dougados, Merryn Jongkees, Philippe Carron, Helena Marzo-Ortega, Gleb Slobodin, Annelies Boonen, Percival D. Sampaio-Barros, Anna Molto, Nurullah Akkoc, Désirée van der Heijde, Filip Van den Bosch, Martin Rudwaleit, Astrid van Tubergen, Interne Geneeskunde, MUMC+: MA Reumatologie (9), RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, 44801, Germany, Amsterdam Rheumatology Center, AMC, Amsterdam, Netherlands, Rheumatology, Zuyderland MC, Heerlen, Netherlands, Rheumatology, Leiden University Medical Center, Leiden, Netherlands, Internal Medicine and Rheumatology, Klinikum Bielefeld Rosenhöhe, Bielefeld, Germany, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, Los Angeles, CA, United States, Department of Medicine, Division of Rheumatology, Celal Bayar University School of Medicine, Manisa, Turkey, Internal Medicine, Division of Rheumatology, Maastrich University Medical Center, Maastricht, Netherlands, Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands, Rheumatology, Private Practice, Berlin, Germany, Rheumatology, Ghent University Hospital, Ghent, Belgium, VIB Inflammation Research Center, Ghent, Belgium, Hopital Cochin, Rheumatology, Université Paris Descartes, Paris, France, INSERM (U1153): Epidémiologie Clinique et Biostatistiques, PRES Sorbonne Paris-Cité, Paris, France, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), UMR S 1136, Sorbonne Universite, Paris, France, APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France, Patient Research Partner, Amsterdam, Netherlands, MRC Centre for Neuromuscular Diseases, University College London, London, United Kingdom, Rheumatology, University College London Centre for Rheumatology, London, United Kingdom, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Faculty of Medicine and Health, Leeds, United Kingdom, Rheumatology, Hopital Cochin, Paris, France, Department of Rheumatology, University Hospital la Paz, IdiPaz, Madrid, Spain, School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland, Faculdade de Medicina, Universidade de São Paulo, Hospital das Clínicas, Sao Paulo, Brazil, Department of Internal Medicine A, Bnai Zion Medical Center, Technion, Haifa, Israel, Department of Internal Medicine and Pediatrics, Ghent University, Faculty of Medicine and Health Sciences, Gent, Belgium, Reade, Centre for Rehabilitation and Rheumatology, Amsterdam, Netherlands, Patient Research Partner, Huenxe, Germany, Clinical Immunology and Rheumatology, and AII - Inflammatory diseases
Subjects: Adult, Male, INDICATORS, Sondyloarthritis, medicine.medical_specialty, Consensus, Quality management, Referral, INFLAMMATORY ARTHRITIS, media_common.quotation_subject, Advisory Committees, Immunology, Qality Indicators, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Spondylarthritis, ankylosing spondylitis, Health care, Medicine and Health Sciences, medicine, Humans, quality Indicators, Immunology and Allergy, Quality (business), 030212 general & internal medicine, Axial spondyloarthritis, Societies, Medical, media_common, 030203 arthritis & rheumatology, Community level, Adult patients, business.industry, Biology and Life Sciences, OUTCOME MEASURES, spondyloarthritis, Quality Improvement, RHEUMATOID-ARTHRITIS, Family medicine, OF-CARE, DELAY, 616.7: Krankheiten des Bewegungsapparates und Orthopädie, Female, business, Delivery of Health Care, Stepwise approach
Abstract: ObjectivesThe Assessment of SpondyloArthritis International Society (ASAS) aimed to develop a set of quality standards (QS) to help improve the quality of healthcare provided to adult patients affected by axial spondyloarthritis (axSpA) worldwide.MethodsAn ASAS task force developed a set of QS using a stepwise approach. First, key areas for quality improvement were identified, discussed, rated and agreed on. Thereafter, areas were prioritised and statements for the most important key areas were phrased on consensus. Appropriate quality measures were defined to allow quantification of the QS at the community level.ResultsThe ASAS task force, consisting of 20 rheumatologists, two physiotherapists and two patients, selected and proposed 34 potential key areas for quality improvement which were then commented by 140 ASAS members and patients. Within that process three new key areas came up, which led to a re-evaluation of all 37 key areas by 120 ASAS members and patients. Five key areas were identified as most important to determine quality of care: referral including rapid access, rheumatology assessment, treatment, education/self-management and comorbidities. Finally, nine QS were agreed on and endorsed by the whole ASAS membership.ConclusionsASAS successfully developed the first set of QS to help improving healthcare for adult patients with axSpA. Even though it may currently not be realistic to achieve the QS in all healthcare systems, they provide high-quality of care framework for patients with axSpA that should be aimed for.
Published: 2020
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214. Collaboration of primary care and public health at the local level: observational descriptive study of French local health contracts

Author: Kendir, Candan, Breton, Eric, Le Bodo, Yann, Bourgueil, Yann, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Département des sciences humaines et sociales (SHS), Mission RESPIRE, French School of Public Health, French National Health Insurance Fund for Employees, French Institute for Research and Information in Health Economics [EHESP-CNAMTS-IRDES - EA MOS 7348 EHESP], 2016 general grant cycle of the French Public Health Institute [IRePS: BRETON-AAP16-PREV-16], and Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: primary healthcare, primary care, Primary Health Care, Health Personnel, Research, public health, Humans, France, community care, [SHS.SCIPO]Humanities and Social Sciences/Political science
Abstract: International audience; Aim: In this paper, we report on a study investigating the involvement of primary care providers in French local health contracts. Background: Worldwide actions are carried out to improve collaboration between primary care and public health to strengthen primary healthcare and consequently community health. In France, the local health contract is an instrument mobilising local stakeholders from different sectors to join in their actions to improve the health of the population. Methods: We developed an instrument to analyse the frequency and nature of involvement of primary care providers in 428 action plans extracted from a sample of 17 contracts (one per French region). The number of primary care actions were counted, and thematic analyses were conducted to identify the nature and level of involvement of the professionals. Findings: Primary care providers were involved in 20.1% (n = 86) of the action plans and were mostly described as a target of the action rather than leaders or partners. Within those action plans, 76.7% (n = 66) of these action plans aimed to improve access to care for local communities; an issue that appears as the main driver of collaboration between public health and primary care actors.
Published: 2020
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215. The dynamics of frailty and change in socio-economic conditions: evidence for the 65+ in Europe

Author: Nicolas Sirven, Thomas Rapp, Magali Dumontet, EconomiX, Université Paris Nanterre (UPN)-Centre National de la Recherche Scientifique (CNRS), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), and Institut du Management (IDM)
Subjects: Cross-sectional study, Economics, Frail Elderly, media_common.quotation_subject, Vulnerability, Public policy, Socioeconomic factors, Affect (psychology), 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Humans, 030212 general & internal medicine, Poisson regression, Older adult, Aged, media_common, Disability, Frailty, 030503 health policy & services, Stressor, 1. No poverty, Public Health, Environmental and Occupational Health, Fixed effects model, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Health Surveys, Europe, Cross-Sectional Studies, Phenotype, 8. Economic growth, symbols, Income, Demographic economics, Aging and health, 0305 other medical science, Psychology, Autonomy
Abstract: Background The frailty phenotype for older people is defined as an increased vulnerability to stressors, leading to adverse health outcomes. It is acknowledged as a specific precursor of disability besides chronic diseases that allows for some reversibility in the loss of autonomy. Although the literature on the socio-economic determinants of frailty is emerging in cross-sectional settings, little is known about the dynamics of this relationship over time. This article examines the joint evolution of frailty and change in economic conditions for the 65+ in Europe. Methods Individual and longitudinal data from SHARE (Survey on Health, Ageing and Retirement in Europe) over the period 2004–12 has been used. The sample contains 31 044 observations from 12 002 respondents aged 65 or more. A fixed effect Poisson model is estimated in order to control for unobserved individual heterogeneity. Three types of explanative economic variables have been considered in turn: income, wealth and a subjective variable of deprivation. Results Our results indicate that individuals with worsening economic conditions (wealth and subjective deprivation) over time simultaneously experience a rapid increase in the frailty symptoms. Results also show that the nature of economic variable does not affect the frailty process in the same way. Subjective measure of deprivation seems to better evaluate the household’s financial difficulties than objective measure. Conclusion From a public policy perspective, these results show that policies fostering economic conditions of the elderly could have a significant impact on frailty and henceforth, could reduce the risks of disability.
Published: 2020
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216. Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results

Author: Carlos Guijarro, Farid Zand, Mohamed solyman Kabil, Sven Trelle, Birgitte Tholin, Belén Comeche, Johan Alexander Azañero Haro, Gonzalo Sierra Torres, Quarraisha Abdool Karim, Kari Tikkinen, Jean-michel Molina, Atousa Hakamifard, George M Varghese, Oscar Josue Ponce Ponte, Mazin Barry, Pilar Vizcarra, Niccolo Riccardi, Natalia Pérez-Macias, Aynaa AlSharidi, Nelson Lee, Alexandra Binnie, Firouzé BANI-SADR, Beatriz Díaz-Pollán, Aldo Pietro Maggioni, Ilkka Kalliala, Florian Desgranges, Anders Benjamin Kildal, Katerina Nezvalova-Henriksen, Corinne Merle, Andrés Martín Alcántara, Benjamin Gaborit, Daniel Lozano Martín, Antonio Ramos-Martinez, Miguel Villegas-Chiroque, Fredy Orlando Guevara Pulido, Ana Fernández-Cruz, Cormac McCarthy, Thesla Palanee-Phillips, Annalisa Marinosci, Abdullah Assiri, Florent Wallet, Juan Pablo Balbuena, Avik Ray, Francesc Puchades, Rajarao Mesipogu, Marjatta Sinisalo, Jonathan Sterne, Antonio Portolés, Heike Cappel-Porter, Jussi Mustonen, Jeremy Nel, BRUNO MOURVILLIER, María Consuelo Miranda Montoya, Chiara Fanciulli, L Marjukka MyllÃ¤rniemi, Edinson Dante Meregildo Rodriguez, Alexy Inciarte, Mohamed Hassany, François Danion, Elena Muñez Rubio, Jean-Pierre QUENOT, Esperanza Merino de Lucas, Sheela Godbole, Luis Guillermo Barreto Rocchetti, Katerina Spasovska, William Connors, Kiana Shirani, Umang Agrawal, Srinivas Murthy, Bjorn Blomberg, Vasee Moorthy, Amith Balachandran, Antonio De Pablo Esteban, Mahnaz Amini, Dag Arne Lihaug Hoff, Zeinab Siami, Guillaume Martin-Blondel, Heng Gee Lee, Thrilok Chander Bingi, Vijay Krishnan, ANA BELEN RIVAS PATERNA, Eric D'Ortenzio, Samy Zaky, Carlos Arturo Alvarez-Moreno, Alonso Soto, VIKAS MARWAH, Marco Tulio Medina, Zaira R. Palacios-Baena, Jean-Sébastien Hulot, Miguel Angel Hueda Zavaleta, Felipe García, Francisco Fanjul, Hospices Civils de Lyon (HCL), INSERM UMR-S 606, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, PRES Sorbonne Paris-Cité, and Université Paris Denis Diderot, Université Paris Diderot - Paris 7 (UPD7), Michel-Avella, Amandine, Pan, H., Peto, R., Henao-Restrepo, A. -M., Preziosi, M. -P., Sathiyamoorthy, V., Karim, Q. A., Alejandria, M. M., Garcia, C. H., Kieny, M. -P., Malekzadeh, R., Murthy, S., Srinath Reddy, K., Periago, M. R., Hanna, P. A., Ader, F., Al-Bader, A. M., Alhasawi, A., Allum, E., Alotaibi, A., Alvarez-Moreno, C. A., Appadoo, S., Asiri, A., Aukrust, P., Barratt-Due, A., Bellani, S., Branca, M., Cappel-Porter, H. B. C., Cerrato, N., Chow, T. S., Como, N., Eustace, J., Garcia, P. J., Godbole, S., Gotuzzo, E., Griskevicius, L., Hamra, R., Hassan, M., Hassany, M., Hutton, D., Irmansyah, I., Jancoriene, L., Kirwan, J., Kumar, S., Lennon, P., Lopardo, G., Lydon, P., Magrini, N., Maguire, T., Manevska, S., Manuel, O., Mcginty, S., Medina, M. T., Mesa Rubio, M. L., Miranda-Montoya, M. C., Nel, J., Nunes, E. P., Perola, M., Portoles, A., Rasmin, M. R., Raza, A., Rees, H., Reges, P. P. S., Rogers, C. A., Salami, K., Salvadori, M. I., Sinani, N., Sterne, J. A. C., Stevanovikj, M., Tacconelli, E., Tikkinen, K. A. O., Trelle, S., Zaid, H., Rottingen, J. -A., Swaminathan S., &amp, Luzzati, R, Di Bella, S, Doctoral Programme in Population Health, Doctoral Programme in Biomedicine, HUS Abdominal Center, Department of Surgery, Urologian yksikkö, South Carelia Social and Health care District Eksote, HUS Heart and Lung Center, Department of Medicine, Clinicum, Department of Obstetrics and Gynecology, HUS Gynecology and Obstetrics, UCL - SSS/IREC/LTAP - Louvain Centre for Toxicology and Applied Pharmacology, and UCL - (SLuc) Service de médecine interne générale
Subjects: Male, Kaplan Meier method, Intention to Treat Analysi, MESH: Treatment Failure, MESH: Hydroxychloroquine, remdesivir, Rate ratio, MESH: Intention to Treat Analysis, MESH: Length of Stay, law.invention, Lopinavir/*therapeutic use, 0302 clinical medicine, middle aged, Medicine, Hospital Mortality, MESH: Respiration, Artificial, Antiviral Agents/administration & dosage/adverse effects/*therapeutic use, comparative study, beta1a interferon, MESH: Middle Aged, Alanine, Respiration, adult, clinical trial, General Medicine, 3. Good health, Intention to Treat Analysis, [SDV] Life Sciences [q-bio], aged, health care quality, priority journal, drug withdrawal, Artificial, Interferon, Drug Therapy, Combination, medicine.medical_specialty, Initiation of ventilation, Interferon beta-1a/*therapeutic use, World Health Organization, Antiviral Agents, Article, Duration of hospital stay, antiviral drugs, 03 medical and health sciences, Drug Therapy, death, Humans, MESH: Hospital Mortality, human, MESH: Kaplan-Meier Estimate, Aged, MESH: Humans, treatment duration, extracorporeal oxygenation, Hydroxychloroquine, Length of Stay, major clinical study, mortality, Respiration, Artificial, Adenosine Monophosphate/*analogs & derivatives/therapeutic use, multicenter study, Alanine/*analogs & derivatives/therapeutic use, MESH: Interferon beta-1a, randomized controlled trial, MESH: Female, antivirus agent, [SDV]Life Sciences [q-bio], MESH: Hospitalization, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Lopinavir, Adenosine Monophosphate, COVID-19, Female, Hospitalization, Interferon beta-1a, Middle Aged, Treatment Failure, Randomized controlled trial, Interquartile range, law, MESH: COVID-19, MESH: Adenosine Monophosphate, 030212 general & internal medicine, antiviral drugs, Covid-19, MESH: Aged, Hydroxychloroquine/*therapeutic use, MESH: Lopinavir, Covid19, artificial ventilation, drug therapy, ritonavir, hospital patient, female, Combination, medicine.drug, MESH: Antiviral Agents, combination drug therapy, COVID-19/*drug therapy/mortality, Randomization, MESH: Alanine, drug repositioning, drug clearance, adenosine phosphate, coronavirus disease 2019, length of stay, Internal medicine, controlled study, Antiviral Agent, Intention-to-treat analysis, business.industry, MESH: Male, COVID-19 Drug Treatment, purl.org/pe-repo/ocde/ford#3.02.00 [https], MESH: Drug Therapy, Combination, 3121 General medicine, internal medicine and other clinical medicine, business
Abstract: The authors report interim results of the WHO Solidarity trial of four repurposed antiviral drugs - remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a - in patients hospitalized with Covid-19. Effects on overall mortality, initiation of ventilation, and duration of hospital stay are compared. Background World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs - remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a - in patients hospitalized with coronavirus disease 2019 (Covid-19). Methods We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry. Results At 405 hospitals in 30 countries, 11,330 adults underwent randomization; 2750 were assigned to receive remdesivir, 954 to hydroxychloroquine, 1411 to lopinavir (without interferon), 2063 to interferon (including 651 to interferon plus lopinavir), and 4088 to no trial drug. Adherence was 94 to 96% midway through treatment, with 2 to 6% crossover. In total, 1253 deaths were reported (median day of death, day 8; interquartile range, 4 to 14). The Kaplan-Meier 28-day mortality was 11.8% (39.0% if the patient was already receiving ventilation at randomization and 9.5% otherwise). Death occurred in 301 of 2743 patients receiving remdesivir and in 303 of 2708 receiving its control (rate ratio, 0.95; 95% confidence interval [CI], 0.81 to 1.11; P=0.50), in 104 of 947 patients receiving hydroxychloroquine and in 84 of 906 receiving its control (rate ratio, 1.19; 95% CI, 0.89 to 1.59; P=0.23), in 148 of 1399 patients receiving lopinavir and in 146 of 1372 receiving its control (rate ratio, 1.00; 95% CI, 0.79 to 1.25; P=0.97), and in 243 of 2050 patients receiving interferon and in 216 of 2050 receiving its control (rate ratio, 1.16; 95% CI, 0.96 to 1.39; P=0.11). No drug definitely reduced mortality, overall or in any subgroup, or reduced initiation of ventilation or hospitalization duration. Conclusions These remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay. (Funded by the World Health Organization; ISRCTN Registry number, ; ClinicalTrials.gov number, .)
Published: 2020
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217. Les maisons de santé pluriprofessionnelles : un modèle organisationnel au carrefour de multiples logiques

