Les directives psychiatriques anticipées (DPA) et le rôle de l’autonomie

Bien que les directives psychiatriques anticipées (DPA) soient ancrées dans l’éthique de l’autonomie, le lien entre les deux reste imprécis. Les DPA sont des documents juridiques qui permettent aux personnes qui vivent avec un problème de santé mentale de spécifier leurs préférences de traitement advenant une incapacité future. Le rapport entre l’autonomie et les DPA a été abordé en termes tant légaux et éthiques que philosophiques, mais il n’a pas été clairement opérationnalisé sur le plan clinique. L’autonomie est une valeur éthique fondamentale qui englobe la notion d’indépendance face à des influences contrôlantes externes, ainsi que la capacité mentale de prendre ses propres décisions. Les personnes qui vivent avec un problème de santé mentale ont parfois besoin d’aide pour bien comprendre leurs droits éthiques et juridiques en matière de choix autonome, alors que les intervenants professionnels doivent être mieux formés quant à l’importance de l’autonomie dans leur pratique clinique. La capacité de consentir au traitement est le préalable d’ordre mental qui assure que les personnes ayant des troubles mentaux sont en mesure de rédiger des DPA en toute connaissance de cause, alors que l’autonomie est la valeur qui leur donne le pouvoir de contribuer à leur rétablissement.Although psychiatric advance directives (PADs) are grounded in the ethics of autonomy, the relationship between the two is unclear. PADs are legal documents that allow individuals with mental illness to record their treatment preferences should they become incompetent in the future. The relationship between autonomy and PADs has been discussed in ethical, legal, and philosophical terms, but has not been clearly operationalized for clinical purposes. Autonomy is a fundamental ethical value that includes having the independence from outside controlling influences and the mental capacity to direct one’s personal actions. Individuals with mental illness sometimes require assistance to understand their ethical and legal rights with respect to autonomous choice, and professional stakeholders need education regarding the importance of autonomy for clinical practice. Competency to consent to treatment is the mental prerequisite that ensures individuals with mental illness are able to complete PADs with insight, whereas autonomy is the value that empowers individuals to work towards their recovery.Aunque las directivas psiquiátricas anticipadas (DPA) se encuentran ancladas en la ética de la autonomía, la relación entre ambas es imprecisa. Las DPA son documentos jurídicos que permiten a las personas que viven con un problema de salud mental especificar sus preferencias de tratamiento en el caso de una incapacidad futura. La relación entre la autonomía y las DPA se aborda en términos tanto legales y éticos como filosóficos, pero no ha sido claramente puesta en operación en el plan clínico. La autonomía es un valor ético fundamental que engloba la noción de independencia frente a las influencias controladoras externas, así como la capacidad mental de tomar sus propias decisiones. Las personas que viven con un problema de salud mental en ocasiones necesitan ayuda para comprender sus derechos éticos y jurídicos en materia de elección autónoma, mientras que los interventores profesionales deben tener una mejor formación en cuanto a la importancia de la autonomía en la práctica clínica. La capacidad de consentir al tratamiento es la condición mental previa que asegura que las personas con trastornos mentales están en condiciones de redactar las DPA con todo conocimiento de causa. La autonomía les otorga el poder de contribuir a su restablecimiento.Apesar das Diretrizes Psiquiátricas Antecipadas (DPA) estarem enraizadas na ética da autonomia, o elo entre os dois ainda é vago. As DPA são documentos jurídicos que permitem às pessoas, que vivem com um problema de saúde mental, especificar suas preferências de tratamento no caso de uma inaptidão futura. A relação entre a autonomia e as DPA foi abordada em termos tanto legais e éticos quanto filosóficos, mas não foi claramente operacionalizada no plano clínico. A autonomia é um valor ético fundamental que engloba a noção de independência diante das influências controladoras externas, assim como a capacidade mental de tomar suas próprias decisões. As pessoas que vivem com um problema de saúde mental precisam, às vezes, de ajuda para compreender bem seus direitos éticos e jurídicos no que diz respeito à escolha autônoma, ao passo que os profissionais devem ser melhor formados quanto à importância da autonomia em sua prática clínica. A capacidade de consentir no tratamento é o requisito de ordem mental que garante que as pessoas que possuem transtornos mentais sejam capazes de redigir suas DPA em conhecimento de causa, já que a autonomia é o valor que lhes dá o poder de contribuir para seu próprio restabelecimento

