Comparison of two paradigms based on stimulation with images in a spelling brain-computer interface.

A BCI Speller is a typical Brain-Computer Interface (BCI) system for communication purposes. This technology can provide users with severe motor disability with an assistive device controlled by brain activity. The present preliminary study, with only four subjects, is focused on the control of a 5x5 P300-based speller matrix for communication purposes. In this work, we study the effect of flashing stimuli used to highlight the letters in two conditions: pictures and red famous faces (that is, famous faces coloured in red). These preliminary results, based on performance and the Information Transfer Rate (ITR), showed that both conditions are similar, obtaining very good performance compared to conventional P300-speller. In this sense, the use of pictures does not make the performance worse, allowing to develop more attractive and usable interfaces. More tests would confirm if there is a difference in performance between the two conditions proposed.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Comparison of Two Paradigms Based on Stimulation with Images in a Spelling Brain–Computer Interface

A P300-based speller can be used to control a home automation system via brain activity. Evaluation of the visual stimuli used in a P300-based speller is a common topic in the field of brain–computer interfaces (BCIs). The aim of the present work is to compare, using the usability approach, two types of stimuli that have provided high performance in previous studies. Twelve participants controlled a BCI under two conditions, which varied in terms of the type of stimulus employed: a red famous face surrounded by a white rectangle (RFW) and a range of neutral pictures (NPs). The usability approach included variables related to effectiveness (accuracy and information transfer rate), efficiency (stress and fatigue), and satisfaction (pleasantness and System Usability Scale and Affect Grid questionnaires). The results indicated that there were no significant differences in effectiveness, but the system that used NPs was reported as significantly more pleasant. Hence, since satisfaction variables should also be considered in systems that potential users are likely to employ regularly, the use of different NPs may be a more suitable option than the use of a single RFW for the development of a home automation system based on a visual P300-based speller.This work was partially supported by the project PID2021-127261OB-I00 (SICODIS), funded by MCIN (Ministerio de Ciencia e Innovación)/AEI (Agencia Estatal de Investigación)/10.13039/501100011033/FEDER, UE (Fondo Europeo de Desarrollo Regional). The work was also partially supported by the University of Málaga (Universidad de Málaga). Partial funding for open access charge: Universidad de Málag

Measuring benefits and patients' satisfaction when glasses are not needed after cataract and presbyopia surgery: scoring and psychometric validation of the Freedom from Glasses Value Scale (FGVS©)

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to reduce the number of items, create a scoring method and assess the psychometric properties of the Freedom from Glasses Value Scale (FGVS), which measures benefits of freedom from glasses perceived by cataract and presbyopic patients after multifocal intraocular lens (IOL) surgery.</p> <p>Methods</p> <p>The 21-item FGVS, developed simultaneously in French and Spanish, was administered by phone during an observational study to 152 French and 152 Spanish patients who had undergone cataract or presbyopia surgery at least 1 year before the study. Reduction of items and creation of the scoring method employed statistical methods (principal component analysis, multitrait analysis) and content analysis. Psychometric properties (validation of the structure, internal consistency reliability, and known-group validity) of the resulting version were assessed in the pooled population and per country.</p> <p>Results</p> <p>One item was deleted and 3 were kept but not aggregated in a dimension. The other 17 items were grouped into 2 dimensions ('global evaluation', 9 items; 'advantages', 8 items) and divided into 5 sub-dimensions, with higher scores indicating higher benefit of surgery. The structure was validated (good item convergent and discriminant validity). Internal consistency reliability was good for all dimensions and sub-dimensions (Cronbach's alphas above 0.70). The FGVS was able to discriminate between patients wearing glasses or not after surgery (higher scores for patients not wearing glasses). FGVS scores were significantly higher in Spain than France; however, the measure had similar psychometric performances in both countries.</p> <p>Conclusions</p> <p>The FGVS is a valid and reliable instrument measuring benefits of freedom from glasses perceived by cataract and presbyopic patients after multifocal IOL surgery.</p

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Multiciliated Cells in Animals.