Author: Ray, Marine, Bourgueil, Yann, Sicotte, Claude, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut de Recherche et Documentation en Economie de la Santé (IRDES), Institut de la Recherche et Documentation en Economie de la Santé, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, and Institut du Management (IDM)
Subjects: Maison de santé pluriprofessionnelle, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract: International audience; In France, the organization of primary care has been undergoing significant change over the past twenty years, with the emergence of new forms of regulation and new organizational models. Among the latter, multi-professional healthcare homes (Maisons de santé pluriprofessionnelles) have been receiving support from the public authorities since the mid-2000s.Based on a retrospective study of archival documents, we carry out a logical analysis of this organizational model and of the public policies supporting its development in France. Then, drawing on neo-institutional theory, we analyse the logics underpinning the diffusion of these new formal organizations, and discuss the relevance of this theoretical framework for understanding transformations related to reforms in the organization of primary care.; En France, le champ organisationnel des soins primaires connaît des transformations significatives depuis une vingtaine d’années, avec l’émergence de nouvelles formes de régulation et de nouveaux modèles organisationnels. Parmi ces derniers, les maisons de santé pluriprofessionnelles ont bénéficié du soutien des pouvoirs publics depuis le milieu des années 2000.À travers l’étude rétrospective de documents d’archive sur les politiques de développement des maisons de santé en France, nous proposons une analyse logique de ces politiques publiques et de ce modèle organisationnel. Nous caractérisons ensuite, en nous appuyant sur les théories néo-institutionnelles, les logiques qui sous-tendent la diffusion de ces nouvelles organisations formelles et discutons l’utilité de ce cadre d’analyse pour appréhender les transformations associées aux réformes de l’organisation des soins primaires.
Published: 2020
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218. Quelques limites pratiques du principe d’inclusion. L’exemple d’un dispositif à visée inclusive pour personnes âgées dépendantes

Author: Rapegno, Noémie, Rosenfelder, Cécile, EHESP, SCD, Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département des sciences humaines et sociales (SHS), Collectif de recherche handicap, autonomie et société inclusive (CoRHASI), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Réseau d'Études International sur l'Âge, la CitoyenneTé et l'Intégration Socio-économique (REIACTIS), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Inclusion, [SHS.SOCIO]Humanities and Social Sciences/Sociology, Personnes âgées dépendantes, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SHS.SOCIO] Humanities and Social Sciences/Sociology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Principe d’inclusion, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2020

219. Innovative organizational change and public institution

Author: Marrauld, Laurie, Bourez, Stéphane, Sicotte, Claude, Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Sauvage, Johanna, and Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: institutional entrepreneur, organisation de santé, health organization, entrepreneur institutionnel, [SHS] Humanities and Social Sciences, telemedicine, changement organisationnel innovant, [SHS.SCIPO] Humanities and Social Sciences/Political science, innovative organizational change, télémédecine, [SHS.SCIPO]Humanities and Social Sciences/Political science, [SHS]Humanities and Social Sciences
Abstract: Our research is situated in the conceptual framework of institutional entrepreneurship and aims at understanding innovative change in institutional context of healthcare organizations. We studied the point of view of actors of change involved in a telemedicine project. This project offers innovative services between hospital and EHPADs (French nursing homes). We used a qualitative methodology by doing semi-structured interviews with the main promoters and key actors of the project. the actors involved are effective in stimulating innovative changes when these actors come together and act as collective institutional entrepreneurs. Our analysis has highlighted the strategies of change put forward by a collective of public healthcare institutional entrepreneurs, the construction of legitimacy of their project, and their uncommon attitude toward the temporality of innovation., Nuestra investigación está anclada en la teoría del emprendimiento institucional y tiene como objetivo de comprender el cambio innovador en entornos institucionales, específicamente en el sector de la salud. Estudiamos el punto de vista de los actores del cambio involucrados en un proyecto de telemedicina que ofrece servicios innovadores entre hospitales y centros de atención residencial para personas mayores dependientes (EHPAD). Este estudio se realizó a través de una recopilación de datos mediante entrevistas semiestructuradas de los principales promotores y actores clave del proyecto. Los actores involucrados son efectivos para estimular cambios innovadores cuando estos actores se unen y actúan como empresarios institucionales colectivos. Nuestro análisis destacó las estrategias de cambio implementadas por un colectivo de empresarios institucionales pertenecientes al sector de la salud pública, los argumentos de construcción de la legitimidad de su proyecto y sus actitudes inusuales en términos de urgencia de despliegue de la innovación., Notre recherche s’ancre dans le cadre conceptuel de l’entreprenariat institutionnel et vise à comprendre le changement innovant en milieu institutionnel, spécifiquement dans le secteur de la santé. Nous avons étudié le point de vue d’acteurs du changement impliqués dans un projet de télémédecine offrant des services innovants entre hôpital et Établissements d’Hébergement Pour Personnes Âgées Dépendantes (EHPAD). Cette étude s’est faite au travers d’un recueil de données par entretiens semi-directifs des principaux promoteurs et acteurs clefs du projet. Notre étude conclut que les acteurs en présence sont efficaces à impulser des changements innovants lorsque ces acteurs se regroupent et agissent comme des entrepreneurs institutionnels constitués en collectif. Notre analyse met également en lumière les stratégies de changement qui ont été mises en œuvre par ce collectif d’entrepreneurs institutionnels appartenant au secteur public de la santé tels les arguments de construction de légitimité de leur projet, et leurs attitudes peu communes en matière d’urgence de déploiement de l’innovation.
Published: 2020

220. Mesurer la qualité pour transformer l’hôpital ? Analyse sociotechnique d’une discrète quantification

Author: Hugo Bertillot, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Département des sciences humaines et sociales (SHS), Centre de sociologie des organisations (Sciences Po, CNRS) (CSO), Sciences Po (Sciences Po)-Centre National de la Recherche Scientifique (CNRS), and Centre de sociologie des organisations (CSO)
Subjects: Santé, 030505 public health, 050402 sociology, [SHS.SOCIO]Humanities and Social Sciences/Sociology, 05 social sciences, Indicateurs, [SHS.SCIPO]Humanities and Social Sciences/Political science, Action publique, Rationalisation, 03 medical and health sciences, 0504 sociology, Political science, General Earth and Planetary Sciences, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, Evaluation, Humanities, Healthcare system, General Environmental Science
Abstract: International audience; Depuis le début des années 2000, les pouvoirs publics français déploient des instruments d’évaluation de la qualité dans les établissements de santé. En procédant à la déconstruction sociotechnique des « indicateurs de qualité », cet article analyse une discrète entreprise de quantification. Mesurant des dimensions peu conflictuelles de la qualité, nourris de savoirs pluriels, équivoques dans leurs usages, les indicateurs de qualité sont suffisamment doux pour ne pas brusquer les professionnels, tout en étant suffisamment robustes pour instiller discipline et auditabilité. Au nom de la qualité, cette technologie de gouvernement est ainsi équipée pour rationaliser l’hôpital en douceur.
Published: 2020
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221. Alcohol use disorders, beverage preferences and the influence of alcohol marketing: a preliminary study

Author: Morgane Guillou Landreat, Delphine Lever, Marie Bronnec, Delphine Le Goff, Antoine Dany, Céline Beauvais, Karine Gallopel Morvan, Jean Yves Le Reste, Soins Primaires, Santé Publique, Registre des cancers de Bretagne Occidentale (SPURBO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Réseau HUGO-PSY (CHU Rennes) (HUGO-PSY), CH Morlaix, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre de recherche en économie et management (CREM), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), French cancer institute (INCA) Institut National du Cancer (INCA) France, Brest University Hospital, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, HAL UR1, Admin, Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN)-Université de Tours (UT), Soins Primaires, Santé Publique, Registre des cancers de Bretagne Occidentale (EA7479 SPURBO), and Université de Brest (UBO)-Université de Brest (UBO)
Subjects: Male, lcsh:Social pathology. Social and public welfare. Criminology, Logistic regression, lcsh:HV1-9960, 0302 clinical medicine, Advertising, 030212 general & internal medicine, Marketing, [SHS.ECO] Humanities and Social Sciences/Economics and Finance, media_common, education.field_of_study, Alcoholic Beverages, lcsh:Public aspects of medicine, Health Policy, Age Factors, Middle Aged, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Social marketing, 3. Good health, Alcoholism, Psychiatry and Mental health, Health psychology, Female, France, Alcohol, Adult, medicine.medical_specialty, Adolescent, Alcohol Drinking, media_common.quotation_subject, Population, education, Young Adult, 03 medical and health sciences, Sex Factors, Alcohol use disorders, mental disorders, medicine, Humans, Risk factor, Descriptive statistics, business.industry, Research, Public health, Addiction, lcsh:RA1-1270, Cross-Sectional Studies, Socioeconomic Factors, Perception, business, 030217 neurology & neurosurgery
Abstract: Background Alcohol Use Disorders (AUD) are among the most prevalent mental disorders in the world. They are the leading risk factor for premature mortality and disability among 15 to 49-year-olds. Links between alcohol marketing and patterns of alcohol consumption are well defined in adolescents but there is few data on the impact of alcohol marketing on a population of drinkers with an AUD and seeking treatment. This study was designed in collaboration among researchers specialising in addictive disorders, in social marketing and primary care. Methods This was a monocentric, cross-sectional, descriptive study. The main objective of this study was to define the type of marketing identified by drinkers with an AUD who were seeking treatment and their beverage preferences. Drinkers aged 18+ with an AUD and seeking treatment were included. A descriptive analysis and a logistic regression were carried out . Results N = 91 patients were included, 73.6% were male, the average age was 46.2 years. 72% said they were not influenced by alcohol marketing, but 76% recalled an alcohol advertisement in the last 6 months. The most frequently reported beverage preferences were wine (39.6%), standard beers (29.6%), spirits (27.5%) and strong beers (16.5%). Conclusions Patients with AUD, defined as vulnerable, reported exposure to alcohol marketing but did not seem to identify it consciously. Marketing influences differed according to beverage preferences. These results need to be confirmed by a larger study.
Published: 2020
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222. La loi Evin de régulation du marketing de l’alcool. Quelle efficacité dans le cas de publicités/packagings orientés luxe vs. produit ?

