59: Health & Care Technologies

UTC-Costech is an inter­dis­ci­pli­nary lab­o­ra­to­ry of human and social sci­ences at UTC, ded­i­cat­ed to the study of the tech­ni­cal fact, part of the Health & Care Tech­nolo­gies clus­ter with the Bio­me­chan­ics and Bio­engi­neer­ing (UTC-BMBI) Lab­o­ra­to­ry. This cross-dis­ci­pli­nary theme cov­ers var­i­ous fields such as the con­ser­va­tion of bio­log­i­cal mate­ri­als in biobanks, the design of bioar­ti­fi­cial organs, per­cep­tive sub­sti­tu­tion and arti­fi­cial intel­li­gence devices for diag­no­sis (can­cers, Lyme’s disease).

Xavier Guchet, a pro­fes­sor of phi­los­o­phy of tech­nol­o­gy, has been Direc­tor of UTC-Costech since 2019. With a staff of near­ly 60 lec­tur­er-cum-research sci­en­tists, PhD stu­dents, post-doc­tor­al stu­dents, not count­ing asso­ciate research sci­en­tists — Costech is organ­ised around three research teams.

Cre­at­ed in 1993, essen­tial­ly by philoso­phers and cog­ni­tive sci­ence spe­cial­ists, UTC-Costech was ini­tial­ly built around the fol­low­ing prob­lem: the tech­ni­cal­ly con­sti­tut­ed dimen­sion of human cog­ni­tive fac­ul­ties. In oth­er words, the fact that our cog­ni­tive abil­i­ties are only exer­cised through tech­ni­cal sup­ple­men­ta­tion. A human and social sci­ence lab­o­ra­to­ry, it has since opened up to new dis­ci­plines. “Today, there are more than ten dif­fer­ent spe­cial­ist dis­ci­plines. They range from the phi­los­o­phy of tech­nol­o­gy and cog­ni­tive sci­ences to epis­te­mol­o­gy, the his­to­ry of tech­nol­o­gy, design, psy­chol­o­gy, soci­ol­o­gy, infor­ma­tion and com­mu­ni­ca­tion sci­ences, lan­guage sci­ences, polit­i­cal sci­ence, com­put­er sci­ence and eco­nom­ics and man­age­ment,” says Xavier Guchet. This makes it the most inter­dis­ci­pli­nary lab­o­ra­to­ry ded­i­cat­ed to the study of tech­nol­o­gy in France. “Our aim is to study tech­nol­o­gy through the prism of all such dis­ci­plines,” he says.

UTC-Costech is struc­tured around three research teams: the CRED team (Cog­ni­tive Research and Enac­tive Design), the EPIN team (Writ­ing, Prac­tice and dig­i­tal Inter­ac­tions) and last but not least the CRI team (Com­plex­i­ties, Net­works and Innovation).

The first team, more ori­ent­ed towards the human­i­ties and cog­ni­tive sci­ences, includes philoso­phers, psy­chol­o­gists, his­to­ri­ans of tech­nol­o­gy, researchers in cog­ni­tive sci­ences and lan­guage sci­ences, as well as epis­te­mol­o­gists and com­put­er scientists.

Among the CRED’s areas of research? “It is a team with dif­fer­ent dis­ci­pli­nary pro­files, but our work lies at the inter­sec­tion of two major ques­tions. The first con­cerns the study of tech­nol­o­gy from a his­tor­i­cal, philo­soph­i­cal and epis­te­mo­log­i­cal point of view. We explore the the­sis that tech­nol­o­gy is con­sti­tu­tive of the human being in the sense that it makes pos­si­ble our way of being in the world. We are also inter­est­ed in con­tem­po­rary tech­nolo­gies and their eth­i­cal and social issues. The sec­ond con­cerns cog­ni­tion and unfolds through exper­i­men­tal and the­o­ret­i­cal research on per­cep­tion, thought, lan­guage and the role of tech­ni­cal medi­a­tion. These two major ques­tions end up crys­tallis­ing in the issue of design, and in par­tic­u­lar the design of per­cep­tu­al sup­port devices, which lies at at the heart of the tech­no­log­i­cal research car­ried out by the team,” explains Vin­cen­zo Rai­mon­di, head of the CRED.

The sec­ond ques­tion, more ori­ent­ed towards infor­ma­tion and com­mu­ni­ca­tion sci­ences and polit­i­cal sci­ence, is par­tic­u­lar­ly inter­est­ed in two issues: dig­i­tal lit­er­a­cy and polit­i­cal trans­for­ma­tions in the dig­i­tal age.

