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Telemedicine (TM) has augmented healthcare by enabling remote consultations, diagnosis, treatment, and monitoring of patients, thereby improving healthcare access and patient outcomes. However, successful adoption of TM depends on user acceptance, which is influenced by technical, socioeconomic, and health-related factors. Leveraging machine learning (ML) to accurately predict these adoption factors can greatly contribute to the effective utilization of TM in healthcare. The objective of the study was to compare 12 ML algorithms for predicting willingness to use TM (TM try) among patients with rheumatic and musculoskeletal diseases (RMDs) and identify key contributing features. We conducted a secondary analysis of RMD patient data from a German nationwide cross-sectional survey. Twelve ML algorithms, including logistic regression, random forest, extreme gradient boosting (XGBoost), and neural network (deep learning) were tested on a subset of the dataset, with the inclusion of only RMD patients who answered "yes" or "no" to TM try. Nested cross-validation was used for each model. The best-performing model was selected based on area under the receiver operator characteristic (AUROC). For the best-performing model, a multinomial/multiclass ML approach was undertaken with the consideration of the three following classes: "yes", "no", "do not know/not answered". Both one-vs-one and one-vs-rest strategies were considered. The feature importance was investigated using Shapley additive explanation (SHAP). A total of 438 RMD patients were included, with 26.5% of them willing to try TM, 40.6% not willing, and 32.9% undecided (missing answer or "do not know answer"). This dataset was used to train and test ML models. The mean accuracy of the 12 ML models ranged from 0.69 to 0.83, while the mean AUROC ranged from 0.79 to 0.90. The XGBoost model produced better results compared with the other models, with a sensitivity of 70%, specificity of 91% and positive predictive value of 84%. The most important predictors of TM try were the possibility that TM services were offered by a rheumatologist, prior TM knowledge, age, self-reported health status, Internet access at home and type of RMD diseases. For instance, for the yes vs. no classification, not wishing that TM services were offered by a rheumatologist, self-reporting a bad health status and being aged 60–69 years directed the model toward not wanting to try TM. By contrast, having Internet access at home and wishing that TM services were offered by a rheumatologist directed toward TM try. Our findings have significant implications for primary care, in particular for healthcare professionals aiming to implement TM effectively in their clinical routine. By understanding the key factors influencing patients' acceptance of TM, such as their expressed desire for TM services provided by a rheumatologist, self-reported health status, availability of home Internet access, and age, healthcare professionals can tailor their strategies to maximize the adoption and utilization of TM, ultimately improving healthcare outcomes for RMD patients. Our findings are of high interest for both clinical and medical teaching practice to fit changing health needs caused by the growing number of complex and chronically ill patients. [ABSTRACT FROM AUTHOR]

Epidemiological data regarding thyroid diseases are lacking, in particular for occupationally exposed populations. To compare the risk of hypothyroidism and hyperthyroidism between farming activities within the complete population of French farm managers (FMs). Digital health data from retrospective administrative databases, including insurance claims and electronic health/medical records, was employed. This cohort data spanned the entirety of French farm managers (FMs) who had undertaken work at least once from 2002 to 2016. Survival analysis with the time to initial medication reimbursement as timescale was used to examine the association (hazard ratio, HR) between 26 specific farming activities and both treated hypothyroidism and hyperthyroidism. A distinct model was developed for each farming activity, comparing FMs who had never engaged in the specific farming activity between 2002 and 2016 with those who had. All analyses were adjusted for potential confounders (e.g., age), and sensitivity analyses were conducted. Among 1088561 FMs (mean age 46.6 [SD 14.1]; 31% females), there were 31834 hypothyroidism cases (75% females) and 620 hyperthyroidism cases (67% females), respectively. The highest risks were observed for cattle activities for both hyperthyroidism (HR ranging from 1.75 to 2.42) and hypothyroidism (HR ranging from 1.41 to 1.44). For hypothyroidism, higher risks were also observed for several animal farming activities (pig, poultry, and rabbit), as well as fruit arboriculture (HR = 1.22 [1.14–1.31]). The lowest risks were observed for activities involving horses. Sex differences in the risk of hypothyroidism were observed for eight activities, with the risk being higher for males (HR = 1.09 [1.01–1.20]) than females in viticulture (HR = 0.97 [0.93–1.00]). The risk of hyperthyroidism was two times higher for male dairy farmers than females. Our findings offer a comprehensive overview of thyroid disease risks within the FM community. Thyroid ailments might not stem from a single cause but likely arise from the combined effects of various causal agents and triggering factors (agricultural exposome). Further investigation into distinct farming activities—especially those involving cattle—is essential to pinpoint potential risk factors that could enhance thyroid disease monitoring in agriculture. [Display omitted] • Development of thyroid diseases may be promoted by agricultural exposure. • French nationwide population-based study using administrative heath databases. • Risk of thyroid diseases was examined for 26 farming activities. • A higher risk of thyroid diseases was found in all cattle farming activities. • A higher risk of hypothyroidism was observed in fruit arboriculture and viticulture. [ABSTRACT FROM AUTHOR]

