113 research outputs found

    Elusive domination and the fate of critique in neo-participative management: a French pragmatist approach

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    In this theoretical paper we investigate how domination has adapted to the new social settings of a flexible and pluralist economy. Building on French pragmatic sociology, we propose an understanding of organizational domination whereby workers are enabled and encouraged to overtly express critique, yet work is nevertheless effectively obtained from dominated actors. Domination is here mainly understood as a system through which workers are engaged in action despite critiquing that action. We propose the concept of elusive domination as a combination of three mechanisms that undermine critique’s capacity to influence organizational power arrangements. First, ideological plasticity allows elusive domination to disarm critique by depriving it of its argument. Next, a combination of fast-changing rules and sacrosanct conventions prevents critique from settling, and thus deprives it of its object. Finally, emotions displayed in the workplace are filtered. The encouragement of positive and constructive critique coupled with the repression of uncomfortable feelings deprives critique of its source of indignation. The consequences of such developments for current debates on organizational domination are discussed

    JAMA Neurol

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    Importance: Moderately effective therapies (METs) have been the main treatment in pediatric-onset multiple sclerosis (POMS) for years. Despite the expanding use of highly effective therapies (HETs), treatment strategies for POMS still lack consensus.Objective: To assess the real-world association of HET as an index treatment compared with MET with disease activity.Design, setting, and participants: This was a retrospective cohort study conducted from January 1, 2010, to December 8, 2022, until the last recorded visit. The median follow-up was 5.8 years. A total of 36 French MS centers participated in the Observatoire Français de la Sclérose en Plaques (OFSEP) cohort. Of the total participants in OFSEP, only treatment-naive children with relapsing-remitting POMS who received a first HET or MET before adulthood and at least 1 follow-up clinical visit were included in the study. All eligible participants were included in the study, and none declined to participate.Exposure: HET or MET at treatment initiation.Main outcomes and measures: The primary outcome was the time to first relapse after treatment. Secondary outcomes were annualized relapse rate (ARR), magnetic resonance imaging (MRI) activity, time to Expanded Disability Status Scale (EDSS) progression, tertiary education attainment, and treatment safety/tolerability. An adapted statistical method was used to model the logarithm of event rate by penalized splines of time, allowing adjustment for effects of covariates that is sensitive to nonlinearity and interactions.Results: Of the 3841 children (5.2% of 74 367 total participants in OFSEP), 530 patients (mean [SD] age, 16.0 [1.8] years; 364 female [68.7%]) were included in the study. In study patients, both treatment strategies were associated with a reduced risk of first relapse within the first 2 years. HET dampened disease activity with a 54% reduction in first relapse risk (adjusted hazard ratio [HR], 0.46; 95% CI, 0.31-0.67; P < .001) sustained over 5 years, confirmed on MRI activity (adjusted odds ratio [OR], 0.34; 95% CI, 0.18-0.66; P = .001), and with a better tolerability pattern than MET. The risk of discontinuation at 2 years was 6 times higher with MET (HR, 5.97; 95% CI, 2.92-12.20). The primary reasons for treatment discontinuation were lack of efficacy and intolerance. Index treatment was not associated with EDSS progression or tertiary education attainment (adjusted OR, 0.51; 95% CI, 0.24-1.10; P = .09).Conclusions and relevance: Results of this cohort study suggest that compared with MET, initial HET in POMS was associated with a reduction in the risk of first relapse with an optimal outcome within the first 2 years and was associated with a lower rate of treatment switching and a better midterm tolerance in children. These findings suggest prioritizing initial HET in POMS, although long-term safety studies are needed.Observatoire Français de la Sclérose en Plaque

    DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

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    We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR&nbsp;=&nbsp;2.05, 95%CI&nbsp;=&nbsp;1.39–3.02, p&nbsp;&lt;&nbsp;0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR&nbsp;=&nbsp;0.42, 95%CI&nbsp;=&nbsp;0.18–0.99, p&nbsp;=&nbsp;0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

    Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.