Author: Diouf, Jacques-François, Gallopel-Morvan, Karine, Institut de Gestion de Rennes - Institut d'Administration des Entreprises - Rennes (IGR-IAE Rennes), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre de recherche en économie et management (CREM), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), Université de Rennes (UR), Université de Caen Normandie (UNICAEN), and Normandie Université (NU)-Normandie Université (NU)-Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Prévention, Loi Evin, Marketing social, [SHS.GESTION]Humanities and Social Sciences/Business administration, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Alcool, [SHS]Humanities and Social Sciences
Abstract: International audience; Context: The French Evin law (1991) mandates alcohol ads to present strictly the products’ objective qualities. With regard to public health and social marketing, this study calls into question the necessity of such content restriction measures that aim to protect young people from the appeal and desire to drink elicited by alcohol advertising. It also investigates the impact of such health measures on various persuasion variables (beliefs, intentions, etc.).Method: 26 in-depth interviews have been conducted among young people aged 15 to 29, exposed to packagings and ads which content is either product-oriented (neutral and informative, based on the Evin law: PO stimuli) or luxury-oriented (luxury stimuli). Respondents were questioned on various topics such as the attractiveness of the tested stimuli, the desire to purchase the advertised product, etc. The interviews were analysed mainly using manual thematic content analysis and the NVIVO software.Results: The tested persuasion variables are impacted negatively with regard to public health when exposed to luxury stimuli: attention, evocations, perceived quality, attractiveness, perceived image of the consumer, desire to consume the advertised product.Conclusion: These results indicate that alcohol advertising content influences a consumer’s motivation to process an ad message and the (cognitive and affective) routes to persuasion. Therefore, content restriction measures (Evin law) appear like an appropriate tool to limit the influence of advertising messages conveyed by the alcohol industry towards young people.; En France, la loi Evin (1991) impose que les publicités pour des marques d’alcool présentent ces produits de manière objective et informative. En termes de santé publique et de marketing social, cette recherche questionne l’intérêt d’une telle régulation pour protéger les jeunes de l’attractivité et de l’envie de consommer de l’alcool. Sur le plan théorique, elle teste son effet sur les différentes variables de la persuasion publicitaire (croyances, intentions, etc.).Méthode : 26 entretiens individuels semi-directifs ont été menés sur des jeunes (15-29 ans) exposés à des packagings et publicités pour marques d’alcool dont le contenu était objectif (conformément à la loi Evin : stimuli « produit ») ou connoté luxe (stimuli « luxe »). Les questions posées aux répondants étaient relatives à l’attractivité de ces stimuli, à l’envie d’acheter, etc. Les données ont été traitées via une analyse de contenu thématique manuelle et le logiciel NVIVO.Résultats : Les différentes variables de la persuasion publicitaire sont stimulées dans un sens défavorable à la santé publique dès lors que les stimuli sont « luxe » : attention, évocations, qualité perçue, attractivité, image perçue du consommateur, envie d’acheter le produit présenté. Conclusion : Ces résultats montrent que le contenu publicitaire influence la motivation à traiter le message via les routes cognitive et affective de la persuasion. La régulation des messages commerciaux pour les marques d’alcool (Loi Evin) apparaît alors pertinente pour limiter l’influence, sur les jeunes, des publicités diffusées par les industriels de l’alcool.
Published: 2020
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223. Heterogeneity in Drug Recommendation Compliance: The case for Alzheimer’s disease in France

Author: Pauline Chauvin, Nicolas Sirven, Thomas Rapp, Martine Bellanger, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), Université de Paris (UP), and Département des sciences humaines et sociales (SHS)
Subjects: Démence Alzheimer, Recommandation, Clinical guidance, Haute Autorité de Santé, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Alzheimer's disease, Drug, Recommendation, Prescription, Médicament
Abstract: International audience; Objectives: This study examines prescribers’ compliance with the 2011 clinical recommendation of the French National Authority for Health (HAS) aiming to limit the use of drugs specific to Alzheimer’s Disease (AD), and whether prescribers’ compliance differs as a function of patient gender.Study design: The sample consisted of quarterly data from the National Health Insurance claims database from 2010 to 2013 (16 quarters) for individuals living in the community, aged 65 or over at baseline.Methods: The probability of consuming AD drugs was estimated using a fixed effects model to account for individual and unobserved heterogeneity. Time-varying covariates were included to control for changes in health status and insurance effects. Estimations were carried out for men and women separately.Results: Discrepancies in trend of the probability of consuming AD drugs between women and men after the HAS’ 2011 recommendation were observed: the probability decreased for women while it remained constant for men.Conclusions: Our case study complements the literature on the influence of clinical recommendations by HTA body on clinical practices. Public health policies should take into account sex and gender differences in the management of AD patients. Further research should investigate how to implement gender targeted therapies and prevention, and their effects.; Objectif : Cette étude examine si les prescripteurs ont respecté la recommandation de la Haute Autorité de Santé de 2011 concernant la limitation des prescriptions de médicaments spécifiques à la maladie d’Alzheimer (MA) et si le respect de cette recommandation dépend du genre du patient.Design de l’étude : L’échantillon est composé de données trimestrielles de l’EGB de 2010 à 2013 (16 trimestres) pour des individus vivant à domicile et âgés de 65 ans et plus en 2010.Méthodes : La probabilité de consommer des médicaments spécifiques à la MA est estimée à partir d’un modèle de panel à effets fixes permettant de capturer l’hétérogénéité individuelle invariante dans le temps. Les variables explicatives variant dans le temps ont été incluses dans le modèle pour contrôler des variations d’état de santé et de remboursement. Les estimations ont été réalisées séparément pour les hommes et les femmes.Résultats : Une différence de tendance dans la probabilité de consommer des médicaments spécifiques à la MA entre les patients hommes et femmes est observée après la diffusion de la recommandation de la HAS en 2011 : cette probabilité décroit chez les femmes alors qu’elle reste stable chez les hommes.Conclusions : Notre cas d’étude complète la littérature sur l’influence des agences d’évaluation des technologies de santé sur les pratiques médicales. Les politiques de santé publique pour la prise en charge des patients atteints de la MA devraient prendre en compte les différences de genre des patients. De futures recherches devrait étudier comment mettre en place des thérapies et des politiques de prévention prenant en compte les différences de genre entre patients et leurs effets.
Published: 2020

224. A Single Dose of NILV-Based Vaccine Provides Rapid and Durable Protection against Zika Virus

Author: Maryline Bourgine, Etienne Simon-Loriere, François Anna, Min Wen Ku, Stéphane Petres, Pierre Charneau, Philippe Souque, Matthieu Prot, Virologie moléculaire et Vaccinologie, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Ecole Doctorale Frontières du Vivant - Programme Bettencourt (FdV), Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité, Université Paris Diderot, Sorbonne Paris Cité, Paris, France, Université Paris Diderot - Paris 7 (UPD7), Plateforme technologique Production et purification de protéines recombinantes – Production and Purification of Recombinant Proteins Technological Platform (PPR), Génomique évolutive des virus à ARN - Evolutionary genomics of RNA viruses, Institut Pasteur [Paris], Laboratoire commun Pasteur-TheraVectys, Institut Pasteur [Paris]-TheraVectys, M.W.K. is part of the Pasteur-Paris University (PPU) International PhD Program. This was supported by the Institut Carnot Pasteur Microbes & Santé and the European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement no. 665807., Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP), and Institut Pasteur [Paris] (IP)-TheraVectys
Subjects: medicine.medical_treatment, [SDV]Life Sciences [q-bio], Genetic Vectors, Cross Reactions, Antibodies, Viral, Zika virus, Viral vector, 03 medical and health sciences, Flaviviridae, Mice, 0302 clinical medicine, Immunogenicity, Vaccine, Viral Envelope Proteins, Immunity, Drug Discovery, Genetics, medicine, Vaccines, DNA, Animals, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, Neutralizing antibody, Molecular Biology, 030304 developmental biology, Pharmacology, Aedes, 0303 health sciences, Zika vaccine, biology, business.industry, Zika Virus Infection, Lentivirus, Viral Vaccines, Zika Virus, biology.organism_classification, Virology, Antibodies, Neutralizing, 3. Good health, Disease Models, Animal, Immunization, non-integrating lentiviral vector, 030220 oncology & carcinogenesis, Host-Pathogen Interactions, biology.protein, Molecular Medicine, Original Article, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business, Adjuvant
Abstract: Zika virus, a member of the Flaviviridae family, is primarily transmitted by infected Aedes species mosquitoes. In 2016, Zika infection emerged as a global health emergency for its explosive spread and the remarkable neurological defects in the developing fetus. Development of a safe and effective Zika vaccine remains a high priority owing to the risk of re-emergence and limited understanding of Zika virus epidemiology. We engineered a non-integrating lentiviralvector(NILV)-based Zika vaccine encoding the consensus pre-membrane and envelope glycoprotein of circulating Zika virus strains. We further evaluated the immunogenicity and protective efficacy of this vaccine in both immunocompromised and immunocompetent mouse models. A single immunization in both mouse models elicited a robust neutralizing antibody titer and afforded full protection against Zika challenge as early as 7 days post-immunization. This NILV-based vaccine also induced a long-lasting immunity when immunized mice were challenged 6 months after immunization. Altogether, our NILV Zika vaccine provides a rapid yet durable protection through a single dose of immunization without extra adjuvant formulation. Our data suggest a promising Zika vaccine candidate for an emergency situation, and demonstrate the capacity of lentiviral vector as an efficient vaccine delivery platform., Graphical Abstract, Using a non-integrating lentiviral vector delivery platform for prM-E Zika antigen, Ku et al. engineered an adjuvant-free single-dose Zika vaccine that provides protection against Zika virus as rapid as 7 days, and the protection persists over time.
Published: 2020
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225. Spinal Radiographic Progression in Early Axial Spondyloarthritis: Five-Year Results From the DESIR Cohort

Author: Miranda van Lunteren, Alexandre Sepriano, Désirée van der Heijde, Monique Reijnierse, Maria Antonietta D'Agostino, Anna Molto, Pascal Claudepierre, Sofia Ramiro, Maxime Dougados, Damien Loeuille, Antoine Feydy, Leiden University Medical Center (LUMC), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), PRES Sorbonne Paris Cité, Université Paris Descartes - Paris 5 (UPD5), Infection et inflammation (2I), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Ambroise Paré [AP-HP], Université de Lorraine (UL), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), CHU Henri Mondor, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Conservatoire National des Arts et Métiers [CNAM] (CNAM), and HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Adult, Male, Settore MED/16 - REUMATOLOGIA, Radiography, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Lumbar, Rheumatology, Spondylarthritis, Spondyloarthritis, Medicine, Humans, Spondylarthropathies, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, Sacroiliac joint, Syndesmophyte, Ankylosing spondylitis, Lumbar Vertebrae, medicine.diagnostic_test, business.industry, Brief Report, Magnetic resonance imaging, medicine.disease, Prognosis, Magnetic Resonance Imaging, 3. Good health, medicine.anatomical_structure, Cohort, Cervical Vertebrae, Disease Progression, Feasibility Studies, Female, business, Nuclear medicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Objective To analyze the progression of spinal radiographic damage in patients with early axial spondyloarthritis (SpA). Methods Axial SpA patients from the DESIR (Devenir des Spondylarthropathies Indifferenciees Recentes) cohort with 5-year spinal (cervical and lumbar) radiographs available (n = 549) were included. Two- and 5-year modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) progression and development of new syndesmophytes (net change: the number of patients with positive change minus the number of patients with negative change divided by the total number of patients) were assessed in subgroups defined at baseline according to the Assessment of SpondyloArthritis international Society axial SpA criteria and its arms, modified New York criteria (mNYC) and the presence of syndesmophytes. Results Mean ± SD mSASSS progression was 0.2 ± 0.9 at 2 years and 0.4 ± 1.8 at 5 years. Five-year progression was higher in the imaging arm (mean ± SD 0.6 ± 2.3), magnetic resonance imaging (MRI)+/mNYC+ (mean ± SD 1.3 ± 4.0), than in the clinical arm only (mean ± SD 0.1 ± 0.7), and highest in patients with syndesmophytes (mean ± SD 2.7 ± 5.0). At 5 years, 7% of all patients had a net change of any new syndesmophyte; this value was 10% for the imaging arm (mNYC+/MRI+ with 18%), 17% for mNYC+ patients, and 42% for patients with syndesmophytes. Conclusion Spinal radiographic progression, although limited in early axial SpA, can be captured after 2 years. Inflammation and damage in the sacroiliac joint are associated with higher radiographic progression. The presence of baseline syndesmophytes already strongly predicts the development of further structural damage early in the disease.
Published: 2019
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226. The Pre-Dialysis Care Trajectory of Chronic Kidney Disease Patients and the Start of Dialysis in Emergency: A Mixed Method Study Protocol

Author: M. Raffray, Sahar Bayat, Laetitia Laude, Arnaud Campéon, Cécile Vigneau, Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), École des Hautes Études en Santé Publique [EHESP] (EHESP), Modélisation Conceptuelle des Connaissances Biomédicales, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), CHU Pontchaillou [Rennes], Jonchère, Laurent, Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Adult, Male, medicine.medical_specialty, Emergency Medical Services, mixed methods, Health, Toxicology and Mutagenesis, medicine.medical_treatment, 030232 urology & nephrology, urologic and male genital diseases, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, care trajectory, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Risk Factors, big data, Health care, medicine, Protocol, Humans, 030212 general & internal medicine, Renal replacement therapy, Intensive care medicine, Dialysis, Aged, Protocol (science), Aged, 80 and over, business.industry, Public health, Public Health, Environmental and Occupational Health, Pre-dialysis, Middle Aged, medicine.disease, emergency start dialysis, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 3. Good health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Kidney Failure, Chronic, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Emergency Service, Hospital, chronic kidney disease, Kidney disease, Qualitative research
Abstract: International audience; Chronic Kidney Disease (CKD) is an important public health issue that requires early and close medical monitoring to start Renal Replacement Therapy (RRT) in the best conditions. However, in France, about 1/3 of patients start dialysis in emergency, despite the existence of CKD management guidelines. Using both quantitative and qualitative methods, we wanted to analyze the pre-dialysis care trajectory of patients with CKD and document the causes of Emergency dialysis Start (ES). To this aim, we designed a convergent mixed-method study. The quantitative component will analyze individual healthcare consumption and clinical data to identify the risk factors of ES by comparing the trajectories of patients who started dialysis in emergency in 2015 in France with those of patients who started in a planned manner and with the national recommendations. The qualitative component will explore the patients' trajectories and identify barriers to a planned start using semi-structured interviews with patients who started dialysis in emergency and with their general practitioners and nephrologists. Using the strengths of a mixed methodology, this study will bring robust and valuable findings to improve the care of CKD patients.
Published: 2019
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227. La prise en charge des femmes enceintes récemment arrivées en France. Approche comparative Rennes-Strasbourg

