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Spatial Disparities in Disability Prevalence at the District Level in Sub-Saharan African Countries And the issue of the international comparability
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On the Democratic Role of Fact-Checking: A Reflective Essay
No full textInternational audienceIn this reflective chapter, we would like to question the democratic role of fact-checking. The field of study related to disinformation and misinformation has grown quantitatively at an incredible pace, but it relies on a fuzzy ontology and a conflict narrative (Hwang, 2020). The aim of our reflection here is to understand the entanglement between fact-checking, power and institutions. We first go back to the origins of the notion of fact-checking, observe how it has transformed since, and identify the aspects of the question which have been poorly studied. We then reflect on truth-based solutionism and the various factors of distrust in news sources by arguing that private or public interventions may have the power to harm democracy and pluralistic news views. Eventually, we suggest a critical stance on the topic, which can help expose the normative values and assumptions usually silenced in the institutional approach adopted
Neutrophils, not macrophages, aid phage-mediated control of pulmonary Pseudomonas aeruginosa infection
No full textInternational audienceBackground : The increasing prevalence of multidrug-resistant (MDR) bacteria has reduced the effectiveness of standard antibiotics, prompting renewed interest in bacteriophage (phage) therapy as an alternative or adjunctive treatment. Phage therapy offers high specificity, self-amplification at infection sites, and minimal disruption to the gut microbiota. However, clinical implementation is challenging, due to the risk of phage resistance and uncertainties regarding optimal dosing and immune interactions. Methods : Previously, we demonstrated that a two-phage cocktail exhibited low immunogenicity in mice and, when combined with meropenem, significantly improved clearance of ventilator-associated Pseudomonas aeruginosa pneumonia, reduced inflammation, and disrupted biofilms more effectively than either treatment alone. In the present study, we investigated the interplay between this phage cocktail and innate immune defenses using a murine respiratory infection model and human in vitro assays. Results : Our findings reveal that the therapeutic efficacy of phage treatment is critically dependent on the presence of neutrophils, which act synergistically with phages to achieve effective bacterial clearance, particularly when bacterial burden exceeds a defined threshold. Alveolar macrophages, however, do not significantly contribute to infection resolution in vivo. Conclusion : Since neutrophils play a key-role in supporting phage-mediated Pseudomonas clearance, the efficacy of phage therapy is closely linked to the hosts immune competence – an important consideration when treating immunocompromised patients
Different kinematic strategies are adopted by AIS patients during walking depending on Lenke type
No full textInternational audienceIntroductionAdolescent Idiopathic Scoliosis (AIS) is classically evaluated through static X-rays and health-related quality of life questionnaires that do not reflect the functional limitations of patients during daily life activities, such as walking. The aim was to investigate kinematic strategies in non-operated AIS with different types of curvature during walking using 3D gait analysis.Methods13 AIS with Lenke 5 (major Cobb: 23 ± 8°), 30 AIS with Lenke 1 (major Cobb: 40 ± 14°) in addition to 24 controls underwent biplanar X-rays followed by 3D gait analysis. The kinematic parameters of the head, trunk, spinal segments, pelvis and lower limbs were compared between groups.ResultsAIS Lenke 5 had a lumbar segment bending while walking (T12L3-L3L5: 5 ± 7° vs. -3 ± 7° in controls) to the concave side of the scoliosis. They walked with an increased pelvic frontal mobility (12 ± 3° vs. 9 ± 3°) and internal rotation of the right foot (-2 ± 6° vs. -11 ± 8°; all p < 0.05). AIS Lenke 1 increased their thoracic & lumbar segment bending to the concave and to the opposite side respectively (T6T9-T9T12: -4 ± 9° vs. 1 ± 4°; T12L3-L3L5: 8 ± 12° vs. -2 ± 7°). However, they tended to reduce their lumbo-pelvic mobility (7 ± 5° vs. 12 ± 5°; all p < 0.05).ConclusionIn response to their inherent lumbar stiffness and bending, AIS Lenke 5 patients tended to increase their pelvic frontal mobility and to develop a homolateral internal foot rotation, ensuring a dynamic alignment during gait. AIS Lenke 1, by producing opposite bending movement at the thoracic and lumbar segments, tended to reduce their lumbo-pelvic mobility and ensure coronal dynamic alignment
Le paradoxe sémiotique de l’IA générative : enjeux communicationnels et de création
