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  • Northern France
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  • Southwest France
  • Southwest France

Articles published on North-west France

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  • Research Article
  • 10.1016/j.eswa.2026.131216
A code distribution-based trajectory representation and its application to similarity, clustering and classification of AIS big data
  • May 1, 2026
  • Expert Systems with Applications
  • Iwao Fujino + 2 more

• We use PQk-means to convert AIS trajectories into sequences of code documents. • We apply TF-IDF to extract code distribution-based representation of trajectories. • We compute cosine similarity to find similar trajectories and vessels. • We apply K-means to cluster voyages and vessels from the proposed representation. • We use SVM to recognize vessels based on the proposed representation. Automatic Identification System (AIS) data received from vessels in a maritime area of interest is a valuable resource for understanding vessel behavior and gaining insights into maritime activities. This paper presents a novel approach for representing vessel trajectories using code distribution and analyzing AIS trajectory big data through machine learning techniques. By introducing PQk-means vector quantization algorithms, AIS trajectory data records are transformed into a series of code documents. Applying the TF-IDF (Term Frequency-Inverse Document Frequency) technique from text mining to these code documents produces a code distribution-based representation of vessel trajectories. This preliminary process enables the application of machine learning algorithms to AIS trajectory big data. Using this representation, three types of applications have been developed: detecting similar trajectories and vessels using vector space models and cosine similarity, clustering voyages and vessels with the K-means algorithm, and recognizing vessels with support vector machine algorithms. The potential of the proposed approach is demonstrated through a series of experiments using practical AIS datasets from a region in northwest France. Overall, the experimental results show that the proposed approach is highly effective for mining AIS big data, outperforms other methods, and confirms its ability to handle high-dimensional trajectories and massive amounts of AIS data within a reasonable computational cost. Moreover, this work provides an opportunity to develop an AIS-oriented version of a large language model based on our code distribution representation of trajectories, and to extend trajectory representation to any type of moving object or numerical vector from diverse sensors.

  • Research Article
  • 10.1016/j.rvsc.2025.106034
Epidemiology of endoparasite infections in the European hedgehog (Erinaceus europaeus) and association with rehabilitation outcome in wildlife centres in Northwest France.
  • Mar 1, 2026
  • Research in veterinary science
  • Paula Yagüez I López-Jurado + 2 more

The European hedgehog (Erinaceus europaeus) is prevalent across Western Europe, with many individuals admitted to wildlife rehabilitation centres. Parasitic infections, particularly helminth parasites, may threaten rehabilitation success. This study investigated respiratory and gastrointestinal endoparasite prevalence, risk factors, and associations with survival in 300 hedgehogs admitted to four rehabilitation centres in northwestern France (May 2023-May 2024). Faecal samples were analysed using either the modified McMaster technique (Oise) or direct smear (Seine-Maritime, Loir-et-Cher, Essonne). Overall, 58.3% of hedgehogs carried at least one endoparasite. The most common were Capillaria species group (43.6%) and Crenosoma striatum (25.7%), followed by Brachylaemus erinacei (11%) and Cycloisospora species group (7.3%). Co-infection was common; 35% of infected individuals harboured both Capillaria spp. and C. striatum. Younger hedgehogs showed lower prevalence but higher parasite burdens, suggesting reduced resistance. Capillaria spp. prevalence peaked in winter across all age groups. Multivariable analysis identified age, weight, season, and admission reason as significant risk factors for parasitism. Importantly, detection of C. striatum significantly increased mortality risk during rehabilitation (OR=3.44, p=0.0002). These findings highlight the need for targeted parasite screening and treatment protocols for specific risk groups, for example for juveniles and individuals with clinical signs. Coprological analysis offers a practical, non-invasive tool for parasite detection in resource-limited rehabilitation settings. This is the first study to report endoparasite prevalence in live hedgehogs in France using coprological methods and to demonstrate a statistical association between C. striatum infection and mortality in rehabilitation.

  • Research Article
  • 10.1016/j.pgeola.2026.101163
Correlation of the lower and middle Turonian chalks of south-west England and north-west France — condensation towards the Cornubian and Armorican massifs
  • Feb 1, 2026
  • Proceedings of the Geologists' Association
  • Andy Gale

The condensation of lower and middle Turonian chalks towards the western margins of the Anglo-Paris Basin in SW England (UK) and Haute Normandie (northwest France) is investigated using basin-centre to basin-margin transects. Correlations are based on the identification of key marker beds and high-resolution microcrinoid biostratigraphy which enable detailed analysis of the patterns of condensation. Hardgrounds develop and become more intensely lithified and mineralised towards the basin margins. The formation of hardgrounds at the bases of the lower and the middle Turonian can be related to widely recognised eustatic sea-level events. The distribution of a hardground which underlies a major hiatus higher in the middle Turonian (Ogbourne–Tilleul) is related to reactivated thrusts in the Variscan Basement and its formation was caused by early (92.4 Ma) inversion in the Subhercynian Phase, generated by the collision of North Africa and Europe.

