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L’histoire de la pensée managériale. Son histoire, nationale et américaine et son futur probable en France
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Evaluation des impacts environnementaux de prothèses dentaires fixes
No full textNational audienceGrâce à l’évolution des matériaux et des techniques en dentisterie, mettant en avant l’intégration croissante de la technologie numérique, les prothèses obtenues par CFAO remplacent celles issues de méthodes dites conventionnelles. Bien que cette évolution vers l’intégration numérique, améliore la précision et l’efficacité dans la production, celle-ci soulève aussi des inquiétudes quant à ses impacts environnementaux, notamment en termes de consommation de ressources, de gestion des déchets et d’émissions polluantes. L’évaluation des impacts environnementaux des prothèses obtenues par voie numérique constitue donc un enjeu majeur pour l’industrie dentaire.Les méthodes d’évaluation environnementale, notamment l’Analyse de Cycle de Vie, qui quantifie les impacts environnementaux à chaque étape du cycle de vie des prothèses (extraction des matières premières, transport, fabrication, utilisation, fin de vie) sont mises en oeuvre dans cette étude. Selon la littérature, le processus de transformation des matériaux prothétiques nécessite d'importantes quantités d'eau et sont énergivores. La fabrication des prothèses en cabinet ou en laboratoire génère également des déchets dont la gestion est souvent négligée par les praticiens. Aussi, les prothèses en fin de vie sont généralement mises en décharge, sans qu’aucune filière de retraitement ne soit prévue pour le moment. L’étude se concentre sur l’un des biomatériaux de restauration parmi les plus utilisés : vitrocéramique au disilicate de lithium.Cette étude souligne l’importance d’intégrer ces évaluations environnementales dans les processus décisionnels des professionnels de la santé dentaire et propose des axes d’amélioration destinés aux industriels et praticiens afin de promouvoir des pratiques respectueuses de l’environnement et d’encourager une dentisterie plus durable
Coupled quartz crystal microbalance – Surface enhanced Raman scattering strategy for the design and testing of aptasensors for small analytes
No full textInternational audienceBoth quartz crystal microbalance with dissipation (QCM-D) and Surface Enhanced Raman Scattering (SERS) stand at the forefront of label-free transducing techniques to trace and monitor biomolecular association events occurring at solid-liquid interfaces. Although these techniques provide highly complementary information on thin films' structure and molecular composition, they have never been simultaneously coupled in a single sensor element. We report herein the design of nanostructured gold-coated quartz crystal sensors acting as bimodal transducer elements to subsequentially or even in parallel and in situ monitor biomolecular recognition events by QCM-D and SERS. As a proof-of-concept, this bimodal sensor was applied to investigate the interaction between a chemisorbed DNA aptamer and a small molecule target, the antibiotic streptomycin. Combined QCM-D and SERS measurements provided evidence of successful engineering of the aptamer sensing layer as well as thermodynamic and structural information on the subsequent binding of streptomycin. QCM-D data enabled the measurement of a dissociation constant KD of 23±4 nM for the binding of streptomycin to the aptamer with a number of binding sites roughly equal to one. SERS data confirmed the conformational change of the aptamer upon interaction with streptomycin and indicated the nucleotides possibly involved in its recognition
Zola chantre de l’avenir : de l’utopie à l’anticipation dans Les Quatre Évangiles
No full textInternational audienceLe dernier Zola, celui du projet des Quatre Évangiles, développe explicitement une vision de l’avenir. Celle-ci s’ancre avec force dans une pensée utopique qui puise diversement aux théories fouriéristes, anarchistes et collectivistes, comme le met en évidence son roman Travail (1901), dans lequel il imagine la mise en place d’une société nouvelle sous la forme de la Cité heureuse, qui serait la ville ouvrière idéale du XXe siècle. Il réfléchit ainsi aux configurations possibles du phalanstère et explore la complexité des interactions entre les idéaux utopistes du réformisme social et les dangers doctrinaux et totalitaires de la dystopie. Mais, au-delà de cette seule inscription dans l’utopie, c’est toute une écriture de l’anticipation par extrapolation du présent que développe Zola dans son dernier cycle romanesque, envisageant ainsi « un prolongement dans demain » comme il le formule. Cette anticipation motivée par le passage d’un siècle à l’autre s’ancre dans une réalité observable et familière. Elle convoque une temporalité longue, progressive et abstraite, incarnée dans la succession des générations et revisitant le déterminisme par l’atavisme. Elle s’appuie sur la science, tout en empruntant à une forme de lyrisme prophétique mâtiné