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L’amour coaché : ce que la téléréalité fait à la subjectivité adolescente
No full textThis article examines the impact of media-based love coaching on adolescent subjectivation and on young viewers’ representations of psychological care. It also explores how analytically oriented clinicians can respond to requests shaped by such programs—focused on exercises or quick solutions—while preserving a space that supports thinking and psychic work. The analysis draws on one clinical interview, the full viewing of season 10 of La Villa des cœurs brisés, and the study of a couple’s coaching sequence.Cet article étudie l’impact du love coaching médiatique sur la subjectivation adolescente et sur les représentations du travail psychique chez les (pré)adolescents exposés à ces programmes. Il analyse aussi la manière dont le clinicien d’orientation analytique peut accueillir des demandes inspirées de ces modèles (centrées sur des exercices ou des solutions rapides) tout en préservant un cadre propice à la pensée. L’étude s’appuie sur un entretien clinique, le visionnage de la saison 10 de La Villa des cœurs brisés et l’analyse d’un extrait de coaching conjugal
Safety and efficacy intravenous istaroxime up to 60 hours for patients with pre-cardiogenic shock
No full textInternational audienceBackground and aims: A drug that improves blood pressure and cardiac output (CO) while reducing pulmonary wedge pressure safely is needed for patients with cardiogenic shock (CS) due to acute heart failure (AHF).Methods: In a randomized, double-blind, placebo-controlled trial, istaroxime 0.5 to 1.5 µg/kg/min for 24-60 hours was administered to 48 patients, and placebo to 42 patients, with pre-CS due to AHF under hemodynamic monitoring. Echocardiographic and Holter monitoring were done in both parts.Results: Patients randomized to istaroxime had a greater increase in systolic blood pressure (SBP) during the first 6 hours (primary endpoint), ls-mean (SE) 62.0 (6.59) mmHg*hour vs 36.4 (7.11) in the placebo arm (LS mean difference of 25.6 mmHg*hour, 95% CI 7.2-44.0 mmHg*h, P = 0.007). In patients administered istaroxime for at least 48 hours, SBP increase persisted for 60 hours. Istaroxime led to a greater increase in CO (0.66 L/min, P = 0.017) and decrease in wedge pressure (3.8 mmHg, P = 0.0017). Relative to average baselines of 3.6 L/min for CO and 22.5 mmHg for wedge pressure, this translates into improvements of 18.3% and 16.9%, respectively. Echocardiographic assessments showed improvements in E/A, TAPSE, and LA volume at 24 hours. There were improvements in eGFR at 24-72 hours and NYHA class to 72 hours. NT-proBNP increased more in istaroxime-treated patients. Heart rate decreased more in the first 24 hours in istaroxime-treated patients. No significant malignant arrhythmias were detected in patients treated with istaroxime on Holter monitoring.Conclusions: In this small study, istaroxime doses of up to 1.0 µg/kg/min for up to 60 hours were associated with improvements in SBP, CO and reductions in wedge pressure and heart rate without increases in arrhythmias
Guideline-Directed Medical Therapy Use in the STRONG-HF Trial
No full textInternational audienceBACKGROUND: Assessment of medication changes in heart failure trials and registries is complex and may not capture the entirety of care. A comprehensive and standardized method is needed. We used different methods to assess the use of guideline-directed medical therapies (GDMT) and verified the association between GDMT intensity score with the STRONG-HF trial (Safety, Tolerability and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing of Heart Failure Therapies) clinical outcomes. METHODS: We used data from the STRONG-HF trial to examine the baseline GDMT use for all randomized patients by applying the GDMT intensity score and evaluated its change over time. We also examined their basic adherence, indication-corrected adherence, and dose-corrected adherence, and the association with clinical outcomes up to 180 days. RESULTS: At 90 days, triple therapy indication-corrected use increased from 4.5% to 36% in the usual care group, and from 5.2% to 93.5% in the high-intensity care group ( P <0.001 between the 2 groups). Triple therapy dose-corrected use increased from 4.5% to 20.5% in the usual care group, and from 3.3% to 77.4% in the high-intensity care group ( P <0.001). The GDMT intensity score at baseline was <6 in 358 (33%) patients, 6 to 7 in 329 (31%) patients, and >7 in 386 (36%) patients. At 90 days, 88.4% of patients in the high-intensity arm achieved a score >7 versus 14.3% in the usual care arm ( P <0.0001). The GDMT intensity score was correlated with clinical outcomes at 180 days. CONCLUSIONS: The GDMT intensity score provides a comprehensive description of medication use by means of standardized measurements and is linked to clinical outcomes. Future studies should consider utilizing this as a trial end point. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03412201
Pouvoir d'enseigner et de transformer : le genre au cœur de la géographie ?
