Comprendre et ne pas comprendre. Éléments de philosophie herméneutique

It is from the experience of not understanding that we will develop the outline of a reflection on what it is understanding. This experience reveals to us the desire to understand that is extended into the dialectic between the will to understand and the desire to be understood. Insofar talk is mainly to communicate with others, dialogue will serve here as a guide: it not only enables us to recall the conditions of possibility of understanding, but it highlight the nature of the duty to understand. In a second step, we will leave this pragmatic and ethical dimension of the act of understanding and its implications and we will show that the reflection about the intersubjective nature of understanding, finds its meaning in political reflection. Indeed, if it is true that language is essentially understood from the background knowledge shared by individuals, groups or communities of interpretation in a society, then the simple coexistence of a plurality of these interpretive communities requires the consideration of the claims of recognition of each of them claim in a politically structured space. There too the dialogue will be central to the experience of negativity that inhabits the act of understanding.C’est à partir de l’expérience de la non-compréhension que nous développerons les grandes lignes d’une réflexion sur ce que c’est que comprendre. Cette expérience nous découvre le désir de comprendre qui se prolonge dans la dialectique entre la volonté de comprendre et la volonté d’être compris. Dans la mesure où parler est essentiellement communiquer avec d’autres, le dialogue nous servira ici de fil conducteur : il nous permettra non seulement de rappeler les conditions de possibilité de la compréhension, mais encore de mettre en lumière la nature du devoir de comprendre. Dans un second temps, nous partirons de cette dimension pragmatique et éthique de l’acte de comprendre et de ses implications pour montrer que la ré exion sur le caractère intersubjectif de la compréhension, où l’on se laisse dire quelque chose par quelqu’un d’autre, ne trouve son sens que dans une réflexion politique. En effet, s’il est vrai que le langage ne se comprend pour l’essentiel qu’à partir de connaissances d’arrière-plan partagées par des individus, des groupes ou des communautés d’interprétation dans une société, alors la simple coexistence d’une pluralité de ces communautés d’interprétation exige que soit pensée la reconnaissance que peut revendiquer chacune d’entre elles dans un espace politiquement structuré. Là aussi le dialogue s’avèrera central dans l’expérience de la négativité qui habite l’acte de comprendre.

Accordo e differenza

Within the perspective of an analysis of the "hermeneutic age of reason", this contribution revisits the opposition between hermeneutical philosophy (Gadamer) and critical hermeneutics (Apel, Habermas), not in order to conciliate them, but in order to highlight their difference in that the former is oriented towards texts while the latter is developed in a communicative situation. This engages the status of critique, which we show finds its true accomplishment in the dialogical oral situation

Interobserver agreement of Thyroid Imaging Reporting and Data System (TIRADS) and strain elastography for the assessment of thyroid nodules

Background: Thyroid Imaging Reporting and Data System (TIRADS) was developed to improve patient management and cost-effectiveness by avoiding unnecessary fine needle aspiration biopsy (FNAB) in patients with thyroid nodules. However, its clinical use is still very limited. Strain elastography (SE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules. Methods: The aim of the present study was to evaluate the interobserver agreement (IA) of TIRADS developed by Horvath et al. and SE. Three blinded observers independently scored stored images of TIRADS and SE in 114 thyroid nodules (114 patients). Cytology and/or histology was available for all benign (n = 99) and histology for all malignant nodules (n = 15). Results: The IA between the 3 observers was only fair for TIRADS categories 2–5 (Coheńs kappa = 0.27,p = 0.000001) and TIRADS categories 2/3 versus 4/5 (ck = 0.25,p = 0.0020). The IA was substantial for SE scores 1–4 (ck = 0.66,p<0.000001) and very good for SE scores 1/2 versus 3/4 (ck = 0.81,p<0.000001). 92–100% of patients with TIRADS-2 had benign lesions, while 28–42% with TIRADS-5 had malignant cytology/histology. The negative-predictive-value (NPV) was 92–100% for TIRADS using TIRADS-categories 4&5 and 96–98% for SE using score ES-3&4 for the diagnosis of malignancy, respectively. However, only 11–42% of nodules were in TIRADS-categories 2&3, as compared to 58–60% with ES-1&2. Conclusions: IA of TIRADS developed by Horvath et al. is only fair. TIRADS and SE have high NPV for excluding malignancy in the diagnostic work-up of thyroid nodules

