Suchergebnisse

Alors que plus de 50% de la population mondiale est connectée à l'Internet, les grandes plateformes, et particulièrement Facebook, ont acquis un énorme pouvoir politique. Cette nouvelle situation nous oblige a repenser le projet d'émancipation des lumières. Je propose dans cet article que les chercheurs en sciences humaines et sociales relèvent ce défi en adoptant et en diffusant de nouvelles normes d'intelligence collective réflexive. Les communs de la connaissance, la science ouverte et la souveraineté des individus sur les données qu'ils produisent font l'unanimité. Mais ces principes incontournables sont encore insuffisants. La puissance de calcul et de communication disponible, combinée à l'utilisation d'IEML (une langue à la sémantique calculable), nous permettent d'envisager une mise en transparence des opérations de création de connaissance, de sens et d'autorité. Je présente ici les grandes orientations stratégiques permettant d'atteindre ces objectifs. Une révolution épistémologique des sciences humaines est à portée de main, et avec elle une nouvelle étape dans l'évolution de la pensée critique. ; While more than 50% of the world's population is connected to the Internet, the major platforms, and particularly Facebook, have acquired an enormous political power. This new situation forces us to rethink the emancipation project of the enlightenment. In this article, I propose that researchers in the humanities and social sciences take up this challenge by adopting and disseminating new standards of reflexive collective intelligence. Knowledge commons, open science and the sovereignty of individuals over the data they produce are unanimously accepted. But these essential principles are not enough. The available computing and communication power, combined with the use of IEML (a language with computable semantics), enables us to contemplate a transparency of the knowledge, meaning and authority creation processes. I present here the main strategic orientations for reaching these objectives. An epistemological revolution in the human sciences is within reach, and with it a new stage in the evolution of critical thinking.

Ce texte est la préface du dossier "Facebook. L'école des fans". Le dossier rassemble les principales contributions de Gérard Wormser sur les enjeux politiques et philosophiques de la culture numérique, auxquelles s'ajoutent des textes inédits. ; This text is the preface of the dossier "Facebook. L'école des fans". The dossier proposes a selction of the most important published and unpublished contributions of Gérard Wormser on the political and philosophical issues of digital culture.

The text analyzes the contemporary mutation of the public sphere as an effect of the extension of cyberspace and contemplates the new possibilities of development that this mutation opens up to democracy, particularly to collective deliberation. After recalling the quantitative data concerning the extension of digital communication and describing the progress of social computing, the major trends of the new public sphere are presented: its global reach, its structure of "all towards all" and "equal" like "the same as the fading private / public distinction. However, the new possibilities of democratic collective understanding can only be fully realized if the problems of semantic interoperability posed by the multiplicity of languages and the incompatibility of classification systems are resolved. ; En el texto se analiza la mutación contemporánea de la esfera pública como efecto de la extensión del ciberespacio y se contemplan las nuevas posibilidades de desarrollo que esta mutación abre a la democracia, muy particularmente a la deliberación colectiva. Luego de recordar los datos cuantitativos concernientes a la extensión de la comunicación digital y describir el avance de la computación social, se presentan las grandes tendencias de la nueva esfera pública: su alcance mundial, su estructura de "todos hacia todos" y de "igual a igual" lo mismo que el desvanecimiento de la distinción privado/ público. No obstante, las nuevas posibilidades de entendimiento colectivo democrático sólo podrán realizarse plenamente si se resuelven los problemas de interoperatividad semántica que plantea la multiplicidad de las lenguas y la incompatibilidad de los sistemas de clasificación. ; Ce texte analyse la mutation contemporaine de la sphère publique sous l'effet de l'extension du cyberespace et envisage les nouvelles possibilités de développement que cette mutation ouvre à la démocratie, et tout particulièrement à la délibération collective. Après avoir rappelé les données quantitatives de l'extention de la communication numérique et décrit la montée de la computation sociale, j'évoque les grandes tendances de la nouvelle sphère publique : son ouverture mondiale, sa structure "tous vers tous" et "pair à pair" et l'effacement de la distinction privé/public. Les nouvelles possibilités d'intelligence collective démocratique ne pourront néanmoins se réaliser pleinement qu'à condition de résoudre les problèmes d'interopérabilité sémantique posés par la multiplicité des langues et l'incompatibilité des systèmes de classification. ; O texto analisa a mutação contemporânea da esfera pública como efeito da extensão do ciberespaço e contempla as novas possibilidades de desenvolvimento que essa mutação abre à democracia, particularmente à deliberação coletiva. Depois de recordar os dados quantitativos relativos à extensão da comunicação digital e descrever o progresso da computação social, apresentam-se as principais tendências da nova esfera pública: seu alcance global, sua estrutura de "tudo para todos" e "igual" como "o mesmo que a distinção privada / pública enfraquecida. No entanto, as novas possibilidades de compreensão coletiva democrática só podem ser plenamente realizadas se os problemas de interoperabilidade semântica colocados pela multiplicidade de linguagens e a incompatibilidade dos sistemas de classificação forem resolvidos.