Can you be more explic­it? “We are work­ing on dig­i­tal issues in two main areas. On the one hand, a soci­ol­o­gy of dig­i­tal prac­tices and uses, and on the oth­er, the speci­fici­ty of dig­i­tal writ­ing and lit­er­a­ture. In the first case, we will study how dig­i­tal tech­nolo­gies trans­form social dynam­ics and polit­i­cal prac­tices with work that will focus, for exam­ple, on dig­i­tal democ­ra­cy or the reg­u­la­tion of Inter­net plat­forms and social media. In the sec­ond case, we will study how dig­i­tal tech­nol­o­gy opens the door to new ways of cre­at­ing or inter­act­ing with online cre­ations. In this way, we observe that dig­i­tal tech­nol­o­gy mod­i­fies the lan­guage and the medi­um of cer­tain artis­tic prac­tices. Some of the researchers in our team will thus com­bine research and cre­ation by pro­duc­ing con­tent that aims to show how dig­i­tal tech­nol­o­gy allows us to cre­ate dif­fer­ent­ly,” explains Anne Bel­lon, co-leader of the EPIN research team.

These issues under inves­ti­ga­tion have led to a num­ber of projects, includ­ing one on “dis­cov­er­abil­i­ty”, fund­ed by the French Min­istry of Cul­ture. “The aim is to devel­op tools to study our online cul­tur­al prac­tices and to see to what extent they are guid­ed by the rec­om­men­da­tion algo­rithms of cul­tur­al plat­forms, for exam­ple,” she adds.

To round up, the CRI team, with its 27 high­ly mul­ti­dis­ci­pli­nary research sci­en­tists, embraces var­i­ous fields includ­ing soci­ol­o­gy, eco­nom­ics and man­age­ment, phi­los­o­phy and math­e­mat­ics. “The team size and dis­ci­pli­nary diver­si­ty allows us to explore var­i­ous fields of research all linked to the study of tech­nol­o­gy in its socio-eco­nom­ic, organ­i­sa­tion­al and col­lec­tive dimen­sions. We are inter­est­ed in three areas in par­tic­u­lar. The first area con­cerns the ongo­ing dig­i­tal tran­si­tion, arti­fi­cial intel­li­gence and big data. The sec­ond area is con­cerned with the theme of organ­i­sa­tion, inno­va­tion via col­lec­tives bod­ies and the gov­er­nance of inno­va­tion, and the third explores eco­log­i­cal tran­si­tion,” explains Hadrien Coutant, co-direc­tor of the CRI team.

Tell us about the projects linked to these themes? “We have sev­er­al, includ­ing one on so-called “indus­try 4.0” and the dig­i­tal­i­sa­tion of indus­tri­al process­es, and anoth­er on data intel­li­gence and Lyme’s dis­ease. For my part, I am con­duct­ing work on the reg­u­la­tion of pub­lic com­pa­nies and their rela­tions with the State author­i­ties, while tech­no­log­i­cal research on the uses of dig­i­tal tech­nol­o­gy is con­duct­ed with the plat­form at our “Halle numérique”. Final­ly, we are con­duct­ing work on eco­log­i­cal think­ing and the eco­log­i­cal com­mit­ment of engi­neers, pho­to­volta­ic charg­ing sta­tions and decen­tralised indus­tri­al mod­els and their role in the eco­log­i­cal tran­si­tion,” he concludes.

As an exam­ple of a cross-cut­ting theme, the “Health and Care Tech­nolo­gies” (H&CT) clus­ter is linked to Costech’s “Care Tech­nolo­gies” axis and is co-pilot­ed by Costech and BMBI.

What ini­ti­at­ed this mul­ti­dis­ci­pli­nary and cross-dis­ci­pli­nary project? “When I arrived at UTC, I took respon­si­bil­i­ty for the “Health Care Tech­nolo­gies” axis with­in Costech. Today, it is by get­ting involved in the H&CT clus­ter that I am con­tribut­ing to the exis­tence of this lab­o­ra­to­ry axis”, explains Xavier Guchet.

For Costech researchers, tech­nol­o­gy is a total fact. Can you expand in this? “The devices designed by engi­neers are intrin­si­cal­ly car­ri­ers of social, moral and polit­i­cal issues. The tech­ni­cal object aggre­gates, at a very ear­ly stage in the con­cep­tion and design choic­es, issues that go far beyond it. In fact, soci­ety, ethics and pol­i­tics are mate­ri­alised in the choic­es that gov­ern the design of objects,” he stresses.