  • Research Article
  • 10.1016/j.marpolbul.2025.118804
Evaluating factors affecting the sample processing for trace analysis of organophosphate tri- and di-esters in seawater: Application in the Loire estuary (France).
  • Jan 1, 2026
  • Marine pollution bulletin
  • P Zapata-Corella + 3 more

Evaluating factors affecting the sample processing for trace analysis of organophosphate tri- and di-esters in seawater: Application in the Loire estuary (France).

  • Research Article
  • Cite Count Icon 1
  • 10.15258/sst.2025.53.3.03
Breaking seed dormancy in Mediterranean Brassica rapa wild populations: is cold plasma treatment efficient?
  • Dec 31, 2025
  • Seed Science and Technology
  • M.H Wagner + 13 more

Turnip ( Brassica rapa ) is a native species of the Mediterranean area, spread from northwest France to south Algeria. In this study, dormancy and germination traits were assessed for 61 wild Brassica rapa populations collected across the Mediterranean region. Seed dormancy is a key factor influencing germination and seedling establishment. Three dormancy-breaking methods were compared: gibberellic acid, scarification and cold plasma. The efficiency and selectivity were evaluated through germination ability, time to 10% germination (T10), mean germination time and greenhouse emergence. Five days after imbibition, germination was only 18% for the untreated seeds but 60% for the plasma-treated seeds. Germination also began 24 hours earlier and mean germination time was reduced across most populations. However, there was a limited effect on seedling emergence, which remained around 55% for both untreated and treated samples. Comparative analysis indicates that cold plasma was more effective in alleviating embryo dormancy. In addition, histological and scanning electron microscopy showed that the seed coat differed according to the geographical origin of the populations, with a deeper dormancy in seeds from Sicilian populations.

  • Research Article
  • 10.34237/1009342
Multi-year morphological changes at two adjacent high-energy composite beaches: La Palue and Lostmarc’h in northwest France
  • Dec 30, 2025
  • Shore & Beach
  • Stéphane Bertin + 4 more

Composite beaches, defined by a steep gravel berm fronting a low-angle sandy foreshore, remain understudied despite their increasing relevance as models for nature-based coastal defenses called dynamic cobble berm revetments. To support development of effective designs in diverse coastal settings and improve understanding of coastal change and resilience across beach types, detailed field observations of composite beaches are required. Since September 2020, a regular monitoring program has been conducted on two adjacent high-energy composite beaches — La Palue and Lostmarc’h on the Crozon peninsula (northwest France). Using drone photogrammetry, this program investigates the morphodynamic response of gravel berms to varying wave energy and changes in sand level on the beach face. The results reveal consistent temporal patterns, including a pronounced seasonal signal: The gravel berm tends to widen over winter, when sand levels are lower, whereas gravel exposure decreases during calmer, low-energy periods. Berm and foreshore morphologies also exhibit large interannual variability driven by fluctuations in winter wave energy and storm characteristics. Integration of high-frequency satellite imagery further demonstrates that gravel exposure adjusts rapidly to shifts in wave forcing and sand levels. These findings highlight the dynamic and coupled nature of gravel-sand interactions on composite beaches and underscore the need for comparative investigations across sites with differing hydrodynamic and sedimentological settings.

  • Research Article
  • 10.24425/agp.2025.157030
New starfish (Echinodermata, Asteroidea) from the Cenomanian and Turonian (Upper Cretaceous) of Seine-Maritime (France) and a revision of Cretaceous stauranderasterid genera
  • Dec 15, 2025
  • Acta Geologica Polonica
  • Andrew Scott Gale + 1 more

Exceptionally well-preserved asteroid specimens from the Cenomanian and Turonian coastal exposures in Seine-Maritime (north-west France) are described. These include a new genus, Crielaster (type species: C. annae sp. nov.), provisionally assigned to the family Chaetasteridae, a new species of the astropectinid genus Coulonia (C. fournoui sp. nov.), and a new species of stauranderasterid (Stauranderaster pustulosus sp. nov.). A superbly preserved specimen of Oreaster coronatus Forbes, 1848, showing the construction of the abactinal surface, supports subdivision of the genus Stauranderaster. Stauranderaster coronatus is designated as the type species of Coronataster gen. nov., and Squamataster gen. nov. is erected with Oreaster squamatus Forbes, 1848 as its type species.

