Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
BACKGROUND: Thrombophilias are common disorders that increase the risk of pregnancy-associated venous thromboembolism and pregnancy loss and can also increase the risk of placenta-mediated pregnancy complications (severe pre-eclampsia, small-for-gestational-age infants, and placental abruption). We postulated that antepartum dalteparin would reduce these complications in pregnant women with thrombophilia. METHODS: In this open-label randomised trial undertaken in 36 tertiary care centres in five countries, we enrolled consenting pregnant women with thrombophilia at increased risk of venous thromboembolism or with previous placenta-mediated pregnancy complications. Eligible participants were randomly allocated in a 1:1 ratio to either antepartum prophylactic dose dalteparin (5000 international units once daily up to 20 weeks' gestation, and twice daily thereafter until at least 37 weeks' gestation) or to no antepartum dalteparin (control group). Randomisation was done by a web-based randomisation system, and was stratified by country and gestational age at randomisation day with a permuted block design (block sizes 4 and 8). At randomisation, site pharmacists (or delegates) received a randomisation number and treatment allocation (by fax and/or e-mail) from the central web randomisation system and then dispensed study drug to the local coordinator. Patients and study personnel were not masked to treatment assignment, but the outcome adjudicators were masked. The primary composite outcome was independently adjudicated severe or early-onset pre-eclampsia, small-for-gestational-age infant (birthweight <10th percentile), pregnancy loss, or venous thromboembolism. We did intention-to-treat and on-treatment analyses. This trial is registered with ClinicalTrials.gov, number NCT00967382, and with Current Controlled Trials, number ISRCTN87441504. FINDINGS: Between Feb 28, 2000, and Sept 14, 2012, 292 women consented to participate and were randomly assigned to the two groups. Three women were excluded after randomisation because of ineligibility (two in the antepartum dalteparin group and one in the control group), leaving 146 women assigned to antepartum dalteparin and 143 assigned to no antepartum dalteparin. Some patients crossed over to the other group during treatment, and therefore for on-treatment and safety analysis there were 143 patients in the dalteparin group and 141 in the no dalteparin group. Dalteparin did not reduce the incidence of the primary composite outcome in both intention-to-treat analysis (dalteparin 25/146 [17.1%; 95% CI 11.4-24.2%] vs no dalteparin 27/143 [18.9%; 95% CI 12.8-26.3%]; risk difference -1.8% [95% CI -10.6% to 7.1%)) and on-treatment analysis (dalteparin 28/143 [19.6%] vs no dalteparin 24/141 [17.0%]; risk difference +2.6% [95% CI -6.4 to 11.6%]). In safety analysis, the occurrence of major bleeding did not differ between the two groups. However, minor bleeding was more common in the dalteparin group (28/143 [19.6%]) than in the no dalteparin group (13/141 [9.2%]; risk difference 10.4%, 95% CI 2.3-18.4; p=0.01). INTERPRETATION: Antepartum prophylactic dalteparin does not reduce the occurrence of venous thromboembolism, pregnancy loss, or placenta-mediated pregnancy complications in pregnant women with thrombophilia at high risk of these complications and is associated with an increased risk of minor bleeding. FUNDING: Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, and Pharmacia and UpJohn.
ISSN: 0923-7577

hal-01258557
http://hal.univ-brest.fr/hal-01258557
DOI : 10.1016/S0140-6736(14)60793-5
PUBMED : 25066248

Éditeur(s) : HAL CCSD
Résumé : International audience
Fish is a rich source of essential nutrients for fetal development, but in contrast, it is also a well-known route of exposure to environmental pollutants. We assessed whether fish intake during pregnancy is associated with fetal growth and the length of gestation in a panel of European birth cohort studies. The study sample of 151,880 mother-child pairs was derived from 19 population-based European birth cohort studies. Individual data from cohorts were pooled and harmonized. Adjusted cohort-specific effect estimates were combined by using a random- and fixed-effects meta-analysis. Women who ate fish >1 time/wk during pregnancy had lower risk of preterm birth than did women who rarely ate fish (≤ 1 time/wk); the adjusted RR of fish intake >1 but <3 times/wk was 0.87 (95% CI: 0.82, 0.92), and for intake ≥ 3 times/wk, the adjusted RR was 0.89 (95% CI: 0.84, 0.96). Women with a higher intake of fish during pregnancy gave birth to neonates with a higher birth weight by 8.9 g (95% CI: 3.3, 14.6 g) for >1 but <3 times/wk and 15.2 g (95% CI: 8.9, 21.5 g) for ≥ 3 times/wk independent of gestational age. The association was greater in smokers and in overweight or obese women. Findings were consistent across cohorts. This large, international study indicates that moderate fish intake during pregnancy is associated with lower risk of preterm birth and a small but significant increase in birth weight.
The American Journal of Clinical Nutrition

hal-01118513
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118513
PUBMED : 24335057
DOI : 10.3945/ajcn.113.067421

