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Experience of Personal Recovery from Mental Disorders Among West African Refugees: A Clinical Case Study
No full textInternational audienceExposure to multiple vulnerability factors increase the likelihood of refugees experiencing mental health issues. Certain post-migratory factors exacerbate these disorders, while the processes of personal recovery remain unclear. This study explored the experience of personal recovery among West African refugees with mental issue, with the aim of helping health professionals in host countries to provide more appropriate care. We used the qualitative interpretative phenomenological analysis method. Ten participants were purposively sampled for face-to-face semi-structured interviews. Two themes emerged from the analysis. Despite their extreme socio-economic precariousness, mental disorders were perceived as forbidden conditions compared to the processes of acceptance of their somatic pathologies; hindering access to mental healthcare more markedly. Rebuilding a sense of security basis in the host country was seen as an essential step, but was also associated with factors that hindered the care process. Certain encounters could enable a return to care with patience, understanding and warmth. Our results highlighted the need to overcome some short-term self-protection strategies by adopting a benevolent attitude and active listening, ensuring secure socio-economical conditions first to enable mental care, increase the multicultural skills of healers, and support therapies that are not limited to face-to-face approach through activity, art, and group support. This may help to limit the risk of transmission of suffering to future generations
Outcome of acromegalic patients undergoing endoscopic endonasal surgery: collaborative French and Italian cohort, a 25-year experience
No full textInternational audienceIt has been demonstrated that high expertise is crucial for pituitary surgery. Due to the low incidence of acromegaly, large data reporting the outcome of endoscopic surgery are limited. The objective was to evaluate the outcomes of acromegalic patients undergoing endoscopic surgery. This retrospective study included 822 consecutive acromegalic patients treated by endoscopic endonasal surgery by two expert French and Italian neurosurgical teams from 1998 to 2022. The primary outcome was postoperative endocrine remission. The secondary outcome was operative morbidity, including surgical complications and new endocrine deficits. Preoperative predictive factors of persistent postoperative hypersecretion were calculated. Mean follow-up was 46.3 months. The overall remission rate was 63%. Long-term remission was achieved in 202/230 (88%) enclosed microadenomas, 316/452 (70%) macroadenomas without obvious cavernous sinus invasion, and 3/140 (2%) obvious invasive tumors. Hematoma, nerve palsy, cerebrospinal fluid leak, meningitis and epistaxis occurred in 0.1%, 0.1%, 1%, 0.6% and 1.1% respectively. New anterior pituitary deficits and diabetes insipidus occurred in 25/822 (3%) and 30/822 (3.6%) of patients respectively. Age, obvious cavernous sinus invasion, and larger diameter were predictive of persistent hypersecretion in multivariate analysis. Recurrence of somatotroph hypersecretion occurred in 19/540 (4%) patients with early remission, with a mean time of 37.5 months. Endoscopic pituitary surgery is effective and safe for acromegaly, provided that patients are treated in tertiary reference centers. Remission rate is high in microadenomas. If normalized somatotroph axis is achieved after surgery, long-term remission can be expected in most patients
Reconciling sustainability and sovereignty? There is no relationship between nutritional quality, environmental impact and food sovereignty in the French dietary pattern
No full textInternational audienceBackground and objectives:The capacity to provide sustainable diets, covering nutrient requirements, reducing risk of chronic disease and having a low impact on the environment, depends on domestic agricultural production and agricultural commodity trade flows. The transition to more sustainable food systems is therefore closely linked to food sovereignty issues. This study aimed to analyze the nature of the relationships among the nutritional, environmental and food sovereignty dimensions of food groups within the current French food supply.Methods:The dietary pattern was estimated using the food repertory from the latest French representative survey of adult food consumption, INCA3 (n = 2,121). For each food item (n = 1,772), indicators related to the three dimensions were calculated. First, we developed a nutrient-based food scoring system (PANFood, inspired by the PANDiet system) to assess nutritional quality based on the potential to provide sufficient