Adaptive dynamical networks

It is a fundamental challenge to understand how the function of a network is related to its structural organization. Adaptive dynamical networks represent a broad class of systems that can change their connectivity over time depending on their dynamical state. The most important feature of such systems is that their function depends on their structure and vice versa. While the properties of static networks have been extensively investigated in the past, the study of adaptive networks is much more challenging. Moreover, adaptive dynamical networks are of tremendous importance for various application fields, in particular, for the models for neuronal synaptic plasticity, adaptive networks in chemical, epidemic, biological, transport, and social systems, to name a few. In this review, we provide a detailed description of adaptive dynamical networks, show their applications in various areas of research, highlight their dynamical features and describe the arising dynamical phenomena, and give an overview of the available mathematical methods developed for understanding adaptive dynamical networks

Acoustic radiation force impulse imaging for differentiation of thyroid nodules

Background: Acoustic Radiation Force Impulse (ARFI)-imaging is an ultrasound-based elastography method enabling quantitative measurement of tissue stiffness. The aim of the present study was to evaluate sensitivity and specificity of ARFI-imaging for differentiation of thyroid nodules and to compare it to the well evaluated qualitative real-time elastography (RTE). Methods: ARFI-imaging involves the mechanical excitation of tissue using acoustic pulses to generate localized displacements resulting in shear-wave propagation which is tracked using correlation-based methods and recorded in m/s. Inclusion criteria were: nodules $5 mm, and cytological/histological assessment. All patients received conventional ultrasound, real-time elastography (RTE) and ARFI-imaging. Results: One-hundred-fifty-eight nodules in 138 patients were available for analysis. One-hundred-thirty-seven nodules were benign on cytology/histology, and twenty-one nodules were malignant. The median velocity of ARFI-imaging in the healthy thyroid tissue, as well as in benign and malignant thyroid nodules was 1.76 m/s, 1.90 m/s, and 2.69 m/s, respectively. While no significant difference in median velocity was found between healthy thyroid tissue and benign thyroid nodules, a significant difference was found between malignant thyroid nodules on the one hand and healthy thyroid tissue (p = 0.0019) or benign thyroid nodules (p = 0.0039) on the other hand. No significant difference of diagnostic accuracy for the diagnosis of malignant thyroid nodules was found between RTE and ARFI-imaging (0.74 vs. 0.69, p = 0.54). The combination of RTE with ARFI did not improve diagnostic accuracy. Conclusions: ARFI can be used as an additional tool in the diagnostic work up of thyroid nodules with high negative predictive value and comparable results to RTE

Pflugloser Ökoanbau auf schweren Böden

Auf schweren Böden wurden im System Ökolandbau reduzierte Bodenbearbeitung, Gülledüngung und biologisch-dynamische Präparate geprüft. Stickstoffengpass im Frühjahr, mehr Aufwand für die Unkrautkontrolle, geringere Getreideerträge bei Pflugverzicht stehen belebterem Oberboden und besseren Zwischenfruchterträgen gegenüber. Überraschend senkten die biologisch-dynamischen Präparate den Gehalt an Fusariumtoxinen

Table ronde autour de l’ouvrage d’Ayşe Yuva : Transformer le monde ? L’efficace de la philosophie en temps de révolution, 1794-1815

Table ronde autour du livre d’Ayşe Yuva (Transformer le monde ? L’efficace de la philosophie en temps de révolution, 1794-1815, Paris, MSH, 2016), organisée le 27 mars 2017 à la Sorbonne, avec la participation de Christian Berner, Stéphane Haber et Ayşe Yuva

Medical Gas Plasma Treatment in Head and Neck Cancer—Challenges and Opportunities