Éditeur(s) : HAL CCSD WB Saunders
Résumé : International audience
OBJECTIVE: We hypothesized that, in Human Immunodeficiency Virus and Hepatitis C Virus (HIV/HCV) co-infected patients who did not respond to peg-interferon and ribavirin, a maintenance therapy with peg-interferon could induce fibrosis regression. METHODS: This was a randomized study with two parallel groups. HIV/HCV co-infected patients received peg-interferon α-2a at 180 μg/week or remained on observation for 96 weeks. The primary endpoint was the percentage of patients who experienced a decrease of at least one point in their Metavir fibrosis score between initial and final liver biopsies. Secondary endpoints included plasma fibrosis markers at week 96, occurrence of HCV-related complications, and survival. RESULTS: A total of 52 patients were randomized (peg-interferon: 25; control: 27) including 18 with cirrhosis. The median (interquartile range) age was 44 (40-46) years, and 69% were male. A total of 64% had ALT levels >1.5 normal values, and the CD4 cell count was 391 (296-537) cells/mm(3); 67% of patients had HIV RNA <200 copies/mL at entry. The main endpoint was assessed in 41 patients. Response rates were 3/20 (15%) and 4/21 (19%) in the peg-interferon and control groups, respectively (p = 0.99). There was no significant difference between peg-interferon and control groups on plasma fibrosis markers at the final visit. Severe liver-related complications were observed in 2 and 5 patients in peg-interferon and control groups, respectively. Three deaths were observed, all in the control group. CONCLUSIONS: A maintenance therapy with peg-interferon α-2a over 96 weeks in HIV/HCV co-infected patients, who were non-responders to HCV treatment, did not change liver fibrosis. ClinicalTrials.gov Identifier: NCT00122616.
ISSN: 0163-4453

hal-00875067
https://hal.archives-ouvertes.fr/hal-00875067
DOI : 10.1016/j.jinf.2013.05.007
PUBMED : 23800784

Éditeur(s) : HAL CCSD
Résumé : International audience
A prospective study on randomized patients was conducted to determine how morphokinetic parameters are altered in embryos grown in sequential versus global culture media. Eleven morphokinetic parameters of 160 single embryos transferred were analyzed by time lapse imaging involving two University-affiliated in vitro fertilization (IVF) centers. We found that the fading of the two pronuclei occurred earlier in global (22.56±2.15 hpi) versus sequential media (23.63±2.71 hpi; p=0.0297). Likewise, the first cleavage started earlier at 24.52±2.33 hpi vs 25.76±2.95 hpi (p=0.0158). Also, the first cytokinesis was shorter in global medium, lasting 18±10.2 minutes in global versus 36±37.8 minutes in sequential culture medium (p <0.0001). We also observed a significant shortening in the duration of the 2-cell stage in sequential medium: 10.64 h±2.75 versus 11.66 h±1.11 in global medium (p=0.0225) which suggested a faster progression of the embryos through their first mitotic cell cycle. In conclusion, morphokinetic analysis of human embryos by Time lapse imaging reveals significant differences in five kinetic variables according to culture medium. Our study highlights the need to adapt morphokinetic analysis accordingly to the type of media used to best support human early embryo development.
Annales de Biologie Clinique

hal-01579406
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01579406
DOI : 10.1684/abc.2017.1259
PUBMED : 28751285