No full textInternational audienceAborder le genre en géographie éclaire les inégalités et les rapports de pouvoir dans l’espace, tout en suscitant réflexion et engagement. Malgré des avancées dans la recherche et l’enseignement, les politiques publiques peinent à intégrer pleinement cette dimension, freinant ainsi l’émergence de pratiques de l'espace plus justes et inclusives. Alliant une réflexion sur les places du genre dans les politiques urbaines et dans l'enseignement, cette communication invite à interroger les super-pouvoirs du genre en géographie
Household costs of care in children under five attending primary care in Burkina Faso, Guinea, Mali and Niger: a cross-sectional study nested in the AIRE project
No full textInternational audienceIntroduction Out-of-pocket payments limit access to care in Africa. The Amélioration de l'Identification des détresses Respiratoires de l'Enfant/Improving Identification of Respiratory Distress in Children (AIRE) project evaluated the implementation of pulse oximetry within Integrated Management of Childhood Illness (IMCI) guidelines at primary health centres (PHCs) in Burkina Faso and Niger (with total exemption policies) and in Mali and Guinea (with partial exemption policies). We measured households’ out-of-pocket expenditures for treating children under 5 years of age and analysed the associated factors. Methods Between June 2021 and May 2022, all children under 5 years of age attending IMCI consultations, excluding simple non-respiratory cases, aged 2–59 months, were enrolled in the AIRE study with parental consent. Five non-severe cases and five severe cases (followed up over 14 days) per PHC were randomly selected every month. We collected medical and non-medical direct costs and indirect costs. We described the median costs and investigated the factors associated with medical direct costs (MDCs) using two-part models for countries with total exemption and a general linear model for those with partial exemption. Results Overall, 940 non-severe cases and 745 severe cases were selected. The median MDCs were US7.1, US3.6 for non-severe cases and US8.6, US14.4 for severe cases, in Burkina Faso, Guinea, Mali and Niger, respectively. Medicine expenditures were the main MDC items, accounting for 79% of costs for non-severe cases and 59% for severe cases. In all countries, disease severity and the unavailability of prescribed medicines at PHCs or referral hospital depots were associated with out-of-pocket payments and higher expenses. Conclusion With the exception of Burkina Faso, household out-of-pocket payments for children under five remain high despite free care policies, particularly for treating severe cases. This is mainly explained by medicines expenditures. Action is needed to identify efficient financing systems that ensure the regular and adequate supply of medicines in public health facilities and to support free healthcare policies
Knowledge Distillation Between 2D and 3D Vision Transformers for Point Cloud Quality Assessment
No full textInternational audiencePoint Cloud Quality Assessment (PCQA) is essential for preservingthe perceptual fidelity of 3D data across various applications, suchas industrial design, autonomous driving, and immersive gaming.Existing no-reference (NR) approaches face significant challengesdue to the limited availability of labeled datasets and the irregularstructure of point clouds. Methods that rely on 2D projections ben-efit from the strengths of well-established 2D networks and achievecompetitive performance. However, the pre-processing required forthese methods makes them less practical for real-time applications.Conversely, point-based techniques directly process 3D data, elimi-nating the need for projections, but they often struggle to accuratelycapture perceptual quality. To address these limitations, we intro-duce a Cross-Modal Knowledge Distillation framework that trans-fers quality-relevant features from a deep 2D Vision Transformer(Teacher) to a lightweight 3D Vision Transformer (Student). Thisapproach aligns perceptual features across 2D and 3D modalitiesduring training, enabling the 3D model to achieve enhanced qualityassessment performance. At inference, the student model requiresonly the 3D input, making it highly suitable for real-time appli-cations. Experimental results on benchmark datasets demonstratethat the proposed method achieves competitive accuracy with signif-icantly reduced model complexity and inference time
Qsox1 Contributes to Vascular Remodelling in Response to Hypertension
No full textInternational audienceIntroduction: QSOX1, a sulfhydryl oxidase involved in arterial remodelling, has recently emerged as a biomarker for preeclampsia and acute heart failure. This study sought the cardiovascular roles of Qsox1 in response to angiotensin II (AngII)-induced hypertension. Methods: With approval from an Animal Ethics Committee (CNREEA#9), two models were developed: Qsox1-invalidated adult male mice (Qsox1−/−) mice (C57BL/6J background) and a tamoxifen-inducible, vascular smooth muscle cell (VSMC)-specific Qsox1 knockout. Hypertension was induced via AngII minipumps and trans-aortic constriction, with assessments of cardiac function, vessel size, and VSMC phenotype. Results: Qsox1−/− at baseline had lower blood pressure and exhibited a synthetic/immature VSMC phenotype in coronary arteries when compared to wild-type (WT). After 4 weeks of AngII infusion, Qsox1−/− mice showed acute heart failure, absent coronary media hypertrophy, and increased perivascular fibrosis compared to hypertensive WT controls (p < 0.01). VSMC-specific Qsox1 knockout leading to the lack of Qsox1 in VSMC only impairs the phenotype of these cells without effecting cardiac function in response to AngII. Conclusion: These data implicate vascular Qsox1 in the adaptive mechanisms of VSMC to pressure overload such as the development of media hypertrophy
