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International audience; Au Pérou comme en Bolivie, la pandémie de Covid 19 a donné lieu à la mise en place de confinement nationaux. Nous avons choisi d’examiner la manière dont la pandémie a affecté les sociétés des Amériques à travers l’examen des mobilités induites par l’imposition du confinement. Cette recherche sera conduite à partir d’enquêtes ethnographiques et historiques menées auprès de populations et/ou minorités péruviennes et boliviennes. Notre approche sera résolument comparative et à deux échelles : au-delà d’une comparaison entre différentes études de cas, il s’agira de faire dialoguer deux disciplines, l’histoire et l’anthropologie. Cette « conversation » à deux voix se propose aussi d’envisager successivement, sous l’angle de ces deux disciplines, deux modalités consubstantielles à l’expérience humaine et bousculées par la période actuelle, le spatial — les marches incarnant des mobilités paradoxales en temps d’immobilisations nationales — et le temporel — le règne actuel de l’incertitude induisant des rapports divers au futur. Ce texte souhaite ainsi envisager, dans une double perspective spatiale et temporelle, l’appréhension humaine des errances induites par la situation sanitaire et sa gestion: de quelles dynamiques sont-elles porteuses? Qu’interrogent-elles des trajectoires historiques prises par leurs pays respectifs?

International audience; The SARS-CoV-2 pandemic has led to the implementation of unprecedented public health intervention measures, not least the lockdown of countries worldwide. In our hyperconnected world exemplified by social media, it is now possible to derive quantitative measures of human mobilities at useful spatial scales. In this chapter we discuss how the use of Facebook data enables us not only to capture the impact of lockdown on human mobility but also to assess how changes in mobility contribute to the spread of the virus. By performing a comparative analysis across four countries of differing levels of lockdown—Sweden, US, France and Colombia—we show that mobility contributes a substantial amount to the spread of the disease. This contribution is strongest when the local number of cases is low, but, importantly, is maintained even when the virus is widespread. Current epidemiological models do not take into account such mobility patterns and yet there exists a developed theoretical framework within which mobility can be included. Inclusion of mobility data would allow public health authorities to focus on highly connected hubs of infection and, because mobility patterns are relatively stable over time, would also enable forecasting of how the spread of this or another novel virus is going to occur. Anticipating epidemics and their spread is key for developing suitable but targeted intervention strategies and avoiding draconian lockdowns that are so harmful to the economy.

Abstract Background Cardiogenic shock (CS) is a life-threatening condition characterized by circulatory insufficiency caused by an acute dysfunction of the heart pump. The pathophysiological approach to CS has recently been enriched by the tissue consequences of low flow, including inflammation, endothelial dysfunction, and alteration of the hypothalamic-pituitary-adrenal axis. The aim of the present trial is to evaluate the impact of early low-dose corticosteroid therapy on shock reversal in adults with CS. Method/design This is a multicentered randomized, double-blind, placebo-controlled trial with two parallel arms in adult patients with CS recruited from medical, cardiac, and polyvalent intensive care units (ICU) in France. Patients will be randomly allocated into the treatment or control group (1:1 ratio), and we will recruit 380 patients (190 per group). For the treatment group, hydrocortisone (50 mg intravenous bolus every 6 h) and fludrocortisone (50 μg once a day enterally) will be administered for 7 days or until discharge from the ICU. The primary endpoint is catecholamine-free days at day 7. Secondary endpoints include morbidity and all-cause mortality at 28 and 90 days post-randomization. Pre-defined subgroups analyses are planned, including: postcardiotomy, myocardial infarction, etomidate use, vasopressor use, and adrenal profiles according the short corticotropin stimulation test. Each patient will be followed for 90 days. All analyses will be conducted on an intention-to-treat basis. Discussion This trial will provide valuable evidence about the effectiveness of low dose of corticosteroid therapy for CS. If effective, this therapy might improve outcome and become a therapeutic adjunct for patients with CS. Trial registration ClinicalTrials.gov, NCT03773822. Registered on 12 December 2018

Nowadays, supply chain disruptions caused by COVID-19 pandemic, demand variation, raw material shortage, etc., made the supply chains unable to deal with emerging market problems. Responding to the new requirements has underscored the need to ensure a reconfigurable supply chain in order to survive in this uncertain economic environment. Indeed, the objective of this study is to identify the quantitative factors of each reconfigurability characteristic representing the reconfigurability assessment indicators (modularity, integrability, convertibility, diagnosability, scalability and customization). Based on the literature review, quantitative factors used to assess the degree of reconfigurability in supply chain are determined. These factors allow classifying reconfigurability characteristics according to the degree of their influence on the supply chain structure or supply chain functions. Through this research work, we try to facilitate the assessment of reconfigurability based on its characteristics in order to determine the ability of the supply chain to cope with new emerging disruptions.