Objectives A vast data mining project called 'TRACking and moniToring Occupational Risks in agriculture' (TRACTOR) was initiated in 2017 to investigate work-related health events among the entire French agricultural workforce. The goal of this work is to present the TRACTOR project, the challenges faced during its implementation, to discuss its strengths and limitations and to address its potential impact for health surveillance. Methods Three routinely collected administrative health databases from the National Health Insurance Fund for Agricultural Workers and Farmers (MSA) were made available for the TRACTOR project. Data management was required to properly clean and prepare the data before linking together all available databases. Results After removing few missing and aberrant data (4.6% values), all available databases were fully linked together. The TRACTOR project is an exhaustive database of agricultural workforce (active and retired) from 2002 to 2016, with around 10.5 million individuals including seasonal workers and farm managers. From 2012 to 2016, a total of 6 906 290 individuals were recorded. Half of these individuals were active and 46% had at least one health event (e.g. declared chronic disease, reimbursed drug prescription) during this 5-year period. Conclusions The assembled MSA databases available in the TRACTOR project are regularly updated and represent a promising and unprecedent dataset for data mining analysis dedicated to the early identification of current and emerging work-related illnesses and hypothesis generation. As a result, this project could help building a prospective integrated health surveillance system for the benefit of agricultural workers. [ABSTRACT FROM AUTHOR]

Young solar analogs reaching the main sequence experience very strong magnetic activity, directly linked to their angular momentum loss through wind and mass ejections. We investigate here the surface and chromospheric activity of the ultra-rapid rotator AP 149 in the young open cluster alpha Persei. With a time-series of spectropolarimetric observations gathered over two nights with ESPaDOnS, we are able to reconstruct the surface distribution of brightness and magnetic field using the Zeeman-Doppler-Imaging (ZDI) method. Using the same data set, we also map the spatial distribution of prominences through tomography of H-alpha emission. We find that AP 149 shows a strong cool spot and magnetic field closed to the polar cap. This star is the first example of a solar-type star to have its magnetic field and prominences mapped together, which will help to explore the respective role of wind and prominences in the angular momentum evolution of the most active stars. [ABSTRACT FROM AUTHOR]

L'intelligence artificielle (IA) se développe à une vitesse impressionnante dans le domaine de la santé. L'IA ouvre la voie à de nouvelles pratiques d'aide au diagnostic, de médecine préventive, de suivi individualisé du patient, d'appui au choix d'une thérapie, d'aide à l'interprétation de résultats d'examens complémentaires... Loin d'être une solution miracle, la délégation de tâches à l'IA soulève de nombreuses questions éthiques portant notamment sur la supervision des algorithmes, l'égalité d'accès à l'innovation et l'utilisation des données des patients. Il est encore difficile de prédire si l'IA restera un « filet de sécurité » pour le médecin ou si elle le supplantera. La France et l'Europe ont posé le principe de « garantie humaine » à l'interprétation des résultats diagnostiques et thérapeutiques, impliquant que la machine ne peut agir seule et consacrant la responsabilité du professionnel de santé. Cet article vise à comprendre à quel point l'IA est complexe à encadrer au plan juridique au risque d'en négliger le secret, que ce soit au plan individuel ou collectif. Artificial intelligence (AI) is developing at an impressive speed in the field of health. AI paves the way for new practices in diagnostic assistance, preventive medicine, individualized patient follow-up, support in choosing a therapy, assistance in interpreting the results of additional examinations, etc. Far from being a magic bullet, delegating tasks to AI raises many ethical questions relating in particular to the supervision of algorithms, equal access to innovation and the use of patient data. It is still difficult to predict whether AI will remain a "safety net" for the doctor or if it will supplant him. France and Europe have laid down the principle of "human guarantee" in the interpretation of diagnostic and therapeutic results, implying that the machine cannot act alone and enshrining the responsibility of the health professional. This article aims to understand how complex AI is to regulate legally at the risk of neglecting its secrecy, whether at the individual or collective level. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the intra-session relative and absolute reliability of obstacle-crossing parameters during overground walking in young adults, and to determine the number of trials required to ensure reliable assessment. We analysed data from 43 young male adults who were instructed to walk at a self-selected velocity on a pathway and to step over an obstacle (height = 15 cm; width = 80 cm, thickness = 2 cm) three times. Spatial–temporal gait parameters of the approaching and crossing phases (i.e., before and after the obstacle) and obstacle clearance parameters (i.e., vertical and horizontal distance between the foot and the obstacle during crossing) were computed using a three-dimensional motion analysis system. Intraclass correlation coefficients were used to compute the relative reliability, while standard error of measurement and minimal detectable change were used to assess the absolute reliability for all possible combinations between trials. Results showed that most spatial–temporal gait parameters and obstacle clearance parameters are reliable using the average of three trials. However, the mean of the second and third trials ensures the best relative and absolute reliabilities of most obstacle-crossing parameters. Further works are needed to generalize these results in more realistic conditions and in other populations. [ABSTRACT FROM AUTHOR]