Tech­nol­o­gy is there­fore not neu­tral, as the human and social sci­ences (SHS) have amply demon­strat­ed over the past 50 years. How­ev­er, there is a gap between the the­o­ret­i­cal knowl­edge accu­mu­lat­ed on tech­nol­o­gy and the world of tech­no­log­i­cal design. “If we want­ed to draw the log­i­cal con­clu­sion of these social stud­ies of tech­nol­o­gy, any process of design­ing a tech­nol­o­gy should be deemed mul­ti­dis­ci­pli­nary. Pro­fes­sion­al engi­neers should be equipped with a cul­ture of social sci­ences and human­i­ties, just as the philoso­pher or anthro­pol­o­gist should be famil­iar with the con­straints of con­cep­tion or design, among oth­er things. But it is not so easy to get these dif­fer­ent com­mu­ni­ties to work togeth­er,’ he says.

His­tor­i­cal­ly, UTC has always had the ambi­tion to cre­ate spaces for inter­dis­ci­pli­nary dia­logue and to train, accord­ing to Pro­fess­sor Guy Daniélou, founder of the uni­ver­si­ty, what we can des­ig­nate as ‘philo­soph­i­cal engi­neers’. That is to say, engi­neers with tech­ni­cal skills but also in social sci­ences (SHS). The H&CT clus­ter is designed to con­tribute to this objective.

A cross-disciplinary centre

Can you expand a bit, in con­crete terms? “The idea is to defend the idea that tech­no­log­i­cal design in bio­engi­neer­ing ben­e­fits from the con­tri­bu­tion of phi­los­o­phy and social and human sci­ences. The aim is not to pro­vide engi­neers with an ‘extra soul’, a bit of ethics cov­er­ing the engi­neer’s activ­i­ty like a lay­er of var­nish: the voca­tion of the H&CT clus­ter is to demon­strate the fruit­ful­ness of engineering/SHS col­lab­o­ra­tion from the ini­tial process of design, tack­ling the guid­ing con­cepts that ori­ent engi­neers’ work, or by demon­strat­ing the inter­est for engi­neers in replac­ing their activ­i­ties in its his­to­ry,” insists Xavier Guchet.

The idea caught on and, in 2016, the two lab­o­ra­to­ries launched a joint Annu­al Study Day on a wide range of themes. “Among oth­er things, we organ­ised a day ded­i­cat­ed to organ replace­ment using bioar­ti­fi­cial devices, and anoth­er on 3D bio­print­ing, again in con­nec­tion with organ replace­ment. Prof. Cécile Legal­lais and I are also co-direct­ing a the­sis on the his­to­ry and epis­te­mol­o­gy of arti­fi­cial organs. Manon Guil­let, one of our PhD stu­dents, has also set up an eth­i­cal meet­ing with­in BMBI. And the under­ly­ing idea? To con­vince engi­neers of the impor­tance of know­ing the his­to­ry of their own field, i.e., the his­to­ry of the con­cepts and tools they use on a dai­ly basis, but also to encour­age them to reflect on their own prac­tice from an eth­i­cal point of view,” he explains.

Since Jan­u­ary 2023, these spaces for inter­dis­ci­pli­nary dia­logue have been enhanced by a month­ly seminar.

The H&CT clus­ter’s cross-dis­ci­pli­nary approach has tak­en con­crete form in three projects coor­di­nat­ed by Xavier Guchet.


The first project (acronym Bioban­quePer­so), launched in 2017 and financed by the Hauts de France Region (for­mer­ly Picardy) and the Euro­pean Region­al Fund (Fed­er), con­cerns biobanks, or Bio­log­i­cal Resource Cen­tres. “These infra­struc­tures, main­ly hos­pi­tal-based in France, aim to sup­port bio­med­ical research by pro­vid­ing research teams with bio­log­i­cal sam­ples such as blood, tumour tis­sues, cell cul­tures, asso­ci­at­ed with the health data of the donors con­cerned, hav­ing received their informed con­sent before­hand. The col­lec­tion, prepa­ra­tion and stor­age of these bio­log­i­cal resources fol­low a very pre­cise and stan­dard­ized pro­to­col to ensure their qual­i­ty. Indeed, numer­ous stud­ies have shown that the non-repro­ducibil­i­ty of research results from one lab­o­ra­to­ry to anoth­er was often linked to the lack of homo­gene­ity and qual­i­ty of the sam­ples made avail­able to research sci­en­tists,’ he explains.