Author: Gasquet, Clelia, Hoyez, Anne-Cécile, Millot, Ana, Espaces et Sociétés (ESO), Institut de Géographie et d'Aménagement Régional de l'Université de Nantes (IGARUN), Université de Nantes (UN)-Université de Nantes (UN)-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-AGROCAMPUS OUEST, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université d'Angers (UA)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Le Mans Université (UM), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département des sciences humaines et sociales (SHS), Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES), Institut du Management (IDM), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, ANR, UMR ESO 6590 CNRS, ANR-16-CE36-0002,MIGSAN,Migrations et Santé : expériences de la santé et trajectoires de soin des populations primo-arrivantes en France.(2016), Le Mans Université (UM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université d'Angers (UA)-AGROCAMPUS OUEST-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Institut de Géographie et d'Aménagement Régional de l'Université de Nantes (IGARUN), and Université de Nantes (UN)-Université de Nantes (UN)
Subjects: Grossesse, [SHS.SOCIO]Humanities and Social Sciences/Sociology, Migrant, Femmes, [SHS.GEO]Humanities and Social Sciences/Geography, PASS
Abstract: Ce rapport a pour objectif d’analyser, au travers une recherche qualitative, les spécificités de la prise en charge des femmes migrantes récemment arrivées en France. L’étude se déploie dans deux PASS gynéco-obstétriques (Rennes et Strasbourg), dans la volonté de prendre en compte les situations des femmes et des professionnels à l’échelle locale. L’objectif de la comparaison est de pouvoir mettre en perspective les fonctionnements des mêmes services publics dédiés aux publics précaires qui évoluent dans des formes de prises en charge qui diffèrent en raison des spécificités locales.Ce rapport aborde à la fois le contexte de vie en migration des femmes dans le cadre de leur grossesse ainsi que les conditions d’exercice des professionnels qui les prennent en charge. Il s’inscrit dans le cadre des activités du programme de recherche MIGSAN « Expériences de la santé et trajectoires de soins des primo-arrivants en France. Il a été mené entre avril 2018 et avril 2019 par Ana Millot (diplômée du M2 « Promotion en Santé et Prévention» de l’EHESP et formée initialement aux soins infirmiers), Clélia Gasquet-Blanchard (MCF en géographie à l’EHESP), Anne-Cécile Hoyez (CR CNRS à l’UMR ESO/Université Rennes 2), en étroite collaboration avec les équipes des deux PASS.
Published: 2019

228. The age-performance relationship in the general population and strategies to delay age related decline in performance

Author: Fabien Pifferi, Patrick A. Carter, Adrien Marck, Archana Singh Manoux, Philippe Noirez, François-Denis Desgorces, Jean-François Toussaint, Juliana Antero, Michael Spedding, Geoffroy Berthelot, Stacey Johnson, Institut de recherche biomédicale et d’épidémiologie du sport (IRMES - EA 7329), Institut national du sport, de l'expertise et de la performance (INSEP)-Université Paris Descartes - Paris 5 (UPD5), Institut national du sport, de l'expertise et de la performance (INSEP), UFR STAPS, Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité, Mécanismes adaptatifs : des organismes aux communautés (MAOAC), Muséum national d'Histoire naturelle (MNHN)-Collège de France (CdF)-Centre National de la Recherche Scientifique (CNRS), School of Biological Sciences, Washington State University (WSU), Spedding Research solutions SARL, Epidémiologie des déterminants professionnels et sociaux de la santé, Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpitaux de Saint Maurice (HNSM), Université Paris Descartes - Paris 5 (UPD5)-Institut national du sport, de l'expertise et de la performance (INSEP), Muséum national d'Histoire naturelle (MNHN)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Mécanismes Adaptatifs et Evolution (MECADEV), and Muséum national d'Histoire naturelle (MNHN)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Gerontology, Aging, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Performance, Population, Poison control, Age-performance, Occupational safety and health, 03 medical and health sciences, 0302 clinical medicine, Injury prevention, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Medicine, 030212 general & internal medicine, education, ComputingMilieux_MISCELLANEOUS, 2. Zero hunger, Public health, education.field_of_study, business.industry, lcsh:Public aspects of medicine, Research, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Cognition, medicine.disease, Obesity, Cognitive training, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, 030217 neurology & neurosurgery
Abstract: The age-performance relationship describes changes in the organism’s structural and functional capabilities over the course of the lifespan. The typical, empirical pattern is an asymmetrical inverted-U shape association with peak capacity occurring early in life. This process is well described in the literature, with an increasing interest in features that characterize this pattern, such as the rate of growth, age of peak performance, and rate of decline with aging. This is usually examined in cohorts of individuals followed over time with repeat assessments of physical or cognitive abilities. This framework ought to be integrated into public health programs, embedding the beneficial (such as physical or cognitive training) or adverse effects (such as chronic diseases or injuries) that respectively sustain or limit capabilities. The maintenance of physical or cognitive performances at older ages would result in both optimal health and promote resistance to disabling conditions and chronic diseases, such as obesity and type 2 diabetes. The causes of accelerated degeneration of health optima are mainly: sedentary and unhealthy lifestyles -including poor nutrition-, exposure to environmental pollutants, and heterogeneity in aging. Better knowledge of optima, compatible with or required for good health, should also allow for establishing ideal conditions for longevity.
Published: 2019
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229. Transethnic, Genome-Wide Analysis Reveals Immune-Related Risk Alleles and Phenotypic Correlates in Pediatric Steroid-Sensitive Nephrotic Syndrome

Author: Elisabet Ars, Claire Dossier, José Ballarín, Stéphanie Debette, Pierre Ronco, Eric Letouzé, Hanna Debiec, Tabassome Simon, Siham Chafai Elalaoui, Matthias Kretzler, Georges Deschênes, Marina Vivarelli, Manuela Colucci, Valery Elie, Matthew G. Sampson, Philippe Amouyel, Evelyne Jacqz-Aigrain, Christopher E. Gillies, Valérie Dubois, Francesco Emma, Abdelaziz Sefiani, Rosemary K B Putler, Des Maladies Rénales Rares aux Maladies Fréquentes, Remodelage et Réparation, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Néphrologie pédiatrique [Hôpital Robert Debré, Paris], Hôpital Robert Debré-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe labellisée Ligue contre le Cancer, Labex Immuno-oncology, Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité, Unité de Formation et de Recherche Santé, Médecine, Biologie Humaine [Bobigny], Université Paris 13 (UP13)-Sorbonne Paris Cité, Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7), Pediatric Nephrology [Ann Arbor, MI, USA] (School of Medicine), University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, Nephrology and Dialysis Department [Rome, Italy], Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino Gesù [Rome, Italy], Molecular Biology Laboratory [Barcelona, Spain] (Fundació Puigvert - UAB), Universitat Autònoma de Barcelona (UAB)-Instituto de Investigaciones Biomédicas Sant Pau [Barcelona, Spain]-Fundació Puigvert [Barcelona, Spain], Centre d'Investigation Clinique 1426 (CIC 1426), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie des maladies chroniques : impact des interactions gène environnement sur la santé des populations, Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Department of Medical Genetics [Rabat, Morocco], Institut National d’Hygiène [Rabat, Morocco], Human Genomic Center [Rabat, Morocco], Université Mohamed V - Souissi, Etablissement français du sang - Auvergne-Rhône-Alpes (EFS), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche Clinique de l’Est Parisien [CHU Saint-Antoine] (URC-EST), Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Internal Medicine and Computational Medicine and Bioinformatics [Ann Arbor, MI, USA], Department of Nephrology [Barcelona, Spain], Fundación Puigvert [Barcelona, Spain], Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Service de Néphrologie et Dialyses [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), This study was funded by European Research Council grant ERC-2012- ADG_20120314 (grant agreement 322947) and Agence Nationale pour la Recherche 'Genetransnephrose' grant ANR-16-CE17-004-01. M.G.S. is supported by the Charles Woodson Clinical Research Fund and National Institutes of Health grant R01-DK108805. The Nephrotic Syndrome Study Network Consortium (NEPTUNE, U54-DK-083912) is a part of the National Center for Advancing Translational Sciences (NCATS) Rare Disease Clinical Research Network (RDCRN) supportedthrough a collaboration between the Office of Rare Diseases Research(ORDR), the NCATS, and the National Institute of Diabetes, Digestive,and Kidney Diseases. The RDCRN is an initiative of the ORDR of theNCATS. Additional funding and/or programmatic support for thisproject has also been provided by the University of Michigan, NephCureKidney International, and the Halpin Foundation. The NEPHROVIRcohort has been supported by two grants from the Programme Hospitalier de Recherche Clinique: grants PHRC 2007-AOM07018 and PHRC 2011-AOM11002. The NEPHROVIR network is coordinated by the Pediatric Nephrology Unit of Robert Debré Hospital, the 'Unité de Recherche Clinique de l’Est Parisien,' and the 'Délégation de la Recherche Clinique de la Région Ile-de-France.' M.V. and M.C. are supported by the Associazone per la Cura del bambino Nefropatico Organizzazione Non Lucrativa di Utilità Sociale., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré, Universitat Autònoma de Barcelona (UAB)-Fundació Puigvert [Barcelona, Spain]-Instituto de Investigaciones Biomédicas Sant Pau [Barcelona, Spain], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Mohammed V de Rabat [Agdal] (UM5), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Direction de la Recherche Clinique et de l'Innovation [AP-HP] (DRCI), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Département de Néphrologie = Service de Néphrologie et Dialyses [CHU Tenon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and RONCO, Pierre
Subjects: Male, 0301 basic medicine, 030232 urology & nephrology, Genome-wide association study, Cohort Studies, 0302 clinical medicine, Africa, Northern, HLA-DQ beta-Chains, Medicine, Child, Genetics, nephrotic syndrome, genetic renal disease, General Medicine, Phenotype, Italy, Nephrology, Child, Preschool, Cohort, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Female, Steroids, France, pediatrics, Quantitative Trait Loci, Black People, Single-nucleotide polymorphism, Polymorphism, Single Nucleotide, White People, 03 medical and health sciences, HLA-DQ Antigens, Up Front Matters, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Humans, SNP, Allele, Alleles, Genetic association, focal segmental glomerulosclerosis, genome-wide association study, Butyrophilins, business.industry, HLA-DR Antigens, Genetic architecture, HLA-DRB5 Chains, 030104 developmental biology, Spain, Case-Control Studies, Expression quantitative trait loci, gene expression, business, HLA-DRB1 Chains
Abstract: Background Steroid-sensitive nephrotic syndrome (SSNS) is a childhood disease with unclear pathophysiology and genetic architecture. We investigated the genomic basis of SSNS in children recruited in Europe and the biopsy-based North American NEPTUNE cohort. Methods We performed three ancestry-matched, genome-wide association studies (GWAS) in 273 children with NS (Children Cohort Nephrosis and Virus [NEPHROVIR] cohort: 132 European, 56 African, and 85 Maghrebian) followed by independent replication in 112 European children, transethnic meta-analysis, and conditional analysis. GWAS alleles were used to perform glomerular cis -expression quantitative trait loci studies in 39 children in the NEPTUNE cohort and epidemiologic studies in GWAS and NEPTUNE (97 children) cohorts. Results Transethnic meta-analysis identified one SSNS-associated single-nucleotide polymorphism (SNP) rs1063348 in the 3′ untranslated region of HLA-DQB1 ( P =9.3×10 −23 ). Conditional analysis identified two additional independent risk alleles upstream of HLA-DRB1 (rs28366266, P =3.7×10 −11 ) and in the 3′ untranslated region of BTNL2 (rs9348883, P =9.4×10 −7 ) within introns of HCG23 and LOC101929163 . These three risk alleles were independent of the risk haplotype DRB1*07:01-DQA1*02:01-DQB1*02:02 identified in European patients. Increased burden of risk alleles across independent loci was associated with higher odds of SSNS. Increased burden of risk alleles across independent loci was associated with higher odds of SSNS, with younger age of onset across all cohorts, and with increased odds of complete remission across histologies in NEPTUNE children. rs1063348 associated with decreased glomerular expression of HLA-DRB1, HLA-DRB5, and HLA-DQB1. Conclusions Transethnic GWAS empowered discovery of three independent risk SNPs for pediatric SSNS. Characterization of these SNPs provide an entry for understanding immune dysregulation in NS and introducing a genomically defined classification.
Published: 2018
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230. Economic evaluation of patient navigation programs in colorectal cancer care, a systematic review

Author: Anne Girault, Chloé Gervès-Pinquié, Serena Phillips, Mandi Pratt-Chapman, Sarah Raskin, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), The George Washington University (GW), Virginia Commonwealth University (VCU), Institut de Recherche en Santé Respiratoire Pays de la Loire (IRSR PL), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Troccaz, Olivier
Subjects: medicine.medical_specialty, MEDLINE, Review, CINAHL, JEL: I - Health, Education, and Welfare/I.I1 - Health/I.I1.I18 - Government Policy • Regulation • Public Health, 03 medical and health sciences, Indirect costs, 0302 clinical medicine, Quality of life (healthcare), Patient navigation, ddc:330, medicine, 030212 general & internal medicine, [SHS.ECO] Humanities and Social Sciences/Economics and Finance, ComputingMilieux_MISCELLANEOUS, lcsh:R5-920, Health economics, business.industry, Health Policy, Health services research, Cost-benefit analysis, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Colorectal cancer, 3. Good health, Systematic review, 030220 oncology & carcinogenesis, Family medicine, Economic evaluation, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Health care costs, business, lcsh:Medicine (General)
Abstract: Patient navigation has expanded as a promising approach to improve cancer care coordination and patient adherence. This paper addresses the need to identify the evidence on the economic impact of patient navigation in colorectal cancer, following the Health Economic Evaluation Publication Guidelines. Articles indexed in Medline, Cochrane, CINAHL, and Web of Science between January 2000 and March 2017 were analyzed. We conducted a systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment of the included studies was based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Inclusion criteria indicated that the paper’s subject had to explicitly address patient navigation in colorectal cancer and the study had to be an economic evaluation. The search yielded 243 papers, 9 of which were finally included within this review. Seven out of the nine studies included met standards for high-quality based on CHEERS criteria. Eight concluded that patient navigation programs were unequivocally cost-effective for the health outcomes of interest. Six studies were cost-effectiveness analyses. All studies computed the direct costs of the program, which were defined a minima as the program costs. Eight of the reviewed studies adopted the healthcare system perspective. Direct medical costs were usually divided into outpatient and inpatient visits, tests, and diagnostics. Effectiveness outcomes were mainly assessed through screening adherence, quality of life and time to diagnostic resolution. Given these outcomes, more economic research is needed for patient navigation during cancer treatment and survivorship as well as for patient navigation for other cancer types so that decision makers better understand costs and benefits for heterogeneous patient navigation programs. Electronic supplementary material The online version of this article (10.1186/s13561-018-0196-4) contains supplementary material, which is available to authorized users.
Published: 2018
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231. Le management au défi du stress des professionnels dans les établissements d’accueil des personnes âgées dépendantes

