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La pénurie de personnel soignant:le malentendu
No full textL’Organisation Mondiale de la Santé estime que d’ici 2030, il va manquer 10 millions de professionnels de la santé, avec une pénurie actuelle de 5,9 millions d’infirmières, principalement dans les pays à faible et moyen revenu Dans une note d’orientation du Conseil International des Infirmières (CII), on peut lire que pour pallier la pénurie d’infirmières, il faudra à l’avenir engager jusqu’à 13 millions de soignants . En Belgique, une étude conjointe de la Mutualité Chrétienne et de l’Institut pour l’égalité des femmes et des hommes (IEFH) fait clairement apparaître une pénurie croissante d’infirmières, en raison du vieillissement de la population et de l'augmentation des besoins en matière de soins. On peut estimer qu’il manque aujourd’hui entre 25.000 et 30.000 infirmiers en Belgique. D’ici 2046, l’inadéquation entre les besoins et l’offre ne fera que s’accroître dans le secteur des soins infirmiers .Confrontés à cette pénurie, certains estiment que les solutions se trouvent à coup sûr dans une boîte à outils pour construire rapidement les trucs et astuces qui permettront de remédier à la situation. On pourrait par exemple, sans ordre de préférence : gratifier le personnel soignant de primes diverses, leur offrir des cadeaux, les flatter davantage, organiser à leur intention des séances de yoga ou de méditation pleine conscience, mais aussi faire appel à du personnel venant de l’étranger, déléguer certains actes à des personnes formées en quelques mois, proposer des formations coûteuses, etc. Ces trucs et astuces sont tout à fait comparables à ce que l’on peut offrir à des employés du secteur marchand : dans l’industrie automobile, l’électronique, l’alimentaire, etc. Le recours à une telle boîte à outils ne relève-t-il pas d’un grave malentendu. En effet, n’est-il pas problématique de ne pas faire la différence entre, d’une part, un soin donné à un être humain en détresse du point de vue de sa santé par un autre être humain doué d’une série de compétences techniques, psychologiques et sociales, et, d’autre part, la fabrication ou la vente d’un bien de consommation ou d’un service ? N’est-il pas questionnant que des techniques de management propres au commerce en général puissent être utilisées dans un monde des soins qui repose avant tout sur des questions de sens ?<br/
Impact of asundexian on a panel of coagulation assays
No full textBACKGROUND: During the last few years, the small, oral, activated factor XI inhibitor, asundexian, has been investigated in different cardiovascular disorders. However, little is known about its impact on laboratory coagulation assays.OBJECTIVES: To describe the effects of asundexian on a panel of laboratory coagulation assays.METHODS: The following assays were performed in normal pooled plasma spiked with increasing concentrations of asundexian (0-2000 ng/mL): activated partial thromboplastin time (aPTT), prothrombin time (PT), fibrinogen quantification (PT-derived and Clauss method), one-stage aPTT and PT-based coagulation factor assays, chronometric protein C and immunoturbidimetric protein S assays, reptilase time, chromogenic ecarin assay, dilute Russell's viper venom time assays, thrombin generation assay initiated by tissue factor (1, 5, and 20 pM) and ellagic acid (0.42 μM), rotational thromboelastometry intrinsically- and extrinsically-triggered assays, kaolin-activated clotting time, and glass bead-activated clotting time. This latter assay was also carried out in whole blood.RESULTS: Asundexian up to 2000 ng/mL impacted aPTT and one-stage aPTT-based coagulation factor assays, with high variability between reagents and methodologies. Asundexian reduced thrombin generation triggered by ellagic acid and 1 or 5 pM tissue factor. The rotational thromboelastometry intrinsically-triggered assays and kaolin- and glass bead-activated clotting time assays were affected by asundexian 2000 ng/mL, while overall, no significant interference was observed with any of the remaining assays.CONCLUSION: Despite this study including a comprehensive panel of coagulation assays, asundexian may still affect other coagulation assays not assessed here. Further investigations in patients treated with asundexian are therefore warranted.</p
L’EQUATION A LA CROISEE DES MATHEMATIQUES ET DE LA CHIMIE
No full textDans cette contribution, nous nous intéressons aux liens entre l’équation en mathématiques et l’équation chimique. Nous explorons ces liens du point de vue du savoir savant (Chevallard, 1985), historiquement et épistémologiquement, et du savoir à enseigner (ibidem)
