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Therapies - Sous presse. Epreuves corrigees par l'auteur. Disponible en ligne depuis le jeudi 10 juin 2021

Face à la pandémie du COVID-19, la science de l’information se trouve confrontée à un certain nombre de nouvelles problématiques, liées aux crises d’information, auxquelles elle n’était pas préparée. Qui dit crise mondiale, crise économique, crise énergétique, changement climatique, etc... dit crise d’information, crise caractérisée par une augmentation drastique de la quantité d’informations, par une épidémie d’information i.e. une infodémie et par de nouvelles et nombreuses mauvaises conduites des pratiques informationnelles. La crise sanitaire liée à la pandémie du COVID-19 n’échappe pas à la règle: infodémie de bonnes informations médicales et sanitaires mais aussi infodémie de mauvaises informations, bonnes pratiques informationnelles mais aussi nombreuses inconduites. Habituée au registre de la vérité scientifique, la science de l’information doit affronter le registre de la post-vérité et du complotisme qui semble caractériser nos sociétés actuelles. Information-soupçon, information-dénonciation, information- mensonge, c’est, pour la science de l’information, un nouvel horizon guère réjouissant qu’elle devrait pouvoir maîtriser sans problème en mobilisant son arsenal de concepts, de méthodes, de lois, de modèles et de théories bien établis en conservant et en développant l’horizon réjouissant de l’information-vérité. In the face of the COVID-19 pandemic, information science is facing a number of new challenges related to information crises for which it was not prepared. Who says global crisis, economic crisis, energy crisis, climate change, etc ... says information crisis, crisis characterized by a drastic increase in the amount of information, by an information epidemic ie an infodemic and by news and numerous misconduct of information practices. The health crisis linked to the COVID-19 pandemic is no exception to the rule: infodemic of good medical and health information but also infodemic of bad information, good informational practices but also numerous misconduct. Accustomed to the register of scientific truth, information science must confront the register of post-truth and conspiracy that seems to characterize our current societies. Information-suspicion, information-denunciation, information-lies, it is, for the science of information, a hardly encouraging new horizon that it should be able to master without problem by mobilizing its arsenal of concepts, methods, laws, of well- established models and theories by preserving and developing the joyous horizon of information-truth.

The aim is to show how forgetting the disasters of the past contributes to increasing exposure to risks in our societies. It first addresses the question of historical materials and methods and emphasizes the role of expert speech and modeling, as almost revealed truth and irrefutable proof of the unprecedented nature of a catastrophe. In practice, such a posture often leads to unpreparedness in the face of the coming disaster and to a form of routine risk management, as evidenced by the examples of the flood risk in Paris, the Xynthia storm of 2010 and, more recently still, the Covid 19 crisis. These weaknesses demonstrated, it is finally important to propose other horizons capable of reducing vulnerability. Cet article vise à montrer comment l’oubli des catastrophes du passé contribue à accroître l’exposition aux risques de nos sociétés. Il aborde la question des matériaux et des méthodes historiques, et souligne le rôle de la parole et de la modélisation de l’expert, comme vérité quasi révélée et preuve irréfutable du caractère inédit d’une catastrophe. En pratique, une telle posture conduit souvent à une impréparation face à la catastrophe à venir et à une forme de gestion routinière du risque, comme en témoignent les risques d’inondation à Paris, la tempête Xynthia de 2010 et la crise du Covid 19. Ces faiblesses démontrées, d’autres horizons à même de réduire la vulnérabilité sont proposés.

International audience

International audience; During the early spring of 2020, as the COVID-19 (coronavirus disease 2019) pandemic spread across the globe like a viral tsunami, many countries urgently implemented unprecedented mitigation measures to slow it down, following the example of China, where the disease first emerged at the end of 2019. As a result, more than 3 billion unprepared people worldwide had to cope with living under stringent lockdown measures for weeks or months, depending on the country. Together with the deaths of hundreds of thousands of people from this disease, a frightening emotional shock has touched populations everywhere around the planet. Millions have lost their jobs, others have had their personal lives changed drastically; the elderly, for example, have sometimes been isolated from any visits. To our knowledge, no guidelines to prevent psychological trauma have been proposed, even for the most vulnerable individuals. Nonetheless, before this crisis began, several experts had warned about the potential impact of such measures on the populations’ mental health, based on previous experiences of quarantine, as summarised in a review published, as this pandemic reached Europe and before any lockdowns.1 This warning was confirmed a few days later by the publication of a nationwide study conducted in China reporting that the quarantine triggered a wide variety of psychological disorders.2 In France, one of the hardest hit countries in Europe, a nationwide lockdown started on 17 March and lasted till 11 May. Public health authorities made daily recommendations on how to prevent COVID-19 infection with almost no specific advice on psychological prevention.

The high neutrophil to lymphocyte ratio observed in critically ill patients with COVID-19 is associated with excessive levels of reactive oxygen species (ROS), which promote a cascade of biological events that drive pathological host responses. ROS induce tissue damage, thrombosis and red blood cell dysfunction, which contribute to COVID-19 disease severity. We suggest that free radical scavengers could be beneficial for the most vulnerable patients. In this Comment article, Becker and colleagues consider how the excessive release of reactive oxygen species by neutrophils may perpetuate red blood cell dysfunction, thrombosis and tissue damage in severe cases of COVID-19.

BackgroundA novel disease poses special challenges for informatics solutions. Biomedical informatics relies for the most part on structured data, which require a preexisting data or knowledge model; however, novel diseases do not have preexisting knowledge models. In an emergent epidemic, language processing can enable rapid conversion of unstructured text to a novel knowledge model. However, although this idea has often been suggested, no opportunity has arisen to actually test it in real time. The current coronavirus disease (COVID-19) pandemic presents such an opportunity. ObjectiveThe aim of this study was to evaluate the added value of information from clinical text in response to emergent diseases using natural language processing (NLP). MethodsWe explored the effects of long-term treatment by calcium channel blockers on the outcomes of COVID-19 infection in patients with high blood pressure during in-patient hospital stays using two sources of information: data available strictly from structured electronic health records (EHRs) and data available through structured EHRs and text mining. ResultsIn this multicenter study involving 39 hospitals, text mining increased the statistical power sufficiently to change a negative result for an adjusted hazard ratio to a positive one. Compared to the baseline structured data, the number of patients available for inclusion in the study increased by 2.95 times, the amount of available information on medications increased by 7.2 times, and the amount of additional phenotypic information increased by 11.9 times. ConclusionsIn our study, use of calcium channel blockers was associated with decreased in-hospital mortality in patients with COVID-19 infection. This finding was obtained by quickly adapting an NLP pipeline to the domain of the novel disease; the adapted pipeline still performed sufficiently to extract useful information. When that information was used to supplement existing structured data, the sample size could be increased sufficiently to see treatment effects that were not previously statistically detectable.

The recent emergence of the SARS-CoV-2 in China has raised the spectre of a novel, potentially catastrophic pandemic in both scientific and lay communities throughout the world. In this particular context, people have been accused of being excessively pessimistic regarding the future consequences of this emerging health threat. However, consistent with previous research in social psychology, a large survey conducted in Europe in the early stage of the COVID-19 epidemic shows that the majority of respondents was actually overly optimistic about the risk of infection. https://psyarxiv.com/364qj/