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Non-invasive evaluation of the hemodynamic significance of renal artery stenosis in fibromuscular dysplasia through quantitative image analysis
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Améliorer la connaissance et la reconnaissance des interventions non médicamenteuses : implications pour la santé publique d’une étude participative et de consensus
No full textInternational audienceIntroduction: In the absence of a consensus on the definition and evaluation of non-pharmacological interventions (NPI)-despite the use of the concept by the World Health Organization, the French Health Authority, the Ministry of Health, and the European Centre for Disease Prevention and Control-this study has co-constructed a consensus-based paradigm aligned with international health research standards. This article outlines its relevance and limitations for public health.Method: Over a two-year period, the study engaged all stakeholders, i.e., more than 1,000 participants. Participatory workshops based on international health research recommendations and experiential knowledge, and consensus sessions were conducted under the guidance of a multidisciplinary committee and with the logistical support of the Non-Pharmacological Intervention Society. These efforts helped to identify the key descriptive and evaluative invariants specific to NPIs. Four phases followed: development, improvement, voting, and consultation.Results: The term NPI refers to prevention or care protocols with a physical, nutritional, or psychosocial focus, targeting a health issue and personalized by a qualified professional. The evaluation framework comprises 77 invariants—14 ethical and 63 methodological—distributed across five types of study: mechanistic, observational, prototypical, interventional, and implementation. The NPIS Model paradigm was endorsed by 31 learned societies and three French health authorities.Conclusion: The term NPI should be reserved for prevention and care protocols that are described, explainable, effective, safe, and implementable. The consensual framework for co-constructed evaluation should promote the transfer of NPIs from research to practice, their interprofessional coordination, contextual adaptation, continuous improvement, training, and, finally, their recognition. This scientific paradigm strengthens the role of public health professionals in developing targeted, efficient, and potentially fundable interventions for at-risk or ill populations. It paves the way for the development of an open registry of intangible health care practices that can be codified, shared, traced, and improved, informed by user feedback. This paradigm does not, however, cover all areas of public health.Introduction : Devant l’absence de consensus sur la définition et l’évaluation des interventions non médicamenteuses (INM) malgré l’utilisation de la notion par l’OMS, la HAS, le ministère de la santé et le Centre européen de prévention et contrôle des maladies par exemple, une étude a co-construit un paradigme consensuel répondant aux standards de la recherche internationale dans le domaine de la santé. L’article présente ses intérêts et ses limites pour la santé publique. Méthode : L’étude a mobilisé durant deux ans toutes les parties prenantes, soit plus de 1000 personnes. Des ateliers participatifs s’appuyant sur les recommandations internationales de la recherche en santé et l’expérience et des sessions de consensus ont été menés sous le pilotage d’un comité pluridisciplinaire et la logistique de la société savante Non-Pharmacological Intervention Society. Ils ont permis d’identifier les invariants descriptifs et évaluatifs spécifiques aux INM. Quatre phases se sont succédé, élaboration, amélioration, vote, consultation. Résultats : Le terme INM désigne des protocoles de prévention ou de soin ayant une dominante corporelle, nutritionnelle ou psychosociale, ciblés sur un problème de santé et personnalisés par un professionnel qualifié. Le cadre d’évaluation comporte 77 invariants, 14 éthiques et 63 méthodologiques. Ces derniers sont répartis en cinq types d’étude : mécanistique, observationnelle, prototypique, interventionnelle et d’implémentation. Le paradigme NPIS Model a reçu le soutien de 31 sociétés savantes et trois autorités de santé françaises. Conclusion : Le terme INM devrait être réservé aux protocoles de prévention et de soin décrits, explicables, efficaces, sûrs et implémentables. Le cadre consensuel d’évaluation co-construit devrait favoriser la transférabilité des INM de la recherche à la pratique, leur coordination pluriprofessionnelle, leur adaptation au contexte, leur amélioration continue, leur formation, et finalement leur reconnaissance. Ce paradigme scientifique renforce le rôle des professionnels de la santé publique dans le développement d’actions ciblées, efficientes, et possiblement finançables au bénéfice des publics à risque ou malades. Il ouvre la voie au développement d’un référentiel en accès libre de pratiques immatérielles de santé codifiables, partageables, traçables et améliorables par la prise en compte des retours d’expérience. Ce paradigme ne couvre en aucun cas tous les domaines de la santé publique
Are manual wheelchair rear wheel rolling resistance and friction (in)-dependent of load, tire pressure, and camber angle? An evaluation across different surfaces
No full textInternational audiencePurpose: Rolling resistance of manual wheelchair (MWC) has been widely studied, and while many studies have focused on the effects of rear-wheel configurations and surface types, few studies have comprehensively explored a broad range of surfaces and their interactions with wheel configurations. Additionally, rear wheel grip (i.e., friction) remains underexplored. Materials and methods: To assess the specific impact of rear-wheel configurations on both rolling resistance and grip, a deceleration cart with four identical wheels was developed. The rolling resistance and static friction of three tire types were tested across two loads, four camber angles, three inflation pressures, and seven surface types, including sports and everyday surfaces. Measurements were obtained using wireless inertial measurement units during deceleration tests and using a handheld dynamometer during grip tests, following an experimental design approach. Results: Statistical analysis identified surface type as the most influential factor on rolling resistance and static friction, with tire pressure and camber angle also having significant surface-dependent effects. Conclusion: The use of the deceleration cart enabled precise determination of the specific rolling resistance properties and static friction coefficients of MWC wheels, facilitating the creation of a dataset that characterizes the rolling resistance and grip properties of wheels on various surfaces