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Talc is a hydrous magnesium rich layered silicate that is widely disseminated in the Earth from the seafloor to over 100 km depth, in ultra-high pressure metamorphism of oceanic crust. In this paper we determine the single crystal elastic constants at pressures from 0 to 12 GPa of talc triclinic (C 1¯) and monoclinic (C2/c) polytypes using ab initio methods. We find that talc has an extraordinarily high elastic anisotropy at zero pressure that reduces with increasing pressure. The exceptional anisotropy is complemented by a negative Poisson's ratio for many directions in crystal space. Calculations show that talc is not only one of very few common minerals to exhibit auxetic behaviour, but the magnitude of this effect may be the largest reported so far for a mineral. The compression (Vp) and shear (Vs) wave velocity anisotropy is 80% and 85% for the triclinic polytype. At pressures where talc is known be stable in the Earth (up to 5 GPa) the Vp and Vs anisotropy is reduced to about 40% for both velocities, which is still a very high value. Vp is slow parallel to the c-axis and fast perpendicular to it. This remains unchanged with increasing pressure and is observed in both polytypes. The shear wave splitting (difference between fast and slow S-wave velocities) at low pressure has high values in the plane normal to the c-axis, with a maximum near the alow asterisk-axis in the triclinic and the b-axis in the monoclinic polytype. The c-axis is the direction of minimum splitting. The pattern of shear wave splitting does not change significantly with pressure. The volume fraction of talc varies between 11 and 41% for hydrated mantle rocks, but the lack of data on the crystallographic preferred orientation (CPO) precludes a detailed analysis of the impact of talc on seismic anisotropy in subduction zones. However, it is highly likely that CPO can easily develop in zones of deformation due to the platy habit of talc crystals. For random aggregates of talc, the isotropic Vp, Vs and Vp/Vs ratio have significantly lower values than those of antigorite and may explain low-velocity regions in the mantle wedge. Vp/Vs ratios are more complex in anisotropic media because there are fast and slow S-waves, resulting in Vp/Vs1 and Vp/Vs2 ratios for every propagation direction, making interpretation difficult in deformed polycrystalline talc with a CPO. Talc on the subduction plate boundary can strongly influence guided wave velocity as CPO would develop in this region of intense shearing. The very low coefficient of friction (< 0.1) of talc above 100 °C could also explain silent earthquakes at shallow depths (ca 30 km) along the subduction plate boundaries, frequently responsible for tsunami.
ISSN: 0012-821X

hal-00411481
https://hal.archives-ouvertes.fr/hal-00411481
DOI : 10.1016/j.epsl.2008.07.047

Éditeur(s) : HAL CCSD
Résumé : poster presentation, 22nd European Meeting on Hypertension and Cardiovascular protection, London,26-29 April 2012
OBJECTIVE: Several studies demonstrate that the perception of overweight is associated with attempts at weight control in overweight subjects. Our objective is to describe the factors associated with the perception of overweight in an adult Caribbean population, and in particular, to assess the relationship between the perception of overweight and previous medical diagnosis of overweight. METHOD AND DESIGN: Consant was a cross-sectional study carried out in 2007 on a representative sample of the adult Guadeloupean population. Included were 1,005 subjects aged 25-74 years, drawn from stratified random sampling, and interviewed at home. The perception of overweight was evaluated by the question: "Do you consider yourself to be overweight?" with a binary response. RESULTS: Among overweight subjects (Body Mass Index ≥ 25 kg/m2, n = 576), 38.6% provided an incorrect assessment of their weight status. This proportion falls to 17.4% in those who stated to have previously received a medical diagnosis of overweight. However, only 48.8% of overweight subjects stated to have received such a diagnosis. A logistic regression shows that the underestimation of weight status is associated with the absence of previous diagnosis for overweight (OR: 5.35 - p < 10-3), as well as an age greater than or equal to 55 years (OR: 2.91 - p < 10-3), a BMI of less than 30 kg/m² (OR: 2.26 - p: 0.001), the male sex (OR: 1.86 - p: 0.004), and a low income level (OR: 1.62 - p: 0.030), but not a lack of awareness regarding the role of weight control in the prevention of cardiovascular diseases. Similar results are observed if waist circumference is taken as a factor instead of BMI. CONCLUSION: In this population, the lack of medical diagnosis of overweight was the leading factor associated with misperception of overweight. Screening for overweight therefore appears to be one of the preconditions to weight management, and remains a fundamental but often unused element in the fight against obesity.
https://hal.univ-antilles.fr/hal-00739785

Droits : info:eu-repo/semantics/OpenAccess
hal-00739785
https://hal.univ-antilles.fr/hal-00739785
https://hal.univ-antilles.fr/hal-00739785/document
https://hal.univ-antilles.fr/hal-00739785/file/The_lacksur screening_is_the_leading_factor_associated_with_the_misperceptionsur overweight_cor.pdf