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    Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events

    Neurology

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    The question of the long-term safety of pregnancy is a major concern in patients with multiple sclerosis (MS), but its study is biased by reverse causation (women with higher disability are less likely to experience pregnancy). Using a causal inference approach, we aimed to estimate the unbiased long-term effects of pregnancy on disability and relapse risk in patients with MS and secondarily the short-term effects (during the perpartum and postpartum years) and delayed effects (occurring beyond 1 year after delivery). We conducted an observational cohort study with data from patients with MS followed in the Observatoire Français de la Sclérose en Plaques registry between 1990 and 2020. We included female patients with MS aged 18-45 years at MS onset, clinically followed up for more than 2 years, and with ≥3 Expanded Disease Status Scale (EDSS) measurements. Outcomes were the mean EDSS score at the end of follow-up and the annual probability of relapse during follow-up. Counterfactual outcomes were predicted using the longitudinal targeted maximum likelihood estimator in the entire study population. The patients exposed to at least 1 pregnancy during their follow-up were compared with the counterfactual situation in which, contrary to what was observed, they would not have been exposed to any pregnancy. Short-term and delayed effects were analyzed from the first pregnancy of early-exposed patients (who experienced it during their first 3 years of follow-up). We included 9,100 patients, with a median follow-up duration of 7.8 years, of whom 2,125 (23.4%) patients were exposed to at least 1 pregnancy. Pregnancy had no significant long-term causal effect on the mean EDSS score at 9 years (causal mean difference [95% CI] = 0.00 [-0.16 to 0.15]) or on the annual probability of relapse (causal risk ratio [95% CI] = 0.95 [0.93-1.38]). For the 1,253 early-exposed patients, pregnancy significantly decreased the probability of relapse during the perpartum year and significantly increased it during the postpartum year, but no significant delayed effect was found on the EDSS and relapse rate. Using a causal inference approach, we found no evidence of significantly deleterious or beneficial long-term effects of pregnancy on disability. The beneficial effects found in other studies were probably related to a reverse causation bias.Observatoire Français de la Sclérose en Plaque

    The SIB Swiss Institute of Bioinformatics' resources: focus on curated databases

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    The SIB Swiss Institute of Bioinformatics (www.isb-sib.ch) provides world-class bioinformatics databases, software tools, services and training to the international life science community in academia and industry. These solutions allow life scientists to turn the exponentially growing amount of data into knowledge. Here, we provide an overview of SIB's resources and competence areas, with a strong focus on curated databases and SIB's most popular and widely used resources. In particular, SIB's Bioinformatics resource portal ExPASy features over 150 resources, including UniProtKB/Swiss-Prot, ENZYME, PROSITE, neXtProt, STRING, UniCarbKB, SugarBindDB, SwissRegulon, EPD, arrayMap, Bgee, SWISS-MODEL Repository, OMA, OrthoDB and other databases, which are briefly described in this article

    Variation in the use of discourse markers in a language contact situation

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    Use of discourse markers by 17 speakers of Anglophone Montreal French (AMF) showed great variation in individual repertoires and frequency of use. Only five subjects manifested rates of usage comparable to those native speakers or to their own L1 usage in English. In decreasing order of frequency, the speakers used tu sais 'y'know'; la 'there' (the most frequent among L1 Montreal French speakers); bon 'good', alors 'so', comme 'like', and bien 'well'; and the local discourse conjunction fait que 'so'. The subjects occasionally made use of the English markers you know, so, like, and well. Quebecois French markers with no English equivalent were used by the speakers who had been exposed to French in their early childhood environment. The one marker that showed influence from English was comme, apparently calqued on English like. Overall, frequent use of discourse markers correlated only with the speakers' knowledge of French grammar—evidence that a higher frequency of discourse marker use is the hallmark of the fluent speaker. As a feature that is not explicitly taught in school, mastery of the appropriate use of discourse markers is thus particularly revealing of the speakers' integration into the local speech community

    La couleur locale du français L2 des Anglo-Montréalais

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    Les travaux rapportés ici portent sur le français parlé des anglo-montréalais scolarisés après la mise sur pied de classes d'immersion et socialisés dans un québec officiellement francophone. Nous cherchons principalement à découvrir dans quelle mesure la compétence en l2 (grammaire, maîtrise de la variété locale, contrôle de la variation socio-stylistique) est tributaire de contacts soutenus avec des francophones et de l'environnement général, y compris l'apprentissage en contact scolaire. Nous analysons aussi la perception de ce français l2 par des jeunes franco-montréalais
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