Uma vida por nascer

O texto se debruça sobre o último livro de Gilbert Simondon, L'individuation psychique et collective. O nosso objetivo é mostrar como a maneira pela qual Simondon pensa a questão, que ele nomeia individuação psíquica e coletiva, que longe de instituir uma partilha, uma separação entre biológico e físico, ou natureza e sociedade, força a repensar em conjunto vida e sujeito, e permite de conceber entre eles uma singular inseparabilidade

Life and the Technical Transformation of Différance: Stiegler and the Noopolitics of Becoming Non-Inhuman

Through a re-articulation of Derridean différance, Bernard Stiegler claims that the human is defined by an originary default that displaces all psychic and social life onto technical supplements. His philosophy of technics re-articulates the logic of the supplement as concerning both human reflexivity and its supports, and the history of the différance of life itself. This has been criticised for reducing Derrida’s work to a metaphysics of presence, and for instituting a humanism of the relation to the inorganic. By refuting these claims, this article will show that Stiegler’s doubling of différance enables him to articulate the human as constituted by both the individuation characteristic of ‘life’, and that of a technical, psychic and collective individuation. Putting forward a reading of the logic of the trace in life, and emphasising the aspects of Leroi-Gourhan, Simondon, and Canguilhem that Stiegler uses in his reading of Derrida, I will demonstrate that the political stakes of adaption and adoption in Noo-Politics require this re-articulation of différance. Technics shapes the human future, arising from this differential mutation; marking the invention of the human as the site of the political

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Experimental Methodology for Analysing Macromolecular Interactions in the Context of Marine Bacterial Adhesion to Stainless Steel

In the frame of a long-term study of biofilm formation in the marine environment, protein-coated amine latex microbeads were used as a simplified bacterial model, in order to elucidate the role of surface protein on adhesion to 316 L stainless steel. Bovine serum albumin (BSA), chosen as the model protein, was covalently immobilized to the amine latex beads using glutaraldehyde as cross-linker. The adhesion of BSA-coated latex beads to stainless steel was then examined under a well-controlled physico-chemical environment, using a shear stress flow chamber. The shear-induced detachment of beads was analysed by testing three different microbeads/stainless steel systems: bare latex beads, activated latex beads with poly(glutaraldehyde) and BSA-coated latex beads in adhesive contact with stainless steel. The suspending medium used for detachment was representative of seawater in terms of pH and ionic strength. Adhesion was quantified through two complementary parameters: the wall shear stress threshold needed to cause 2% bead detachment (τW2%) and the wall shear stress required to remove 50% of the initially adhered bead (τW50%). Zeta potential measurements, paired with protein quantification, indicated that the coating density was weak. Nevertheless, the BSA-coated latex beads promoted an increased adhesion compared to bare beads, which was demonstrated by higher τW2% and τW50% values (τW2%=15.9±8.1 Pa and 39.4±10.7 Pa; τW50%=41.4±7.9 and 73.5±14.8 Pa for bare and BSA-coated beads, respectively). These results confirmed the role of surface proteins on adhesion to stainless steel. The shear stress flow chamber and the associated method for bead coating were demonstrated to be a relevant approach to analyse nano-scale molecular interactions between biological and physical surfaces

Predicting 90-day survival of patients with COVID-19: Survival of Severely Ill COVID (SOSIC) scores.

peer reviewed[en] BACKGROUND: Predicting outcomes of critically ill intensive care unit (ICU) patients with coronavirus-19 disease (COVID-19) is a major challenge to avoid futile, and prolonged ICU stays. METHODS: The objective was to develop predictive survival models for patients with COVID-19 after 1-to-2 weeks in ICU. Based on the COVID-ICU cohort, which prospectively collected characteristics, management, and outcomes of critically ill patients with COVID-19. Machine learning was used to develop dynamic, clinically useful models able to predict 90-day mortality using ICU data collected on day (D) 1, D7 or D14. RESULTS: Survival of Severely Ill COVID (SOSIC)-1, SOSIC-7, and SOSIC-14 scores were constructed with 4244, 2877, and 1349 patients, respectively, randomly assigned to development or test datasets. The three models selected 15 ICU-entry variables recorded on D1, D7, or D14. Cardiovascular, renal, and pulmonary functions on prediction D7 or D14 were among the most heavily weighted inputs for both models. For the test dataset, SOSIC-7's area under the ROC curve was slightly higher (0.80 [0.74-0.86]) than those for SOSIC-1 (0.76 [0.71-0.81]) and SOSIC-14 (0.76 [0.68-0.83]). Similarly, SOSIC-1 and SOSIC-7 had excellent calibration curves, with similar Brier scores for the three models. CONCLUSION: The SOSIC scores showed that entering 15 to 27 baseline and dynamic clinical parameters into an automatable XGBoost algorithm can potentially accurately predict the likely 90-day mortality post-ICU admission (sosic.shinyapps.io/shiny). Although external SOSIC-score validation is still needed, it is an additional tool to strengthen decisions about life-sustaining treatments and informing family members of likely prognosis.Program “Alliance tous unis contre le virus