  • Research Article
  • Cite Count Icon 1
  • 10.1002/jqs.70025
New age‐estimate data and implications for marine isotope stage 7 and 5e sea levels in Fenland, eastern England
  • Nov 11, 2025
  • Journal of Quaternary Science
  • H E Langford + 7 more

ABSTRACT Only one last interglacial relative sea‐level indicator point (SLIP) has been recognised for Fenland, eastern England, and the nearest penultimate interglacial SLIP is located on the north Norfolk coast. Such limited information restricts the regional input to, and hence the relevance of, global reconstructions of late Middle and Late Pleistocene sea level. Marine‐influenced deposits without such relevant data are known in Fenland, but their age and connection to past relative sea level (RSL) were largely uncertain. To improve this situation, new age‐estimate data are presented and assessed in combination with existing age‐estimate and new and existing palaeoecological data. Sea level relative to the marine‐influenced deposits of Fenland is approximated based on brackish‐marine faunal analyses. Results distinguish between marine‐influenced deposits of penultimate and last interglacial sites. Fenland marine‐influenced deposits of both interglacial stages share similar altitudinal envelopes (between a few metres above and below present ordnance datum (OD)), in common with Kirmington to the north and those of the British south coast, the Channel Islands and northwest France. Peak Fenland minimum RSL approximation (RSLA) of 2.5 m OD in the penultimate interglacial is commensurate with the north Norfolk coast SLIP but contrasts with the below OD peak of the global record. Timing of the peak Fenland maximum RSLA of 3.75 m OD late in the last interglacial at 116 ± 16 ka is commensurate with the Dutch record (116–105 ka), but contrasts with the early peak of some global records.

  • Research Article
  • 10.3897/aca.8.e150925
Hydrological fragmentation alters the spatial configuration of dissolved nutrient and organic carbon concentrations in temperate river networks
  • May 28, 2025
  • ARPHA Conference Abstracts
  • Andrés Casanova + 3 more

Intermittent streams are characterised by a fragmentation phase during which the biogeochemistry of isolated pools differs from that of perennial streams. Studies of the former have mainly focused on arid and Mediterranean climates, although intermittent streams also exist in temperate climates where intensive agriculture and wetter conditions cause high nutrient loads. Our aim was to analyse how hydrological fragmentation alters the spatial variability of dissolved nutrient and organic matter concentrations among isolated pools. We conducted repeated synoptic sampling campaigns along the stream network of the Ria d'Etel catchment (northwest France, 65 km2) during the spring and summer of 2024. We sampled 30 sites and analysed dissolved organic carbon (DOC) concentrations and fluorescence properties, as well as dissolved inorganic nitrogen (DIN), dissolved organic nitrogen (DON) and soluble reactive phosphorus (SRP) concentrations, during three sampling campaigns, including stream recession (27 May 2024), early and late fragmentation (2 and 29 August 2024, respectively). The results showed an increase in the spatial variability of concentrations during hydrological fragmentation. In contrast to the flowing phase, where nutrient concentrations were highly correlated with catchment properties (DIN and agricultural land use; DOC and hydromorphic soils, etc.), concentrations in isolated pools appeared to be disconnected from catchment characteristics. We interpret this observation as a result of local in-stream processes gaining importance in determining concentrations in the isolated pools. More specifically, DOC concentrations were higher in isolated pools than in flowing reaches, while the DIN concentrations were lower. SRP concentrations were lower during the initial formation of isolated pools and then showed no difference compared to the flowing reaches. The chemical composition of the dissolved nitrogen pool also changed, with an increasing proportion of ammonium in DIN and an increasing proportion of DON in total dissolved nitrogen measured in isolated pools, both with greater spatial variability than in flowing reaches. With increasing degree of humification in isolated pools, the DOC composition showed more decomposed DOM with a probable terrestrial source. These results, together with the observed variations in dissolved oxygen concentrations, suggest that anoxic microbial respiration processes drive these concentration changes during hydrological fragmentation. As the number of intermittent streams is predicted to increase under climate change, we anticipate that the biogeochemical conditions that we observed are likely to become more common in temperate aquatic ecosystems.