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
Random walk (RW) or Continuous Time Random Walk (CTRW) are recurring Monte Carlo methods used to model convective and diffusive transport in complex heterogeneous media. Many applications can be found, including fluid mechanic, hydrology, and chemical reactors modeling. These methods are easy to implement, very versatile and flexible enough to become appealing for many applications because they generally overlook of deeply simplify the building of explicit complex meshes required by deterministic methods. RW and CTRW provide a good physical understanding of the interactions between the space scales of het-erogeneities and the transport phenomena under consideration. In addition, they can result in efficient up-scaling methods, especially in context of flow and transport in fractured media. In the present study, we review the applications of RW or CTRW for several situations coping with various spatial scales, and different insights into up-scaling applications. RW and CTRW advantages and downsides are also discussed, thus providing a few avenues for further works and applications.
ISSN: 0169-3913

hal-01449131
https://hal.archives-ouvertes.fr/hal-01449131
https://hal.archives-ouvertes.fr/hal-01449131/document
https://hal.archives-ouvertes.fr/hal-01449131/file/0025972-02.pdf
DOI : 10.1007/s11242-016-0693-z

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
We study diffusion in a heterogeneous medium that is characterized by spatially varying diffusion properties from a random walk point of view. We show that an inhomogeneous continuous time random walk (CTRW) with a spatially variable exponential transition time distribution solves the spatially discretized heterogeneous diffusion equation. This demonstrates the equivalence of the widely used time-domain random walk (TDRW) scheme and spatially inhomogeneous CTRW and at the same time provides a demonstration of the formal equivalence of the TDRW particle formulation and the heterogeneous diffusion equation. Based on this equivalence, we develop a TDRW method for heterogeneous diffusion under spatially variable multirate mass transfer properties. We discuss the implementation of these schemes and study the diffusion behavior in the presence of traps that are characterized by a truncated power-law trapping time distribution.
ISSN: 0309-1708

hal-00767566
https://hal.archives-ouvertes.fr/hal-00767566
DOI : 10.1016/j.advwatres.2012.07.015

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
Random walk (RW) methods are recurring Monte Carlo methods used to modelconvective and diffusive transport in complex heterogeneous media. Many applications canbe found, including fluid mechanic, hydrology and chemical reactors modeling. These methodsare easy to implement, very versatile and flexible enough to become appealing for manyapplications because they generally overlook or deeply simplify the building of explicit complexmeshes required by deterministic methods. RWprovides a good physical understandingof the interactions between the space scales of heterogeneities and the transport phenomenaunder consideration. In addition, they can result in efficient upscaling methods, especiallyin the context of flow and transport in fractured media. In the present study, we review theapplications of RW to several situations that cope with diverse spatial scales and differentinsights into upscaling problems. The advantages and downsides of RW are also discussed,thus providing a few avenues for further works and applications.
ISSN: 0169-3913

insu-01308060
https://hal-insu.archives-ouvertes.fr/insu-01308060
DOI : 10.1007/s11242-016-0693-z

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
OBJECTIVES: The aims of the study were to assess in patients with advanced HIV disease receiving antiretroviral therapy (ART) intensification with enfuvirtide (i) resistance at virological failure (VF), (ii) impact of baseline tropism on immunovirological response, and (iii) HIV-1 DNA tropism evolution during ART. METHODS: The ANRS 130 APOLLO randomized trial evaluated in naive patients the immunovirological impact of standard ART without (control arm) or with enfuvirtide. Tropism was determined on RNA and DNA by V3-loop sequencing interpreted using the Geno2Pheno algorithm. RESULTS: At baseline the median CD4 cell count was 30 cells/mm(3). Among the 170 patients assessable in this virological substudy, HIV-1 RNA tropism was as follows: 60% of viruses were R5 and 40% were R5X4/X4. HIV-1 DNA tropism was as follows: 54% were R5 and 46% were R5X4/X4. At week 24, 39% and 49% of patients experienced VF in the enfuvirtide and control arms, respectively. In the enfuvirtide arm, only resistance-associated mutations to enfuvirtide were detected. In the control arm, two patients displayed drug-resistant viruses at the time of VF. No impact of baseline tropism was observed on immunovirological response, regardless of the study arm. Among the 25 patients experiencing DNA tropism switch between baseline and week 24, 16 (64%) switched from R5 to R5X4/X4. These latter were mostly successfully suppressed patients receiving enfuvirtide and exhibiting poorer immunological response. CONCLUSIONS: Baseline RNA tropism had no impact on the immunovirological response. Drug resistance mutations were only detected for the fusion inhibitor. Finally, the mechanism of replenishment of the viral cellular reservoir with X4 viruses observed needs to be further analysed.
ISSN: 0305-7453