Flexibility of ED surveillance system to monitor dengue outbreak in Reunion Island

ObjectiveTo describe the characteristics of ED vitis related to dengue fever and to show how the syndromic surveillance system can be flexible for the monitoring of this outbreak.IntroductionIn Reunion Island, a French overseas territory located in the southwestern of Indian Ocean, the dengue virus circulation is sporadic. Since 2004, between 10 and 221 probable and confirmed autochthonous dengue fever cases have been reported annually. Since January 2018, the island has experienced a large epidemic of DENV serotype 2. As of 4 September 2018, 6,538 confirmed and probable autochthonous cases have been notified1. From the beginning of the epidemic, the regional office of National Public Health Agency (ANSP) in Indian Ocean enhanced the syndromic surveillance system in order to monitor the outbreak and to provide hospital morbidity data to public health authorities.MethodsIn Reunion Island, the syndromic surveillance system called OSCOUR® network (Organisation de la Surveillance Coordonnée des Urgences) is based on all emergency departments (ED)2. Anonymous data are collected daily directly from the patients’ computerized medical files completed during medical consultations. Every day, data files are sent to the ANSP via a regional server over the internet using a file transfer protocol. Each file transmitted to ANSP includes all patient visits to the ED logged during the previous 24 hours (midnight to midnight). Finally, data are integrated in a national database (including control of data quality regarding authorized thesauri) and are made available to the regional office through an online application3.Following the start of dengue outbreak in week 4 of 2018, the regional office organized meetings with physicians in each ED to present the dengue epidemiological update and to recommend the coding of ED visit related to dengue for any suspect case (acute fever disease and two or more of the following signs or symptoms: nausea, vomiting, rash, headache, retro-orbital pain, myalgia). During these meetings, it was found that the version of ICD-10 (International Classification of Diseases) was different from one ED to another. Indeed, some ED used A90, A91 (ICD-10 version: 2015) for visit related to dengue and others used A97 and subdivisions (ICD-10 version: 2016). As the ICD-10 version: 2015 was implemented at the national server, some passages could be excluded. In this context, the thesaurus of medical diagnosis implemented in the national database has been updated so that all codes can be accepted. ED visits related to dengue fever has been then described according to age group, gender and hospitalization.ResultsFrom week 9 of 2018, the syndromic surveillance system was operational to monitor dengue outbreak. The regional office has provided each week, an epidemic curve of ED visits for dengue and a dashboard on descriptive characteristic of these visits. In total, 441 ED visits for dengue were identified from week 9 to week 34 of 2018 (Figure 1). On this period, the weekly number of ED visits for dengue was correlated with the weekly number of probable and confirmed autochthonous cases (rho=0.86, p&lt;0.001). Among these visits, the male/female ratio was 0.92 and median (min-max) age was 44 (2-98) years. The distribution by age group showed that 15-64 year-old (72.1%, n=127) were most affected. Age groups 65 years and more and 0-14 year-old represented respectively 21.8% (n=96) and 6.1% (n=27) of dengue visits. About 30% of dengue visits were hospitalized.ConclusionsAccording Buehler et al., “the flexibility of a surveillance system refers to the system's ability to change as needs change. The adaptation to changing detection needs or operating conditions should occur with minimal additional time, personnel, or other resources. Flexibility generally improves the more data processing is handled centrally rather than distributed to individual data-providing facilities because fewer system and operator behavior changes are needed...” 4.During this dengue outbreak, the syndromic surveillance system seems to have met this purpose. In four weeks (from week 5 to week 9 of 2018), the system was able to adapt to the epidemiological situation with minimal additional resources and personnel. Indeed, updates were not made in the IT systems of each EDs’ but at the level of the national ANSP server (by one person). This surveillance system was also flexible thank to the reactivity of ED physicians who timely implemented coding of visits related to dengue fever.In conclusion, ED surveillance system constitutes an added-value for the dengue outbreak monitoring in Reunion Island. The automated collection and analysis data allowed to provide hospital morbidity (severe dengue) data to public health authorities. Although the epidemic has decreased, this system also allows to continue a routine active surveillance in order to quickly identify a new increase.References1Santé publique France. Surveillance de la dengue à la Réunion. Point épidémiologique au 4 septembre 2018. http://invs.santepubliquefrance.fr/fr/Publications-et-outils/Points-epidemiologiques/Tous-les-numeros/Ocean-Indien/2018/Surveillance-de-la-dengue-a-la-Reunion.-Point-epidemiologique-au-4-septembre-2018. [Accessed September 8, 2018].2Vilain P, Filleul F. La surveillance syndromique à la Réunion : un système de surveillance intégré. [Syndromic surveillance in Reunion Island: integrated surveillance system]. Bulletin de Veille Sanitaire. 2013;(21):9-12. http://invs.santepubliquefrance.fr/fr/Publications-et-outils/Bulletin-de-veille-sanitaire/Tous-les-numeros/Ocean-indien-Reunion-Mayotte/Bulletin-de-veille-sanitaire-ocean-Indien.-N-21-Septembre-2013. [Accessed September 4, 2018].3Fouillet A, Fournet N, Caillère N et al. SurSaUD® Software: A Tool to Support the Data Management, the Analysis and the Dissemination of Results from the French Syndromic Surveillance System. OJPHI. 2013; 5(1): e118.4Buehler JW, Hopkins RS, Overhage JM, Sosin DM, Tong V; CDC Working Group. Framework for evaluating public health surveillance systems for early detection of outbreaks: recommendations from the CDC Working Group. MMWR Recomm Rep. 2004;53(RR-5):1-11