  • Research Article
  • 10.1371/journal.pone.0316248
Spatial risk modelling of highly pathogenic avian influenza in France: Fattening duck farm activity matters.
  • Feb 4, 2025
  • PloS one
  • Jean Artois + 8 more

In this study, we present a comprehensive analysis of the key spatial risk factors and predictive risk maps for HPAI infection in France, with a focus on the 2016-17 and 2020-21 epidemic waves. Our findings indicate that the most explanatory spatial predictor variables were related to fattening duck movements prior to the epidemic, which should be considered as indicators of farm operational status, e.g., whether they are active or not. Moreover, we found that considering the operational status of duck houses in nearby municipalities is essential for accurately predicting the risk of future HPAI infection. Our results also show that the density of fattening duck houses could be used as a valuable alternative predictor of the spatial distribution of outbreaks per municipality, as this data is generally more readily available than data on movements between houses. Accurate data regarding poultry farm densities and movements is critical for developing accurate mathematical models of HPAI virus spread and for designing effective prevention and control strategies for HPAI. Finally, our study identifies the highest risk areas for HPAI infection in southwest and northwest France, which is valuable for informing national risk-based strategies and guiding increased surveillance efforts in these regions.

  • Research Article
  • 10.1017/s0025315425100854
The first record of Didemnum pseudovexillum (Ascidiacea, Didemnidae) in the UK
  • Jan 1, 2025
  • Journal of the Marine Biological Association of the United Kingdom
  • John Derek Duval Bishop + 2 more

Abstract The colonial ascidian Didemnum vexillum (Carpet Sea Squirt) is globally established as a non-native species with diverse negative impacts. A second Didemnum species, D. pseudovexillum , was described in 2020, living alongside D. vexillum and virtually indistinguishable from it in external appearance. It is not known whether this second species has environmental and economic impacts similar to those of D. vexillum , nor whether it should be regarded as native or non-native in Europe. Early records were from four sites, all in or adjacent to marinas, in north-west France, the Mediterranean coast of Spain and the east coast of Italy. Here, an occurrence of D. pseudovexillum in a seagrass bed in south-west England is reported, identified by both sequencing of the cytochrome c oxidase subunit 1 gene (COI) and examination of internal morphology. Separate studies collected and identified specimens of D. vexillum/pseudovexillum from 11 marinas on the English and Welsh coasts, and D. pseudovexillum was not found amongst these. Only two pre-2020 didemnid COI sequences now referrable to D. pseudovexillum have been found in the BOLD System and GenBank databases (these records being from Mediterranean Spain in 2013); this suggests that the species is a relatively recent addition to the European fauna from an unrecognized existing range.

  • Research Article
  • 10.1016/j.revpalbo.2024.105257
A Paleocene occurrence of cornelian cherries Cornus subg. Cornus in the land-mammal site of Berru (Paris Basin, France)
  • Dec 3, 2024
  • Review of Palaeobotany and Palynology
  • Cédric Del Rio + 2 more

A Paleocene occurrence of cornelian cherries Cornus subg. Cornus in the land-mammal site of Berru (Paris Basin, France)

  • Research Article
  • Cite Count Icon 12
  • 10.1038/s43247-024-01716-w
National and transboundary contributions to surface ozone concentration across European countries
  • Oct 14, 2024
  • Communications Earth & Environment
  • Roger Garatachea + 8 more

Tropospheric ozone impacts health, climate, and ecosystems. Effective ozone mitigation policies are challenged by limited quantitative understanding of national versus transboundary contributions to surface ozone. This study uses a chemical transport model with a source apportionment algorithm to analyze ozone contributions across Europe from 2015 to 2017 during peak ozone season. We quantify country-level ozone production and imported ozone, distinguishing contributions from 35 European countries, neighboring countries, seas, and hemispheric influences. Results show substantial contributions from outside the 35 European countries, with hemispheric contributions playing a significant role. European contributions are crucial during high ozone episodes, especially from Germany, France, Italy, the UK, Poland, and Spain. Spain, northern Italy, and northwest France are identified as areas where national precursor reductions would be more effective in improving national air quality. Furthermore, 25 of the 35 European countries studied are net importers of cumulative ozone mass, with the Netherlands, Belgium, and the UK acting as major exporters. These findings highlight the need for comprehensive air quality policies and cross-border cooperation.