de rhétorique biblique. Ces caractéristiques romanesques gagnent à être resituées dans les poétiques du « merveilleux scientifique » (Maurice Renard) et les écritures d’anticipation qui émergent au XIXe siècle, dont Zola a pu être tributaire. On compte d’ailleurs, parmi ses sources avérées, Cent ans après ou L’An 2000 d’Edward Bellamy (1888). On observe aussi des hybridations entre l’essayisme et la fiction, dans le prolongement des textes d’Étienne Cabet et de Jean Grave. On décèle, plus largement, une certaine inscription dans la lignée des récits conjecturaux, où se côtoient notamment les œuvres d’Émile Souvestre, H.G. Wells, Jules Verne, Rosny aîné, Didier de Chousy, Albert Robida, Paul Adam. En croisant les poétiques romanesques naturaliste et conjecturale, cette communication propose de préciser la situation du dernier Zola dans les courants esthétiques divisés de la fin du siècle, dans les options littéraires relatives à la « conjecture romanesque rationnelle » (Pierre Versins) et dans les attributions respectives de l’utopie et l’anticipation, envisagées comme deux modalités distinctes d’écriture et de pensée de l’avenir
Use of gastrointestinal syndromic multiplex molecular assays and detection of Escherichia coli pathotypes in pediatric wards
No full textInternational audienceEscherichia coli pathotypes are enteric pathogens detected in gastrointestinal multiplex polymerase chain reaction (mPCR), with controversial clinical relevance. Our study aimed to describe clinical features and therapeutic decisions associated with E. coli detections in gastrointestinal mPCR. Children with positive mPCR for enteroaggregative (EAEC) , enteropathogenic (EPEC) , enterotoxigenic (ETEC), Shiga toxin-producing E. coli (STEC), and enteroinvasive E. coli (EIEC)/ Shigella identified in two pediatric hospitals over 18 months (2020–2021) were included. We described the frequency of E. coli detection and subsequent modifications in antibiotic strategies. Among the 2,471 mPCRs performed, 338 (14%) tested positive for at least one E. coli pathotype. The patient's mean age was 4.2 years, with 95% experiencing gastrointestinal symptoms. Clinical presentation was generally comparable between E. coli pathotypes. A recent travel abroad was reported in 68/338 (20%) cases and was mainly observed in EIEC/ Shigella infections. An E. coli was detected alone in 177/338 (52%) cases and with another virus, bacteria, or parasite in 161 (48%) cases. Multiple enteric pathogens were mainly detected with ETEC ( n = 24/26, 92%) and EAEC ( n = 82/121, 68%) detections. Antibiotic therapy was prescribed in 136/338 (40%) cases, with initiation based on mPCR results in 69/338 (20%). No antibiotic therapy was discontinued following positive mPCR results. Among the 69 initiations, 31 were deemed inappropriate after retrospective chart review. E. coli detection with mPCR tests may lead to inappropriate antibiotic initiation. Caution is advised when interpreting results from gastrointestinal mPCRs in children, as clinicians may be unaware of their often unclear or irrelevant clinical significance
Refined blow-up behavior for reaction-diffusion equations with non scale invariant exponential nonlinearities
No full text24 pagesWe consider positive radial decreasing blow-up solutions of the semilinear heat equation \begin{equation*} u_t-\Delta u=f(u):=e^{u}L(e^{u}),\quad x\in \Omega,\ t>0, \end{equation*} where or and is a slowly varying function (which includes for instance logarithms and their powers and iterates, as well as some strongly oscillating unbounded functions). We characterize the aymptotic blow-up behavior and obtain the sharp, global blow-up profile in the scale of the original variables . Namely, assuming for instance , we have \begin{equation*} u(x,t)=G^{-1}\bigg(T-t+\frac{1}{8}\frac{|x|^2}{|\log |x||}\bigg)+o(1)\ \ \hbox{as ,\quad where } G(X)=\int_{X}^{\infty} \frac{ds}{f(s)}ds. \end{equation*} This estimate in particular provides the sharp final space profile and the refined space-time profile. For exponentially growing nonlinearities, such results were up to now available only in the scale invariant case . Moreover, this displays a universal structure of the global blow-up profile, given by the resolvent of the ODE composed with a fixed time-space building block, which is robust with respect to the factor
Sur la fin comme stratégie (ou contre la fin de la stratégie)
