HAL-Paris 13
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Entre deuil invisible et maternité interrompue, vécu d’une fausse couche spontanée lors d’un parcours de PMA
No full textInternational audienceBased on a clinical case in the context of medically assisted reproduction, this article explores spontaneous miscarriage as an experience that disrupts a developing psychological process. Between invisible grief and interrupted motherhood, it questions the mother's place in the bond with motherhood, the issues of transmission, and the need for symbolic recognition, so that the loss is not silenced
Cadrer puis recadrer les rappeurs : comment les émissions de divertissement musical ont rendu « un certain rap chinois » acceptable
No full textInternational audienceMalgré le succès phénoménal rencontré grâce à la diffusion de l’émission The Rap of China à l’été 2017, le rap chinois est subitement écarté des écrans l’année suivante, jugé vulgaire et incompatible avec les règles audiovisuelles du pays. Pour autant, les rappeurs réapparaissent rapidement dans les médias, jusqu’à interpréter des morceaux sur les chaînes d’État. Comment un tel changement a-t‑il été possible ? Cet article propose d’analyser l’évolution du cadrage médiatique du rap en Chine et d’observer comment les émissions de divertissement ont rendu « un certain rap » acceptable
Argumentation-Based Framework Selection for Clinical Decision Support
No full textInternational audienceClinical decision-making involves complex considerations, such as treatment options, patient preferences, and conflicting medical opinions. Argumentation frameworks provide a structured approach to modeling and reasoning through these complexities by constructing and evaluating arguments for and against specific decisions. This paper reviews existing AFs to identify the most suitable one for clinical decision support. We perform a comparative analysis of several frameworks—Dung’s AF, PAF, VAF, WAF, BAF, IBIS, and QuAD—using criteria tailored to clinical decision-making needs. Our analysis suggests that QuAD and DF-QuAD are those that best satisfy our criteria
From Guidelines to Code: Formalizing STOPP/START Criteria Using LLMs and RAG for Clinical Decision Support
No full textInternational audienceSTOPP/START v3 is a set of criteria for optimizing therapy for elderly patients with polypharmacy. Implementing these criteria in prescribing software requires to formalize them, which is a difficult task. This project aimed to automate the formalization of these criteria using large language models (LLMs), specifically leveraging Retrieval-Augmented Generation (RAG) for enhanced accuracy. We employed DeepSeek and GPT-4o-mini for entity extraction, code mapping to ICD-10, LOINC, and ATC, and the generation of executable Python code. A preliminary evaluation conducted on a subset of rules yielded a notably high F1-score (0.90, 0.92, 1 for drug, disease and observation entity mapping respectively and perfect results for medical entity extraction and code logic consistency). These results confirm the model’s effectiveness in accurately transforming complex clinical rules into executable code. In conclusion, we successfully automated the creation of executable code from medical guidelines, proving that LLMs, supported by RAG, can be effective for automating clinical decision support tasks and formalizing medical rule
Qui a droit à la médecine ?