Alhena A (γ Gem A) is a bright Am star, with the strongest disc-integrated magnetic field strength reported so far for an Am star. Its spectrum exhibits standard circularly polarized Zeeman signatures, contrary to all previously studied Am stars that display abnormal signatures dominated by a single-signed lobe. We present here the result of follow-up observations of Alhena, using very high signal-to-noise spectropolarimetric data obtained over 25 observing nights with NARVAL at Télescope Bernard Lyot, in the frame of the BRITE (BRIght Target Explorer) spectropolarimetric survey. We confirm that Alhena A is magnetic and we determine its surface magnetic properties using different methods. Inclined dipole models are used to reproduce the longitudinal field measurements, as well as the Stokes V line profiles themselves. In both cases, the model is consistent with a polar field strength of ∼30 G. This is confirmed by a Zeeman-Doppler Imaging (ZDI) model, which also unveils smaller scale magnetic structures. A rotational period of 8.975 d was identified using intensity line profile variations. The ZDI inversion suggests that the surface magnetic field is sheared by differential rotation, with a difference in rotation rate between high and low latitudes at about 15 per cent of the solar value. This result challenges theories of the development of surface differential rotation in intermediate mass main-sequence stars. [ABSTRACT FROM AUTHOR]

Abstract Background Millions of workers are exposed to carcinogenic polycyclic aromatic hydrocarbon (PAH) mixtures. The toxicity of PAH mixtures is variable and depends on the composition of the mixture, which is related to the emission sources. Although several indicators exist, the cancer risk estimation associated with occupational exposure to PAHs is poorly known. Objectives To assess the risk of lung cancer associated with PAHs in several industries using the atmospheric concentrations of benzo[ a ]pyrene (BaP) as a proxy. Methods A total of 93 exposure groups belonging to 9 industries were investigated. Eight indicators found in the literature were compared to assess risks. A consensual indicator was used to estimate lung cancer risks. Results Approximately 30% of the exposure groups were above the maximal risk level of the European Union (10−4). The risk probabilities were >10−3 for coke and silicon production; >10−4 for the manufacturing of carbon products and aluminum production; >10−5 for foundries and combustion processes; >10−6 for the use of lubricating oils and engine exhaust emissions; and >10−7 for bitumen. The risk probabilities were highly variable within industries (from 1 to 1000 likelihood). A total of 27 (95% CI: 0.1–54) contemporary additional lung cancer cases could be expected per year in the French exposed population based on estimations using published data. Conclusion This study provides an overview of cancer risk estimation in many industries. Despite efforts and changes that had been made to decrease risks, PAHs remain a sanitary threat for people exposed to these pollutants in occupational environments. Graphical abstract Unlabelled Image Highlights • The risk of developing lung cancer was variable (1 to 103 likelihood) among industries. • 27 out of 93 exposure groups in industries were found to exceed the EU risk threshold. • Industries using products derived from coal were the most at risk of lung cancer. • 27 contemporary additional lung cancer cases per year could be expected in France. • Despite efforts and changes made in the past, PAHs remain a sanitary threat. [ABSTRACT FROM AUTHOR]

Background: Millions of workers are exposed to polycyclic aromatic hydrocarbons (PAHs), a well-known family of carcinogens, but occupational exposure data about PAH mixture compositions are scarce.Objectives: To provide a detailed picture of airborne PAH exposures encountered in the French industrial landscape over the previous 20 years and to identify determinants driving exposures.Methods: Results from 1643 airborne samples of 16 gaseous and particulate PAHs implemented into the Exporisq HAP database from 1995 to 2014 were used to describe exposure levels and aerosol chemical composition in many industries and activities. Compliance of benzo[a]pyrene (BaP) levels with several existing occupational exposure limits for long-term exposure was assessed.Results: BaP levels were lower than those reported in the literature, but the level and composition of PAH mixtures were highly variable between and within industries. Numerous exposure determinants (e.g., product composition, type and temperature of process, ventilation and confinement) were assumed to explain these differences. The highest levels were found in industries using products derived from coal (aluminum, silicon, and coke production, manufacturing of carbon products and foundries), with mean BaP levels up to 23 times higher than the French recommended value of 150 ng/m3. Forty-seven percent of the occupational activities exceeded this value. Conversely, exposures resulting from petroleum-derived products were relatively low.Conclusions: As health effects depend on PAH levels but also on the composition of the mixture, exposure assessments must characterize the entire mixtures and record specific determinants to define homogeneous exposure groups and to accurately assess health risks. [ABSTRACT FROM AUTHOR]