Investigating biographical post-bariatric surgery uncertainties in the light of changes in bodily practices: a mixed-method, multicentric and longitudinal research protocol
No full textInternational audienceIntroduction The effects of bariatric surgery have largely been studied from a medical viewpoint, seeking to measure changes in anthropometric, physiological or quality-of-life factors after the operation. Few studies, however, have focused on the dynamics of lifestyle changes. Yet we know that changing lifestyle habits—which are often part of the established social configurations at the origin of morbid obesity—is essential for a sustainable recovery from obesity. We also know that the major bodily transformations that occur in the six to twelve months following surgery produce a high degree of biographical uncertainty and affect social interactions. From a sociological perspective, the authors propose to study the processes of disruption and re-establishment of lifestyle habits in the first 24 months following bariatric surgery. Methods and analysis The ChiBarAPS study relies on a mixed-method longitudinal survey, comprising three components: qualitative, quantitative, literature and data review. It aims to document three main dimensions, which must be articulated to understand the dynamics of change: (1) the work undertaken by patients on themselves in order to identify and measure the evolutionary effects of surgery, as well as to adapt to them; (2) the experience of using pre- and post-surgery information and support systems, and evaluating their effects on the agency of the people who have undergone surgery; (3) the evolution of social participation and lifestyle habits. The qualitative component concerns a cohort of 30 patients, interviewed in depth (2 hours) on these three dimensions, 6 months, 12 months and 24 months after the operation. The quantitative part uses questionnaires applied to a second group of 200 patients, following the same timeline. Ethics and dissemination This study complies with reference methodology MR004 of the French National Data Protection Authority and was registered by the Data Protection Officer of the University of Montpellier on the activity registry of the institution (24 April 2024). Ethics approval has been obtained from the University of Montpellier ethics research board (n°UM2024-037). Informed consent will be obtained from all participants before data collection. The project has received funding from the French National Research Agency (n°ANR-23-CE41-0020-01) from February 2024 to the end of January 2028. The first results of the research will be disseminated from 2026 onwards to researchers, health professionals and patient support organisations. The results of the study will then be published in peer-reviewed scientific journals, both national and international
Écrire la peinture en Espagne au XVIIe siècle
No full textFrancisco Calvo Serraller’s Teoría de la pintura del Siglo de Oro, published in 1981, serves as a compass for anyone interested in writings on art and images in the 17th century. The aim of this dossier is to echo, expand and enrich it. It addresses the conceptual challenges posed by writings on painting in the Spanish language in the 17th century and the complexity of conceptualizing the arts and their construction through texts that are insufficiently or partially known. The article proposed as a counterpoint is an in-depth reflection on what ekphrasis really was in the early modern era. It questions the descriptive nature of ut pictura poesis by extending the scope of the dossier to the links between literature and painting.La Teoría de la pintura del Siglo de Oro, de Francisco Calvo Serraller, publicada en 1981, sirve de brújula para todo aquel interesado en los escritos sobre el arte y las imágenes en el siglo xvii. El objetivo de este dosier es hacerse eco de ella, a la vez que ampliarla y enriquecerla. Se abordan en particular los retos conceptuales que plantean los escritos sobre pintura en lengua española en el siglo xvii. Se trata de expresar la complejidad del pensamiento sobre el arte y su construcción a través de textos insuficiente o parcialmente conocidos. El artículo que se propone como contrapunto es una reflexión de fondo sobre lo que fue realmente la écfrasis para los modernos. Cuestiona el carácter descriptivo del ut pictura poesis ampliando el ámbito del dosier a los vínculos entre literatura y pintura.L’ouvrage qui sert de boussole à tous ceux qui s’intéressent aux écrits sur l’art et sur l’image au xviie siècle est celui que Francisco Calvo Serraller a publié en 1981: Teoría de la pintura del Siglo de Oro. Ce dossier a pour objectif de lui faire écho tout en le prolongeant et en l’enrichissant. Il aborde en particulier les défis conceptuels que posent les écrits sur la peinture en langue espagnole au xviie siècle. Il s’agit d’exprimer la complexité de la pensée de l’art, de sa construction à travers des textes insuffisamment ou partiellement connus. L’article proposé comme contrepoint est une réflexion fondamentale sur ce qu’était réellement l’ekphrasis pour les modernes. Il questionne la nature descriptive de l’ut pictura poesis, élargissant le propos du dossier au champ des liens entre littérature et peinture
BMI in children: the promising future for an index reflecting body fat development
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¿Zurbarán, pintor de la espiritualidad?