Stereopsis in sports: Visual skills and visuomotor integration models in professional and non-professional athletes

Visual skills in sport are considered relevant variables of athletic performance. However, data on the specific contribution of stereopsis—as the ability to perceive depth—in sport performance are still scarce and scattered in the literature. The aim of this review is therefore to take stock of the effects of stereopsis on the athletic performance, also looking at the training tools to improve visual abilities and potential differences in the visuomotor integration processes of professional and non-professional athletes. Dynamic stereopsis is mainly involved in catching or interceptive actions of ball sports, whereas strategic sports use different visual skills (peripheral and spatial vision) due to the sport-specific requirements. As expected, professional athletes show better visual skills as compared to non-professionals. However, both non-professional and professional athletes should train their visual skills by using sensory stations and light boards systems. Non-professional athletes use the visual inputs as the main method for programming motor gestures. In contrast, professional athletes integrate visual information with sport expertise, thus, they encode the match (or the athletic performance) through a more complex visuomotor integration system. Although studies on visual skills and stereopsis in sports still appear to be in their early stages, they show a large potential for both scientific knowledge and technical development

Strangeness production in heavy ion collisions at SPS and RHIC within two-source statistical model

The experimental data on hadron yields and ratios in central Pb+Pb and Au+Au collisions at SPS and RHIC energies, respectively, are analysed within a two-source statistical model of an ideal hadron gas. These two sources represent the expanding system of colliding heavy ions, where the hot central fireball is embedded in a larger but cooler fireball. The volume of the central source increases with rising bombarding energy. Results of the two-source model fit to RHIC experimental data at midrapidity coincide with the results of the one-source thermal model fit, indicating the formation of an extended fireball, which is three times larger than the corresponding core at SPS.Comment: Talk at "Strange Quarks in Matter" Conference (Strangeness'2001), September 2001, Frankfurt a.M., German

lmeEEG: Mass linear mixed-effects modeling of EEG data with crossed random effects

Background: Mixed-effects models are the current standard for the analysis of behavioral studies in psycholinguistics and related fields, given their ability to simultaneously model crossed random effects for subjects and items. However, they are hardly applied in neuroimaging and psychophysiology, where the use of mass univariate analyses in combination with permutation testing would be too computationally demanding to be practicable with mixed models. New method: Here, we propose and validate an analytical strategy that enables the use of linear mixed models (LMM) with crossed random intercepts in mass univariate analyses of EEG data (lmeEEG). It avoids the unfeasible computational costs that would arise from massive permutation testing with LMM using a simple solution: removing random-effects contributions from EEG data and performing mass univariate linear analysis and permutations on the obtained marginal EEG. Results: lmeEEG showed excellent performance properties in terms of power and false positive rate. Comparison with existing methods: lmeEEG overcomes the computational costs of standard available approaches (our method was indeed more than 300 times faster). Conclusions: lmeEEG allows researchers to use mixed models with EEG mass univariate analyses. Thanks to the possibility offered by the method described here, we anticipate that LMM will become increasingly important in neuroscience. Data and codes are available at osf.io/kw87a. The codes and a tutorial are also available at github.com/antovis86/lmeEEG

Buffering Adaptive Immunity by Hydrogen Sulfide

Abstract: T cell-mediated adaptive immunity is designed to respond to non-self antigens and pathogens through the activation and proliferation of various T cell populations. T helper 1 (Th1), Th2, Th17 and Treg cells finely orchestrate cellular responses through a plethora of paracrine and autocrine stimuli that include cytokines, autacoids, and hormones. Hydrogen sulfide (H2S) is one of these mediators able to induce/inhibit immunological responses, playing a role in inflammatory and autoimmune diseases, neurological disorders, asthma, acute pancreatitis, and sepsis. Both endogenous and exogenous H2S modulate numerous important cell signaling pathways. In monocytes, polymorphonuclear, and T cells H2S impacts on activation, survival, proliferation, polarization, adhesion pathways, and modulates cytokine production and sensitivity to chemokines. Here, we offer a comprehensive review on the role of H2S as a natural buffer able to maintain over time a functional balance between Th1, Th2, Th17 and Treg immunological responses

Colonização micorrízica e crescimento da videira (Vitis vinifera, Porta-Enxerto P1103) em solo com alto teor de cobre.