Background: Similar exposure groups (SEGs) are needed to reliably assess occupational exposures and health risks. However, the construction of SEGs can turn out to be rather challenging because of the multifactorial variability of exposures. Objectives: The objective of this study is to put forward a semi-empirical approach developed to construct and implement a SEG database for exposure assessments. An occupational database of airborne levels of polycyclic aromatic hydrocarbons (PAHs) was used as an illustrative and working example. Methods: The approach that was developed consisted of four steps. The first three steps addressed the construction and implementation of the occupational Exporisq-HAP database (E-HAP). E-HAP was structured into three hierarchical levels of exposure groups, each of which was based on exposure determinants, along 16 dimensions that represented the sampled PAHs. A fourth step was implemented to identify and generate SEGs using the geometric standard deviation (GSD) of PAH concentrations. Results: E-HAP was restructured into 16 (for 16 sampled PAHs) 3 x 3 matrices: three hierarchical levels of description versus three degrees of dispersion, which included low (the SEG database: GSD ≤ 3), medium (3 < GSD ≤ 6), and high (GSD > 6). Benzo[a]pyrene (BaP) was the least dispersed particulate PAH with 41.5% of groups that could be considered as SEGs, 48.5% of groups of medium dispersion, and only 8% with high dispersion. These results were comparable for BaP, BaP equivalent toxic, or the sum of all carcinogenic PAHs but were different when individual gaseous PAHs or ∑PAHG were chosen. Conclusion: Within the framework of risk assessment, such an approach, based on groundwork studies, allows for both the construction of an SEG database and the identification of exposure groups that require improvements in either the description level or the homogeneity degree toward SEG. [ABSTRACT FROM AUTHOR]

Background The health risk assessment associated with polycyclic aromatic hydrocarbon (PAH) mixtures faces three main issues: the lack of knowledge regarding occupational exposure mixtures, the accurate chemical characterization and the estimation of cancer risks. Objectives To describe industries in which PAH exposures are encountered and construct working context–exposure function matrices, to enable the estimation of both the PAH expected exposure level and chemical characteristic profile of workers based on their occupational sector and activity. Methods Overall, 1729 PAH samplings from the Exporisq-HAP database (E-HAP) were used. An approach was developed to (i) organize E-HAP in terms of the most detailed unit of description of a job and (ii) structure and subdivide the organized E-HAP into groups of detailed industry units, with each group described by the distribution of concentrations of gaseous and particulate PAHs, which would result in working context–exposure function matrices. PAH exposures were described using two scales: phase (total particulate and gaseous PAH distribution concentrations) and congener (16 congener PAH distribution concentrations). Results Nine industrial sectors were organized according to the exposure durations, short-term, mid-term and long-term into 5, 36 and 47 detailed industry units, which were structured, respectively, into 2, 4, and 7 groups for the phase scale and 2, 3, and 6 groups for the congener scale, corresponding to as much distinct distribution of concentrations of several PAHs. For the congener scale, which included groups that used products derived from coal, the correlations between the PAHs were strong; for groups that used products derived from petroleum, all PAHs in the mixtures were poorly correlated with each other. Conclusions The current findings provide insights into both the PAH emissions generated by various industrial processes and their associated occupational exposures and may be further used to develop risk assessment analyses of cancers associated with PAH mixtures. [ABSTRACT FROM AUTHOR]

Introduction The value of ultrasound guidance for intermediate cervical blocks in patients undergoing carotid artery endarterectomy is poorly described. This study aimed at comparing the efficacy of ultrasound-guided intermediate cervical block to superficial cervical block for carotid artery endarterectomies. Patients and methods We conducted a single-centre randomized-controlled study in a French University Hospital, from April 2011 to March 2012. The anaesthesia technique was randomly allocated to patients scheduled for carotid artery endarterectomy under regional anaesthesia (ropivacaine 4.75 mg/mL): superficial cervical block in the Control group, and ultrasound-guided intermediate cervical block in the Echo group. The main outcome measure was the percentage of surgery performed without supplemental topical anaesthesia. The secondary outcomes were: rate of conversion to general anaesthesia, amount of supplemental topical lidocaine and block-related complications. P < 0.05 was considered significant. Results Demographic data for the 86 patients included [mean (SD) age 73 (11) years] did not differ between groups. Surgery was performed without supplemental topical lidocaine in 23% and 7% of the patients in the Echo and Control groups, respectively ( P = 0.068). Conversion to general anaesthesia for inadequate analgesia was needed in 0 and 2 patients in the Echo and Control groups, respectively. The mean dose of topical lidocaine was not different between groups. No complication directly related to a cervical block was observed. Conclusions Ultrasound-guided intermediate cervical plexus block and superficial cervical blocks performed for carotid artery surgery seems to provide similar results, but this study was probably underpowered to detect any difference. Trial registration European Union Drug Regulating Authorities Clinical Trials (Eudra-CT) registration number: 2010-A 01490-39. [ABSTRACT FROM AUTHOR]