Participation au titre d'expert à la Table-ronde "Sécurité et droits des patients face à l'enfermement" dans le cadre des 22èmes journées de la schizophrénie, événement en ligne organisé par Positive Minders du 15 au 22 mars 2025
No full textUnconventional nucleus export and secondary necrosis of human leukemia T lymphocytes (Jurkat cells) transfected with HIV-1 LTR CAT-TAT-72:ultrastructural assessment
No full textEfficient transcriptional activation and replication of the human immunodeficiency virus (HIV-1) is dependent on Tat protein. Initial observations have shown that human leukemia T lymphocytes (Jurkat cells aka Wild type or WT) transfected with HIV-1 LTR CAT TAT-72 plasmid as Control (CTJ) cells, and CTJ transfected by electroporation with pcDNA3-pU3R-CAT-TAT-72 (TJ cells) showed growth and maintenance resulting in giant and small cells with accumulated corpses. The lack of fine structure in Jurkat cells and both transfected cells aimed at us to verify their respective ultrastructure modifications. Scanning and transmission electron microscopy showed evidentCajal bodies in CTJ cells compared with WT cells and revealed unconventional nucleus export of viral-associated transcripts where eruption of the nucleus envelope spilled content from the perinuclear space toward exocytosis via a lined membranous channel continuum of endoplasmic reticulum – mitochondria envelope. TJ cells grew as small and giant cells where giant cells bore virological synapses stimulating apoptogenic impetus but where cell demise included osmotic bursts mostly resulted into secondary necrosis. Jurkat transfected cells could model in vitro resilient human T lymphocytes (or other infected cells) that remain factories of expressed HIV-1 virus proteins such as Tat, secreted and captured by other cells as in viral infections and can form giant cells. Those Tat and other transcripts induced cell demise, as in vivo those HIV-1 viral proteins and traces can amplify infectivity as in AIDS, altering primary lymphoid organs and secondary lymphoid organs
Ponderarium, a place for Cyber Physical System conformity assessment
No full textNowadays, complex Cyber-Physical Systems (CPSs) are commonly exchanged on the market. However, this complexity does not allow citizens or consumers to properly understand the quality, security, and safety of these products. When considering CPS, such as Advanced Driver Assistance Systems, autopilots on aircraft, or in vitro medical devices, consumers rely on local regulations, international standards, or even simply on their presence on the market to buy, use, and trust these products. Still, when examining regulations and directives provided by the European Union and other governments, only the documentation, not the product, needs to be assessed for compliance. Of course, manufacturers are also interested in knowing if their products satisfy their own set of requirements before putting them on the market. In this paper, we discuss the need for a Conformity Assessment tool, Ponderarium, that enables interested parties to assess the quality, security, and safety of CPSs based on static resources. Then, we devise a methodology supported by a first version of \tool\ that we validate using open-source software for a medical device. The purpose of \tool\ is to enable the conformity assessment of a CPS from related static resources (such as source code or network frames) with respect to specific requirements extracted from natural language legal texts
AI-Driven Applications in Clinical Pharmacology and Translational Science:Insights From the ASCPT 2024 AI Preconference
No full textArtificial intelligence (AI) is driving innovation in clinical pharmacology and translational science with tools to advance drug development, clinical trials, and patient care. This review summarizes the key takeaways from the AI preconference at the American Society for Clinical Pharmacology and Therapeutics (ASCPT) 2024 Annual Meeting in Colorado Springs, where experts from academia, industry, and regulatory bodies discussed how AI is streamlining drug discovery, dosing strategies, outcome assessment, and patient care. The theme of the preconference was centered around how AI can empower clinical pharmacologists and translational researchers to make informed decisions and translate research findings into practice. The preconference also looked at the impact of large language models in biomedical research and how these tools are democratizing data analysis and empowering researchers. The application of explainable AI in predicting drug efficacy and safety, and the ethical considerations that should be applied when integrating AI into clinical and biomedical research were also touched upon. By sharing these diverse perspectives and real-world examples, this review shows how AI can be used in clinical pharmacology and translational science to bring efficiency and accelerate drug discovery and development to address patients' unmet clinical needs.</p