A aplicação de fungicidas cúpricos em vinhedos aumenta o teor de Cu no solo, potencializando a toxidez para a videira. Entretanto, tem sido relatado que os fungos micorrízicos arbusculares (FMA) podem propiciar efeito protetor às plantas em solos contendo excesso de metais pesados. O trabalho objetivou avaliar a colonização micorrízica e o crescimento da videira (porta-enxerto P1103) em solo contendo elevados teores de Cu. Avaliou-se seis tratamentos de inoculação com FMA (Dentiscutata heterogama, Gigaspora gigantea, Acaulospora morrowiae, A. colombiana, Rhizophagus clarus e R. irregularis), além de um não inoculado. Verificou-se que a colonização micorrízica da videira foi elevada (média de 33%), mesmo em solo contendo excesso de Cu. A inoculação dos isolados de FMA testados pouco influenciou o crescimento da videira, mas a inoculação com R. irregulares e R. clarus beneficiou a produção de massa seca das raízes das mudas.Resumo expandido

Upper limb soft robotic wearable devices: a systematic review

Introduction: Soft robotic wearable devices, referred to as exosuits, can be a valid alternative to rigid exoskeletons when it comes to daily upper limb support. Indeed, their inherent flexibility improves comfort, usability, and portability while not constraining the user’s natural degrees of freedom. This review is meant to guide the reader in understanding the current approaches across all design and production steps that might be exploited when developing an upper limb robotic exosuit. Methods: The literature research regarding such devices was conducted in PubMed, Scopus, and Web of Science. The investigated features are the intended scenario, type of actuation, supported degrees of freedom, low-level control, high-level control with a focus on intention detection, technology readiness level, and type of experiments conducted to evaluate the device. Results: A total of 105 articles were collected, describing 69 different devices. Devices were grouped according to their actuation type. More than 80% of devices are meant either for rehabilitation, assistance, or both. The most exploited actuation types are pneumatic (52%) and DC motors with cable transmission (29%). Most devices actuate 1 (56%) or 2 (28%) degrees of freedom, and the most targeted joints are the elbow and the shoulder. Intention detection strategies are implemented in 33% of the suits and include the use of switches and buttons, IMUs, stretch and bending sensors, EMG and EEG measurements. Most devices (75%) score a technology readiness level of 4 or 5. Conclusion: Although few devices can be considered ready to reach the market, exosuits show very high potential for the assistance of daily activities. Clinical trials exploiting shared evaluation metrics are needed to assess the effectiveness of upper limb exosuits on target users

Different waters for different performances: Can we imagine sport-related natural mineral spring waters?

Preserving the hydration status means to balance daily fluids and salt losses with gains, where the losses depend on several physiological and environmental factors. Especially for athletes, these losses could be relevant and negatively influence the performance: therefore, their hydro-saline status must be preserved with personalized pre-and rehydration plans all along the performance period. Scientific literature in this field is mainly dedicated to artificial sport drinks. Different territories in most world areas are rich in drinking natural mineral spring waters with saline compositions that reflect their geological origin and that are used for human health (often under medical prescription). However, scarce scientific attention has been dedicated to the use of these waters for athletes. We therefore reviewed the existing literature from the innovative viewpoint of matching spring water mineral compositions with different athletic performances and their hydro-saline requirements

Outcomes of balloon dilation for paediatric laryngeal stenosis.

Balloon dilation (BD) is a minimally invasive endoscopic treatment for paediatric laryngeal stenosis (LS) with reduced morbidity compared to open surgery. We retrospectively describe our experience in a cohort of children with chronic LS. Fourteen children (median age: 28.5; range: 2-81 months) with chronic LS (multilevel in 8) were treated with tubeless total intravenous anaesthesia under spontaneous ventilation. Grade III LS was preoperatively detected in 12 children; the remaining 2 had grade IV stenosis. Six had prior tracheotomy, and one received it during the first intervention. Dilation laryngoplasty was the primary treatment in 11 children and was used as an adjuvant treatment in 3 after open reconstructive surgery. The median number of dilations was 2 (range: 1-6). There were no postoperative complications. At the end of the follow-up (median: 20.5; range: 2-46 months), detectable laryngeal lumen widening and/or respiratory improvement occurred in 12 children. Two of 7 patients with tracheostomy were decannulated. Balloon laryngoplasty is a valuable therapeutic option to improve laryngeal patency in children with chronic multilevel LS, both as a primary and secondary adjuvant treatment after reconstructive surgery

role of evaluating tumor infiltrating lymphocytes programmed death ligand 1 and mismatch repair proteins expression in malignant mesothelioma

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