Background: Knowledge of hazards and exposure data about chemical pollutants are essential for epidemiological studies for assessing health risks and preventing the development of diseases. Access to this type of information is clearly needed and although numerous databases (DBs) have been compiled, they are often extremely difficult to find and navigate.Objectives: This paper presents the creation of an online inventory of toxicological and exposure DBs to support human health risk assessment resulting from the chemical exposome.Methods: A free searchable online inventory, called TEDI (Toxicological and Exposure Database Inventory), was set up to collect meta-data on toxicological and exposure DBs resulting from a review of the literature conducted on PubMed. Only chemical agents, including drugs, natural and manufactured/synthetic chemicals and air pollutants, were considered. Regarding exposure DBs, only human exposure to chemicals were included. Because of time and resource constraints, only an inventory was performed, and no effort was made to rate, assess or rank DBs on quality criteria.Results: A total of 715 DBs were identified, catalogued, described and made available on TEDI. The number of chemicals ranged from one single chemical to 90 million for toxicological DBs and from 1 to 103,817 chemicals for exposure DBs. Some DBs were restricted to specific chemicals, with for instance 71 exposure DBs reporting polycyclic aromatic hydrocarbon measurements. Toxicological DBs (n = 362) provided a broad range of different information such as toxicity data (57%), physicochemical properties (38%), experimental study results (28%) or prediction data (16%). A total of 382 exposure DBs were found, including exposure measurements DBs (71%), web application/tool (21%), exposure and risk assessment models (19%) and epidemiological DBs (13%).Discussion: TEDI is of value to the broader community and could support human health risk assessment to chemicals in various contexts. This inventory remains open for further additions, to enlarge its coverage, increase the meta-data collected and include newly developed DBs. [ABSTRACT FROM AUTHOR]

V530 Per is a solar-like member of the young open cluster α Persei, with an ultra-short rotation period (P∼0.32d). We report on two spectropolarimetric campaigns using ESPaDOnS, aimed at characterizing the short-term variability of its magnetic activity and large-scale magnetic field. We used time-resolved spectropolarimetric observations obtained in 2006 and 2018 and reconstructed the brightness distribution and large-scale magnetic field geometry of V530 Per through Zeeman-Doppler imaging. Using the same data sets, we also mapped the spatial distribution of prominences through tomography of Hα emission. We reconstruct, at both epochs, a large, dark spot occupying the polar region of V530 Per while smaller (dark and bright) spots were reconstructed at lower latitudes. The maximal field strength reached ∼1 kG. The prominence pattern displayed a stable component that was confined close to the corotation radius. In 2018, we also observed rapidly evolving Hα emitting structures, over timescales ranging from minutes to days. The fast Hα evolution was not linked to any detected photospheric changes in the spot or magnetic coverage. [ABSTRACT FROM AUTHOR]

Atmospheric levels of polycyclic aromatic hydrocarbons (PAHs) have been monitored in many companies since 1940. Because of the use of respiratory protective equipment (RPE) and cutaneous absorption, the measurement of urinary 1-hydroxypyrene (1-OHP), metabolite of pyrene (Pyr), and, more recently, 3-hydroxybenzo[a]pyrene (3-OHBaP), metabolite of benzo[a]pyrene (BaP), has been carried out to assess PAH exposure and estimate health risks. This study aimed to investigate the agreement between 523 air and biological levels recorded in the Exporisq-HAP database by taking into account the effectiveness of RPE. The agreement/consistency between 523 air and biological exposure levels was assessed by estimating and comparing the probability of exceeding French limit values (LVs) for both BaP and 3-OHBaP and ACGIH LV for 1-OHP, respectively. PAH airborne levels (w PAHs) were weighted by an assigned protection factor (APF) depending on the type of mask worn by workers, while urinary 1-OHP concentrations were adjusted with the w BaP/ w Pyr ratio of each industrial sector (wadj 1-OHP). Within occupational groups, there was an overall agreement between airborne PAH levels and urinary biomarker concentrations. A clear dichotomy was found between "petroleum-derived" and "coal-derived" groups, with much higher exposures in the latest group despite the use of RPEs by two-thirds of the workers. The type of RPE varied from one plant to another, which underlines the importance of taking into account their effectiveness. The analysis of urinary 3-OHBaP was not relevant for low PAH exposure levels. In addition, this biomarker underdiagnosed the exceedance of LV relative to BaP levels for 6% of "coal-derived" groups. The use of urinary wadj 1-OHP seemed to be more protective to assess the exceedance of LVs than those of urinary 3-OHBaP and air w BaP, but adjustment of the 1-OHP concentration by the BaP/Pyr ratio requires air sampling due to highly variable ratios observed in the studied occupational groups. • Comparing air and urine levels requires considering mask efficacy and pyrene/BaP ratio. • Adjusted 1OHP level is more protective than 3-OHBaP and BaP levels to assess risk. • The urinary 3-OHBaP analysis is not relevant for "petroleum-derived" groups. • 3-OHBaP underdiagnoses BaP limit value exceedance for 6% of high level groups. [ABSTRACT FROM AUTHOR]