International audience ; Aims: The burden of diabetes-related complications is important and increasing in France. Early screening of microvascular complications could avoid the occurrence of more severe consequences. An economic model using a 5-year time horizon was developed to estimate the potential impact in France of large screening of diabetic autonomic neuropathy using Sudoscan, a quick, non-invasive and quantitative method developed for screening of small fiber neuropathy.Methods: A disease progression model was first developed to describe the long-term evolution of patients with type 2 diabetes regarding microvascular complications over successive time periods and patients were classified in 4 groups according to the severity. Complication-related costs were then calculated for a cohort of patients treated according to the current pattern of care and compared with the costs incurred by the same cohort assuming the introduction and widespread use of a large screening of small fiber neuropathy using the Sudoscan method. Comparison of treatment costs between the two situations was used to evaluate the potential budget impact of such a prevention policy in France.Results: According to this general screening of early complications more than 25,000 patients could avoid more severe complications. The gross benefit of such a new prevention strategy would be around € 280 million at 5th year. After 5 years of follow-up, the cumulated gross benefit would be € 837 million and in the worst case scenario (decrease of 20% for each uncertain parameter, namely the distribution of patients among severity groups, the death rates in each severity group, and the distribution of newly diagnosed patients in each severity group) gross benefit would remain at more than € 50 million for the first year and more than € 255 million at the 5th year (using 6% as global efficacy of screening method as basal value).Conclusion: Large screening of small fiber neuropathy could avoid more severe peripheral neuropathy and consequently ...

International audience ; Aims: The burden of diabetes-related complications is important and increasing in France. Early screening of microvascular complications could avoid the occurrence of more severe consequences. An economic model using a 5-year time horizon was developed to estimate the potential impact in France of large screening of diabetic autonomic neuropathy using Sudoscan, a quick, non-invasive and quantitative method developed for screening of small fiber neuropathy.Methods: A disease progression model was first developed to describe the long-term evolution of patients with type 2 diabetes regarding microvascular complications over successive time periods and patients were classified in 4 groups according to the severity. Complication-related costs were then calculated for a cohort of patients treated according to the current pattern of care and compared with the costs incurred by the same cohort assuming the introduction and widespread use of a large screening of small fiber neuropathy using the Sudoscan method. Comparison of treatment costs between the two situations was used to evaluate the potential budget impact of such a prevention policy in France.Results: According to this general screening of early complications more than 25,000 patients could avoid more severe complications. The gross benefit of such a new prevention strategy would be around € 280 million at 5th year. After 5 years of follow-up, the cumulated gross benefit would be € 837 million and in the worst case scenario (decrease of 20% for each uncertain parameter, namely the distribution of patients among severity groups, the death rates in each severity group, and the distribution of newly diagnosed patients in each severity group) gross benefit would remain at more than € 50 million for the first year and more than € 255 million at the 5th year (using 6% as global efficacy of screening method as basal value).Conclusion: Large screening of small fiber neuropathy could avoid more severe peripheral neuropathy and consequently ...

