7 research outputs found
Eyeâhand coordination during manual object transport with the affected and less affected hand in adolescents with hemiparetic cerebral palsy
In the present study we investigated eyeâhand coordination in adolescents with hemiparetic cerebral palsy (CP) and neurologically healthy controls. Using an object prehension and transport task, we addressed two hypotheses, motivated by the question whether early brain damage and the ensuing limitations of motor activity lead to general and/or effector-specific effects in visuomotor control of manual actions. We hypothesized that individuals with hemiparetic CP would more closely visually monitor actions with their affected hand, compared to both their less affected hand and to control participants without a sensorimotor impairment. A second, more speculative hypothesis was that, in relation to previously established deficits in prospective action control in individuals with hemiparetic CP, gaze patterns might be less anticipatory in general, also during actions performed with the less affected hand. Analysis of the gaze and hand movement data revealed the increased visual monitoring of participants with CP when using their affected hand at the beginning as well as during object transport. In contrast, no general deficit in anticipatory gaze control in the participants with hemiparetic CP could be observed. Collectively, these findings are the first to directly show that individuals with hemiparetic CP adapt eyeâhand coordination to the specific constraints of the moving limb, presumably to compensate for sensorimotor deficits
âAffordancesâ: a notion that reveals how artificial it is to separate the body and its environment
International audienc
Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: a modelling study
Abstract
BACKGROUND:
Hepatitis C virus (HCV) is a leading cause of liver-related morbidity and mortality worldwide. In the European Union (EU), treatment and cure of HCV with direct-acting antiviral therapies began in 2014. WHO targets are to achieve a 65% reduction in liver-related deaths, a 90% reduction of new viral hepatitis infections, and 90% of patients with viral hepatitis infections being diagnosed by 2030. This study assessed the prevalence of HCV in the EU and the level of intervention required to achieve WHO targets for HCV elimination.
METHODS:
We populated country Markov models for the 28 EU countries through a literature search of PubMed and Embase between Jan 1, 2000, and March 31, 2016, and a Delphi process to gain expert consensus and validate inputs. We aggregated country models to create a regional EU model. We used the EU model to forecast HCV disease progression (considering the effect of immigration) and developed a strategy to acehive WHO targets. We used weighted average sustained viral response rates and fibrosis restrictions to model the effect of current therapeutic guidelines. We used the EU model to forecast HCV disease progression (considering the effect of immigration) under current screening and therapeutic guidelines. Additionally, we back-calculated the total number of patients needing to be screened and treated to achieve WHO targets.
FINDINGS:
We estimated the number of viraemic HCV infections in 2015 to be 3â238â000 (95% uncertainty interval [UI] 2â106â000-3â795â000) of a total population of 509â868â000 in the EU, equating to a prevalence of viraemic HCV of 0·64% (95% UI 0·41-0·74). We estimated that 1â180â000 (95% UI 1â003â000-1â357â000) people were diagnosed with viraemia (36·4%), 150â000 (12â000-180â000) were treated (4·6% of the total infected population or 12·7% of the diagnosed population), 133â000 (106â000-160â000) were cured (4·1%), and 57â900 (43â900-67â300) were newly infected (1·8%) in 2015. Additionally, 30â400 (26â600-42â500) HCV-positive immigrants entered the EU. To achieve WHO targets, unrestricted treatment needs to increase from 150â000 patients in 2015 to 187â000 patients in 2025 and diagnosis needs to increase from 88â800 new cases annually in 2015 to 180â000 in 2025.
INTERPRETATION:
Given its advanced health-care infrastructure, the EU is uniquely poised to eliminate HCV; however, expansion of screening programmes is essential to increase treatment to achieve the WHO targets. A united effort, grounded in sound epidemiological evidence, will also be necessary