Is finance-led capitalism politically sustainable? Finance-led growth regimes have been identified as unstable regimes of accumulation, and the question of whether they can be monitored by modes of regulation and thus be politically sustainable is highly debatable. This paper lists the pros and cons of arguments for their sustainability, and considers alternatives beyond the present situation of transition. [ABSTRACT FROM PUBLISHER]

This paper investigates the comparison between the US and European Venture Capital (VC) industries and their developmental conditions. Some characteristics of the US VC industry cannot be carelessly used as a benchmark for European VC industries. We then distinguish R&D-oriented and market access-oriented VC objectives which leads us to develop a comprehensive approach of the VC industry by insisting on the economic implications of its current industrialisation. The intermediation function, covered by venture capital, is characterised by its sectoral and institutional dimensions. Moreover, accounting for this diversity of VC industries helps in recommending policies that comply with national and local specific requirements. [ABSTRACT FROM AUTHOR]

Conducting a risk assessment is challenging because various and contrasting risk indicators are available, which can lead to discrepancies and, sometimes, conflicting conclusions. Constructing and using a consensus risk indicator (CRI) could provide a reliable alternative that is consistent and supports direct comparisons. The goal of this study is to propose a structured and pragmatic approach for constructing a CRI distribution and demonstrate its feasibility and easy implementation when conducting risk assessments. A CRI distribution is constructed as a weighted combination of existing indicators where the weights are obtained by using the overlapping areas of an individual indicator's distribution and an aggregated reference distribution. The approach is illustrated through an assessment of human cancer risk following inhalation exposure. The CRI is constructed using eight risk indicators. The CRI distribution parameters for 199 human carcinogenic chemicals associated with inhalation exposure were determined and are presented in an interactive table. To aid the wider implementation of the CRI approach, a user-friendly and interactive web application, named InCaRisk, was created to facilitate the cancer risk estimation following inhalation exposure. Our approach could be useful for enhancing the quality of regulatory decisions and protecting human health from environmental pollutants; our approach can be applied for a given health outcome, route of exposure and exposure setting. • Assessing health risks when dealing with contrasted risk indicators is challenging. • A consensus risk indicator (CRI) is developed as a benchmark for multiple indicators. • A new indicator CRI is constructed as a weighted combination of existing indicators. • A CRI-based web app is developed for assessing inhalation cancer risk. • The developed approach could be applied to any outcome described with distributions. [ABSTRACT FROM AUTHOR]

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous pollutants of significant public health concern, with several that are highly toxic to humans, including some proven or suspected carcinogens. To account for the high variability of PAH mixtures encountered in occupational settings, adjusting urinary 1-hydroxypyrene (1-OHP) levels by the total airborne pyrene (PyrT)/benzo[a]pyrene (BaP) ratio is essential for human biomonitoring (HBM). Given the complexity and cost of systematically monitoring atmospheric levels, alternative approaches to simultaneous airborne and HBM are required. The aim of this review was to catalog airborne PyrT/BaP ratios measured during different industrial activities and recommend 1-OHP-dedicated biological guidance values (BGV). A literature search was conducted. Seventy-one studies were included, with 5619 samples pertaining to 15 industrial sectors, 79 emission processes, and 213 occupational activities. This review summarized more than 40 years of data from almost 20 countries and highlighted the diversity and evolution of PAH emissions. PyrT/BaP ratios were highly variable, ranging from 0.8 in coke production to nearly 40 in tire and rubber production. A single PyrT/BaP value cannot apply to all occupational contexts, raising the question of the relevance of defining a single biological limit value for 1-OHP in industrial sectors where the PyrT/BaP ratio variability is high. Based upon the inventory, a practical approach is proposed for systematic PAH exposure and risk assessment, with a simple frame to follow based upon specific 1-OHP BGVs depending upon the occupational context and setup of a free PAH HBM interactive tool. [ABSTRACT FROM AUTHOR]