International audienceMany animal cells assemble single cilia involved in motile and/or sensory functions. In contrast, multiciliated cells (MCCs) assemble up to 300 motile cilia that beat in a coordinate fashion to generate a directional fluid flow. In the human airways, the brain, and the oviduct, MCCs allow mucus clearance, cerebrospinal fluid circulation, and egg transportation, respectively. Impairment of MCC function leads to chronic respiratory infections and increased risks of hydrocephalus and female infertility. MCC differentiation during development or repair involves the activation of a regulatory cascade triggered by the inhibition of Notch activity in MCC progenitors. The downstream events include the simultaneous assembly of a large number of basal bodies (BBs)-from which cilia are nucleated-in the cytoplasm of the differentiating MCCs, their migration and docking at the plasma membrane associated to an important remodeling of the actin cytoskeleton, and the assembly and polarization of motile cilia. The direction of ciliary beating is coordinated both within cells and at the tissue level by a combination of planar polarity cues affecting BB position and hydrodynamic forces that are both generated and sensed by the cilia. Herein, we review the mechanisms controlling the specification and differentiation of MCCs and BB assembly and organization at the apical surface, as well as ciliary assembly and coordination in MCCs

Internet, santé et médecine générale (état des lieux en France en 2004)

L'extraordinaire essor d'Internet dans les dix dernières années a conquis le monde de la santé. Une multitude d'applications est désormais disponible aussi bien pour les médecins que pour les patients. Mais où en sommes nous exactement en 2004? C'est à cette question que nous avons voulu répondre. Le Web santé regorge de milliers de sites Web, d'origines et d'orientations très diverses. Les informations recueillies peuvent être d'une exhaustivité et d'une actualité sans commune mesure avec les autres sources d'information plus conventionnelles. Fiabilité et pertinence des réponses semblent néanmoins être les deux principaux points faibles qu'une éventuelle maturation du système et des utilisateurs devra savoir pallier. D'autres outils comme la messagerie, les forums et autres listes de discussion ont ouvert les portes à une nouvelle forme d'échanges et de communication entre les médecins d'un part, et entre les médecins et leurs patients d'autre part. Cela risque fort, du fait de leurs nombreux avantages d'être amené à se développer dans les prochaines années. Mais les deux authentiques révolutions de l'Internet santé du futur sont sans nul doute le développement de la Télémédecine et l'avènement, enfin, d'un vrai Dossier Médical de partage. Ce dernier proposé dans le cadre de la réforme de l'Assurance Maladie portera le nom de DMP et liera d'une façon durable la Santé à Internet. Ces différents points tendent à nous prouver que l'institution Internet Santé est l'affaire de demain mais ses fondements sont le chantier, capital, d'aujourd'hui.TOULOUSE3-BU Santé-Centrale (315552105) / SudocTOULOUSE3-BU Santé-Allées (315552109) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Régulation automatisée multi-objectif en temps réel d'une ligne suburbaine en zone dense

International audienceA l'instar des métros et suite à l'augmentation du trafic en milieu urbain, un intervalle temporel régulier entre les trains des lignes suburbaines devient désormais nécessaire. Les lignes suburbaines traversent des zones ouvertes. Par conséquent, il est aussi important de respecter les horaires théoriques des circulations sous peine de perturber le réseau environnant. Les lignes équipées d'un système de contrôle automatisé (ex : Communication Based Train Control System (CBTC)) permettent d'assurer une régulation en temps réel pour ajuster les horaires et l'intervalle temporel entre les trains lors de perturbations. Pour ce faire, le problème de train retiming est résolu sur une ligne équipée d'un système CBTC. De nouveaux horaires de départs et d'arrivées sont proposés pour optimiser la ponctualité et l'intervalle temporel.Une représentation microscopique, détaillant l'infrastructure ferroviaire et le fonctionnement des trains en station, est considérée dans une approche centralisée pour traiter simultanément toutes les stations de la ligne. Plusieurs fonctions multi-objectif sont testées dans le cadre d'une approche simulation-optimisation