No full textInternational audience¿Era Zurbarán un pintor espiritual y, en qué sentido? ¿Podemos decir que su pintura era mística? Con motivo de la exposición Zurbarán (sobre)natural, celebrada en el Museu Nacional d'Art de Catalunya entre marzo y junio de 2025, este capítulo del catálogo analiza la religiosidad del maestro nacido en Extremadura en 1598. Durante mucho tiempo se le ha presentado como un intérprete de la Contrarreforma
Progression of Kidney Fibrosis after Sepsis: The Underestimated Role of Resident Macrophages and Recruited Monocytes
No full textInternational audienceSepsis is a life-threatening condition affecting each year an estimated 49 million people and causing 11 million deaths. Short-term mortality of sepsis was substantially reduced during the past decades and is still improving. Besides its short-term lethality, awareness regarding long-term consequences of sepsis is rising. Among all organs affected during sepsis, the kidney is the most vulnerable. Up to 40% of patients suffering from sepsis develop acute kidney injury (AKI), and sepsis is the leading cause of AKI among critically ills. Half of patients will recover from AKI during their stay; however, several studies have pointed out that those patients were at increased risk for the development of subsequent chronic kidney disease (CKD). In patients suffering from transient AKI, a second injury was found to hasten renal fibrogenesis. Taken together those findings challenge the concept of ad integrum recovery and strongly suggest maladaptive repair AKI, together with profound and durable alterations at intra-organ level. Factors driving AKI to CKD after sepsis are poorly understood and could be of multiple origins. Kidney macrophages have pleiotropic roles in health and disease. Following sepsis, a proportion of kidney macrophages undergoes pyroptosis in an “altruist” maneuver to recruit inflammatory cells. Empty niches are later colonized by circulating monocyte arising from bone marrow in a process called emergency myelopoiesis but also by expansion of resident cells. The role of monocytes and macrophages in the acute phase of sepsis is well described, however, their role in the resolution of inflammation is just beginning to be understood. In the present review, we will discuss the fate of kidney resident macrophages and recruited monocytes in septic AKI. We will review the evidence linking changes in the immune landscape and maladaptive repair after sepsis. Finally, we will consider how targeting macrophage recruitment and polarization might influence sepsis long-term consequences
The pedagogical liminality of patient and public involvement in initial healthcare professional education: an umbrella review
No full textInternational audienceObjectivesPatient and public involvement in undergraduate healthcare professional education (PPI-PE) raises questions about its value and the ways it can be implemented, which has been explored by several literature reviews from various angles. This study aimed to take stock of our current knowledge of the foundations and effects of PPI-PE, the structure of programs of this type, their implementation conditions and identify any gaps in the studies conducted so far. The aim was also to identify the questions that run through the studies, pinpoint their foundations and implicit assumptions, and make sense of any discordant elements.DesignThree databases were searched to conduct an umbrella review based on the recommended quality criteria.ResultsThe 27 reviews included were based on 529 independent articles. The analysis carried out has enabled us to consolidate existing knowledge of stakeholders’ motivations, patient recruitment process, the implemented educational initiatives and their impact. Numerous studies agree on the benefits of PPI-PE. In contrast, there are few studies on patient profiles, and the lack of grounding in intervention theories does not help to structure curricula.ConclusionThe results explain the lack of chrono-pedagogical reflection. At this stage, it would be useful to develop realistic evaluations of whose aim is to link effects to contextual elements and the mechanisms that produce them, to optimize actions. Despite the well-documented benefits of PPI-PE, its limited integration suggests a form of pedagogical liminality. This may stem from institutional inertia in medical and nursing education, where entrenched traditions, power dynamics, and the dominance of qualitative research create barriers to change