A theoretical analysis of contemporary institutional changes in the developed economies is attempted in order to characterize what a post fordist growth regime could be. One starts to recall some stylized facts about the present growth regime, i.e. about the contemporary dynamics of productivity on one side and of demand formation on the other side. We then discuss the main theoretical tools provided by the Regulation theory to analyse the institutional nexus which frames the growth regimes. The analytical framework of institutional change that we derive insist on the predominance at each period of one of the five structural forms that are distinguished by the Regulation School. As did the dynamics of institutional changes with the wage labor relationships in the previous period, today's evolutions of the forms of competition (broadly taken) condition all institutional changes. This gives us a general grid to define the features of a post Fordist regime. Still differences in history and structures leave room for sizeable differentiation in the national trajectories of the developed economies, all the more so that competition between nation States much prevent them to launch the structural policies that would be relevant with the new regime. [ABSTRACT FROM AUTHOR]

The article discusses some of the main features of globalization in terms of trade and investments. Despite the new features of these international transactions the real mark of the new phase of globalization is linked to intangible transactions, the expansion of which contributes to what is define as the third dimension of globalization. Some of the parameters of this transformation are surveyed and the new information and communication technologies are exposed as providing its central engine. It is observed that over the last 30 years, trade flows have undergone some structural changes. The share of trade flows relative to GDP increased continuously, although they grew more rapidly during economic upswings. As a result, the proportion of world trade to GDP was close to 25 per cent in the mid-l990s. The substantive changes that occurred with respect to the nature and direction of these flows may be indicative of a new phase. It is seen that trade flows developed rather unevenly. In particular, they were concentrated in some regions and developed highly differentiated product markets and inter-nationalized production processes within a triadic pattern.

• High PAH occupational exposures (including BaP) are still experienced when tearing-off old roofs containing coal tar pitch. • 2–3 ring gaseous PAHs are highly dominant when applying polymer-modified bitumen (PMB) roofing membranes. • 3-Fluorenol and 2-Phenanthrol are the most suitable metabolites for biomonitoring of PMB roofers. • Among BaP metabolites, TetraolBaP reflecting the genotoxic pathway of BaP seems more relevant than 3-OHBaP. • 1-OHP (pyrene metabolite) remains an interesting and useful biomarker of PAH exposures. The aims of this work were to assess the PAH exposure among roofers and to identify relevant biomarkers for monitoring occupational exposure. Several campaigns were conducted between 2004 and 2017, with 28 individual air samples and 240 urinary samples collected from 73 roofers. Seventeen parent PAHs and 14 urinary biomarkers, metabolites of pyrene (1-OHP), benzo(a)pyrene (3-OHBaP and TetraolBaP), naphthalene (1- and 2-naphtols), fluorene (1- 2- 3- 9-fluorenols) and phenanthrene (1- 2- 3- 4- 9-phenanthrols), were analysed. Three exposure groups were considered: soft-applied roofing using polymer-modified bitumen ("PMB"), hot-applied roofing using oxidized bitumen ("OB") and the tearing off of old roof coatings containing coal tar ("CT"). The PAHs containing 2–3 rings were much more abundant, and the highest airborne levels were observed in the "CT" group. The biomonitoring results were consistent with these results, with a large predominance of 2–3 ring PAH metabolites. 1-OHP, 3-fluorenol and 2-phenanthrol were better correlated with airborne levels and less influenced by smoking than the other metabolites. Conversely, 1-/2-naphtol levels were heavily influenced by smoking and not correlated with airborne naphthalene levels. Moreover, 3-OHBaP and TetraolBaP levels were very low when applying bitumen membranes, and much higher exposures were observed during tear-off activities. In this context, the recommended strategy for roofer biomonitoring should include 1-OHP, fluorenols and phenanthrols, as well as carcinogenic BaP metabolites (3-OHBaP or TetraolBaP) when evaluating the occupational exposure of roofers that are tearing off old roof coatings. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including global financial crises, Fordism and finance dominated capitalism.