  • Research Article
  • Cite Count Icon 3
  • 10.3390/heritage7090226
Sustainable Construction through Tradition: Inventory of Cob Buildings in the Guérande Peninsula (France)
  • Aug 31, 2024
  • Heritage
  • Philippe Poullain + 4 more

This paper delves into the investigation and inventory of cob buildings within the Guérande Peninsula, employing an interdisciplinary framework merging academic inquiry, fieldwork, and digital cartographic methodologies. Against the backdrop of escalating environmental concerns within the construction sector, raw earth construction emerges as a compelling avenue for sustainable building practices due to its low embodied energy and reversible characteristics. Despite historical prevalence in regions such as northwest France, traditional earth-building techniques have experienced waning prominence with the advent of industrial materials. However, the resurgence of interest in raw earth’s minimal carbon footprint has catalyzed renewed attention towards earth-building methods. Through a meticulous investigation methodology, this study identifies and analyzes 802 potentially old cob buildings, with 46 structures confirmed as cob constructions. Employing statistical analyses of building characteristics, including wall and lift heights, preservation states, and geographical distributions, this research sheds light on the significance of preserving cob heritage amidst rapid urbanization. The findings underscore the imperative for ongoing research and awareness efforts to safeguard these vernacular architectural traditions. By illuminating centuries-old building practices, this research contributes to the scholarly discourse on sustainable construction methodologies and local cultural preservation. Moreover, it underscores the necessity of integrating traditional knowledge systems with contemporary sustainability initiatives to foster resilience and longevity within the built environment.

  • Research Article
  • Cite Count Icon 6
  • 10.1038/s41467-024-51087-1
Human genetic structure in Northwest France provides new insights into West European historical demography
  • Aug 7, 2024
  • Nature Communications
  • Isabel Alves + 51 more

The demographical history of France remains largely understudied despite its central role toward understanding modern population structure across Western Europe. Here, by exploring publicly available Europe-wide genotype datasets together with the genomes of 3234 present-day and six newly sequenced medieval individuals from Northern France, we found extensive fine-scale population structure across Brittany and the downstream Loire basin and increased population differentiation between the northern and southern sides of the river Loire, associated with higher proportions of steppe vs. Neolithic-related ancestry. We also found increased allele sharing between individuals from Western Brittany and those associated with the Bell Beaker complex. Our results emphasise the need for investigating local populations to better understand the distribution of rare (putatively deleterious) variants across space and the importance of common genetic legacy in understanding the sharing of disease-related alleles between Brittany and people from western Britain and Ireland.

  • Research Article
  • Cite Count Icon 4
  • 10.1016/j.rse.2024.114297
Characterizing the spatial structure and aliasing effect of ocean tide loading on InSAR measurements
  • Jun 28, 2024
  • Remote Sensing of Environment
  • Zhou Wu + 3 more

Characterizing the spatial structure and aliasing effect of ocean tide loading on InSAR measurements

  • Research Article
  • 10.33920/igt-2-2404-02
Prospects for the development of individual tourism in Normandy
  • Apr 12, 2024
  • Gostinichnoe delo (Hotel Business)
  • R Badreddin + 1 more

In this article, on the basis of statistical data and through the use of applied research methods, the main characteristics of Normandy as an attractive tourist region in the North-West of France were presented and analyzed. The article also presented some provisions of the strategic program for the development of individual tourism in Normandy, its goals and measures to achieve these goals. General conclusions are given on the current state of affairs in Normandy in the field of tourism.

  • Research Article
  • Cite Count Icon 2
  • 10.5038/1827-806x.53.1.2482
Climate monitoring in the Caumont cave and quarry system (northern France) reveal near oxygen isotopic equilibrium conditions for carbonate deposition
  • Jan 1, 2024
  • International Journal of Speleology
  • Ingrid Bejarano-Arias + 5 more

The study of modern cave deposits forming under near isotopic equilibrium conditions can potentially help disentangle the processes influencing the oxygen isotope system and suitability of stalagmites as archives of past hydrological or thermal changes. We used cave monitoring to evaluate the impact of kinetic isotope fractionation and assess the conditions under which modern cave carbonates form in the Caumont cave and quarry system, located in Normandy, northwest France. Over 20 months, we collected climatological data, dripwater, and modern carbonate samples at 2–4-week intervals at three different stations inside the Caumont cave and quarry system. We find highly stable (10.4 ± 0.3°C – 11.3 ± 0.1°C) temperature in the deeper sections of the Caumont cave and quarry system. The temporal dynamics of δ18Odrip indicates that the drip water composition in Caumont reflects the original (though subdued) signal of precipitation, rather than the impact the seasonal to interannual cave air temperature has on isotopic fractionation. The monitoring reveals that δ13C of modern carbonate is influenced by prior carbonate precipitation that occurs during the summer season when evapotranspiration can minimize effective infiltration. Comparison of δ18O from dripwater and modern calcite, precipitated on glass plates and collected every two to four weeks, reveals that modern calcite forms near oxygen isotope equilibrium. A Hendy test on modern carbonate deposited on a stalagmite-shaped glass flask over 20 months confirms this finding because neither does δ13C increase with distance from the apex, nor are δ13C and δ18O positively correlated. We conclude that the δ13C signal in speleothems reflect summer (and longer-term) prior carbonate precipitation in response to effective infiltration dynamics, and that the δ18O signal likely reflects annual to multi-annual changes in the composition of precipitation above the cave.