Nitrogen-vacancy centers in epitaxial laterally overgrown diamond: towards up-scaling of color center-based quantum technologies
No full textInternational audienceProviding high-quality, single-crystal diamond (SCD) with a large area is desirable for up-scaling quantum technology applications that rely on color centers in diamond. Growth methods aiming to increase the area of SCD are an active research area. Native color centers offer a sensitive probe for local crystal quality in such novel materials e.g. via their reaction to stress. In this work, we investigate individual native nitrogen-vacancy (NV) centers in SCD layers manufactured via laterally overgrowing hole arrays in a heteroepitaxially grown large-scale substrate. Heteroepitaxy has become a common tool for growing large SCDs; however, achieving the high crystal quality needed for quantum applications remains a challenge. In the overgrown layer, we identify NV centers with spin-decoherence times in the order of hundreds of µs, comparable to high-purity homoepitaxial SCD. We quantify the effective crystal stress in different regions of the overgrown layer, indicating a low stress overall and a stress reduction in the diamond layer above the holes
Factors associated with Senegalese health workers’ willingness to receive mobile digital payments: cross-sectional study
No full textInternational audienceIntroduction Although Senegal began digitising servants’ salaries in 2004, payments to community health workers have not yet followed suit. This study explored factors associated with health professionals’ and community health workers’ willingness to receive payments via mobile digital systems. Methodology We carried out a cross-sectional study, from October to December 2023 among healthcare staff and community health workers using telephone surveys. At national level, one district per medical region was selected by random draw for the study. In each district, data were collected from all health workers agreeing to participate, using a questionnaire instrument derived from pre-existing conceptual frameworks for the acceptability of technological innovations in healthcare. We conducted a descriptive analysis, followed by a bivariate analysis with a 5% alpha risk and a multivariate analysis. Results We recruited 2965 healthcare workers (of whom 70.1% were women), including community health workers (70.8%) and health professionals (29.2%). The arithmetic mean age was 42.7 years (SD 11.2 years). 98.6% of the sample had access to a smartphone and 80% had internet access. Healthcare workers reported a high willingness (88.2%) to be paid by mobile digital systems. Factors negatively associated with this willingness included contractual professional status (adjusted OR (AOR) 0.46, 95% CI 0.23 to 0.93), having been in practice for more than 10 years (AOR 0.45, 95% CI 0.28 to 0.72), perceived difficulties in using technology (AOR 0.43, 95% CI 0.23 to 0.81) and carrying out additional administrative procedures. On the other hand, the simplification of payment processes (AOR 3.45, 95% CI 1.86 to 6.32) and positive opinion from health authorities (AOR 1.85, 95% CI 1.17 to 2.94) were positively associated with willingness. Conclusion We found that individual, socioprofessional and contextual factors are associated with health workers’ willingness to receive full digitisation of payments. Seamless integration of these systems into existing organisational structures could strengthen worker buy-in
Effect of oxide barriers and graphene intercalation on the magnetic properties of graphene/oxide/ferromagnet heterostructures
No full textInternational audienceWe report on the effect of tunnel barrier intercalation between a monolayer Gr (MLGr) and a ferromagnet on structural, static and dynamic properties of SiO 2 /MLGr/Oxide Barrier/Co 40 Fe 40 B 20 /Ta heterostructures. Gr-based multilayers with MgO, elaborated by Molecular Beam Epitaxy, and Al 2 O 3 , elaborated by Atomic Layer Deposition, as tunnel barriers were investigated. Raman spectroscopy and vibrating sample magnetometry measurements were employed to evaluate the quality of Gr and the static magnetic properties of the material stacks, respectively. Additionally, Brillouin light scattering and micro-strip ferromagnetic resonance measurements were carried out to investigate the dynamic magnetic parameters, including the perpendicular magnetic anisotropy, the magnetic damping, and the interfacial Dzyloshinskii-Moriya interaction, whose control is essential for spintronic applications. Our study was completed by comparing the results with those obtained from control samples (without MLGr) and allowed discriminating the role played by the MLGr and pointing out the influence of oxide barriers on the magnetic properties of Gr/tunnel barrier/FM heterostructures