Author: Alan Vinot, Didier Vinot, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Centre de Recherche Magellan, Institut d'Administration des Entreprises (IAE) - Lyon-Université Jean Moulin - Lyon 3 (UJML), and Université de Lyon-Université de Lyon
Subjects: job stress, stress, organisation, JEL: M - Business Administration and Business Economics • Marketing • Accounting • Personnel Economics/M.M5 - Personnel Economics/M.M5.M54 - Labor Management, elderly-care facilities, [SHS.GESTION]Humanities and Social Sciences/Business administration, organization, EHPAD, JEL: M - Business Administration and Business Economics • Marketing • Accounting • Personnel Economics/M.M1 - Business Administration/M.M1.M12 - Personnel Management • Executives, Executive Compensation, performance, management, JEL: I - Health, Education, and Welfare/I.I1 - Health/I.I1.I18 - Government Policy • Regulation • Public Health
Abstract: International audience; Objective: The main objective of this article is to propose a management tool for perception of the job stress within medical and social structures and to analyze the results.This research was led within 26 elderly-care facilities for dependent persons throughout France.Method: The questionnaire was built from three experimental structures. Every scale was tested according to the alphas of Cronbach. The results were exploited via a multiple linear regression of the functions of different perceptions of the stress job.The research concerns 914 professionals who participated in this study. The questionnaire contains 42 questions concerning specific variables in the conditions of work and others more specific to the criteria identified during the phases of meadow make out a test. The alpha of Cronbach reveals a coefficient of .893, as for 13 relative questions in the conditions of work, and of .848 as for 21 questions specific to the stress identified in focus group.The results highlight 8 factors in connexion with the rhythm of the work, the clarity of the missions, the interruptions of the activities, the direction in the work, the contradictory orders and the general management.Conclusions: Some factors such as the relation with families do not intervene in the analysis of the causes of the stress, putting in front of the more marked organizational factors, which are real levers of actions for the management.; Objectif : L’objectif de cet article est de proposer un outil de mesure de perception du stress au sein de structures médico-sociales et à en analyser les résultats.Champs de l’étude : Cette recherche a été menée au sein de 26 Etablissements Hébergeant des Personnes Agées Dépendantes (EHPAD) répartis sur toute la France et intègre des structures citadines, rurales, de tailles, de statuts et de niveau de dépendance différents.Population étudiée : Tous les professionnels présents au sein de l’établissement au moment de l’étude.Méthode : Le questionnaire a été construit à partir de de trois structures pilote. Chaque échelle a été testée en fonction des alphas de Cronbach, α. Les résultats ont été exploités via une régression linéaire multiple de la fonction perception du stress.Résultats : La recherche porte sur 914 professionnels qui ont participé à cette étude. Le questionnaire comporte 42 questions portant sur des variables spécifiques aux conditions de travail et d’autres plus spécifiques aux critères identifiés lors des phases de pré test. L’alpha de Cronbach fait apparaître un coefficient de .893, quant aux 13 questions relatives aux conditions de travail, et de .848 quant aux 21 questions spécifiques au stress identifiées en focus group. Les résultats mettent en exergue 8 facteurs propres au rythme de travail, à la clarté des missions, aux interruptions des activités, au sens au travail, à la relation avec les résidents ou avec les collègues, aux ordres contradictoires et à l’encadrement.Conclusions : Certains facteurs tels que la relation avec les familles n’interviennent pas dans l’analyse des causes du stress, mettant en avant des facteurs organisationnels plus marqués, qui sont de réels leviers d’actions pour le manager.
Published: 2018
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232. Involvement of hepcidin in iron metabolism dysregulation in Gaucher disease

Author: Lefebvre, Thibaud, Reihani, Niloofar, Daher, Raed, de Villemeur, Thierry Billette, Belmatoug, Nadia, Rose, Christian, Colin-Aronovicz, Yves, Puy, Hervé, Le Van Kim, Caroline, Franco, Mélanie, Karim, Zoubida, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Français des Porphyries, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biologie Intégrée du Globule Rouge (BIGR (UMR_S_1134 / U1134)), Institut National de la Transfusion Sanguine [Paris] (INTS)-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles (UA), GRC ConCer-LD, Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université catholique de Lille (UCL), Institut National de la Transfusion Sanguine [Paris] (INTS)-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA), Laboratory of Excellence GR-Ex ' The red cell : from genesis to death ', PRES Sorbonne Paris Cité, Hôpital Armand Trousseau [AP-HP] (AP-HP), Hôpitaux Universitaires Paris Nord Val de Seine, Hôpital Claude Huriez, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Français des Porphyries Hôpital Louis Mourier, Université Paris Diderot - Paris 7 (UPD7), Institut National de la Transfusion Sanguine [Paris] (INTS), HAL UPMC, Gestionnaire, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), and Institut National de la Transfusion Sanguine [Paris] (INTS)-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Université des Antilles (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: [SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology, Adult, Male, congenital, hereditary, and neonatal diseases and abnormalities, Adolescent, [SDV]Life Sciences [q-bio], Iron, Article, Mice, Young Adult, Hepcidins, Animals, Humans, Enzyme Replacement Therapy, Child, Cation Transport Proteins, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Aged, 80 and over, Gaucher Disease, Macrophages, nutritional and metabolic diseases, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Middle Aged, Bone Marrow Failure, Child, Preschool, Ferritins, Female
Abstract: International audience; Gaucher disease (GD) is an inherited deficiency of glucocerebrosidase leading to accumulation of glucosylceramide in tissues such as the spleen, liver, and bone marrow. The resulting lipid-laden macrophages lead to the appearance of “Gaucher cells”. Anemia associated with an unexplained hyperferritinemia is a frequent finding in GD, but whether this pathogenesis is related to an iron metabolism disorder has remained unclear. To investigate this issue, we explored the iron status of a large cohort of 90 type I GD patients, including 66 patients treated with enzyme replacement therapy. Ten of the patients treated with enzyme replacement were followed up before and during treatment. Serum levels of hepcidin, the iron regulatory peptide, remained within the physiological range, while the transferrin saturation was slightly decreased in children. Inflammation-independent hyperferritinemia was found in 65% of the patients, and Perl’s staining of the spleen and marrow smear revealed iron accumulation in Gaucher cells. Treated patients exhibited reduced hyperferritinemia, increased transferrin saturation and transiently increased systemic hepcidin. In addition, the hepcidin and ferritin correlation was markedly improved, and, in most patients, the hemoglobin level was normalized. To further explore eventual iron sequestration in macrophages, we produce a Gaucher cells model by treating the J774 macrophage cell line with a glucocerebrosidase inhibitor and showed induced local hepcidin and membrane retrieval of the iron exporter, ferroportin. These data reveal the involvement of Gaucher cells in abnormal iron sequestration, which may explain the mechanism of hyperferritinemia in GD patients. Local hepcidin-ferroportin interaction was involved in this pathogenesis.
Published: 2018
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233. Effects of hydroxyurea on blood rheology in sickle cell anemia: A two-years follow-up study

Author: Yann Lamarre, Xavier Waltz, Marc Romana, Marie-Dominique Hardy-Dessources, Philippe Connes, Berenike Möckesch, Sophie Antoine-Jonville, Keyne Charlot, Nathalie Lemonne, Yohann Garnier, Maryse Etienne-Julan, Unité Transversale de la Drépanocytose, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Université des Antilles (Pôle Guadeloupe), Université des Antilles (UA), Biologie Intégrée du Globule Rouge (BIGR (UMR_S_1134 / U1134)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles (UA)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université de La Réunion (UR)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Transfusion Sanguine [Paris] (INTS), Dynamique des Structures et Interactions des Macromolécules Biologiques - Pôle de La Réunion (DSIMB Réunion), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles (UA)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université de La Réunion (UR)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Transfusion Sanguine [Paris] (INTS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles (UA)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université de La Réunion (UR)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Transfusion Sanguine [Paris] (INTS), Adaptation, Climat Tropical, Exercice et Santé (ACTES), Protéines de la membrane érythrocytaire et homologues non-érythroides, Université des Antilles et de la Guyane (UAG)-Institut National de la Transfusion Sanguine [Paris] (INTS)-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Hôpital Ricou, Institut National de la Transfusion Sanguine [Paris] (INTS)-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles (UA), Laboratory of Excellence GR-Ex 'The red cell: from genesis to death', PRES Sorbonne Paris Cité, Université des Antilles et de la Guyane (UAG), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM ), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)
Subjects: Adult, Male, medicine.medical_specialty, Physiology, [SDV]Life Sciences [q-bio], Blood viscosity, Anemia, Sickle Cell, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Antisickling Agents, Physiology (medical), White blood cell, Internal medicine, Fetal hemoglobin, medicine, Humans, Hydroxyurea, Platelet, blood rheology, business.industry, Follow up studies, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Hematology, medicine.disease, Acute chest syndrome, Sickle cell anemia, 3. Good health, medicine.anatomical_structure, clinical severity, 030220 oncology & carcinogenesis, sickle cell disease, Female, Hemoglobin, Rheology, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, 030215 immunology
Abstract: International audience; The aim of the present study was to test the effects of hydroxyurea (HU) therapy on clinical, hematological and hemorheological parameters in adult patients with sickle cell anemia (SCA). Hematological and hemorheological parameters were measured in 28 SCA patients before HU therapy (i.e., baseline) and at 6, 12 and 24 months of treatment. RBC deformability was determined by ektacytometry at 30 Pa. RBC aggregation properties were investigated by light-backscatter method. Blood viscosity was measured at 225 s-1 by a cone-plate viscometer. The rates of vaso-occlusive crises and acute chest syndrome were lower at 1 and 2 years of HU therapy compared to baseline. The proportion of patients with leg ulcers tended to decrease after 2 years of treatment. Hemoglobin oxygen saturation improved with HU therapy. HU therapy induced a decrease of platelet and white blood cell counts and a rise in fetal hemoglobin level and mean cell volume. While hemoglobin concentrations increased under HU, blood viscosity remained unchanged all along the study. RBC deformability increased over baseline values at 6 months of HU therapy and continued to rise until the end of the follow-up period. In conclusion, the improvement in RBC deformability probably compensates the increase of hemoglobin on blood viscosity and participates to the improvement of the clinical status of patients.
Published: 2017
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234. Les directeurs des soins dans la préfiguration des GHT

Author: François-Xavier Schweyer, Centre Maurice Halbwachs (CMH), École normale supérieure - Paris (ENS Paris)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département des sciences humaines et sociales (SHS), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), École normale supérieure - Paris (ENS Paris), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Public health, [SHS.SOCIO]Humanities and Social Sciences/Sociology, Enquête, Health Policy, Director of nursing, Santé publique, GHT, [SHS]Humanities and Social Sciences, 3. Good health, Rôle du professionnel, Sociology, Sociologie, Directeur des soins, Evolution of professions, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Territory hospital group, General Nursing, Medical-nursing project
Abstract: During their training at the Institute of Advanced Studies in Public Health, the 2016 intake of student directors of nursing observed and analysed a work situation within the context of territory hospital groups. The positioning of directors of nursing can be explained by two factors: the territorial configuration judged to be more or less favourable and their personal engagement in the preliminary discussion process.; Au cours de sa formation à l'École des hautes études en santé publique, la promotion 2016 des élèves directeurs des soins a observé et analysé une situation de travail à l'heure des groupements hospitaliers de territoire. Le positionnement du directeur des soins s'explique par deux facteurs : la configuration territoriale jugée plus ou moins favorable et l'engagement personnel dans le processus de préfiguration. (R.A.).
Published: 2017
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235. Clonally Expanded T Cells Reveal Immunogenicity of Rhabdoid Tumors

