IgA vasculitis (IgAV) is an autoimmune disease that affects the small vessels of the skin, joints, gastrointestinal (GI) tract, and kidneys. In the long term, IgAV associated with nephritis (IgAV-N) can progress to kidney failure. Evidence-based clinical studies of IgAV-N are few, leading to huge variations in treatment approaches and suboptimal outcomes. The wealth of emerging efficacious treatments for IgA nephrology brings new opportunities to this disease. The aim of this report is to describe the proceedings of a multiprofessional collaborative workshop convened to identify the barriers to developing high quality evidence for patients with IgAV-N. A multiprofessional group consisting of 53 attendees from 13 countries met. The meeting was represented by a variety of professional backgrounds, including lay attendees, with different levels of expertise (32% professors and 19% midcareer doctors). Using predefined aims, key themes were extracted, and an action plan developed. Consensus was obtained that there is sufficient similarity between adults and children in terms of the organs involved, pathophysiology, histological features, and likely response to treatment. Important differences included the greater spontaneous improvement in children and worse kidney outcomes in some populations. It was agreed that patients at greatest risk of kidney failure should be the primary focus of initial clinical trials. Important considerations included the following: diagnostic classification for adult onset IgAV, observational data, evidence of scientific similarity to IgA nephropathy (IgAN), an age-inclusive approach to trial design, systemic disease secondary end points, and the inclusion of patient-reported outcomes. This manuscript communicates an expert-informed pathway to high-quality evidence for IgAV-N.
This exploratory study aims to better understand the psychological drivers and barriers to returning to work in France, using the integrative push-pull-anti-push-anti-pull model. Thirteen semi-structured interviews were conducted with 8 women and 5 men (M_age = 31.46 years). The interview guide addressed the four dimensions of the model: push, anti-push, pull, and anti-pull. Data were analyzed using thematic analysis with NVivo 14. Results indicate a predominance of motivational drivers over psychological barriers. Cross-cutting themes emerged, including meaning, status, time structure, financial aspects, and need for activity, functioning both as facilitators and inhibitors of reemployment.
This study focuses on the origins of different strains in the cement pastes that condition the viscoelastic properties and the structural build-up/thixotropy. Owing to the complexity of demonstrating the contribution of the nucleation of hydrates during the induction period of cement hydration, different chemically inert mineral suspensions with different granular properties (fineness, shape and particle size) are tested. The effect of the solid volume fraction and time on the different strains is also investigated. The results reveal that all of the suspensions studied display a critical strain of the same order of magnitude, and this critical strain does not change over time in the case of cement pastes. So the critical strain cannot be associated only with the nucleation of hydrates (C–S–H bridges) at the contact points between particles, as reported in the literature. The nucleation and increase of hydration products just increase the surface contact between particles, resulting in rigidification of the particles network characterised by an increase of the storage modulus after the formation of a colloidal network.
The growing population of adults aged ≥ 80 represents major challenges for critical care. Intermediate care units (IMCUs) offer a level that could bridge the gap between ICU and standard ward, but information is lacking regarding IMCU use for older critically ill patients. This study aimed to characterize critical-care trajectories involving IMCU use among older critically ill patients at a national level. A nationwide retrospective cohort study was conducted in France, including all patients hospitalized in medical critical care in 2018. Patients were categorized as young (18–64), old (65–79), and very old adults (≥ 80). Trajectories between critical care units and general wards were visualized using Sankey diagrams. Overall survival was represented with Kaplan–Meier curves according to trajectory patterns. Of 439,213 individuals admitted to medical critical care, 28.2
Sustainable Development Goal 2 (SDG2) aims to end world hunger, but Africa is currently not on track to meet this goal. Sub-Saharan Africa is particularly affected, with a significant increase in undernourished people. The issue of food security is, therefore, a pressing concern, and promoting trade has been suggested as one solution. This study examines the impact of cereal import openness on the prevalence of undernourishment for 27 Sub-Saharan African countries for the period 2000-2020. Using a two stage least squares instrumental variable (2SLS-IV) estimator, we found that greater cereal import openness is significantly associated with higher levels of undernourishment in Sub-Saharan Africa and then increases food insecurity. Our empirical findings are robust according to several tests, including adding additional control variables and alternative food security indicators. Our analysis also highlights that government effectiveness and political stability increase food security.