Les réformes engagées depuis les années 2000 en matière d’orientation et de formation professionnelle sont centrées sur la flexicurité à l’échelle européenne et son corollaire français, la sécurisation des parcours professionnels (SPP). Elles promeuvent des dispositifs censés permettre et compenser la flexibilité de l’emploi demandée aux actifs notamment en corrigeant les inégalités d’accès à la formation et en développant des dispositifs d’accompagnement. Dans une logique d’individualisation...

International audience; Cet article questionne la capacité des musées français à faire preuve de résilience organisationnelle face à la crise sanitaire. La nature complexe et contingente de ces établissements nous a conduits à employer une méthodologie exploratoire holistique à même de répondre à leurs caractéristiques. Nous avons construit, sur la base de données secondaires (rapports officiels, guides et webinaires), une taxonomie pragmatique selon la méthode de Grémy et Le Moan (1977), permettant ainsi de répondre à une confusion généralisée dans les sciences humaines et sociales sur les procédures de classification. Cinq dimensions ressortent dans cette taxonomie, révélant la capacité de résilience muséale.

International audience

International audience; The COVID-19 pandemic brings to light an obvious fact that has been forgotten for 20 years: health cannot be treated as a commercial good, and consequently, hospitals cannot be managed like companies. The current situation should help us to conceive of a different hospital for tomorrow. However, the problem of the hospital is more structural than cyclical. Onwhat basis can these principles be rethought? After a diagnosis of the structural blockages in hospitals, principles are put forward to propose the bases of a hospital management renewed by the values of care.; La pandémie du Covid-19 a fait apparaître une évidence oubliée depuis 20 ans : la santé ne peut pas être traitée comme un bien marchand, et donc, l’hôpital ne peut pas être géré comme une entreprise. L’événement conjoncturel que nous vivons doit mieux aider à penser un autre hôpital pour demain. Or, la problématique de l’hôpital est plus structurelle que conjoncturelle. Mais sur quellesbases pourraient être repensés ces principes ? Après un diagnostic des blocages structurels des hôpitaux, nous proposons les fondements d’un management hospitalier renouvelé par les valeurs du soin.

International audience; This article examines how France, a model of centralism, responded during the first phase of the Covid-19 crisis between January and October 2020. The theoretical framework of intergovernmental relations is mobilized to reflect on the successes and failures of our administrative-political system in the face of the pandemic. The article is based on a qualitative and quantitative analysis of reports and speeches published by institutional actors during the crisis and shows relations in permanent tension between hyper-centralization and the development of a more flexible and reactive horizontal governance.; Cet article étudie la façon dont la France, modèle de centralisme, a réagi lors de la première phase de la crise de la Covid-19 entre janvier et octobre 2020. Le cadre théorique des relations intergouvernementales est mobilisé pour réfléchir les réussites et les échecs de notre système administrativo-politique face à la pandémie. L’article s’appuie sur une analyse qualitative et quantitative des rapports et discours publiés par les acteurs institutionnels pendant la crise et montre des relations en tension permanente entre une hyper-centralisation et le développement d’une gouvernance horizontale plus souple et réactive.

International audience; Daily pandemic surveillance, often achieved through the estimation of the reproduction number, constitutes a critical challenge for national health authorities to design countermeasures. In an earlier work, we proposed to formulate the estimation of the reproduction number as an optimization problem, combining data-model fidelity and space-time regularity constraints, solved by nonsmooth convex proximal minimizations. Though promising, that first formulation significantly lacks robustness against the Covid-19 data low quality (irrelevant or missing counts, pseudo-seasonalities,.. .) stemming from the emergency and crisis context, which significantly impairs accurate pandemic evolution assessments. The present work aims to overcome these limitations by carefully crafting a functional permitting to estimate jointly, in a single step, the reproduction number and outliers defined to model low quality data. This functional also enforces epidemiology-driven regularity properties for the reproduction number estimates, while preserving convexity, thus permitting the design of efficient minimization algorithms, based on proximity operators that are derived analytically. The explicit convergence of the proposed algorithm is proven theoretically. Its relevance is quantified on real Covid-19 data, consisting of daily new infection counts for 200+ countries and for the 96 metropolitan France counties, publicly available at Johns Hopkins University and Santé-Publique-France. The procedure permits automated daily updates of these estimates, reported via animated and interactive maps. Open-source estimation procedures will be made publicly available.