This shows the fun­da­men­tal role of biobanks for bio­med­ical research.

What are the clus­ter’s objec­tives in this area? “It seemed to me that, com­pared with the exist­ing lit­er­a­ture dom­i­nat­ed by eth­i­cal, legal and soci­o­log­i­cal stud­ies, two aspects were miss­ing. First­ly, the his­tor­i­cal aspect. Name­ly, how was this activ­i­ty of biobank­ing – born as it was with the 20th cen­tu­ry — made pos­si­ble, what were its tra­jec­to­ries? The oth­er aspect is strict­ly epis­te­mo­log­i­cal: how do these infra­struc­tures and their evo­lu­tion trans­form the way knowl­edge is pro­duced in biol­o­gy and med­i­cine? The project involved the Picardie Biobank, one of the first in France, with his­to­ri­ans of tech­nol­o­gy and philoso­phers of tech­nol­o­gy. I would add that we prac­tice a phi­los­o­phy of ‘field­work’, in the sense that we devel­op our analy­ses by feed­ing them with empir­i­cal inves­ti­ga­tion, in situ, by observ­ing the activ­i­ty of the actors as well as the objects they han­dle and pro­duce, in order to under­stand the issues at stake,” he emphasises.

The “Organ” project

Launched in 2021, this sec­ond project is financed by the Nation­al Bio­med­ical Agency, whose main field of com­pe­tence con­cerns organ trans­plants and all relat­ed issues. This ranges from organ dona­tion to organ graft assignment.

The char­ac­ter­is­tics of this project (acronym ITEGOREC)? “At UTC, our BMBI col­leagues are work­ing on the design of bioar­ti­fi­cial organs, the aim of which is to design exter­nal or implantable devices capa­ble of ensur­ing the func­tions of fail­ing organs and/or of replac­ing them. These devices are one of the areas inves­ti­gat­ed by the project. It also explores two oth­er organ tech­nolo­gies: first­ly, per­fu­sion tech­nolo­gies, the func­tion of which is to ensure that organs are well pre­served between the time they are removed from a donor and the time they are trans­plant­ed into a patient. These machines also allow the graft to be test­ed to assess its qual­i­ty – all of which rep­re­sents valu­able infor­ma­tion for the trans­plant sur­geon. Sec­ond­ly, the project is also inter­est­ed in ‘organoids’ and organ-on-chips, i.e., 3D cell cul­tures that are designed to repro­duce cer­tain metab­o­lisms and even func­tions of the tar­get organ. These high­ly sim­pli­fied ver­sions of organs are the sub­ject of much hope, par­tic­u­lar­ly in clin­i­cal and tox­i­co­log­i­cal research and poten­tial­ly in regen­er­a­tive med­i­cine,’ explains Xavier Guchet. These new objects are thus at the cross­roads of the field of cell cul­ture, which dates back to the ear­ly 20th cen­tu­ry, that of bio­ma­te­ri­als and that of mod­el­ling. The idea is to under­stand when, how and why these dif­fer­ent fields came togeth­er, giv­ing rise to these new bio­engi­neer­ing sectors.

The project also aims to address the touchy eth­i­cal and reg­u­la­to­ry issues raised by these organ technologies.

Artificial intelligence in oncology

Launched in 2022 and financed by the French Nation­al Can­cer Insti­tute, this project (acronym MaLO), which focus­es on breast can­cer, aims to shed mul­ti­dis­ci­pli­nary light on AI devices being devel­oped in the field of cancerology.

More con­crete­ly? “As with the “Organs” project, it is first of all a ques­tion of plac­ing these devices in a his­toric con­text. Indeed, his­to­ry can be con­struc­tive in order to shed light on the present since it can teach us about the mis­takes made ear­li­er, plus some dead ends that were reached, for exam­ple by link­ing today’s devices to the his­to­ry of expert sys­tems in the 1970s/1980s which, on the whole, did not keep up their promis­es. It is also a ques­tion of under­stand­ing the extent to which these sys­tems are trans­form­ing the man­u­fac­ture of knowl­edge about can­cer. Thus, 20 years ago, the rise of genomics changed the way we pro­duce knowl­edge about can­cer, define what can­cer is, under­stand its mech­a­nisms and ulti­mate­ly how we treat it. Will AI have a sim­i­lar impact on can­cer clas­si­fi­ca­tion and patient man­age­ment? The project also intends to address the eth­i­cal and reg­u­la­to­ry issues raised by these AIs when they are devel­oped in med­i­cine. Our approach is based on a con­vic­tion: these devices only make sense in con­text, it is not rel­e­vant to hold a gen­er­al and off-the-wall dis­course on med­ical AI. Final­ly, in a more explorato­ry approach, we want to exper­i­ment with part­ners — uni­ver­si­ty hos­pi­tals, research cen­tres — a process of co-design of devices, encour­ag­ing mul­ti­dis­ci­pli­nary reflec­tion on the prob­lems of AI in can­cerol­o­gy,” explains Xavier Guchet.