International audience ; Aims: The burden of diabetes-related complications is important and increasing in France. Early screening of microvascular complications could avoid the occurrence of more severe consequences. An economic model using a 5-year time horizon was developed to estimate the potential impact in France of large screening of diabetic autonomic neuropathy using Sudoscan, a quick, non-invasive and quantitative method developed for screening of small fiber neuropathy.Methods: A disease progression model was first developed to describe the long-term evolution of patients with type 2 diabetes regarding microvascular complications over successive time periods and patients were classified in 4 groups according to the severity. Complication-related costs were then calculated for a cohort of patients treated according to the current pattern of care and compared with the costs incurred by the same cohort assuming the introduction and widespread use of a large screening of small fiber neuropathy using the Sudoscan method. Comparison of treatment costs between the two situations was used to evaluate the potential budget impact of such a prevention policy in France.Results: According to this general screening of early complications more than 25,000 patients could avoid more severe complications. The gross benefit of such a new prevention strategy would be around € 280 million at 5th year. After 5 years of follow-up, the cumulated gross benefit would be € 837 million and in the worst case scenario (decrease of 20% for each uncertain parameter, namely the distribution of patients among severity groups, the death rates in each severity group, and the distribution of newly diagnosed patients in each severity group) gross benefit would remain at more than € 50 million for the first year and more than € 255 million at the 5th year (using 6% as global efficacy of screening method as basal value).Conclusion: Large screening of small fiber neuropathy could avoid more severe peripheral neuropathy and consequently ...

International audience ; Background: Morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) imposes a substantial economic burden on the UK healthcare system. Objectives: An existing Markov model was adapted to assess the real-world cost-effectiveness of rivaroxaban and apixaban, each compared with a vitamin K antagonist (VKA), for stroke prevention in patients with NVAF from the National Health Service (NHS) and personal and social services (PSS) perspective. Methods: The model considered a cycle length of 3 months over a lifetime horizon. All inputs were drawn from real-world evidence (RWE): baseline patient characteristics, clinical event and persistence rates, treatment effect (meta-analysis of RWE studies), utility values and resource use. Deterministic and probabilistic sensitivity analyses were performed. Results: The incremental cost per quality-adjusted life year was £14,437 for rivaroxaban, and £20,101 for apixaban, compared with VKA. The probabilities to be cost-effective compared with VKA were 90% and 81%, respectively for rivaroxaban and apixaban, considering a £20,000 threshold. In both comparisons, the results were most sensitive to clinical event rates. Conclusions: These results suggest that rivaroxaban and apixaban are cost-effective vs VKA, based on RWE, considering a £20,000 threshold, from the NHS and PSS perspective in the UK for stroke prevention in patients with NVAF. This economic evaluation may provide valuable information for decision-makers, in a context where RWE is more accessible and its value more acknowledged.

International audience ; Background: Morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) imposes a substantial economic burden on the UK healthcare system. Objectives: An existing Markov model was adapted to assess the real-world cost-effectiveness of rivaroxaban and apixaban, each compared with a vitamin K antagonist (VKA), for stroke prevention in patients with NVAF from the National Health Service (NHS) and personal and social services (PSS) perspective. Methods: The model considered a cycle length of 3 months over a lifetime horizon. All inputs were drawn from real-world evidence (RWE): baseline patient characteristics, clinical event and persistence rates, treatment effect (meta-analysis of RWE studies), utility values and resource use. Deterministic and probabilistic sensitivity analyses were performed. Results: The incremental cost per quality-adjusted life year was £14,437 for rivaroxaban, and £20,101 for apixaban, compared with VKA. The probabilities to be cost-effective compared with VKA were 90% and 81%, respectively for rivaroxaban and apixaban, considering a £20,000 threshold. In both comparisons, the results were most sensitive to clinical event rates. Conclusions: These results suggest that rivaroxaban and apixaban are cost-effective vs VKA, based on RWE, considering a £20,000 threshold, from the NHS and PSS perspective in the UK for stroke prevention in patients with NVAF. This economic evaluation may provide valuable information for decision-makers, in a context where RWE is more accessible and its value more acknowledged.