No full textArticle original.International audienceThis article proposes to characterize a semiotic paradox of generative AI: models promise to produce meaning, yet their principles are based on statistical processing of tokens without analyzing signs and their social and cultural contexts. This paradox raises issues related to communication and the notion of creation. Although generative AI systems are not capable of producing meaning, we perceive their outputs as discourse and as creations. Meaning is thus produced by the receiver themselves, through a process of subjectivation and belief.Unlike communication and creation, the outputs of generative AI thus appear to contribute to the simplification of symbolic language, the reproduction and even reinforcement of domination, and the reduction of the critical and emancipatory powers of communication and creation. Situated in a contemporary semantic, ideological, and political context of Manichaeism, rationalization of human activities, and repression of discourses alternative to hypermodernist capitalism, generative AI systems contribute to the generalization of doubt and the simplification of representations of the world, to the benefit of totalitarian regimes.Este artículo propone caracterizar una paradoja semiótica de la IA generativa: los modelos prometen la producción de sentido, mientras que sus principios se basan en un tratamiento estadístico de tokens sin análisis de los signos y sus contextos sociales y culturales. Esta paradoja plantea retos comunicativos y relacionados con la noción de creación. Si los sistemas de IA generativa no son capaces de producir sentido, percibimos sus producciones como discursos y como creaciones. El sentido sería así producido por el propio receptor, a través de un proceso de subjetivación y creencia.A diferencia de la comunicación y la creación, las producciones de la IA generativa parecen contribuir a la simplificación del lenguaje simbólico, a la reproducción e incluso al refuerzo de las dominaciones, y a la reducción de los poderes críticos y emancipadores de la comunicación y la creación. Situados en un contexto semántico, ideológico y político contemporáneo de maniqueísmo, racionalización de las actividades humanas y represión de los discursos alternativos al capitalismo hipermodernista, los sistemas de IA generativa contribuyen a generalizar la duda y la simplificación de las representaciones del mundo, en beneficio de las posibilidades de los regímenes totalitarios.Cet article propose de caractériser un paradoxe sémiotique de l'IA générative : les modèles promettent la production de sens alors que leurs principes reposent sur un traitement statistique de tokens sans analyse des signes et de leurs contextes sociaux et culturels. Ce paradoxe pose des enjeux communicationnels et liés à la notion de création. Si les systèmes d'IA générative ne sont pas en capacité de produire du sens, nous percevons leurs productions comme des discours et comme des créations. Le sens serait ainsi produit par le récepteur lui-même, via un processus de subjectivation et de croyance.A l'inverse de la communication et de la création, les productions des IAs génératives apparaissent ainsi contribuer à des dynamiques de simplification du langage symbolique, de reproduction voire de renforcement des dominations, et de réduction des pouvoirs critiques et émancipateurs de la communication et de la création. Situées dans un contexte sémantique, idéologique et politique contemporain de manichéisme, de rationalisation des activités humaines et de répression des discours alternatifs au capitalisme hypermoderniste, les systèmes d'IA générative contribuent à généraliser le doute et la simplification des représentations du monde, au profit de possibilités de régimes totalitaires
Raising awareness of occupational carcinogens among apprentices in an approach to promoting health in the workplace
No full textInternational audienceThe aim of this article is to report on an interventional research project - based in the human and social sciences, particularly sociology and educational sciences - designed to better understand how auto body technician, hairdresser, and beautician apprentices perceive the prevention of occupational carcinogenic risks, and to experiment with educational interventions aimed at raising their awareness of this issue.Methods: The associated methodology combines interviews with apprentices and training professionals (n = 72), and over a hundred hours of observations in practice workshops and in classrooms. Interventions were carried out in four classrooms, the effects of which were measured by interviews and administered questionnaires.Results: Although apprentices are concerned about their health, their position within the division of labour offers them very limited scope for preventive action. Professional norms tend to reinforce certain barriers to prevention. Carcinogenic risk, due to its delayed effects, remains difficult to apprehend and calls for specific intervention strategies. The interventions help to inform and initiate changes in their practices, but they struggle to make learners' awareness of the structural obstacles to prevention. All of these findings have been used to create tools that make up an educational kit available to trainers.Conclusion: Preventing occupational carcinogenic risk among apprentices is a complex issue, and interventions in schools are one way of addressing it. However, a global change in practices requires these projects to be transferred to a larger scale, along with structural changes in working environments to promote the health of apprentices
Éducation Thérapeutique du Patient en formation initiale : quels curriculums prescrits pour les formations en santé à l’aune du développement de l’approche par compétences ?
