L’application de l’analyse heideggerienne de l’angoisse en psychiatrie

Nous nous demanderons, dans ce travail, quels peuvent être les points communs entre l’angoisse telle que la voit Heidegger et celle à laquelle sont confrontés les praticiens de la psychiatrie. Quel est le lien entre l’affect qui révèle le dénominateur commun de toutes les structures existentiales, c’est-à-dire le souci, affect ayant une signification ontologique, et l’angoisse vécue par les patients de la psychiatrie ? Avons-nous le droit de penser que l’angoisse telle que la décrit Heidegger au sein de Être et Temps puisse correspondre à une réalité psychologique ? Pour être en mesure d’apporter des éléments de réponse à cette question, nous devons nous demander si certains points de la description heideggerienne de l’angoisse ne seraient pas susceptibles d’évoquer des éléments propres à l’angoisse traitée en psychologie ou psychiatrie. Cette description de l’angoisse développée par Heidegger est-elle réellement purement ontologique et existentiale ? Il nous faut répondre à cette interrogation afin de comprendre comment le psychiatre Binswanger peut se référer à la réflexion de Heidegger pour construire sa propre pensée en psychiatrie. Nous devons donc nous pencher sur la façon dont Binswanger utilise les propos du philosophe. Peut-être serons-nous alors en mesure de mieux nous prononcer sur le lien qui semble relier la pensée heideggerienne à la psychiatrie. Et peut-être en apprendrons-nous davantage sur nos propres angoisses

Das valas comuns aos direitos humanos: a descoberta dos desaparecimentos forçados na Espanha contemporânea

Este texto se baseia numa investigação de campo “multissituada” de sete anos sobre o impacto do ciclo mais recente de exumações de fossas comuns da Guerra Civil espanhola, levada a termo em diversos cenários: exumações, atos comemorativos, conferências acadêmicas sobre a memória, apresentações de livros, concertos musicais, retiros universitários, assembléias, diversas ONG, grupos de trabalho com apoio institucional, laboratórios forenses, exposições de arte, manifestações, etc. Explora a forma pela qual os discursos e conceitos transnacionais dos direitos humanos tem se convertido paulatinamente em guias fundamentais da ação de muitas das associações que promovem o que se conhece como “recuperação da memória histórica, na medida em que o debate tem ido crescendo, se sofisticando, institucionalizando e, finalmente, indo a juízo. Neste sentido, a sequência de informações da Anistia Internacional sobre o processo ou o auto ditado por Baltasar Garzón aos 16 de setembro de 2008, a controvérsia gerada por ele até sua inibição aos 18 de novembro de 2008 e os sucessos derivados do processo que se lhe abriu no Supremo Tribunal, tem atuado como catalisadores desta irrupção dos direitos humanos nos debates sobre a memória, através de figuras jurídicas como as dos “crimes contra a humanidade”, os “desaparecimentos forçados”, e outras.Peer reviewe

LAS BATALLAS FESTIVAS DE ESPANA

Serving individual customer needs at reasonable prices can be a profitable target market in high-wage countries. The dilemma between scale and scope-oriented production is one major research topic within the Cluster of Excellence "Integrative Production Technology for High-Wage Countries" at the RWTH Aachen University. One main objective of this project is to bridge the existing gap between individual manufacturing and mass production. Modularization is a widely accepted approach in tool-based manufacturing processes. In this paper, we propose a flexible design methodology for modular tools and dies. The methodology will assist the design engineer in setting up a series of modularized tools in a conceptually closed manner. The described methodology covers modularization in a broad sense, i.e. it includes hardware modularization as well as modularization of the construction process. The methodology consists of three phases: initiation, analysis and design phase

No evidence on infectious DNA-based agents in pediatric acute lymphoblastic leukemia using whole metagenome shotgun sequencing

The etiology of pediatric acute lymphatic leukemia (ALL) is still unclear. Whole-metagenome shotgun sequencing of bone marrow samples in patients with treatment-naïve ALL (n=6) was performed for untargeted investigation of bacterial and viral DNA. The control group consisted of healthy children (n=4) and children with non-oncologic diseases (n=2) undergoing bone marrow sampling. Peripheral blood of all participants was investigated at the same time. After bioinformatical elimination of potential contaminants by comparison with the employed controls, no significant amounts of microbial or viral DNA were identified

Leukemia reconstitution in vivo is driven by cells in early cell cycle and low metabolic state