Generation of BAC Transgenic Tadpoles Enabling Live Imaging of Motoneurons by Using the Urotensin II-Related Peptide (ust2b) Gene as a Driver

International audienceXenopus is an excellent tetrapod model for studying normal and pathological motoneuron ontogeny due to its developmental morpho-physiological advantages. In mammals, the urotensin II-related peptide (UTS2B) gene is primarily expressed in motoneurons of the brainstem and the spinal cord. Here, we show that this expression pattern was conserved in Xenopus and established during the early embryonic development, starting at the early tailbud stage. In late tadpole stage, uts2b mRNA was detected both in the hindbrain and in the spinal cord. Spinal uts2b+ cells were identified as axial motoneurons. In adult, however, the uts2b expression was only detected in the hindbrain. We assessed the ability of the uts2b promoter to drive the expression of a fluorescent reporter in motoneurons by recombineering a green fluorescent protein (GFP) into a bacterial artificial chromosome (BAC) clone containing the entire X. tropicalis uts2b locus. After injection of this construction in one-cell stage embryos, a transient GFP expression was observed in the spinal cord of about a quarter of the resulting animals from the early tailbud stage and up to juveniles. The GFP expression pattern was globally consistent with that of the endogenous uts2b in the spinal cord but no fluorescence was observed in the brainstem. A combination of histological and electrophysiological approaches was employed to further characterize the GFP+ cells in the larvae. More than 98% of the GFP+ cells expressed choline acetyltransferase, while their projections were co-localized with α-bungarotoxin labeling. When tail myotomes were injected with rhodamine dextran amine crystals, numerous double-stained GFP+ cells were observed. In addition, intracellular electrophysiological recordings of GFP+ neurons revealed locomotion-related rhythmic discharge patterns during fictive swimming. Taken together our results provide evidence that uts2b is an appropriate driver to express reporter genes in larval motoneurons of the Xenopus spinal cord

Influence de l'ingestion précoce ou du ratio protéine amidon sur les performances de croissance et le microbiote caecal chez le lapin