Despite progress in oncotherapy, cancer is still among the deadliest diseases in the Western world, emphasizing the demand for novel treatment avenues. Cold physical plasma has shown antitumor activity in experimental models of, e.g., glioblastoma, colorectal cancer, breast carcinoma, osteosarcoma, bladder cancer, and melanoma in vitro and in vivo. In addition, clinical case reports have demonstrated that physical plasma reduces the microbial contamination of severely infected tumor wounds and ulcerations, as is often seen with head and neck cancer patients. These antimicrobial and antitumor killing properties make physical plasma a promising tool for the treatment of head and neck cancer. Moreover, this type of cancer is easily accessible from the outside, facilitating the possibility of several rounds of topical gas plasma treatment of the same patient. Gas plasma treatment of head and neck cancer induces diverse effects via the deposition of a plethora of reactive oxygen and nitrogen species that mediate redox-biochemical processes, and ultimately, selective cancer cell death. The main advantage of medical gas plasma treatment in oncology is the lack of adverse events and significant side effects compared to other treatment modalities, such as surgical approaches, chemotherapeutics, and radiotherapy, making plasma treatment an attractive strategy for the adjuvant and palliative treatment of head and neck cancer. This review outlines the state of the art and progress in investigating physical plasma as a novel treatment modality in the therapy of head and neck squamous cell carcinoma

Effect of crew resource management training in a multidisciplinary obstetrical setting

Objective To assess the effect of a Crew Resource Management (CRM) intervention specifically designed to improve teamwork and communication skills in a multidisciplinary obstetrical setting. Method Design-A before-and-after cross-sectional study designed to assess participants' satisfaction, learning and change in behaviour, according to Kirkpatrick's evaluation framework for training programmes. Setting-Labour and delivery units of a large university-affiliated hospital. Participants-Two hundred and thirty nine midwives, nurses, physicians and technicians from the department of anaesthesia, obstetrics and paediatrics. Intervention-All participants took part in a CRM-based training programme specifically designed to improve teamwork and communication skills. Principal measures of outcome-We assessed participants' satisfaction by means of a 10-item standardized questionnaire. A 36-item survey was administered before and after the course to assess participants' learning. Behavioural change was assessed by a 57-item safety attitude questionnaire measuring staff's change in attitude to safety over 1 year of programme implementation. Results Most participants valued the experience highly and 63-90% rated their level of satisfaction as being very high. Except for seven items, the 36-item survey testing participants' learning demonstrated a significant change (P < 0.05) towards better knowledge of teamwork and shared decision making after the training programme. Over the year of observation, there was a positive change in the team and safety climate in the hospital [odds ratio (OR) 2.9, 95% confidence interval (CI) (1.3-6.3) to OR 4.7, 95% CI (1.2-17.2)]. **There was also improved stress recognition [OR 2.4, 95% CI (1.2-4.8) to OR 3.0, 95% CI (1.0-8.8)]. Conclusion The implementation of a training programme based on CRM in a multidisciplinary obstetrical setting is well accepted and contributes to a significant improvement in interprofessional teamwor

Medical Gas Plasma Treatment in Head and Neck Cancer—Challenges and Opportunities

Despite progress in oncotherapy, cancer is still among the deadliest diseases in the Western world, emphasizing the demand for novel treatment avenues. Cold physical plasma has shown antitumor activity in experimental models of, e.g., glioblastoma, colorectal cancer, breast carcinoma, osteosarcoma, bladder cancer, and melanoma in vitro and in vivo. In addition, clinical case reports have demonstrated that physical plasma reduces the microbial contamination of severely infected tumor wounds and ulcerations, as is often seen with head and neck cancer patients. These antimicrobial and antitumor killing properties make physical plasma a promising tool for the treatment of head and neck cancer. Moreover, this type of cancer is easily accessible from the outside, facilitating the possibility of several rounds of topical gas plasma treatment of the same patient. Gas plasma treatment of head and neck cancer induces diverse effects via the deposition of a plethora of reactive oxygen and nitrogen species that mediate redox-biochemical processes, and ultimately, selective cancer cell death. The main advantage of medical gas plasma treatment in oncology is the lack of adverse events and significant side effects compared to other treatment modalities, such as surgical approaches, chemotherapeutics, and radiotherapy, making plasma treatment an attractive strategy for the adjuvant and palliative treatment of head and neck cancer. This review outlines the state of the art and progress in investigating physical plasma as a novel treatment modality in the therapy of head and neck squamous cell carcinoma