hal-00875130
https://hal.archives-ouvertes.fr/hal-00875130
DOI : 10.1093/jac/dks455
PUBMED : 23152480

Éditeur(s) : HAL CCSD American Geophysical Union
Résumé : International audience
We derive a general formulation of the time domain random walk (TDRW) approach to model the hydrodynamic transport of inert solutes in complex geometries and heterogeneous media. We demonstrate its formal equivalence with the discretized advection-dispersion equation and show that the TDRW is equivalent to a continuous time random walk (CTRW) characterized by space-dependent transition times and transition probabilities. The transition times are exponentially distributed. We discuss the implementation of different concentration boundary conditions and initial conditions as well as the occurrence of numerical dispersion. Furthermore, we propose an extension of the TDRW scheme to account for mobile-immobile multirate mass transfer. Finally, the proposed TDRW scheme is validated by comparison to analytical solutions for spatially homogeneous and heterogeneous transport scenarios.
ISSN: 0043-1397

hal-01356319
https://hal.archives-ouvertes.fr/hal-01356319
DOI : 10.1002/2015WR018511

Éditeur(s) : HAL CCSD
Résumé : International audience
The carbon capture and storage is considered as one of the solutions of reducing the effects of global warming. It consists in injecting large quantities of CO 2 in supercritical form directly into deeply located geological formations. One of the methods involves sequestration in the carbonate sedimentary rocks (sandstones and limestones) which are considered as a promising solution. The morphology of the pore network and solid skeleton defines important macroscopic prop-erties of the rock (permeability, stiffness). Modelling at micro scale of random heterogeneous materials (porous media) should be based on morphological and statistical characterisation 1,2 of the investigated microstructure. The work is focused on a reconstruction method by grains deposit 3 , for various range of pa-rameters, to obtain equivalent model of natural rock samples (oolitic limestone and fontainebleau sandstone). Generated samples satisfy morphological and statistical informations 4 which were obtained by 3D image analysis of X-ray tomography of the natural rock samples. For validation of the modelling numerical computations of mechanical and transfer properties are also provided.
14th European Mechanics of Materials Conference - EMMC14
Gothembourg, Sweden

hal-01103163
https://hal.archives-ouvertes.fr/hal-01103163

Éditeur(s) : HAL CCSD Paris, Masson et Cie
Résumé : National audience
Decreased frequency of pulmonary exacerbations, mainly related to immunomodulatory effects of macrolide antibiotics, has been demonstrated in bronchiectasis and chronic obstructive pulmonary diseases (COPD). Due to its tolerance, azithromycin is the antibiotic of choice for maintenance therapy at the dose of 250 mg per day or 500 mg × 3 per week (for body weight >55 kg). Maintenance therapy with macrolide could be proposed in selected patients with bronchiectasis or COPD with more than 3 acute exacerbations in the previous year or decreased lung function despite compliance with optimum treatment. The risk of sudden cardiac death with azithromycin is rare and controversial. It should be avoided in patients with a high baseline risk of cardiovascular disease, QT>450 msec, pulse rate>100 bpm and potential drug interactions, particularly those known to cause QT prolongation. It is recommended to search for hearing deficit (audiometry) and sputum culture positive for mycobacteria. Patients must also be aware that it can rapidly lead to macrolide resistance in commensal or pathogenic flora. Follow-up evaluation every 3 month can be proposed with medical history (hearing deficit) and electrocardiography. After one year, the treatment should be stopped in the absence of reduction in the frequency of exacerbations.
Points essentielsLes macrolides administrés au long cours permettent, grâce en partie à leurs propriétés anti-inflammatoires, de diminuer la fréquence des exacerbations dans la DDB et la BPCO.Du fait de sa tolérance, l’azithromycine est le macrolide de choix, pouvant être utilisé à la dose de 250 mg/j ou 500 mg 3 fois par semaine chez les patients de plus de 55 kg.Un traitement par macrolides au long cours pourrait être proposé à des patients atteints de DDB ou de BPCO ayant eu plus de 3 exacerbations l’année précédente ou ayant une dégradation de leur fonction respiratoire malgré un traitement de fond bien conduit.Du fait d’un risque rare et controversé de mort subite d’origine cardiaque, il ne doit pas être proposé en cas de pathologie cardiovasculaire évoluée, d’intervalle QT > 450 ms, de traitement pouvant allonger l’intervalle QT, de tachycardie > 100/min.Il est recommandé de s’assurer de l’absence de troubles auditifs (audiogramme) et de mycobactérie atypique dans les cultures des expectorations. Les patients doivent aussi être informés du risque d’apparition de résistance aux macrolides de la flore commensale et pathogène.Une surveillance clinique, avec en particulier la recherche de troubles auditifs et électrocardiographique, peut être proposée tous les 3 mois. L’absence de diminution de la fréquence des exacerbations, lors du bilan annuel, justifie l’arrêt du traitement.
ISSN: 0032-7867