No full textInternational audienceLes inégalités forment aujourd'hui le principal obstacle à la santé humaine. Une Japonaise vivra en moyenne 88 ans, une Suisse, 86 ans, mais une Nigériane, 55 ans. Depuis les Lumières françaises, pour la tradition conceptuelle occidentale, les hiérarchies entre les êtres ne souffrent aucune justification acceptable. L'égalité est un horizon d'aspirations par défaut, et les organisations internationales ont été créées pour poursuivre cet idéal. Cependant, plusieurs rapports ont montré que leur action n'a pas conduit à une diminution effective des inégalités. Comment défendent-elles aujourd’hui le droit à la santé, la plus universelle et incontestable de leurs ambitions
Correction: Clinical features, etiologies, and outcomes in adult patients with meningoencephalitis requiring intensive care (EURECA): an international prospective multicenter cohort study
No full textInternational audienceNo abstract availabl
The Absence of Claudin-10 in the Enamel Organ Alters Its Integrity
No full textInternational audienceRare disorders related to tight junction (TJ) proteins have been associated with amelogenesis imperfecta. Pathogenic variants of CLDN10, encoding claudin-10b, a cation transport pore, cause the autosomal recessive HELIX syndrome (Hypohidrosis, Electrolyte imbalance, hypoLacrymia, Ichthyosis, Xerostomia). Patients exhibit salivary dysfunction and rapid enamel wear after tooth eruption. Since Cldn10 is expressed in the dental epithelium, this study explores the role of claudin-10b in amelogenesis. We analyzed amelogenesis in constitutive and conditional Cldn10 knockout (KO) murine models, comparing the findings to human HELIX enamel. First, analysis of constitutive Cldn10 knockout (KO) mice, which die within a few hours after birth, showed that claudin-10 is present at the plasma membrane of the stratum intermedium but not at the TJs during the secretory stage. Its absence altered gene expression related to ion transport and pH control, although without major disturbance in cell polarization or enamel matrix synthesis. Examination of later stages of amelogenesis in epithelium-targeted conditional Cldn10 KO mice showed that claudin-10 is present in the papillary layer at the maturation stage. In its absence, the pH of the enamel matrix was more basic during early maturation, suggesting that claudin-10 determines enamel matrix pH. However, at later stage of the maturation process, the pH was corrected and the resulting enamel did not show major structural or elemental alterations. These later findings were confirmed by exploring the enamel of Cldn10 KO transplanted tooth germs, which have developed in a controlled mineral environment. Nevertheless, higher contents of aluminum were detected in the enamel of transplanted germs and in human HELIX enamel, suggesting that claudin-10 deficiency may lead to a loss of enamel organ integrity. These data suggest that while salivary dysfunction is the main cause of enamel wear in HELIX, claudin-10 plays a direct role in amelogenesis by determining pH and enamel organ integrity
Towards Secure and Transparent Cloud Auditing: A Blockchain and IPFS-Driven Framework with Batch Verification
No full textInternational audienceWith the rapid advancement of cloud storage and the increasing use of connected devices, uploading data to the cloud results in the loss of physical control by data owners, making confidentiality and integrity entirely dependent on Cloud Service Providers (CSPs). This raises concerns about whether CSPs effectively safeguard outsourced data, as any malicious behavior can lead to data tampering or deviation. Traditional auditing schemes rely on Third Party Authorities (TPAs), which are not always trustworthy. Although various cloud data auditing mechanisms have been proposed, few effectively address the challenge of ensuring data integrity without relying on trusted third parties. To overcome this limitation, we propose a secure and efficient distributed blockchain-based data integrity auditing scheme. Specifically, our approach randomly assigns the audit task to a user selected from among the system participants via blockchain. Blockchain and InterPlanetary File System (IPFS) technologies are leveraged to enforce access control and store ciphertext and policies, thereby preventing unauthorized data alterations. Furthermore, the proposed scheme supports low-cost batch integrity verification without the need for a TPA. Theoretical analyses confirm that our solution ensures data traceability and auditability, reduces reliance on third parties, enhances security, and improves system resilience. Finally, experimental results demonstrate that our approach effectively improves the performance of data integrity verification and demonstrate that the simulated gas costs are compatible with the theoretical ones
Voies d’un cinéma potentiel dans l’avant-garde française
No full textInternational audienceCe chapitre explore le cinéma d’avant-garde français des années 1910-1920 à travers la notion de « cinéma potentiel », où le virtuel, l’inachevé et le spéculatif jouent un rôle central. Les artistes comme Epstein, Dulac ou Gance envisagent le cinéma comme un art en devenir, mêlant fragments, utopies technologiques et quête d’une totalité idéale. Le scénario, les images latentes et les dispositifs expérimentaux incarnent cette tension entre réalisation et potentialité, révélant une vision prophétique du média