Identification of Potential Inhibitors of Plasmodium Falciparum L-Lactate Dehydrogenase from Selected African Compound Libraries: Virtual Screening, Molecular Mechanics-Generalized Born Surface Area, and Molecular Dynamics Studies
No full textWe evaluated 4,512 natural products from natural product library from Central African medicinal plants for drug discovery and South African natural compounds database libraries for the identification of potential Plasmodium falciparum L-lactate dehydrogenase inhibitors considering the virtual screening process. Extra precision virtual screening enabled the ranking of the top hundred hit molecules based on their docking properties. The selected hits were further shortened based on docking and molecular mechanics-generalized born surface area parameters in comparison with the reference. As a result, four hits were chosen: Mol1, Mol2, Mol3, and Mol4, all of them from the chalcone and quinone families. These molecules showed good predicted absorption, distribution, metabolism, and excretion, and toxicity properties. Finally, the molecular dynamics simulation results showed that the three chalcones, Mol1-4, formed an H-bond, hydrophobic interaction with key amino acids in the active site. This in silico study suggests that the chalcone compounds could serve as a potential source for developing new effective antimalarial drugs to combat malaria. Further in vitro or in vivo studies might be conducted to determine their actual effectiveness.</p
An adaptive self-guarded and risk-aware honeypot using DRL
No full textWe propose a novel adaptive self-guarded honeypot called Asgard2.0, designed to capture shell-based attacks on real Linux-based systems via remote SSH access and to automatically recover when severely compromised. Asgard2.0 leverages Deep Q-Networks (DQN), a Deep Reinforcement Learning (DRL) algorithm, to balance two often conflicting objectives: (i) Collecting attack data and (ii) Preventing deep compromise of the honeypot itself.By employing a rich environmental state representation and risk-aware reward functions, Asgard2.0 develops a nuanced understanding of its operational context, enabling informed and flexible decision-making to learn its objectives. Asgard2.0 was evaluated in a real-world deployment alongside its predecessor Asgard1.0 (a more restricted version), as well as two conventional honeypots: Cowrie, a medium-interaction honeypot (MiHP), and a non-filtered Linux-based system serving as a high-interaction honeypot (HiHP). Experimental results demonstrate that Asgard2.0 effectively collects attack data while significantly reducing the risk of deep compromise compared to the other systems. These findings highlight its ability to strike a well-balanced trade-off between MiHP and HiHP approaches
Senescence Under the Lens: X-ray vs. Proton Irradiation at Conventional and Ultra-High Dose Rate
No full textConventional radiotherapy based on X rays is used to treat more than 50% of cancers. Although effective, radiotherapy can damage healthy tissues around the tumor due to the X-ray dose deposition profile, as well as the safety margin needed to compensate for dose uncertainties. A notable side effect is cellular senescence, characterized by the cessation of cell division while maintaining metabolic activity and promoting the secretion of various components, called the senescence-associated secretory phenotype. To minimize toxicity in healthy tissues, proton therapy holds great promise as it enables tumors to be targeted more precisely while sparing healthy tissues beyond the tumor site. Another innovative method is ultra-high dose rate irradiation, which seems to induce less damage to healthy tissues while generating an anti-tumor response similar to standard dose rate irradiation. In this work, we aimed to compare the effects of X rays and protons at conventional dose rate (2 Gy/min) and ultra-high dose rate (454 Gy/s), on the induction of senescence in primary normal human dermal fibroblasts by analyzing several senescence biomarkers. Irradiation with ultra-high dose rate protons caused more pronounced cellular and nuclear morphological changes in normal human dermal fibroblasts than irradiation with conventional protons or X-rays. For other biomarkers, all three types of irradiations induced an increase in the proportion of senescence-associated beta-gal-positive cells, an irreversible cell cycle arrest and an accumulation of unrepaired DNA damage, but did not affect senescence-associated secretory phenotype