hal-01073027
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01073027
DOI : 10.1016/j.lpm.2013.08.006
PUBMED : 24631048

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Background We conducted this systematic review and meta-analysis to address the open question of a possible association between the socioeconomic level of the neighborhoods in which pregnant women live and the risk of Congenital Heart Defects (CHDs), Neural Tube Defects (NTDs) and OroFacial Clefts (OFCs). Methods We searched MEDLINE from its inception to December 20th, 2015 for case-control, cohort and ecological studies assessing the association between neighborhood socioeconomic level and the risk of CHDs, NTDs and the specific phenotypes Cleft Lip with or without Cleft Palate (CLP) and Cleft Palate (CP). Study-specific risk estimates were pooled according to random-effect and fixed-effect models. Results Out of 245 references, a total of seven case-control studies, two cohort studies and two ecological studies were assessed in the systematic review; all studies were enrolled in the meta-analysis with the exception of the two cohort studies. No significant association has been revealed between CHDs or NTDs and neighborhood deprivation index. For CLP phenotype subgroups, we found a significantly higher rate in deprived neighborhoods (Odds Ratios (OR) = 1.22, 95% CI: 1.10, 1.36) whereas this was not significant for CP phenotype subgroups (OR = 1.20, 95%CI: 0.89, 1.61). Conclusion In spite of the small number of epidemiological studies included in the present literature review, our findings suggest that neighborhood socioeconomic level where mothers live is associated only with an increased risk of CLP phenotype subgroups. This finding has methodological limitations that impede the formulation of firm conclusions, and further investigations should confirm this association. © 2016 Deguen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
ISSN: 1932-6203

hal-01406070
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01406070
DOI : 10.1371/journal.pone.0159039
PUBMED : 27783616

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
OBJECTIVE: The WEGENT trial and other short-term studies suggested that azathioprine or methotrexate could effectively maintain granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) remission. Whether differences in relapse or adverse event rates would appear after discontinuation of those 2 maintenance regimens and longer follow-up remains unknown. METHODS: Long-term outcomes for the patients enrolled in the WEGENT trial were analyzed according to their randomization group. Parameters at trial entry were evaluated as potential prognostic factors for death, relapse or damage in multivariate models. RESULTS: Data were returned for 88.8% of the 126 original participants. Median [95% confidence interval] followup was 11.9 [11.3-12.5] years. For the azathioprine and methotrexate arms, respectively, the 10-year overall survival rates were 75.1% [64.8-86.9] and 79.9% [70.3-90.8] (P = 0.56), and relapse-free survival rates 26.3% [17.3-40.1] and 33.5% [23.5-47.7] (P = 0.29). No between-arm differences were observed for relapse, adverse events, damage, survival rates without severe side effects and survival rates without relapse and severe side effects. Considering only the 97 GPA patients, no between-arm survival differences were observed. Relapse-free survival was shorter for GPA than MPA patients but the multivariate analysis retained anti-PR3-ANCA-positivity, and not GPA, as being independently associated with relapse. CONCLUSION: This long-term analysis confirms that azathioprine and methotrexate are comparable options for maintaining GPA or MPA remission. Despite good overall survival, relapses, adverse events and damage remain matters of concern and further studies are needed to reduce them.
ISSN: 2326-5205

hal-01217989
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01217989
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01217989/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01217989/file/Long-term%20outcomes%20of%20the%20WEGENT%20trial_accepted.pdf
DOI : 10.1002/art.39450