No full textInternational audienceIntroduction: TPE was developed in France with the help of continuing education for healthcare professionals, before being integrated into the into the undergraduate education of healthcare professionals. However, some authors have shown that it remains highly heterogeneous. In the context of the development of competency-based approach (CBA), do the prescribed curricula of the various undergraduate health education programs integrate TPE? Method: The analysis focuses on the prescribed curricula of the five initial training courses: Dietician, Nurse, Physiotherapist, Maieutician and General Practitioner. The analysis of curriculum structure and type was combined with a descriptive analysis of the integration of TPE, based on content and internal consistency criteria. Results: Our results highlight the predominance of traditional curricula in which competencies coexist with a disciplinary organization. TPE appears to be integrated into broader competencies (educational care, prevention or health promotion). Student progress is mostly expressed in terms of knowledge (content). There is heterogeneity in terms of aims (skills, target learning), format (volume, organization of TVE training), teaching method and assessment. Discussion: The predominance of the “traditional” profile (for 4 of the 5 curricula) indicates that CBA has not yet been fully integrated into prescribed health curricula. This translates into competencies that are not very operational, detailed in a separate section of the training model. Teaching and assessment methods do not appear to be specific to these competencies. On the contrary, training is divided up according to knowledge, i.e. , course content, with no link between them. In their current formats, curricula do not seem to support the real integration of TPE into initial training. This work shows the urgent need to set up a reference framework for initial training, which would enable TPE to be developed in the new CBA formats. These proposals are intended as pointers for decision-makers and training managers wishing to support institutes and universities in such reforms, and to open up prospects for the evolution of the prescribed reference frameworks with regard to TPE.Introduction : L’ETP s’est développée en France à l’aide de la formation continue des professionnels de santé avant d’être intégrée dans les formations initiales (FI) des professionnels de santé. Cependant, certains auteurs montrent que l’offre est restée très hétérogène. Dans le contexte du développement de l’APC, comment les référentiels de compétences des différentes formations initiales en santé intègrent l’ETP ? Méthode : L’analyse porte sur les curriculums prescrits des cinq formations initiales : Diététicien, Infirmier, Masseurs-kinésithérapeute, Maïeutique et Médecin généraliste. L’analyse de la structure et du type de curriculum est combinée avec une analyse descriptive de l’intégration de l’ETP à partir de critères de contenu et de cohérence interne. Résultats : A été mise en évidence la prédominance des curriculums traditionnels qui font coexister des compétences avec une organisation par enseignement disciplinaire. L’ETP apparaît intégrée à des compétences plus larges (soins éducatifs, prévention ou promotion de la santé). La progression de l’étudiant est majoritairement exprimée en termes de connaissance (contenu). Il y a une hétérogénéité en termes de finalités (compétences, apprentissages cibles), de format (volume, organisation de la formation à l’ETP), de méthode d’enseignement et d’évaluation. Discussion : La prédominance du profil « traditionnel » (pour 4 des 5 curriculums) indique que l’APC n’est pas encore pleinement intégrée dans les curriculums prescrits en santé. Cela se traduit par des compétences qui sont peu opérationnelles, détaillées dans une section à part de la maquette de formation. Les modalités d’enseignement ou d’évaluation ne semblent pas leur être spécifiques. Au contraire, on constate un découpage de la formation selon les connaissances, c’est-à-dire le contenu des enseignements sans qu’il n’y ait de lien entre eux. Dans leurs formats actuels, les curriculums ne semblent pas soutenants pour l’intégration réellement l’ETP dans la formation initiale. Ce travail montre l’urgence de la mise en place d’un référentiel pour la formation initiale qui permettrait de développer l’ETP dans les nouveaux formats par APC. Ces propositions constituent des repères pour les décideurs et les responsables de formations qui souhaiteraient accompagner les instituts et les universités dans de telles réformes et ouvrir des perspectives d’évolution des référentiels prescrits vis-à-vis de l’ETP
Left and Right Atrioventricular Coupling: state-of-the-art review
No full textInternational audienceThe coordinated interaction between atria and ventricles, termed atrioventricular (AV) coupling, is essential for maintaining efficient cardiac performance. The left/right atrium (LA/RA) modulates left/right ventricular (LV/RV) filling through its reservoir, conduit, and booster pump functions, while the LV/RV in turn determines atrial pressures and compliance. Disruption of this finely balanced interplay leads to impaired filling dynamics, abnormal pressure–volume relationships, and progressive remodeling. Mechanisms of uncoupling include mechanical dysfunction from atrial dilatation and fibrosis, ventricular diastolic stiffness, and loss of atrial contractile reserve, as well as electromechanical desynchrony due to conduction abnormalities such as AV block or prolonged PR interval. The concept of quantifying AV coupling has been formalised through the left/right atrioventricular coupling index (LACI/RACI), defined as the ratio of LA/RA end-diastolic volume to LV/RV end-diastolic volume. LACI/RACI can be noninvasively derived across imaging modalities—including echocardiography, computed tomography, and cardiovascular magnetic resonance—without requiring specific acquisition protocols. First described in large population cohorts, LACI has demonstrated independent and incremental prognostic value for heart failure, atrial fibrillation and mortality, outperforming isolated atrial or ventricular parameters. Moreover, its ability to capture dynamic remodeling make it a promising biomarker for risk stratification across a broad spectrum of cardiovascular diseases. This review synthesises current knowledge on left and right AV coupling, outlines the physiological and pathophysiological mechanisms of uncoupling, and highlights the role of LACI/RACI as both a diagnostic and prognostic tool. Standardisation of assessment strategies and reference values will be essential to facilitate clinical translation and precision cardiology
Le jardin pendant la crise sanitaire de la Covid-19 : entre anti-confinement familial et exceptionnel normal
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De l’ami imaginaire au compagnon artificiel : grandir avec l’intelligence artificielle
No full textInternational audienceThe article explores the psychological and psychopathological transformations associated with the emergence of artificial companions in childhood and adolescence. From a clinical and theoretical perspective, the author examines how artificial intelligence (AI) is invested as an affective partner, blurring the boundaries between human and machine. While some studies highlight potential benefits—emotional support, cognitive stimulation, and reduced loneliness—the article warns about the risks of anthropomorphization, relational dependency, and the commercial exploitation of young people’s psychological vulnerabilities. The author calls for ethical regulation and the design of child-safe AI systems, developed in collaboration with clinicians and researchers, to preserve children’s psychological development and subjectivation processes