No full textInternational audienceThis article analyses the contemporary rise of neo-reactionary and neo-fascist forces as a continuation of neoliberalism, which was violently imposed in Latin America in the 1970s. Unlike that period, which was characterised by military dictatorships, the current wave of authoritarianism has managed to establish itself through electoral mechanisms (digital screens and the legitimacy of votes). It argues that the key to this emergency lies in a neoliberal-digital subjectivity that has been produced in recent decades and is particularly susceptible to the so-called neo-reactionary. This subjectivity is characterised by three central dimensions: counter-empathy (a meritocratic individualism based on economic Darwinism), digital disconnection-through-hyperconnection (which promotes information saturation and a fascination with the ephemeral and viral), and political neutralisation through the commodification of personal well-being.It also discusses how current neo-fascist discourses have strategically exploited the idea of the end, channelling existential fears about economic, cultural and ecological collapse towards clearly defined enemies (migrants, feminists, progressive ideologies). In the face of this neo-reactionary advance, the text criticises the strategic difficulty faced by the left in effectively challenging a subjectivity largely shaped by neoliberal-digital logic, pointing to the urgent need to develop new political and affective tools to counter the mobilising power of fear and indignation characteristic of neo-fascism. English and French versions are available here.Este artículo analiza el ascenso contemporáneo de las fuerzas neorreaccionarias y neofascistas como continuidad histórica del neoliberalismo implantado violentamente en América Latina en la década de 1970. A diferencia de aquel período caracterizado por dictaduras militares, la actual oleada autoritaria ha logrado instalarse mediante mecanismos electorales (pantallas digitales y la legitimidad de los votos). Se sostiene que la clave de esta emergencia radica en una subjetividad neoliberal-digital que ha sido producida en las últimas décadas y que resulta particularmente susceptible al llamado neorreaccionario. Tal subjetividad se caracteriza por tres dimensiones centrales: la contra-empatía (un individualismo meritocrático basado en el darwinismo económico), la desconexión-por-hiperconexión digital (que promueve una saturación informativa y una fascinación por lo efímero y viral) y la neutralización política mediante la mercantilización del bienestar personal.Asimismo, se plantea cómo los discursos neofascistas actuales han sabido explotar estratégicamente la idea del fin, canalizando temores existenciales frente al colapso económico, cultural y ecológico en torno a enemigos claramente definidos (migrantes, feminismos, ideologías progresistas). Frente a esta avanzada neorreaccionaria, se critica la dificultad estratégica que enfrentan las izquierdas para interpelar eficazmente a una subjetividad ampliamente marcada por la lógica neoliberal-digital, señalando la necesidad urgente de desarrollar nuevas herramientas políticas y afectivas que confronten la eficacia movilizadora del miedo y la indignación propias del neofascismo.Cet article analyse la montée contemporaine des forces néoréactionnaires et néofascistes comme une continuité du néolibéralisme imposé violemment en Amérique latine dans les années 1970. Contrairement à cette période caractérisée par des dictatures militaires, la vague autoritaire actuelle a réussi à s'installer grâce à des mécanismes électoraux (écrans numériques et légitimité des votes). Il est soutenu que la clé de cette émergence réside dans une subjectivité néolibérale-numérique qui s'est développée au cours des dernières décennies et qui est particulièrement sensible à l'appel néo-réactionnaire. Cette subjectivité se caractérise par trois dimensions centrales : la contre-empathie (un individualisme méritocratique fondé sur le darwinisme économique), la déconnexion par l'hyperconnexion numérique (qui favorise une saturation de l'information et une fascination pour l'éphémère et le viral) et la neutralisation politique par la marchandisation du bien-être personnel.De même, il examine comment les discours néofascistes actuels ont su exploiter stratégiquement l'idée de la fin, en canalisant les peurs existentielles face à l'effondrement économique, culturel et écologique vers des ennemis clairement définis (migrants, féminismes, idéologies progressistes). Face à cette avancée néo-réactionnaire, le texte critique la difficulté stratégique à laquelle se heurte la gauche pour interpeller efficacement une subjectivité largement marquée par la logique néolibérale-numérique, soulignant la nécessité urgente de développer de nouveaux outils politiques et affectifs pour contrer l'efficacité mobilisatrice de la peur et de l'indignation propres au néofascisme. Les versions en français et en anglais sont disponibles ici
A simulation trial evaluating ABiMed, a clinical decision support system for medication reviews and polypharmacy management