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  • Research Article
  • Cite Count Icon 10
  • 10.3390/solar4010001
Impact of Flexibility Implementation on the Control of a Solar District Heating System
  • Dec 27, 2023
  • Solar
  • Manuel Betancourt Schwarz + 2 more

Renewable energy sources, distributed generation, multi-energy carriers, distributed storage, and low-temperature district heating systems, among others, are demanding a change in the way thermal networks are conceived, understood, and operated. Governments around the world are moving to increase the renewable share in energy distribution networks through legislation like the European Directive 2012/27 in Europe, and solar energy integration into district heating systems is arising as an interesting option to reduce operation costs and carbon footprint. This conveys an important investment that adds complexity to the management of thermal networks and often delays the return on investment due to the unpredictability of renewable energy sources, like solar radiation. To this end, this paper presents an optimisation methodology to aid in the operative control of an existing solar district heating system located in the northwest of France. The modelling of the system, which includes a large-scale solar field, a biomass boiler, a gas boiler, and thermal energy storage, was previously built in Dymola. The optimisation of this network was performed using MATLAB’s genetic algorithm (GA) and running the Dymola model as functional mock-up units, FMUs, using Simulink’s FMI Kit. The results show that the methodology presented here can reduce the current operation costs and improve the use of the daily storage of the DH system by a combination of mass flow control and the implementation of a flexibility function for the end-users. The cost-per-kWh was reduced by as much as 16% in a single day, and the share of heat supplied by the solar field on this day was increased by 5.22%.

  • Research Article
  • 10.1093/eurpub/ckad160.793
The care trajectories leading to emergency dialysis start: a qualitative study
  • Oct 24, 2023
  • European Journal of Public Health
  • M Raffray + 4 more

Abstract Introduction Emergency dialysis start (EDS) is an important issue to understand and tackle in Chronic Kidney Disease (CKD) care. Late referral, absent previous nephrology care and higher comorbidity scores have been associated with EDS. However, how those factors happen and contribute to EDS remains unexplored. We conducted a qualitative study in France to identify and describe the mechanisms that shape the trajectories that lead to EDS, using patients, GPs and nephrologists perspectives. Methods Three groups of participants were recruited in Brittany, north-west France: Patients who started dialysis in emergency between 2017 and 2019, GPs and nephrologists. Maximum variation sampling approach was used based on patients’ socio-economic profiles and GPs’ and nephrologists’ years and settings of practice. Semi-structured interviews were conducted between 2017 and 2020. A crossed thematic analysis between the 3 groups of transcripts was performed, informing how EDS trajectories come to be. Results Twenty patients, 12 GPs and 18 nephrologists were interviewed. Five themes were identified: 1) Learning about dialysis, 2) Dialysis and nephrology care representations: a) an unacceptable biographical disruption, b) a dreadful invasive machinery, c) a straw that breaks the camel's back, 3) The gap between the “illness” perceived and the “disease” treated, 4) Slipping through the primary care prevention net, 5) the unavoidable unpredictability of CKD course. Conclusions This study shows how EDS is, in part, the results of an interplay between patients’ constructed representations of dialysis, relation with the medical sphere and CKD physiopathology. The results suggests a need for evaluation of kidney replacement therapy education programs and reinforcement of psychological care. Finally, results support ambitious mass prevention campaign focused on kidney health to counter the persistent negative representation of dialysis and seal off prevention cracks. Key messages • Emergency dialysis start is the result of an interplay between patients’ constructed representations of dialysis, relation with the medical sphere and CKD physiopathology. • Evaluation of kidney replacement therapy education programs and reinforcement of psychological care as well as an ambitious prevention campaign focused on kidney health could contribute to reduce EDS.

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