Éditeur(s) : HAL CCSD American Physical Society
Résumé : 1 tex, 16 figures
International audience
We make use of a subtraction procedure, introduced to overcome double--counting problems in beyond--mean--field theories, in the second random--phase--approximation (SRPA) for the first time. This procedure guarantees the stability of SRPA (so that all excitation energies are real). We show that the method fits perfectly into nuclear density--functional theory. We illustrate applications to the monopole and quadrupole response and to low--lying $0^+$ and $2^+$ states in the nucleus $^{16}$O. We show that the subtraction procedure leads to: (i) results that are weakly cutoff dependent; (ii) a considerable reduction of the SRPA downwards shift with respect to the random--phase approximation (RPA) spectra (systematically found in all previous applications). This implementation of the SRPA model will allow a reliable analysis of the effects of 2 particle--2 hole configurations ($2p2h$) on the excitation spectra of medium--mass and heavy nuclei.
ISSN: 0556-2813

in2p3-01193119
http://hal.in2p3.fr/in2p3-01193119
DOI : 10.1103/PhysRevC.92.034303
ARXIV : 1506.05975

Éditeur(s) : HAL CCSD American Geophysical Union
Résumé : International audience
Mobile-immobile mass transfer is widely used to model non-Fickian dispersion in porous media. Nevertheless, the memory function, implemented in the sink/source term of the transport equation to characterize diffusion in the matrix (i.e., the immobile domain), is rarely measured directly. Therefore, the question can be posed as to whether the memory function is just a practical way of increasing the degrees of freedom for fitting tracer test breakthrough curves or whether it actually models the physics of tracer transport. In this paper we first present a technique to measure the memory function of aquifer samples and then compare the results with the memory function fitted from a set of field-scale tracer tests performed in the same aquifer. The memory function is computed by solving the matrix diffusion equation using a random walk approach. The properties that control diffusion (i.e., mobile-immobile interface and immobile domain cluster shapes, porosity, and tortuosity) are investigated by X-ray microtomography. Once the geometry of the matrix clusters is measured, the shape of the memory function is controlled by the value of the porosity at the percolation threshold and of the tortuosity of the diffusion path. These parameters can be evaluated from microtomographic images. The computed memory function compares well with the memory function deduced from the field-scale tracer tests. We conclude that for the reservoir rock studied here, the atypical non-Fickian dispersion measured from the tracer test is well explained by microscale diffusion processes in the immobile domain. A diffusion-controlled mobileimmobile mass transfer model therefore appears to be valid for this specific case.
ISSN: 0043-1397

insu-00373705
https://hal-insu.archives-ouvertes.fr/insu-00373705
https://hal-insu.archives-ouvertes.fr/insu-00373705/document
https://hal-insu.archives-ouvertes.fr/insu-00373705/file/Gouze_et_al-2008-Water_Resources_Research.pdf
DOI : 10.1029/2007WR006690

Éditeur(s) : HAL CCSD Springer
Résumé : Borehole logs provide in situ information about the fluctuations of petrophysical properties with depth and thus allow the characterization of the crustal heterogeneities. A detailed investigation of these measurements may lead to extract features of the geological media. In this study, we suggest a regularity analysis based on the continuous wavelet transform to examine sonic logs data. The description of the local behavior of the logs at each depth is carried out using the local Hurst exponent estimated by two (02) approaches: the local wavelet approach and the average-local wavelet approach. Firstly, a synthetic log, generated using the random midpoints displacement algorithm, is processed by the regularity analysis. The obtained Hurst curves allowed the discernment of the different layers composing the simulated geological model. Next, this analysis is extended to real sonic logs data recorded at the Kontinentales Tiefbohrprogramm (KTB) pilot borehole (Continental Deep Drilling Program, Germany). The results show a significant correlation between the estimated Hurst exponents and the lithological discontinuities crossed by the well. Hence, the Hurst exponent can be used as a tool to characterize underground heterogeneities.
ISSN: 1866-7411

hal-00617470
https://hal.archives-ouvertes.fr/hal-00617470
DOI : 10.1007/s12517-010-0129-y