indispensable nutrients without excessive nutrients to limit (n=32), using the CIQUAL database. Second, environmental impact was estimated using the single Environmental Footprint (EF) score from the Agribalyse database. In addition, a sustainability score was calculated by normalizing and standardizing these two indicators to create a more synthetic score. Third, food sovereignty was estimated as the food self-sufficiency (FSS) capacity, calculated as the ratio of domestic production to food availability using international (FAOSTAT) and national databases. Finally, these indicators were calculated for each food group as the consumption-weighted average of the food indicators to analyze their distribution across the dimensions. The long-term health value of food categories, as outlined in the Global Burden of Disease study, was also considered in the analysis.Results: There was no significant correlation between self-sufficiency and nutritional or environmental dimensions. Nevertheless, certain patterns were observed. The cereals and tubers achieved a favorable sustainability profile and a strong self-sufficiency. Dairy products presented a high self-sufficiency capacity, but their overall sustainability profile was moderate. Fruits, vegetables, and legumes demonstrated favorable sustainability profiles, with low cardiovascular disease risk, but their self-sufficiency capacities were not adequate and varied within the groups (e.g., low for citrus and high for apples). Finally, the Meat group exhibited a poor sustainability profile achieving the highest environmental impact and moderate self-sufficiency capacity overall. However, there were notable discrepancies between the type of products and the species (e.g., red meat and poultry).Conclusions: In France, based on the current dietary pattern, food sovereignty does not align with these sustainability dimensions. However, certain food groups can serve as lever to enhance sovereignty. These data could be used to model more sustainable and self-sufficient diets
Violences et risque suicidaire en Afrique subsaharienne : le cas du Sénégal
No full textInternational audienceIntroduction Assessing violence and suicide risk is a critical preventive action in the fight against suicide. Objectives This study aimed to analyze the vulnerability factors associated with violence and suicide risk in the general Senegalese population. Methods This was an observational, population-based, national, cross-sectional, descriptive, and analytical survey. Data collection was conducted from July to August 2023 on 496 randomly selected households proportionally distributed according to the demographic weight of different areas. The assessment of suicide risk was derived from the Mini International Neuropsychiatric Interview (MINI) V5. Data were directly entered into ODK, and analysis was performed using R software. Ethical approval was granted by the National Health Research Ethics Committee of Senegal. Results A total of 2,174 individuals were surveyed, with a mean age of 41.4±12.2 years. The prevalence of violence in Senegal was 52.76%. The most common forms were psychological violence (47.38%), verbal violence (43.47%), and physical violence (32.84%) (Refer to table I: Distribution by type of violence). Associations of violence were observed, with physical violence associated with psychological violence accounting for 19.59%. Women were more exposed to the different type of violence. Geographic disparities were identified, with the Dakar region emerging as the main hotspot for these forms of violence (refer to image 1: mapping of violence by region of Senegal). The suicide risk was found to be 8.4%, with a high level at 1.66%. Regardless of the type of violence, the suicide risk was elevated; it was 47.6% for sexual violence (refer to image 2: Distribution of Suicide Risk According to the Type of Violence). Unfortunately, recourse to victim assistance was low, with 6.2% of victims receiving psychological support and 10.4% receiving police assistance. Table I: Distribution by type of violence Nature of violence (N=2174) Numbers Percentages (%) IC 95% Physical violence 714 32.84 [31 - 35] Sexual violence 83 3.82 [3.1- 4.7] Psychological violence 1030 47.38 [45 - 50] Neglect violence 204 9.38 [8.2 - 11] Domestic violences 332 15.27 [14 -17] Verbal violence 945 43.47 [41 - 46] Domestic harassment 273 12.56 [11 -14] Domestic assault 184 8.46 [7.3 - 9.7] All violences 1147 52.76 [51 - 55] Image 1: Image 2: Conclusions Violence was significant in Senegal, with gaps in administrative and medicopsychological assistance. The suicide risk is high, but suicide remains underreported. It is crucial for Senegal to have a political and health framework with a public health approach centered on vulnerable groups for managing violence and suicide risks. Keywords Violence, Suicide risk, Senegal, Africa Disclosure of Interest None Declare