No full textInternational audienceBackground: Medication review is a structured interview of the patient, performed by the pharmacist and aimed at optimizing drug treatments. In practice, medication review is a long and cognitively-demanding task that requires specific knowledge. Various tools and criteria have been proposed, but their application is tedious.Methods: We designed ABiMed, a clinical decision support system for medication reviews. The design was supported by literature reviews and clinicians focus groups. ABiMed supports the pharmacist by implementing the STOPP/START v2 criteria and by presenting aggregated drug knowledge, such as dosage, interactions or adverse effects, visually using tables, graphs and flower glyphs. We evaluated ABiMed with 39 community pharmacists during a simulation trial, each pharmacist performing a medication review for two fictitious patients without ABiMed, and two others with ABiMed. We recorded the problems identified by the pharmacist, the interventions proposed, the response time, the perceived usability and the comments. Pharmacists' medication reviews were compared to an expert-designed gold standard.Results: With ABiMed, pharmacists found 1.6 times more relevant drug-related problems during the medication review (p < 0.0001) and proposed better interventions (p < 0.0001), without needing more time (p = 0.56). The System Usability Scale score is 82.7, which is ranked "excellent". In their comments, pharmacists appreciated the visual aspect of ABiMed and its ability to compare the current treatment with the proposed one. A multifactor analysis showed no difference in the support offered by ABiMed according to the pharmacist's age or sex, in terms of percentage of problems identified or quality of the proposed interventions.Conclusions: The use of an intelligent and visual clinical decision support system can help pharmacists when they perform medication reviews. Our main perspective is the evaluation of the system with real patients, and its diffusion among pharmacists
Consensus on the Management of Anesthetic Agents During Digestive Motility Measurements and Proposal of a Standardized Protocol for Anesthesia (French Neuro Gastroenterology Group GFNG and Committee of Anesthetic French Experts)
No full textInternational audienceIntroduction Techniques for measuring digestive motility are becoming increasingly precise and enable therapeutic interventions. However, while most of these interventions require general anesthesia, there is limited data on the impact of anesthetic agents on these measurements, and no standardized anesthesia protocol currently exists to guide such procedures. Our working group carried out two Delphi processes involving experts in neurogastroenterology and anesthesiology to reach a consensus on which drugs affect these measurements and to establish an anesthesia protocol. Method Two expert groups were formed, comprising 13 neurogastroenterology experts from the French Neuro‐Gastroenterology Group (GFNG) and 15 full‐ or associate professors in anesthesia and intensive care. The first Delphi process involved the neurogastroenterologists and aimed to identify which anesthetic drugs influenced digestive pressure measurements. The second Delphi process, involving anesthetists, sought to develop an anesthesia protocol. Each expert indicated their level of agreement with each statement using a 6‐point Likert scale. A statement was endorsed when at least 80% of experts agreed with it. The strength of evidence for each statement was evaluated using the GRADE system. Results The Delphi process with neurogastroenterologists was conducted over three rounds and ultimately resulted in 91 amendments. The second Delphi process with anesthetists took place over two rounds and included 28 amendments, leading to the development of an anesthesia protocol. Conclusion To our knowledge, this work is the first to establish an expert consensus on anesthetic agents that can affect digestive motility measurements and to propose an anesthesia protocol that accounts for the needs of neurogastroenterologists
Setbacks of supply-side economics in the face of fundamental uncertainty - The case for unleashing aggregate demand
No full textAlthough fundamentally the General Theory and the orthodox approach both study the functioning of a market economy in which rational individuals operate, they obtain radically opposite properties in competitive equilibrium. One of the most remarkable differences is the predominance of aggregate supply conditions in the orthodox approach and aggregate demand conditions in the General Theory. The article discusses why the General Theory obtains such different results while studying an apparently similar system. The fact is that the appearance is deceptive, and that because of the radically different way in which the two approaches approach uncertainty and decisionmaking in the face of risk, one leads to a 'supply-side economy' in which money is neutral, while in the other it is, on the contrary, the non-neutrality of money that creates the conditions for a 'demand-side economy'. The article also explains why supply-side conditions only affect equilibrium income if they influence aggregate demand, and why supply-side policies have perverse effects when they are implemented in a system where demand takes precedence. In so doing, it reveals all the benefits that simply abandoning these policies can produce for economic growth. In passing, the article points out a number of recurring problems in the macroeconomic literature, concerning among other things the definition of aggregates, the conceptual and formal treatment of equilibrium and the interpretation of the General Theory