L’objectif de notre étude était de stimuler l’ingestion solide du lapereau allaité en modulant l’âge d’accès à l’aliment solide granulé (8j vs 18j) ou le ratio protéine/amidon de l’aliment (j18-j42). Dans le lot 1, les lapereaux allaités avaient accès, dès 8j dans le nid, à l’aliment P+A- (protéine digestible 13,5%; amidon 6,8%) ; dans le lot 2, les lapereaux avaient accès au même aliment mais à partir de 18j seulement. Pour le lot 3, les lapereaux étaient nourris à partir de 18 j avec un aliment P-A+ (protéine digestible 9,9%, amidon 8,9%) (17 portées par groupe). Au sevrage (35 j), les lapereaux ont été rationnés à 80% de l’ingestion volontaire. L’état sanitaire a été contrôlé quotidiennement, la production laitière de la lapine a été mesurée 2 fois par semaine, le poids vif et la consommation d'aliment des lapereaux, dans le nid entre 8 et 18j, puis dans la mangeoire (18-35j) ont été mesurés. Le poids relatif des organes, les paramètres fermentaires et la composition du microbiote caecal ainsi que les concentrations d’IgA fécale et d’IgG plasmatique ont été déterminés à 18 et 42 j (n=10 par groupe). Le taux de mortalité n’était pas différent entre les lots (2,8% entre 8 et 35 j ; et 0,4 % entre 35 et 70 j). L’ingestion précoce de granulé (0,75 granulé/lapin/jour 8 et 18j) n’a pas eu d’incidence sur la croissance jusqu’au sevrage des lapereaux. Sur la période 35 – 70 j, le lot 3 présente la croissance la plus élevée (39,5±0,4 g/j), la plus faible est observée pour le lot 2 (37,6 ± 0,4 g/j) tandis que le lot 1 présente une valeur intermédiaire (38,8±0,5 g/j). L’alimentation précoce affecte l’abondance relative de 10 et 20 espèces bactériennes (dont 16 appartiennent à la famille des Ruminococcaceae) à 18 et 42 j respectivement. A 42 j le ratio protéine/amidon de l’aliment modifie l’abondance relative de 45 espèces bactériennes (dont 20 appartiennent à la famille des Lachnospiraceae). L’ingestion précoce ou la qualité de l’aliment impacte modérément le microbiote caecal. Les répercussions sur la maturation du système immunitaire sont en cours d’analyse.The objective of our study was to stimulate the solid intake of suckling rabbit by modulating the age of access to pelleted solid food (8 vs 18d) or protein / starch ratio of the feed from 18d. In group 1, suckling rabbits had access to feed P+A- (8.5% digestible protein, starch 6.8%) as early as 8 d. in the nest. In group 2, the rabbits had access to the same food but only from 18 d. For group 3, rabbits were fed from 18 d with a P-A+ feed (digestible protein: 9.9%, starch 8.9%) (17 litters per group). At weaning (35 d), the rabbits were fed at 80% of the voluntary intake. Health status was monitored daily, milk production was measured twice a week, young rabbits live weight and feed consumption in the nest between 8 and 18 d, and then in the feeder (18 - 35d) were measured. The relative organ weight, fermentation parameters and composition of the caecal microbiota, concentrations of fecal IgA and plasma IgG were determined at 18 and 42 d (n = 10 per group). The mortality rate was not different between the groups (2.8% between 8 and 35 days, and 0.4% between 35 and 70 d). In the nest between 8 and 18 days pellet consumption was 0.75 pellet / rabbit / day. This early pellet consumption did not affect the rabbit growth until weaning. During the period 35-70 days, group 3 had the highest growth (39.5 ± 0.4 g/d), the lowest was observed for lot 2 (37.6 ± 0.4 g/d) While group 1 has an intermediate value (38.8 ± 0.5 g/d). Early feeding affects the relative abundance of 10 and 20 bacterial species (16 belonging to the Ruminococcaceae family) at 18 and 42 d respectively. At 42 d the feed protein / starch ratio alters the relative abundance of 45 bacterial species (20 of which belong to the Lachnospiraceae family). Early ingestion or feed quality moderately influence the composition of the microbiota. The implications on immune system maturation are currently being analyzed

Lack of P2Y13 in mice fed a high cholesterol diet results in decreased hepatic cholesterol content, biliary lipid secretion and reverse cholesterol transport.

International audienceBACKGROUND: The protective effect of HDL is mostly attributed to their metabolic function in reverse cholesterol transport (RCT), a process whereby excess cellular cholesterol is taken up from peripheral cells, processed in HDL particles, and later delivered to the liver for further metabolism and biliary secretion. Mechanistically, the purinergic P2Y13 ADP-receptor is involved in hepatic HDL endocytosis (i.e., uptake of both HDL protein + lipid moieties), which is considered an important step of RCT. Accordingly, chow-fed P2Y13 knockout (P2Y13-/-) mice exhibit lower hepatic HDL uptake, which translates into a decrease of hepatic free cholesterol content and biliary cholesterol and phospholipid secretion. FINDINGS: The aim of this study was to determine the effect of high cholesterol diet (HCD) in P2Y13-/- mice, in order to mimic high dietary cholesterol intake, which is a major cause of dyslipidemia in humans. As previously reported with chow-diet, HCD did not affect plasma lipid levels in P2Y13-/- compared with control mice but decreased hepatic free and esterified cholesterol content (p < 0.05, P2Y13-/- versus control). Interestingly, biliary lipid secretion and macrophages-to-feces RCT were more dramatically impaired in P2Y13-/- mice fed a HCD than chow-diet. HCD did not enhance atherosclerosis in P2Y13-/- compared with control mice. CONCLUSION: This study demonstrates that high dietary cholesterol intake accentuated the metabolic phenotype of P2Y13-/- mice, with impaired hepatobiliary RCT. Although other animal models might be required to further evaluate the role of P2Y13 receptor in atherosclerosis, P2Y13 appears a promising target for therapeutic intervention aiming to stimulate RCT, particularly in individuals with lipid-rich diet