Author: Sonia Lameiras, Pamela Caudana, Sylvain Baulande, Arnault Tauziède-Espariat, Nicolas Servant, Franck Bourdeaut, Amaury Leruste, Joshua J. Waterfall, Didier Surdez, Mamy Andrianteranagna, Stéphanie Puget, Sandrine Grossetête-Lalami, Eliane Piaggio, Christine Sedlik, Jimena Tosello, Mylène Bohec, Philippe Benaroch, Rodrigo Nalio Ramos, Celio Pouponnot, Jovan Nikolic, Julie Helft, Solene Brohard, Valeria Manriquez, Louise Galmiche, Leticia Laura Niborski, Olivier Delattre, Aurore Coulomb, Zhi-Yan Han, Céline Chauvin, Kevin Beccaria, Julien Masliah-Planchon, Wilfrid Richer, Unité de génétique et biologie des cancers (U830), Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe, Institut Curie [Paris]-MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Bioinformatique (CBIO), MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Université Paris sciences et lettres (PSL), Centre de recherche Croissance et signalisation (UMR_S 845), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Genetique et Biotherapies des Maladies Degeneratives et Proliferatives du Systeme Nerveux (Inserm U745), Institut des sciences du Médicament -Toxicologie - Chimie - Environnement (IFR71), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Curie [Paris], Signalisation normale et pathologique de l'embryon aux thérapies innovantes des cancers, Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Anatomie et cytologie pathologiques [CHU Pitié-Salpêtrière] (ACP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Pathology Department [Paris], Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Department of Gene and Cell Medicine [New York], Icahn School of Medicine at Mount Sinai [New York] (MSSM), Immunité et cancer (U932), Université Paris Descartes - Paris 5 (UPD5)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), PRES Sorbonne Paris Cité, Immunité et cancer, Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Génétique Somatique, This work was funded by the BMS and the Janssen Horizon Foundations, the Société Française des Cancers de l’Enfant (SFCE) with the associations 'Enfants et Santé' and 'L’Étoile de Martin,' INCA PL-BIO 2016 call for Project from the French Minister of Research, the 'Abigael,' 'ADAM,' 'Au Nom d’Andréa,' and 'Marabout de Ficelles' associations. RTOP team is supported by the SiRIC-Curie Program (grant INCa-DGOS-4654). INSERM U830 is supported by the Institut National de la Santé et de la Recherche Médicale, Curie Institute and the Ligue Nationale Contre Le Cancer. TransImm team is supported by the SiRIC-Curie Program (grant INCa-DGOS-12554), the LabEx DCBIOL (ANR-10-IDEX-0001-02 PSL and ANR-11-LABX-0043), and the Center of Clinical Investigation (CIC IGR-Curie 1428). A.L. and P.C. were supported by the PhD program of Curie Institute., The authors thank S. Cairo, M. Chicard, J. Denizeau, C. Goudot, P. Gueguen, I. Jimenez, N. Manel, A. Pinto, S. Viel, S. Zaidi, and the mouse and the cytometry facility cores at Curie Institute., Université Paris Descartes - Paris 5 (UPD5)-Institut Curie-Institut National de la Santé et de la Recherche Médicale (INSERM), Cancer et génôme: Bioinformatique, biostatistiques et épidémiologie d'un système complexe, MINES ParisTech - École nationale supérieure des mines de Paris-Institut Curie-Institut National de la Santé et de la Recherche Médicale (INSERM), MINES ParisTech - École nationale supérieure des mines de Paris-PSL Research University (PSL), PSL Research University (PSL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL (ENSCP)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL (ENSCP)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Curie, Signalisation normale et pathologique de l'embryon aux thérapies innovante des cancers, Institut Curie-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'anatomie pathologique [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP]-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Curie-Université Paris Descartes - Paris 5 (UPD5), and Institut Curie-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Cancer Research, Chromosomal Proteins, Non-Histone, medicine.medical_treatment, T-Lymphocytes, [SDV]Life Sciences [q-bio], SMARCB1, Mice, Transgenic, [SDV.CAN]Life Sciences [q-bio]/Cancer, Biology, single-cell RNA sequencing, 03 medical and health sciences, 0302 clinical medicine, Immune system, endogenous retrovirus, medicine, Animals, Humans, tumor immunology, AT/RT, rhabdoid tumor, Immunogenicity, T-cell receptor, Nuclear Proteins, Cell Biology, Immunotherapy, Chromatin Assembly and Disassembly, Pediatric cancer, Immunohistochemistry, SWI/SNF, 3. Good health, Chromatin, pediatric cancer, DNA-Binding Proteins, Mice, Inbred C57BL, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Mutation, Cancer research, immunotherapy, T cell receptor, CD8, Transcription Factors
Abstract: International audience; Rhabdoid tumors (RTs) are genomically simple pediatric cancers driven by the biallelic inactivation of SMARCB1, leading to SWI/SNF chromatin remodeler complex deficiency. Comprehensive evaluation of the immune infiltrates of human and mice RTs, including immunohistochemistry, bulk RNA sequencing and DNA methylation profiling studies showed a high rate of tumors infiltrated by T and myeloid cells. Single-cell RNA (scRNA) and T cell receptor sequencing highlighted the heterogeneity of these cells and revealed therapeutically targetable exhausted effector and clonally expanded tissue resident memory CD8+ T subpopulations, likely representing tumor-specific cells. Checkpoint blockade therapy in an experimental RT model induced the regression of established tumors and durable immune responses. Finally, we show that one mechanism mediating RTs immunogenicity involves SMARCB1-dependent re-expression of endogenous retroviruses and interferon-signaling activation.
Published: 2019
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236. Mutations in TTC29, Encoding an Evolutionarily Conserved Axonemal Protein, Result in Asthenozoospermia and Male Infertility

Author: Marhaba Chaudhry, Sergey N. Savinov, Caroline Cazin, Gérard Gacon, Laurence Stouvenel, Abbas Daneshipour, Christophe Arnoult, Jean-Philippe Wolf, François Guillonneau, Raoudha Zouari, Pierre F. Ray, Maëlle Givelet, Jean-Fabrice Nsota Mbango, Alain Schmitt, Emmanuel Dulioust, Amir Amiri-Yekta, Lazhar Halouani, Denis Dacheux, Zeinab Sakheli, Patrick Lorès, Selima Fourati Ben Mustapha, Côme Ialy-Radio, Charles Coutton, Seyedeh Hanieh Hosseini, Aminata Touré, Lucile Ferreux, Maryline Favier, Mélanie Bonhivers, Zine-Eddine Kherraf, Catherine Patrat, Derrick R. Robinson, Ahmed Ziyyat, Ouafi Marrakchi, Elma El Khouri, Marjorie Whitfield, Marcio Do Cruzeiro, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Microbiologie cellulaire et moléculaire et pathogénicité (MCMP), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), AGeing and IMagery (AGIM), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-École pratique des hautes études (EPHE)-Centre National de la Recherche Scientifique (CNRS), Génétique, Reproduction et Développement - Clermont Auvergne (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Service d'Histologie-Embryologie, Biologie de la Reproduction (CECOS Paris Cochin), CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Clinique de Promotion des Sciences de la Reproduction - Les Jasmins (CPSR), Clinique de Promotion des Sciences de la Reproduction, Clinique de la reproduction les Jasmins, Polyclinique les Jasmins [Tunis], Plateforme Recombinaison Homologue, Transfert d'Embryons et Cryoconservation [Institut Cochin] (PRHTEC), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Plateforme protéomique 3P5 [Institut Cochin] (3P5), Génétique et Biologie du Développement, Centre National de la Recherche Scientifique (CNRS)-Institut Curie-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), University of Massachusetts [Amherst] (UMass Amherst), University of Massachusetts System (UMASS), Laboratoire des Venins et Toxines, Institut Pasteur de Tunis, Institut Pasteur de Tunis, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Laboratoire d'Histologie Embryologie - Biologie de la Reproduction, Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité-AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS), Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Microbiologie Fondamentale et Pathogénicité (MFP), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-École Pratique des Hautes Études (EPHE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique de Promotion des Sciences de la Reproduction [Tunis] (CPSR), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), ANR-12-BSV1-0011,MUCOFERTIL,La protéine TAT1 (SLC26A8), partenaire et activateur de CFTR dans le spermatozoïde, au carrefour des infertilités masculines et de la mucoviscidose.(2012), and ANR-11-LABX-0024,ParaFrap,Alliance française contre les maladies parasitaires(2011)
Subjects: Male, 0301 basic medicine, Axoneme, Trypanosoma brucei brucei, TPR, Fertilization in Vitro, [SDV.BC.BC]Life Sciences [q-bio]/Cellular Biology/Subcellular Processes [q-bio.SC], Flagellum, Biology, Asthenozoospermia, sperm, [SDV.MP.PRO]Life Sciences [q-bio]/Microbiology and Parasitology/Protistology, Article, Frameshift mutation, Evolution, Molecular, 03 medical and health sciences, 0302 clinical medicine, trypanosome, Trypanosomiasis, Intraflagellar transport, TTC29, [SDV.BC.IC]Life Sciences [q-bio]/Cellular Biology/Cell Behavior [q-bio.CB], Genetics, medicine, Animals, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Gene, Infertility, Male, Genetics (clinical), mouse, asthenozoospermia, 030219 obstetrics & reproductive medicine, Sperm flagellum, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, medicine.disease, Sperm, Mice, Inbred C57BL, [SDV.BBM.BP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biophysics, Tetratricopeptide, 030104 developmental biology, Mutation, MMAF, Female, flagella, infertility, Microtubule-Associated Proteins
Abstract: International audience; In humans, structural or functional defects of the sperm flagellum induce asthenozoospermia, which accounts for the main sperm defect encountered in infertile men. Herein we focused on morphological abnormalities of the sperm flagellum (MMAF), a phenotype also termed "short tails," which constitutes one of the most severe sperm morphological defects resulting in asthenozoospermia. In previous work based on whole-exome sequencing of a cohort of 167 MMAF-affected individuals, we identified bi-allelic loss-of-function mutations in more than 30% of the tested subjects. In this study, we further analyzed this cohort and identified five individuals with homozygous truncating variants in TTC29, a gene preferentially and highly expressed in the testis, and encoding a tetratricopeptide repeat-containing protein related to the intraflagellar transport (IFT). One individual carried a frameshift variant, another one carried a homozygous stop-gain variant, and three carried the same splicing variant affecting a consensus donor site. The deleterious effect of this last variant was confirmed on the corresponding transcript and protein product. In addition, we produced and analyzed TTC29 loss-of-function models in the flagellated protist T. brucei and in M. musculus. Both models confirmed the importance of TTC29 for flagellar beating. We showed that in T. brucei the TPR structural motifs, highly conserved between the studied orthologs, are critical for TTC29 axonemal localization and flagellar beating. Overall our work demonstrates that TTC29 is a conserved axonemal protein required for flagellar structure and beating and that TTC29 mutations are a cause of male sterility due to MMAF.
Published: 2019
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237. Blood Rheology: Key Parameters, Impact on Blood Flow, Role in Sickle Cell Disease and Effects of Exercise

Author: Elie Nader, Sarah Skinner, Marc Romana, Romain Fort, Nathalie Lemonne, Nicolas Guillot, Alexandra Gauthier, Sophie Antoine-Jonville, Céline Renoux, Marie-Dominique Hardy-Dessources, Emeric Stauffer, Philippe Joly, Yves Bertrand, Philippe Connes, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM ), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Pharmacogénétique et abords thérapeutiques des maladies héréditaires, Université des Antilles et de la Guyane (UAG)-Université Paris Diderot - Paris 7 (UPD7)-IFR2-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité Transversale de la Drépanocytose [Pointe-à-Pitre, Guadeloupe], CHU Pointe-à-Pitre/Abymes [Guadeloupe], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Adaptations au Climat Tropical, Exercice et Santé (ACTES), Université des Antilles et de la Guyane (UAG), Institut de recherche en informatique de Toulouse (IRIT), Université Toulouse 1 Capitole (UT1)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées, Amélioration génétique et adaptation des plantes méditerranéennes et tropicales (UMR AGAP), Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro)-Institut National de la Recherche Agronomique (INRA)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro), Laboratoire d'Excellence : Biogenèse et pathologies du globule rouge (Labex Gr-Ex), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL), Unité Transversale de la Drépanocytose, Hôpital Ricou-CHU Pointe-à-Pitre/Abymes [Guadeloupe], Chimie, Structures et Propriétés de Biomatériaux et d'Agents Thérapeutiques (CSPBAT), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 13 (UP13)-Institut Galilée-Université Sorbonne Paris Cité (USPC), Adaptation, Climat Tropical, Exercice et Santé (ACTES), Université des Antilles (UA), Laboratory of Excellence GR-Ex ' The red cell : from genesis to death ', PRES Sorbonne Paris Cité, Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris 13 (UP13)-Institut Galilée-Université Sorbonne Paris Cité (USPC)-Centre National de la Recherche Scientifique (CNRS)
Subjects: medicine.medical_specialty, Physiology, Blood viscosity, Review, 030204 cardiovascular system & hematology, Hematocrit, lcsh:Physiology, Microcirculation, [SCCO]Cognitive science, 03 medical and health sciences, red blood cell aggregation, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, blood rheology, 0303 health sciences, Shear thinning, lcsh:QP1-981, medicine.diagnostic_test, exercise, Chemistry, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Blood flow, red blood cell deformability, Red blood cell, medicine.anatomical_structure, Endocrinology, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Vascular resistance, Hemorheology, sickle cell disease
Abstract: Blood viscosity is an important determinant of local flow characteristics, which exhibits shear thinning behavior: it decreases exponentially with increasing shear rates. Both hematocrit and plasma viscosity influence blood viscosity. The shear thinning property of blood is mainly attributed to red blood cell (RBC) rheological properties. RBC aggregation occurs at low shear rates, and increases blood viscosity and depends on both cellular (RBC aggregability) and plasma factors. Blood flow in the microcirculation is highly dependent on the ability of RBC to deform, but RBC deformability also affects blood flow in the macrocirculation since a loss of deformability causes a rise in blood viscosity. Indeed, any changes in one or several of these parameters may affect blood viscosity differently. Poiseuille’s Law predicts that any increase in blood viscosity should cause a rise in vascular resistance. However, blood viscosity, through its effects on wall shear stress, is a key modulator of nitric oxide (NO) production by the endothelial NO-synthase. Indeed, any increase in blood viscosity should promote vasodilation. This is the case in healthy individuals when vascular function is intact and able to adapt to blood rheological strains. However, in sickle cell disease (SCD) vascular function is impaired. In this context, any increase in blood viscosity can promote vaso-occlusive like events. We previously showed that sickle cell patients with high blood viscosity usually have more frequent vaso-occlusive crises than those with low blood viscosity. However, while the deformability of RBC decreases during acute vaso-occlusive events in SCD, patients with the highest RBC deformability at steady-state have a higher risk of developing frequent painful vaso-occlusive crises. This paradox seems to be due to the fact that in SCD RBC with the highest deformability are also the most adherent, which would trigger vaso-occlusion. While acute, intense exercise may increase blood viscosity in healthy individuals, recent works conducted in sickle cell patients have shown that light cycling exercise did not cause dramatic changes in blood rheology. Moreover, regular physical exercise has been shown to decrease blood viscosity in sickle cell mice, which could be beneficial for adequate blood flow and tissue perfusion.
Published: 2019
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238. Marketing social. De la compréhension des publics au changement de comportement

Author: Gallopel-Morvan, Karine, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), and Institut du Management (IDM)
Subjects: Prévention, Marketing social, Comportements de santé, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract: International audience; Qu’est-ce que le marketing social ? Est-ce différent de la communication sociale ? Quels en sont les principes, les atouts, les outils ? Que signifient les 5 C ? En quoi une campagne de marketing social est-elle efficace, dans un programme de prévention, pour modifier les comportements de bien-être et de santé ? Quels sont les risques éthiques du développement de cette technique ?Pour répondre à ces questions et à toutes celles que les acteurs de la santé se posent, cet ouvrage, fruit de la collaboration entre chercheurs et experts, combine éléments théoriques, conseils pratiques et de nombreux exemples de campagnes de marketing social parmi lesquelles « Mois sans tabac » lancée depuis 2016 en France.
Published: 2019