IMPORTANCE Noninvasive ventilation delivered as bilevel positive airway pressure (BiPAP) is often used to avoid reintubation and improve outcomes of patients with hypoxemia after cardiothoracic surgery. High-flow nasal oxygen therapy is increasingly used to improve oxygenation because of its ease of implementation, tolerance, and clinical effectiveness. OBJECTIVE To determine whether high-flow nasal oxygen therapy was not inferior to BiPAP for preventing or resolving acute respiratory failure after cardiothoracic surgery. DESIGN AND SETTING Multicenter, randomized, noninferiority trial (BiPOP Study) conducted between June 15, 2011, and January 15, 2014, at 6 French intensive care units. PARTICIPANTS A total of 830 patients who had undergone cardiothoracic surgery, of which coronary artery bypass, valvular repair, and pulmonary thromboendarterectomy were the most common, were included when they developed acute respiratory failure (failure of a spontaneous breathing trial or successful breathing trial but failed extubation) or were deemed at risk for respiratory failure after extubation due to preexisting risk factors. INTERVENTIONS Patients were randomly assigned to receive high-flow nasal oxygen therapy delivered continuously through a nasal cannula (flow, 50 L/min; fraction of inspired oxygen [FIO2], 50%) (n = 414) or BiPAP delivered with a full-face mask for at least 4 hours per day (pressure support level, 8 cm H2O; positive end-expiratory pressure, 4 cm H2O; FIO2, 50%) (n = 416). MAIN OUTCOMES AND MEASURES The primary outcome was treatment failure, defined as reintubation, switch to the other study treatment, or premature treatment discontinuation (patient request or adverse effects, including gastric distention). Noninferiority of high-flow nasal oxygen therapy would be demonstrated if the lower boundary of the 95% CI were less than 9%. Secondary outcomes included mortality during intensive care unit stay, changes in respiratory variables, and respiratory complications. RESULTS High-flow nasal oxygen therapy was not inferior to BiPAP: the treatment failed in 87 of 414 patients with high-flow nasal oxygen therapy (21.0%) and 91 of 416 patients with BiPAP (21.9%) (absolute difference, 0.9%; 95% CI, −4.9% to 6.6%; P = .003). No significant differences were found for intensive care unit mortality (23 patients with BiPAP [5.5%] and 28 with high-flow nasal oxygen therapy [6.8%]; P = .66) (absolute difference, 1.2% [95% CI, -2.3% to 4.8%]. Skin breakdown was significantly more common with BiPAP after 24 hours (10% vs 3%; 95% CI, 7.3%-13.4% vs 1.8%-5.6%; P < .001). CONCLUSIONS AND RELEVANCE Among cardiothoracic surgery patients with or at risk for respiratory failure, the use of high-flow nasal oxygen therapy compared with intermittent BiPAP did not result in a worse rate of treatment failure. The findings support the use of high-flow nasal oxygen therapy in similar patients. [ABSTRACT FROM AUTHOR]

We simulate possible stellar coronal mass ejection (CME) scenarios over the magnetic cycle of ϵ Eridani (18 Eridani; HD 22049). We use three separate epochs from 2008, 2011, and 2013, and estimate the radio emission frequencies associated with these events. These stellar eruptions have proven to be elusive, although a promising approach to detect and characterize these phenomena are low-frequency radio observations of potential type II bursts as CME-induced shocks propagate through the stellar corona. Stellar type II radio bursts are expected to emit below 450 MHz, similarly to their solar counterparts. We show that the length of time these events remain above the ionospheric cutoff is not necessarily dependent on the stellar magnetic cycle, but more on the eruption location relative to the stellar magnetic field. We find that these type II bursts would remain within the frequency range of LOFAR for a maximum of 20–30 minutes post-eruption for the polar CMEs (50 minutes for second harmonics). We find evidence of slower equatorial CMEs, which result in slightly longer observable windows for the 2008 and 2013 simulations. Stellar magnetic geometry and strength have a significant effect on the detectability of these events. We place the CMEs in the context of the stellar mass-loss rate (27–48× solar mass-loss rate), showing that they can amount to 3%–50% of the stellar wind mass-loss rate for ϵ Eridani. Continuous monitoring of likely stellar CME candidates with low-frequency radio telescopes will be required to detect these transient events. [ABSTRACT FROM AUTHOR]

We have observed the active star ξ Boo A (HD 131156A) with high precision broadband linear polarimetry contemporaneously with circular spectropolarimetry. We find both signals are modulated by the 6.43 d rotation period of ξ Boo A. The signals from the two techniques are 0.25 out of phase, consistent with the broadband linear polarization resulting from differential saturation of spectral lines in the global transverse magnetic field. The mean magnitude of the linear polarization signal is ∼4 ppm G–1 but its structure is complex and the amplitude of the variations suppressed relative to the longitudinal magnetic field. The result has important implications for current attempts to detect polarized light from hot Jupiters orbiting active stars in the combined light of the star and planet. In such work stellar activity will manifest as noise, both on the time-scale of stellar rotation, and on longer time-scales – where changes in activity level will manifest as a baseline shift between observing runs. [ABSTRACT FROM AUTHOR]