Today, the H&CT clus­ter appears as a suc­cess­ful exam­ple of inter­dis­ci­pli­nary engineering/SHS research. “The ambi­tion is to pro­vide the clus­ter with a vis­i­bil­i­ty going beyond the insti­tu­tion, espe­cial­ly through the spe­cial Study Days. At UTC, we want to be iden­ti­fied as impor­tant play­ers in the reflec­tion on the role of engi­neers in the evo­lu­tion of med­i­cine at the lev­el of region­al pol­i­cy,” he concludes.

Marc Shawky is a uni­ver­si­ty pro­fes­sor in com­put­er engi­neer­ing and is attached to the CRI team at Costech. He works, in par­tic­u­lar, on two trans­ver­sal axes “Care” and “Dig­i­tal tools” includ­ing the Num4Lyme project.

Research that focus­es on the analy­sis of mas­sive data and auto­mat­ic learn­ing. This involves arti­fi­cial intel­li­gence. “I am par­tic­u­lar­ly inter­est­ed in health data and espe­cial­ly in long-term infec­tious dis­eases, includ­ing Lyme dis­ease. Hence the Num4Lyme project,” he says.

Lyme dis­ease is the most com­mon infec­tious dis­ease in France — 30 000 to 40 000 new infec­tions per year — and is trans­mit­ted by tick bites, main­ly in for­est regions. This is the case, for exam­ple, in the Com­piègne basin.

What is spe­cial about long-term infec­tious dis­eases? “Peo­ple with a sin­gle infec­tion may not have symp­toms requir­ing treat­ment. On the oth­er hand, those with sev­er­al infec­tions detect­ed by sero­log­i­cal tests and PCRs may have symp­toms sim­i­lar to auto-immune dis­eases and in some cas­es show no symp­toms at all. The clin­i­cal signs of the first group are very few and far between — short mem­o­ry loss, joint pain, etc. — often con­fus­ing gen­er­al prac­ti­tion­ers, caus­ing patients to wan­der around try­ing to make the right diag­no­sis,’ he explains.

What can be done about it? “We need oth­er diag­nos­tic tools, par­tic­u­lar­ly data analy­sis,” adds Marc Shawky.

What does this imply in prac­tice? “We will start with the clin­i­cal signs and com­plaints as expressed by the patient, such as the fre­quen­cy of a par­tic­u­lar symp­tom, its inten­si­ty and also its evo­lu­tion over time. The data col­lect­ed includes the forms filled in by the patients under the super­vi­sion of hos­pi­tal doc­tors, med­ical analy­ses, med­ical imag­ing reports, etc. We are work­ing on 300 to 400 para­me­ters per patient,” he says.

Part­ners for this project? “There are three cen­tres of exper­tise on Lyme dis­ease in France. We are going to sign an agree­ment with Dr Ahed Zedan of the Saint Côme clin­ic, one of the three cen­tres, and dis­cus­sions are under­way with the one in Nantes and the one in Metz,” he says.

What is the role of Marc Shawky’s team in set­ting up these new tools? We are devel­op­ing algo­rithms that will analyse the data using clas­si­fi­ca­tion tech­niques. There are sev­er­al of them, but we’ll start with the sim­plest ones. We’re build­ing a learn­ing data­base with patients we’re sure have Lyme dis­ease, and then using this data­base we shall clas­si­fy data from patients we don’t know. So we acquire data that has nev­er been pre­vi­ous­ly learned. The algo­rithms will then match each of the new patients with this learn­ing set. Let’s not for­get that we have almost 400 para­me­ters per per­son and that all the data is not yet stan­dard­ised. This is a real chal­lenge in the analy­sis of mas­sive data, anonymised data that comes, essen­tial­ly, from our part­ners,” explains Marc Shawky.

A cross-dis­ci­pli­nary project that involves, in addi­tion to Costech, the LMAC and the UTC-GEC Lab­o­ra­to­ry as well as the Saint Côme clinic.

Le magazine

Novembre 2023 - N°61

Activité physique, nutrition & santé

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