239. NFAT primes the human RORC locus for RORγt expression in CD4+ T cells

Author: Elisabetta Bianchi, Lars Rogge, Tharshana Stephen, Magda Rybczynska, Domenica Lovecchio, Hanane Yahia-Cherbal, Chloé Lescale, Jérôme Larghero, Katarzyna Placek, Cellule Pasteur, Université Paris Diderot - Paris 7 (UPD7)-PRES Sorbonne Paris Cité, Immunorégulation - Immunoregulation, Institut Pasteur [Paris], Cytometrie et Biomarqueurs – Cytometry and Biomarkers (UTechS CB), Département de Génomes et Génétique - Department of Genomes and Genetics, Département d'Immunologie - Department of Immunology, Intégrité du génome, immunité et cancer - Genome integrity, Immunity and Cancer, CIC - Biotherapie - Saint Louis ((CIC-BT 301)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Grants from Institut Pasteur, FOREUM Foundation for Research in Rheumatology, the Fondation Arthritis, MSD Avenir (Project iCARE-SpA), and a Bourse Passerelle from Pfizer., Center for Translational Research/Cytometry Biomarkers Unit of Technology and Service (CRT/CB UTechS), Institut Pasteur. Estelle Mottez (CRT/CB UTechS) : drafting of clinical protocols. O. Kaminuma, F. Berberich-Siebelt and G. Natoli: expression constructs (see Methods). Helène Strick-Marchand (Innate Immunity Unit, Institut Pasteur) for human hepatocytes lysates., Institut Pasteur [Paris] (IP), and Kop, Marie-Luce
Subjects: 0301 basic medicine, [SDV.IMM] Life Sciences [q-bio]/Immunology, Science, [SDV]Life Sciences [q-bio], Adaptive immunity, General Physics and Astronomy, Biology, Jurkat cells, General Biochemistry, Genetics and Molecular Biology, Article, 03 medical and health sciences, 0302 clinical medicine, RAR-related orphan receptor gamma, Histone code, NF-kappaB, T-helper 17 cells, lcsh:Science, Transcription factor, Regulation of gene expression, Multidisciplinary, NFAT, General Chemistry, NFATC Transcription Factors, Cell biology, [SDV] Life Sciences [q-bio], Thymocyte, Gene regulation in immune cells, 030104 developmental biology, [SDV.IMM]Life Sciences [q-bio]/Immunology, lcsh:Q, 030215 immunology
Abstract: T helper 17 (Th17) cells have crucial functions in mucosal immunity and the pathogenesis of several chronic inflammatory diseases. The lineage-specific transcription factor, RORγt, encoded by the RORC gene modulates Th17 polarization and function, as well as thymocyte development. Here we define several regulatory elements at the human RORC locus in thymocytes and peripheral CD4+ T lymphocytes, with CRISPR/Cas9-guided deletion of these genomic segments supporting their role in RORγt expression. Mechanistically, T cell receptor stimulation induces cyclosporine A-sensitive histone modifications and P300/CBP acetylase recruitment at these elements in activated CD4+ T cells. Meanwhile, NFAT proteins bind to these regulatory elements and activate RORγt transcription in cooperation with NF-kB. Our data thus demonstrate that NFAT specifically regulate RORγt expression by binding to the RORC locus and promoting its permissive conformation., The master transcription factor RORγt, encoded by the RORC gene, controls the polarization of CD4+ T cells expressing interleukin-17 (Th17). Here the authors describe several regulatory elements at the RORC locus that are recognized by NFAT and NFkB to induce a permissive epigenetic configuration of the RORC gene for RORγt expression and Th17 differentiation.
Published: 2019
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240. Prognostic impact of initial tumor load and intraperitoneal disease dissemination patterns in patients with advanced ovarian cancer undergoing complete cytoreductive surgery

Author: Fabrice Lecuru, Charlotte Ngo, Léa Rossi, Myriam Delomenie, Bastien Rance, Anne-Sophie Bats, Jennifer Uzan, Marie Gosset, Eric Pujade-Lauraine, H Bonsang-Kitzis, and PRES Sorbonne Paris Cité
Subjects: Oncology, Adult, Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Disease, Carcinoma, Ovarian Epithelial, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Progression-free survival, 10. No inequality, education, Peritoneal Neoplasms, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, Chemotherapy, business.industry, General Medicine, Cytoreduction Surgical Procedures, Middle Aged, medicine.disease, Debulking, Prognosis, 3. Good health, Tumor Burden, Survival Rate, 030220 oncology & carcinogenesis, Conventional PCI, Disease Progression, Surgery, Female, Ovarian cancer, business, Cohort study
Abstract: Introduction Complete removal of disease is the most important prognostic factor for patients with advanced epithelial ovarian carcinoma. However, the influence of carcinomatosis distribution on prognosis is unknown and the prognostic impact of implant size according to their location is poorly studied. Our objective was to assess the impact of peritoneal carcinomatosis quantitative and qualitative localizations on progression free survival (PFS) in patients with advanced epithelial ovarian carcinoma (AEOC) after complete cytoreductive surgery. Methods We conducted a monocentric cohort study, retrospective from October 2001 to July 2014. Inclusion criteria were high-grade AEOC patients without residual disease (CC0) after primary debulking surgery (PDS) or after interval debulking surgery (IDS) following neoadjuvant chemotherapy (NACT). Peritoneal carcinomatosis was assessed according to qualitative criteria and quantitative criteria. Results One hundred and one patients were included. Median PFS was 21·2 months and median OS was 62·2 months. On the whole population, involvement of adipocytes-enriched areas tended to be associated with a decreased PFS and was significantly associated with a decreased OS. Any localization was associated with PFS or OS in the “IDS” subgroup. In the “PDS” subgroup, PCI score and involvement of the right mesocolic area were associated with a decreased PFS. Conclusion Initial tumor load has not been found associated with PFS after complete surgery. Adipocytes-enriched areas and right mesocolic areas involvement were associated with poor prognosis in patients receiving primary debulking surgery. Larger-scale studies are needed to assess whether initial tumor load has a prognostic impact even after complete cytoreductive surgery is achieved.
Published: 2019
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241. Which cues (colours and/or warnings) may be the most effective at deterring young people from smoking?

Author: Gallopel-Morvan, Karine, Droulers, Olivier, Pantin-Sohier, Gaelle, Miguel Rey Pino, Juan, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), Centre de recherche en économie et management (CREM), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Université d'Angers (UA), Groupe de Recherche Angevin en Economie et Management (GRANEM), Université d'Angers (UA)-AGROCAMPUS OUEST, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de l'Horticulture et du Paysage, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), and Université d'Angers (UA)-AGROCAMPUS OUEST-Institut National de l'Horticulture et du Paysage
Subjects: Cigarettes, Smoking, [SHS.GESTION]Humanities and Social Sciences/Business administration, Young people, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, ComputingMilieux_MISCELLANEOUS, [SHS]Humanities and Social Sciences
Abstract: International audience
Published: 2019

242. Inclusive education as a work from below: Focus on a French experimental device

Author: Rapegno, Noémie, Rosenfelder, Cécile, Bertillot, Hugo, Dynamiques européennes (DynamE), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Collectif de recherche handicap, autonomie et société inclusive (CoRHASI), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Département des sciences humaines et sociales (SHS), Handicap, Autonomie et développement de la participation sociale (HADéPaS), Experiments, Technology, Human Interactions, Care & Society (ETHICS EA 7446), Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL)-Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL), LAB'URBA (LAB'URBA), Université Paris-Est Marne-la-Vallée (UPEM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), EHESP-ARENES (EHESP-ARENES), Handicap, Autonomie et développement de la participation sociale (HADEPAS), Université catholique de Lille (UCL), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: [SHS.SOCIO]Humanities and Social Sciences/Sociology, [SHS.EDU]Humanities and Social Sciences/Education, Inclusive education, France, ComputingMilieux_MISCELLANEOUS, [SHS.SCIPO]Humanities and Social Sciences/Political science
Abstract: International audience
Published: 2019

243. Apport des données médico-administratives dans la construction d’un score de comorbidités pour prédire la mortalité à 1 an des patients en IRCT

Author: Maxime Raffray, Adélaïde Pladys, Cécile Vigneau, S. Bayat, Cécile Couchoud, École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Agence de la biomédecine [Saint-Denis la Plaine], CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: 03 medical and health sciences, 0302 clinical medicine, Nephrology, Comorbidités, 030232 urology & nephrology, Rennes score, Données médico-administratives, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030204 cardiovascular system & hematology, Mortalité, Insuffisance rénale chronique terminale (IRCT)
Abstract: International audience; IntroductionL’utilisation d’un score permettant de prédire la mortalité, est très utile dans la prise de décision entre le démarrage de la dialyse ou d’un traitement conservateur chez les patients poly-pathologiques.MéthodesL’objectif était d’étudier l’intérêt de l’utilisation des données médico-administratives, en plus des données REIN dans la construction d’un score de comorbidités, prédictif de la mortalité toutes causes à 1 an, chez les patients en insuffisance rénale chronique terminale (IRCT). Les données REIN ont été appariées aux données du système national des données de santé (SNDS). Notre score de comorbidités a été construit à partir de la population incidente en dialyse en 2015, préalablement divisée en 2 pour respectivement construire et valider le score. Plusieurs modèles ont été testés et comparés avant d’identifier le score le plus performant : Rennes score. Enfin, le Rennes score a été comparé aux scores de Wright et de Charlson.Résultats obtenus ou attendusLa performance pronostique du score construit à partir des données REIN appariées aux données SNDS n’est pas supérieure à celle du score issue uniquement des données REIN (Rennes score). Le Rennes score inclut : albumine
Published: 2019
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244. Étude du parcours de soins pré-dialyse des patients insuffisants rénaux chroniques terminaux démarrant la dialyse en urgence

Author: F. Gao, Cécile Vigneau, M. Raffray, Cécile Couchoud, Adélaïde Pladys, Sahar Bayat, Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Agence de la biomédecine [Saint-Denis la Plaine], Registre REIN, EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), and CHU de Pontchaillou
Subjects: Hémodialyse, Nephrology, Parcours de soins, Rein, Registre REIN, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Pré-dialyse, SNDS, 3. Good health
Abstract: International audience; IntroductionEn France, d’après le registre REIN, environ 30 % des patients atteints d’IRCT démarrent l’hémodialyse en urgence. Un tel démarrage augmente le risque de morbidité et de mortalité et diminue la qualité de vie. L’objectif était de comparer le parcours de soins pré-dialyse de ces patients avec celui des patients ayant bénéficié d’une 1re dialyse programmée.MéthodesLes patients ≥ 18 ans ayant démarré la dialyse en 2015 en France ont été inclus. Les données du REIN ont été appariées à celles du Système national des données de santé (SNDS). Les caractéristiques individuelles, les hospitalisations (nombre, durée et diagnostic principal) et le recours aux généralistes et aux néphrologues durant l’année précédant la 1re dialyse ont été comparés entre les deux groupes (démarrage en urgence vs. programmé).Résultats obtenus ou attendusParmi les 8964 patients inclus, 30,6 % avaient démarré la dialyse en urgence. Durant l’année précédant la 1re dialyse, le nombre médian de séjours était inférieur chez ces patients (1 vs. 2, p = 0,001) mais la durée moyenne d’un séjour était plus longue (8,1 jours vs. 5,8 jours, p < 0,001). Le nombre moyen de consultations avec un néphrologue était moindre chez les patients démarrant en urgence (2,5 vs. 4,5, p < 0,001) mais pas différent pour les consultations avec un généraliste (9,7 vs. 9,3, p = 0,064).ConclusionCette étude inédite du parcours de soins, grâce à l’appariement du registre REIN et du SNDS, a permis de montrer que les patients démarrant la dialyse de manière programmée étaient plus fréquemment suivis par des néphrologues et préparés à la dialyse. Cependant, dans les 2 groupes, beaucoup de patients avaient un suivi rapproché avec les généralistes. La comparaison du parcours de ces patients avec celui recommandé par la Haute Autorité de santé est en cours. Une étude qualitative impliquant patients, néphrologues et généralistes, approfondira la question d’adressage et les raisons médicales de ce suivi.
Published: 2019
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245. Dissuasive cigarettes: which cues are the most effective at deterring young people from smoking?

Author: Olivier Droulers, Gaëlle Pantin-Sohier, Karine Gallopel-Morvan, École des Hautes Études en Santé Publique [EHESP] (EHESP), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Institut du Management (IDM), Centre de recherche en économie et management (CREM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), Groupe de Recherche Angevin en Economie et Management (GRANEM), Université d'Angers (UA)-AGROCAMPUS OUEST-Institut National de l'Horticulture et du Paysage, Institut National Du Cancer, Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Université d'Angers (UA)-AGROCAMPUS OUEST, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de l'Horticulture et du Paysage
Subjects: Adult, Male, Attractiveness, Adolescent, media_common.quotation_subject, Embarrassment, Smoking Prevention, Product Labeling, Pictogram, Pleasure, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, 030212 general & internal medicine, Qualitative Research, media_common, 030503 health policy & services, Smoking, Tobacco control, Public Health, Environmental and Occupational Health, Tobacco Products, General Medicine, Tobacco Dissuasive cigarette Warnings, 3. Good health, Risk perception, [SHS.GESTION]Humanities and Social Sciences/Business administration, Female, France, Cues, 0305 other medical science, Psychology, Demography
Abstract: International audience; ObjectivesTo counter the attractiveness of cigarettes, Article 11 of the Framework Convention on Tobacco Control provides for the possibility of including warnings on cigarettes. The objective of our research was to explore perceptions of cigarettes designed to be dissuasive (displaying the warning ‘Smoking kills’ in uppercase or lowercase, a ‘skull and crossbones’ pictogram, unattractive shades of brown or dark green or a combination of all these negative cues).Study designIn-depth interviews were conducted with 31 people in France aged 15–25 years (10 daily smokers, 10 occasional smokers and 11 non-smokers; 15 females and 16 males).MethodsParticipants were shown different dissuasive cigarettes (displaying the warning ‘Smoking kills’, a ‘skull and crossbones’ pictogram, unattractive shades of brown or dark green or a combination of all three) and current branded ones. Open-ended questions were asked about the attractiveness of the cigarettes, perception of risk, the image of the smoker and influence on the desire to quit or not to start. Discussions were audio-recorded and transcribed.ResultsThe different dissuasive cues were found to increase negative health perceptions (e.g., increase risk), reduce positive smoker image and the perceived pleasure of smoking (e.g., embarrassment of smoking in front of friends), decrease the desire to start smoking and increase the desire to quit. The most dissuasive cigarette was an unattractively dark-coloured cigarette which displayed both the warning ‘Smoking kills’ and a ‘skull and crossbones’ pictogram.ConclusionThis study highlights the importance of the appearance of cigarettes and suggests that dissuasive cigarettes may be an innovative tobacco control measure for governments.
Published: 2019
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246. Évaluation de la couverture vaccinale antipneumococcique à l’initiation de la dialyse chronique en 2015, en France, et son impact sur la mortalité dans la première année