In contrast to well-established hierarchical concepts of tumor stem cells, leukemia-initiating cells in B-cell precursor acute lymphoblastic leukemia have not yet been phenotypically identified. Different subpopulations, as defined by surface markers, have shown equal abilities to reconstitute leukemia upon transplantation into immunodeficient mice. Using a non-obese diabetes/severe combined immunodeficiency human acute lymphoblastic leukemia mouse model and cell cycle analysis annotating cells to distinct cycle phases, we functionally characterized leukemia-initiating cells and found that cells in all stages of the cell cycle are able to reconstitute leukemia in vivo, with early cycling cells (G1blow population) exhibiting the highest leukemia-initiating potential. Interestingly, cells of the G2/M compartment, i.e. dividing cells, were less effective in leukemia reconstitution. Moreover, G1blow cells were more resistant to spontaneous or drug-induced cell death in vitro, were enriched for stem cell signatures and were less metabolically active, as determined by lower levels of reactive oxygen species, compared to G2/M stage cells. Our data provide new information on the biological properties of leukemia-initiating cells in B-cell precursor acute lymphoblastic leukemia and underline the concept of a stochastic model of leukemogenesis

Antimicrobial use in pediatric oncology and hematology in Germany and Austria, 2020/2021: a cross-sectional, multi-center point-prevalence study with a multi-step qualitative adjudication process

Background Due to the high risk of severe infection among pediatric hematology and oncology patients, antimicrobial use is particularly high. With our study, we quantitatively and qualitatively evaluated, based on institutional standards and national guidelines, antimicrobial usage by employing a point-prevalence survey with a multi-step, expert panel approach. We analyzed reasons for inappropriate antimicrobial usage. Methods This cross-sectional study was conducted at 30 pediatric hematology and oncology centers in 2020 and 2021. Centers affiliated to the German Society for Pediatric Oncology and Hematology were invited to join, and an existing institutional standard was a prerequisite to participate. We included hematologic/oncologic inpatients under 19 years old, who had a systemic antimicrobial treatment on the day of the point prevalence survey. In addition to a one-day, point-prevalence survey, external experts individually assessed the appropriateness of each therapy. This step was followed by an expert panel adjudication based upon the participating centers’ institutional standards, as well as upon national guidelines. We analyzed antimicrobial prevalence rate, along with the rate of appropriate, inappropriate, and indeterminate antimicrobial therapies with regard to institutional and national guidelines. We compared the results of academic and non-academic centers, and performed a multinomial logistic regression using center- and patient-related data to identify variables that predict inappropriate therapy. Findings At the time of the study, a total of 342 patients were hospitalized at 30 hospitals, of whom 320 were included for the calculation of the antimicrobial prevalence rate. The overall antimicrobial prevalence rate was 44.4% (142/320; range 11.1–78.6%) with a median antimicrobial prevalence rate per center of 44.5% (95% confidence interval [CI] 35.9–49.9). Antimicrobial prevalence rate was significantly higher (p < 0.001) at academic centers (median 50.0%; 95% CI 41.2–55.2) compared to non-academic centers (median 20.0%; 95% CI 11.0–32.4). After expert panel adjudication, 33.8% (48/142) of all therapies were labelled inappropriate based upon institutional standards, with a higher rate (47.9% [68/142]) when national guidelines were taken into consideration. The most frequent reasons for inappropriate therapy were incorrect dosage (26.2% [37/141]) and (de-)escalation/spectrum-related errors (20.6% [29/141]). Multinomial, logistic regression yielded the number of antimicrobial drugs (odds ratio, OR, 3.13, 95% CI 1.76–5.54, p < 0.001), the diagnosis febrile neutropenia (OR 0.18, 95% CI 0.06–0.51, p = 0.0015), and an existing pediatric antimicrobial stewardship program (OR 0.35, 95% CI 0.15–0.84, p = 0.019) as predictors of inappropriate therapy. Our analysis revealed no evidence of a difference between academic and non-academic centers regarding appropriate usage. Interpretation Our study revealed there to be high levels of antimicrobial usage at German and Austrian pediatric oncology and hematology centers with a significant higher number at academic centers. Incorrect dosing was shown to be the most frequent reason for inappropriate usage. Diagnosis of febrile neutropenia and antimicrobial stewardship programs were associated with a lower likelihood of inappropriate therapy. These findings suggest the importance of febrile neutropenia guidelines and guidelines compliance, as well as the need for regular antibiotic stewardship counselling at pediatric oncology and hematology centers. Funding European Society of Clinical Microbiology and Infectious Diseases, Deutsche Gesellschaft für Pädiatrische Infektiologie, Deutsche Gesellschaft für Krankenhaushygiene, Stiftung Kreissparkasse Saarbrücken