International audience ; Background: Morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) imposes a substantial economic burden on the UK healthcare system. Objectives: An existing Markov model was adapted to assess the real-world cost-effectiveness of rivaroxaban and apixaban, each compared with a vitamin K antagonist (VKA), for stroke prevention in patients with NVAF from the National Health Service (NHS) and personal and social services (PSS) perspective. Methods: The model considered a cycle length of 3 months over a lifetime horizon. All inputs were drawn from real-world evidence (RWE): baseline patient characteristics, clinical event and persistence rates, treatment effect (meta-analysis of RWE studies), utility values and resource use. Deterministic and probabilistic sensitivity analyses were performed. Results: The incremental cost per quality-adjusted life year was £14,437 for rivaroxaban, and £20,101 for apixaban, compared with VKA. The probabilities to be cost-effective compared with VKA were 90% and 81%, respectively for rivaroxaban and apixaban, considering a £20,000 threshold. In both comparisons, the results were most sensitive to clinical event rates. Conclusions: These results suggest that rivaroxaban and apixaban are cost-effective vs VKA, based on RWE, considering a £20,000 threshold, from the NHS and PSS perspective in the UK for stroke prevention in patients with NVAF. This economic evaluation may provide valuable information for decision-makers, in a context where RWE is more accessible and its value more acknowledged.

International audience ; Aim: In order to integrate malaria Intermittent Preventive Treatment in infants (IPTi) into the Ghana national immunization programme, there was the need to evaluate the feasibility of IPTi by assessing the intervention operational issues including its implementation costs, and its cost effectiveness. Study Design: Cross-sectional study. Place and Duration of Study: Upper East Region, Ghana, between July 2007 and July 2009 Methods: We calculated the costs of administrating IPTi during vaccination sessions; the costs of programme implementation during the first year of implementation (start-up costs) and in routine years (recurrent costs). For the purposes of cost-effectiveness analysis, all economic costs (including financial and opportunity costs) and the net cost were estimated. To estimate the cost effectiveness ratios of IPTi, the aggregate cost of providing the intervention for a reference target population of 1,000 infants was divided by its health outcome. Sensitivity analyses were carried out to understand the results robustness. Results: IPTi gross costs in start up and in routine years were estimated at 70.66 cents and 29.72 cents per dose, or $2.0 and $0.87 per infant, respectively. The gross cost per DALY saved was estimated at $3.49 and the net cost of IPTi for 1,000 infants was $-3,416.38 in the routine years rending IPTi a highly cost saving intervention. Sensitivity analyses showed that the cost per DALY saved never went up more than $4.50 maintaining the intervention still highly cost effective. Conclusion: IPTi in Ghana is a highly and robust cost effective intervention. The intervention is cost-saving and should be scaled up nationally to save children's health and economic capital.

International audience ; Aim: In order to integrate malaria Intermittent Preventive Treatment in infants (IPTi) into the Ghana national immunization programme, there was the need to evaluate the feasibility of IPTi by assessing the intervention operational issues including its implementation costs, and its cost effectiveness. Study Design: Cross-sectional study. Place and Duration of Study: Upper East Region, Ghana, between July 2007 and July 2009 Methods: We calculated the costs of administrating IPTi during vaccination sessions; the costs of programme implementation during the first year of implementation (start-up costs) and in routine years (recurrent costs). For the purposes of cost-effectiveness analysis, all economic costs (including financial and opportunity costs) and the net cost were estimated. To estimate the cost effectiveness ratios of IPTi, the aggregate cost of providing the intervention for a reference target population of 1,000 infants was divided by its health outcome. Sensitivity analyses were carried out to understand the results robustness. Results: IPTi gross costs in start up and in routine years were estimated at 70.66 cents and 29.72 cents per dose, or $2.0 and $0.87 per infant, respectively. The gross cost per DALY saved was estimated at $3.49 and the net cost of IPTi for 1,000 infants was $-3,416.38 in the routine years rending IPTi a highly cost saving intervention. Sensitivity analyses showed that the cost per DALY saved never went up more than $4.50 maintaining the intervention still highly cost effective. Conclusion: IPTi in Ghana is a highly and robust cost effective intervention. The intervention is cost-saving and should be scaled up nationally to save children's health and economic capital.