Author: Adélaïde Pladys, Sahar Bayat-Makoei, P. Tattevin, Cécile Vigneau, E. Pierre, Centre Hospitalier Universitaire de Rennes (CHU Rennes), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], and Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)
Subjects: Vaccination antipneumococcique, 03 medical and health sciences, 0302 clinical medicine, Dialyse, Immunisation, Nephrology, 030232 urology & nephrology, Couverture vaccinale, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030204 cardiovascular system & hematology, 3. Good health
Abstract: Introduction Les donnees sont limitees sur la couverture vaccinale antipneumococcique et l’impact de cette immunisation parmi les patients dialyses. Methodes Cette etude observationnelle, retrospective, nationale, avait pour objectifs d’estimer la couverture vaccinale selon les differents schemas vaccinaux chez les patients qui demarraient la dialyse chronique en France en 2015, et l’impact de cette vaccination sur la mortalite, selon les caracteristiques des patients et le schema vaccinal. Les donnees ont ete extraites de deux bases de donnees nationales, selon un rapprochement indirect par une methode de regroupement deterministe : le Reseau Epidemiologique et Information en Nephrologie (REIN), et le Systeme National d’Information Inter-Regime de l’Assistance Maladie (SNIIRAM). Les caracteristiques a l’initiation de la dialyse et la vaccination antipneumococcique prescrite 2 ans avant et 1 an apres l’initiation de la dialyse, ont ete collectees. Des analyses de Cox univariees et multivariees ont permis d’evaluer la mortalite toute cause a 1 an. Resultats obtenus ou attendus Parmi les 8294 patients inclus, 1849 (22,3 %) patients ont recu une vaccination antipneumococcique. Parmi ces patients, 35,1 % ont recu le Vaccin Pneumococcique Polyosidique 23 valences (VPP23) seul, 50,7 % le Vaccin Pneumococcique Polyosidique Conjugue 13 valences (VPC13) suivi du VPP23, et 14,1 % seulement le VPC13. Les patients vaccines etaient plus jeunes, ayant plus d’antecedents de glomerulonephrite, et demarrant la dialyse en programme. Apres ajustement sur les donnees clinico-biologiques et le contexte de demarrage de la dialyse, les patients ayant recu le VPC13 seul ou associe au VPP23, avaient moins de risque de deceder (respectivement, HR = 0,35 ; IC95 % : 0,19–0,65, et HR = 0,37 ; IC95 % : 0,28–0,51) ( Fig. 1 ). Conclusion La vaccination antipneumococcique par le VPC13 associe ou non au VPP23, mais pas par le VPP23 seul, est associee a une diminution de la mortalite a 1 an chez les patients demarrant la dialyse. Les patients demarrant la dialyse devraient recevoir une vaccination contre le pneumocoque par le VPC13.
Published: 2019
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247. Plain packaging: legislative differences in Australia, France, the UK, New Zealand and Norway, and options for strengthening regulations

Author: Kylie Lindorff, Janne Scheffels, Crawford Moodie, Janet Hoek, Karine Gallopel-Morvan, University of Stirling, University of Otago [Dunedin, Nouvelle-Zélande], Norwegian Institute of Public Health [Oslo] (NIPH), École des Hautes Études en Santé Publique [EHESP] (EHESP), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, Institut du Management (IDM), and Cancer Epidemiology Centre, Cancer Council Victoria
Subjects: Health (social science), Time Factors, Public policy, Best practice, Global health, Legislation, Product Labeling, Terminology, 03 medical and health sciences, 0302 clinical medicine, Terminology as Topic, Milestone (project management), Product Packaging, Humans, 030212 general & internal medicine, Marketing, Government, 030505 public health, Public Health, Environmental and Occupational Health, Legislature, Tobacco Products, Quitline, Packaging, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Business, 0305 other medical science
Abstract: International audience; By July 2018, five countries (Australia, France, the UK, New Zealand and Norway) had fully implemented plain (standardised) packaging. Using government documents, we reviewed the key legislative differences between these five countries to identify best practice measures and potential lacuna. We then discuss how governments planning to introduce plain packaging could strengthen their legislation. Differences between countries include the terminology used (either ‘plain’, ‘standardised’ or ‘plain and standardised’), products covered and transition times (ranging from 2 to 12 months). Myriad differences exist with respect to the packaging, including the dimensions (explicitly stated for height, width and depth vs minimum dimensions for the health warnings only), structure (straight-edged flip-top packs vs straight, rounded and bevelled-edged flip-top packs and shoulder boxes) and size (minimum number of cigarettes and weight of tobacco vs fixed amounts) and warning content (eg, inclusion of a stop-smoking web address and/or quitline displayed on warnings on one or both principal display areas). Future options that merit further analysis include banning colour descriptors in brand and variant names, allowing pack inserts promoting cessation and permitting cigarettes that are designed to be dissuasive. Plain packaging legislation and regulations are divergent. Countries moving towards plain packaging should consider incorporating the strengths of existing policies and review opportunities for extending these. While plain packaging represents a milestone in tobacco-control policy, future legislation need not simply reflect the past but could set new benchmarks to maximise the potential benefits of this policy.
Published: 2019
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248. Lyssavirus matrix protein cooperates with phosphoprotein to modulate the Jak-Stat pathway

Author: Florian Sonthonnax, Emilie M. Bonnaud, Hervé Bourhy, David Merino, Benoit Besson, Grégory Jouvion, Florence Larrous, Lyssavirus, épidémiologie et neuropathologie - Lyssavirus Epidemiology and Neuropathology, Institut Pasteur [Paris], Cellule Pasteur, Université Paris Diderot - Paris 7 (UPD7)-PRES Sorbonne Paris Cité, Neuropathologie expérimentale / Experimental neuropathology, Institut Pasteur [Paris]-Université de Paris (UP), This research was supported by the European Union Seventh Framework Programme (FP7/2007-2017) PREDEMICS grant #278433, European Project: 278433,EC:FP7:HEALTH,FP7-HEALTH-2011-two-stage,PREDEMICS(2011), Institut Pasteur [Paris] (IP), and Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité)
Subjects: 0301 basic medicine, Cytoplasm, Mice, 0302 clinical medicine, Interferon, [SDV.BC.IC]Life Sciences [q-bio]/Cellular Biology/Cell Behavior [q-bio.CB], STAT1, Promoter Regions, Genetic, Mice, Inbred BALB C, Multidisciplinary, Virulence, biology, Viral immune evasion, Chemistry, NF-kappa B, JAK-STAT signaling pathway, 3. Good health, Cell biology, STAT1 Transcription Factor, Interferon Type I, Medicine, Signal transduction, Signal Transduction, medicine.drug, Myeloma protein, Science, Virus-host interactions, Article, Viral Matrix Proteins, Viral Proteins, 03 medical and health sciences, Th2 Cells, medicine, Animals, Humans, Viral matrix protein, Janus Kinase 1, Phosphoproteins, Immunity, Innate, 030104 developmental biology, Phosphoprotein, Mutagenesis, Site-Directed, biology.protein, Lyssavirus, 030217 neurology & neurosurgery, Viral pathogenesis, HeLa Cells
Abstract: Phosphoprotein (P) and matrix protein (M) cooperate to undermine the immune response to rabies virus (RABV) infections. While P is involved in the modulation of the Jak-Stat pathway through the cytoplasmic retention of interferon (IFN)-activated STAT1 (pSTAT1), M interacts with the RelAp43-p105-ABIN2-TPL2 complex, to efficiently inhibit the nuclear factor-κB (NF-κB) pathway. Using transfections, protein-complementation assays, reverse genetics and DNA ChIP, we identified a role of M protein in the control of Jak-Stat signaling pathway, in synergy with the P protein. In unstimulated cells, both M and P proteins were found to interact with JAK1. Upon type-I IFN stimulation, the M switches toward pSTAT1 interaction, which results in an enhanced capacity of P protein to interact with pSTAT1 and restrain it in the cytoplasm. Furthermore, the role for M-protein positions 77, 100, 104 and 110 was also demonstrated in interaction with both JAK1 and pY-STAT1, and confirmed in vivo. Together, these data indicate that M protein cooperates with P protein to restrain in parallel, and sequentially, NF-κB and Jak-Stat pathways.
Published: 2019
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249. Phage Therapy of Pneumonia Is Not Associated with an Overstimulation of the Inflammatory Response Compared to Antibiotic Treatment in Mice

Author: Jean-Damien Ricard, Nicolas Dufour, Raphaëlle Delattre, Anne Chevallereau, Laurent Debarbieux, Département de Microbiologie - Department of Microbiology, Institut Pasteur [Paris], Centre Hospitalier René Dubos [Pontoise], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Département Anesthésie et Réanimation, Hôpital Beaujon, Clichy, Paris, France., Cellule Pasteur, Université Paris Diderot - Paris 7 (UPD7)-PRES Sorbonne Paris Cité, Service de Réanimation Médico-Chirurgicale [Hôpital Louis Mourier], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), This work was supported by two joint research grants from both the Institut Pasteur and Assistance Publique–Hôpitaux de Paris (Poste d’Accueil pour Praticien Hospitalier) allocated to N.D. and R.D., Institut Pasteur [Paris] (IP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, and Cova Rodrigues, Ana
Subjects: Lung Diseases, Male, antibiotic resistance, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Antibiotics, Bacteremia, bacteriophage therapy, medicine.disease_cause, MESH: Bacterial Load, Bacteriophage, MESH: Lung Diseases, Edema, host response, Pharmacology (medical), MESH: Animals, MESH: Administration, Intranasal, MESH: Bacteremia, MESH: Blood Cell Count, innate immunity, Escherichia coli Infections, MESH: Treatment Outcome, 0303 health sciences, Mice, Inbred BALB C, MESH: Cytokines, biology, lung infection, Ceftriaxone, MESH: Podoviridae, Podoviridae, 3. Good health, Anti-Bacterial Agents, [SDV] Life Sciences [q-bio], MESH: Myoviridae, MESH: Edema, Infectious Diseases, Treatment Outcome, Myoviridae, medicine.drug, MESH: Pneumonia, Phage therapy, medicine.drug_class, MESH: Mice, Inbred BALB C, MESH: Phage Therapy, Microbiology, 03 medical and health sciences, Antibiotic resistance, In vivo, MESH: Anti-Bacterial Agents, medicine, Animals, pneumonia, Experimental Therapeutics, Phage Therapy, Escherichia coli, Administration, Intranasal, 030304 developmental biology, MESH: Escherichia coli Infections, Pharmacology, 030306 microbiology, business.industry, biology.organism_classification, medicine.disease, Bacterial Load, cytokines, MESH: Male, Blood Cell Count, MESH: Ceftriaxone, Pneumonia, inflammation, business
Abstract: International audience; Supported by years of clinical use in some countries and more recently by literature on experimental models, as well as its compassionate use in Europe and in the United States, bacteriophage (phage) therapy is providing a solution for difficult-to-treat bacterial infections. However, studies of the impact of such treatments on the host remain scarce. Murine acute pneumonia initiated by intranasal instillation of two pathogenic strains of Escherichia coli (536 and LM33) was treated by two specific bacteriophages (536_P1 and LM33_P1; intranasal) or antibiotics (ceftriaxone, cefoxitin, or imipenem-cilastatin; intraperitoneal). Healthy mice also received phages alone. The severity of pulmonary edema, acute inflammatory cytokine concentration (blood and lung homogenates), complete blood counts, and bacterial and bacteriophage counts were determined at early (Յ12 h) and late (Ն20 h) time points. The efficacy of bacteriophage to decrease bacterial load was faster than with antibiotics, but the two displayed similar endpoints. Bacteriophage treatment was not associated with overinflammation but in contrast tended to lower inflammation and provided a faster correction of blood cell count abnormalities than did antibiotics. In the absence of bacterial infection, bacteriophage 536_P1 promoted a weak increase in the production of antiviral cytokines (gamma interferon [IFN-␥] and interleukin-12 [IL-12]) and chemokines in the lungs but not in the blood. However, such variations were no longer observed when bacteriophage 536_P1 was administered to treat infected animals. The rapid lysis of bacteria by bacteriophages in vivo does not increase the innate inflammatory response compared to that with antibiotic treatment.
Published: 2019
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250. Consumer Perceptions of Cigarette Design in France: A Comparison of Regular, Slim, Pink and Plain Cigarettes

Author: Emmanuelle Béguinot, Romain Guignard, Karine Gallopel-Morvan, Crawford Moodie, Figen Eker, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut du Management (IDM), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, University of Stirling, Santé publique France - French National Public Health Agency [Saint-Maurice, France], and Comité national contre le tabagisme
Subjects: Adult, Male, Adolescent, medicine.medical_treatment, media_common.quotation_subject, Color, Product Labeling, Cigarette Smoking, Nicotine, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Environmental health, Perception, Surveys and Questionnaires, medicine, Product Packaging, Humans, 030212 general & internal medicine, Cigarette, Consumer behaviour, media_common, 030505 public health, Smokers, Brand names, Tobacco control, Public Health, Environmental and Occupational Health, Tobacco Products, Consumer Behavior, Harm, Consumer Perception, Smoking cessation, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Cigarette Design, 0305 other medical science, Cigarette pack, Psychology, medicine.drug
Abstract: INTRODUCTION: The cigarette, like the cigarette pack, is used by tobacco companies as a promotional tool. We explore how the cigarette could potentially be used as a dissuasive tool. METHODS: An online survey was conducted with 15-30-year-old smokers and nonsmokers (N = 998) in France to explore their perceptions of a plain cigarette (gray with no brand name) and three branded cigarettes (regular, slim, pink). Participants were randomly assigned to view the plain cigarette and either the regular, slim, or pink cigarette. They were asked to rate the cigarettes by Appeal (tastiest, highest quality, and most expensive), Harm (most dangerous and most effective for motivating people to talk about tobacco dangers), and Perceived behavioral impact (most effective to convince teenagers not to start and to motivate smokers to reduce consumption and quit). RESULTS: In comparison to the gray cigarette, each of the branded cigarettes were considered more appealing, less harmful, and more likely to motivate teenagers to start and less likely to motivate smokers to reduce consumption or quit. CONCLUSIONS: The study suggests that altering the appearance of the cigarette may reduce cigarette appeal, increase harm perceptions, and deter both young people and smokers. IMPLICATIONS: Very little research has focused on dissuasive cigarettes whereas the cigarette stick has become very important for tobacco companies for communication purposes. This is the first study to compare the effect of various branded cigarettes (regular, slim, and pink) with a plain gray cigarette on young adult smokers and nonsmokers. The findings suggest that a plain gray cigarette can reduce cigarette appeal, increase perceptions of harm, and may deter use among both smokers and nonsmokers.
Published: 2019
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