Vers une recommandation d'émojis plus humaine
No full textEmojis enrich textual emotional expression. However, current LLM-based emoji recommendations still fall short of being human-like, exhibiting issues such as a lack of fine-grained emoji selection and inconsistency in providing explanatory justifications. Against this backdrop, we explored the embeddings of both LLMs and VLMs and proposed a novel metric to cluster contextually similar emojis. Using the existing Multi-Resolution dataset, we fine-tuned Qwen2.5-7B and incorporated our proposed metric into the training loop by modifying logits with a bias term. We also investigated the impact of applying LoRA at different layers. Ultimately, we aim to propose LLMOJI, a human-like emoji recommendation model.Les émojis enrichissent l’expression émotionnelle du texte. Cependant, les recommandations d’émojis basées sur les LLM demeurent encore éloignées d’un comportement véritablement humain, présentant notamment un manque de finesse dans la sélection des émojis ainsi qu’une incohérence dans la fourniture de justifications explicatives. Dans ce contexte, nous avons exploré les représentations issues des LLM et des VLM et proposé une nouvelle métrique permettant de regrouper les émojis contextuellement similaires. En utilisant le jeu de données existant Multi-Resolution, nous avons affiné Qwen2.5-7B et intégré notre métrique au sein de la boucle d’apprentissage en modifiant les logits à l’aide d’un terme de biais. Nous avons également étudié l’impact de l’application de LoRA à différents niveaux de couches. En définitive, notre objectif est de proposer LLMOJI, un modèle de recommandation d’émojis à caractère plus humain
Ce que l'âge fait aux frontières entre intimité et sexualité: Enfance, vieillesse et catégories de la sexualité
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Digital Pharmacological Twins: Bridging Multi-scale Modelling and Artificial Intelligence for Precision Medicine : the DIGPHAT consortium
No full textInternational audienceThe advent of digital twins in pharmacology presents transformative potential for precision medicine, enabling personalized treatment optimization through dynamic computational simulations of drug interactions at molecular, cellular, and patient levels. These advanced virtual replicas of a patient's biological system are designed to predict individual therapeutic responses with high fidelity, thereby moving beyond the one-size-fits-all paradigm. This paper explores the concept of digital pharmacological twins, detailing how they can integrate heterogeneous data, including multi-omic, pharmacokinetic, pharmacodynamic, clinical, and environmental information, and employing a synergy of advanced mechanistic and machine learning models. Using illustrative examples from ongoing international initiatives, this work highlights the methodological frameworks necessary for developing and validating such comprehensive predictive tools. We underscore the critical importance of model interoperability, robust data integration strategies, and rigorous validation to ensure clinical utility. Ultimately, digital pharmacological twins promise to enhance therapeutic efficacy, minimize adverse drug reactions, and accelerate the translation of pharmacological science into tangible patient benefits
Replication of “Nano-Flares: Probes for Transfection and mRNA Detection in Living Cells”
No full textIn hundreds of articles published over the past two decades, nanoparticles have been described as probes for sensing and imaging of a variety of intracellular cytosolic targets. However, nanoparticles generally enter cells by endocytosis with only a small fraction reaching the cytosol. Most of those articles do not describe the mechanisms of nanoparticles entry into the cell and therefore the paradox of sensing a target in the cytosol when most particles do not access that compartment remains. To address this paradox, we are initiating a replication project of some of the most influential articles in this field with the aim of confirming their ability to detect their targets and getting additional insights into their intracellular localisation. This article is a pre-registered report for the second replication of this project, namely the replication of Seferos et al ‘Nano-Flares: Probes for Transfection and mRNA Detection in Living Cells’. To achieve our aim, we will carry out both a direct replication of the experiments in the original article, with the addition of some experiments and controls (in particular optical and electron microscopy). We hope that this study will contribute to a better understanding of the intracellular fate of nanoparticles and, with the help of the scientific community, help set standards in the design and reporting of studies in this field