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
From outcrops located in Provence (South-East France), we describe the distribution, the microstructures, and the petrophysical properties of deformation band networks related to both contractional and extensional tectonic events. In contraction, pervasively distributed networks of reverse-sense compactional shear bands are observed in all folded sand units of the foreland, whereas localized networks of clustered reverse-sense shear bands are only observed close to a large-scale thrust. In extensional setting, networks of clustered normal-sense shear bands are generally observed adjacent to map-scale faults (100 m–10 km scale), although some randomly distributed bands are also observed between these faults. Normal-sense cataclastic faults, i.e. zone of deformation bands containing a localized slip-surface, are also observed to be restricted to sand units, suggesting that faults initiated in the sands during extension, but not during contraction. Shear bands and faults show cataclastic microstructures with high-permeability reduction whereas compactional shear bands show crush microbreccia or protocataclastic microstructures with moderate permeability reduction. This basin-scale analysis underlines the major role of tectonic settings (thrust-fault versus normal-fault andersonian-stress regime) and the influence of inherited large-scale faults on the formation/localization of low-permeability shear bands. We also provide a geometrical analysis of the band network properties (spacing, thickness, shear/compaction ratio, degree of cataclasis, petrophysical properties) with respect to the median grain size, porosity and grain sorting of host sand. This analysis suggests that grain size, although less important than stress-state conditions and the presence of large-scale faults, has a non-negligible effect on band network geometry. No correlations are observed between the grain sorting, porosity and band network geometry.
ISSN: 0264-8172

hal-01116421
https://hal.archives-ouvertes.fr/hal-01116421
DOI : 10.1016/j.marpetgeo.2013.12.020

Éditeur(s) : HAL CCSD American Medical Association (AMA)
Résumé : International audience
IMPORTANCE Although frequently used in treating intensive care unit (ICU) patients with sepsis, empirical antifungal therapy, initiated for suspected fungal infection, has not been shown to improve outcome. OBJECTIVE To determine whether empirical micafungin reduces invasive fungal infection (IFI)-free survival at day 28. DESIGN, SETTING, AND PARTICIPANTS Multicenter double-blind placebo-controlled study of 260 nonneutropenic, nontransplanted, critically ill patients with ICU-acquired sepsis, multiple Candida colonization, multiple organ failure, exposed to broad-spectrum antibacterial agents, and enrolled between July 2012 and February 2015 in 19 French ICUs. INTERVENTIONS Empirical treatment with micafungin (100mg, once daily, for 14 days) (n = 131) vs placebo (n = 129). MAIN OUTCOMES AND MEASURES The primary end pointwas survival without proven IFI 28 days after randomization. Key secondary end points included new proven fungal infections, survival at day 28 and day 90, organ failure, serum (1-3)-beta-D-glucan level evolution, and incidence of ventilator-associated bacterial pneumonia. RESULTS Among 260 patients (mean age 63 years; 91 [35%] women), 251 (128, micafungin group; 123, placebo group) were included in the modified intent-to-treat analysis. Median values were 8 for Sequential Organ Failure Assessment (SOFA) score, 3 for number of Candida-colonized sites, and 99 pg/mL for level of (1-3)-beta-D-glucan. On day 28, there were 82 (68%) patients in the micafungin group vs 79 (60.2%) in the placebo group who were alive and IFI free (hazard ratio [HR], 1.35 [95% CI, 0.87-2.08]). Results were similar among patients with a (1-3)-beta-D-glucan level of greater than 80 pg/mL (n = 175; HR, 1.41 [95% CI, 0.85-2.33]). Day-28 IFI-free survival in patients with a high SOFA score (> 8) was not significantly different when compared between the micafungin vs placebo groups (HR, 1.69 [95% CI, 0.96-2.94]). Use of empirical micafungin decreased the rate of new invasive fungal infection in 4 of 128 patients (3%) in the micafungin group vs placebo (15/123 patients [12%]) (P =.008). CONCLUSIONS AND RELEVANCE Among nonneutropenic critically ill patients with ICU-acquired sepsis, Candida species colonization at multiple sites, and multiple organ failure, empirical treatment with micafungin, compared with placebo, did not increase fungal infection-free survival at day 28.
ISSN: 0098-7484

hal-01405822
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01405822
DOI : 10.1001/jama.2016.14655
PUBMED : 27706483