Capitalisation et réutilisation avec des patrons dans un cadre d'Ingénierie Système Basée sur les Modèles (ISBM)

International audienceIn order to promote capitalization and reuse within a Model-Based System Engineering (MBSE) framework, this paper proposes a methodological approach that relies on the concept of pattern in order to encapsulate the know-how to be capitalized and reused. Indeed, formalizing and maintaining know-how within a company is essential in order to have a common base of "good practices" available to all engineering teams. To do this, it is necessary to undertake a capitalization process in order to encapsulate these practices. However, it is equally important to make this know-how available and to facilitate its reuse so that engineers can adapt it to their needs. The flexibility of patterns during reuse is an advantage that will contribute to the efficiency of MBSE and where engineering teams are able to rely on the company's know-how

Comparaison des performances de deux saturomètres chez des patients de réanimation

POITIERS-BU Médecine pharmacie (861942103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Impact du changement de code couleur différenciant les seringues d'anesthésie sur l'incidence des erreurs d'injection au bloc opératoire

POITIERS-BU Médecine pharmacie (861942103) / SudocSudocFranceF

Towards model-based systems engineering (MBSE) patterns to efficiently reuse know-how

International audienceKnow-how reuse is an approach that has been always used by engineers to take advantage of their accumulated knowledge and practices. But, the difficulty to formalize and reuse expert know-how is increasing alongside the complexity of systems. To deal with this challenge, this paper aims at opening the way to new approaches of know-how reuse, in order to improve engineering activities. For that purpose, it explores the capabilities of three reuse approaches (commercial off-the-shelf (COTS), set-based design and patterns), and their ability to be linked with a Model-Based Systems Engineering framework

Towards a maturity assessment scale for the Systems Engineering assets valorization to facilitate Model-Based Systems Engineering adoption

International audienceCONTEXT AND OBJECTIVES In the context of engineering practices transition from a document-based approach towards Model-Based Systems Engineering (MBSE) approaches, it is necessary to demonstrate to end-users how MBSE will help them design their system, even if their daily routines are disrupted. However, unlike engineering practices that can change, engineer's know-how is sustainable and remains key to the development of good systems. For that purpose, previous works have shown the relevance of patterns for the capture of engineering assets and their valorization through reuse (Wu et al. 2018). Yet, it appears that the current trend to adopt MBSE methodologies (Figure 1) does not make enough sense for engineers to take the leap towards these new approaches (Huldt and Stenius 2018), as the gap with engineering practices is too significant. Figure 1. Current trend for the adoption of MBSE methodologies Unlike the current trend to capitalize on know-how after a development in MBSE, the adoption process should consider engineer's know-how before rushing towards modelling (Figure 2). In the proposed approach the process starts by extracting System Engineering (SE) patterns. Among them, some will meet the needs of engineering teams more than others. It is therefore these patterns who will be modelled and integrated into an MBSE approach. This approach allows engineering teams to choose the patterns that will have the most added value for them, and thus facilitate the adoption of MBSE methodologies. Figure 2. Proposed approach for the adoption of MBSE methodologies The aim of this article is to propose a scale to evaluate the maturity of the valorization of Systems Engineering assets. This paper assumes that this valorization process consists in the highlighting of valuable engineers' know-how to be disseminated to other engineers at the time and at the level of comprehension needed. It means that, if the final goal is to reuse SE assets, other processes are necessary to achieve these expectations. As promoted in the softwar

Capitalisation et réutilisation sous la forme de patrons dans une démarche d'Ingénierie Système Basée sur les Modèles (ISBM) - Proposition de l'approche Minage-Maturation-Implémentation (MMI)

National audienceLa maîtrise du savoir-faire au sein d'une entreprise est essentielle afin de disposer d'une base commune de « bonnes pratiques » disponible pour toutes les équipes d'ingénierie. Pour cela, il est nécessaire d'entreprendre une démarche de capitalisation afin d'encapsuler ces pratiques. Cependant, il est tout aussi important de rendre disponible l'accès à ce savoir-faire et d'en faciliter sa réutilisation afin que chaque ingénieur puisse se l'approprier. Afin de répondre à ce besoin de capitalisation et de réutilisation, nous proposons une approche méthodologique qui permet d'entreprendre cette démarche dans un cadre d'Ingénierie Système Basée sur les Modèles (ISBM), et qui entend s'appuyer sur le concept de « patron » afin d'encapsuler le savoir-faire à capitaliser. En effet, la flexibilité des patrons lors de la réutilisation est un avantage qui participera à l'efficience d'une ISBM où les équipes d'ingénierie sont capables de s'appuyer sur le savoir-faire de l'entreprise

Capitalisation et réutilisation sous la forme de patrons dans une démarche d'Ingénierie Système Basée sur les Modèles (ISBM) - Proposition de l'approche Minage-Maturation-Implémentation (MMI)

National audienceLa maîtrise du savoir-faire au sein d'une entreprise est essentielle afin de disposer d'une base commune de « bonnes pratiques » disponible pour toutes les équipes d'ingénierie. Pour cela, il est nécessaire d'entreprendre une démarche de capitalisation afin d'encapsuler ces pratiques. Cependant, il est tout aussi important de rendre disponible l'accès à ce savoir-faire et d'en faciliter sa réutilisation afin que chaque ingénieur puisse se l'approprier. Afin de répondre à ce besoin de capitalisation et de réutilisation, nous proposons une approche méthodologique qui permet d'entreprendre cette démarche dans un cadre d'Ingénierie Système Basée sur les Modèles (ISBM), et qui entend s'appuyer sur le concept de « patron » afin d'encapsuler le savoir-faire à capitaliser. En effet, la flexibilité des patrons lors de la réutilisation est un avantage qui participera à l'efficience d'une ISBM où les équipes d'ingénierie sont capables de s'appuyer sur le savoir-faire de l'entreprise

Accuracy of a continuous noninvasive hemoglobin monitor in intensive care unit patients*

International audienc

A tailored multicomponent program to reduce discomfort in critically ill patients: a cluster-randomized controlled trial

International audiencePurpose: Critically ill patients are exposed to stressful conditions and experience several discomforts. The primary objective was to assess whether a tailored multicomponent program is effective for reducing self-perceived discomfort.Methods: In a cluster-randomized two-arm parallel trial, 34 French adult intensive care units (ICUs) without planned interventions to reduce discomfort were randomized, 17 to the arm including a 6-month period of program implementation followed by a 6-month period without the program (experimental group), and 17 to the arm with an inversed sequence (control group). The tailored multicomponent program consisted of assessment of ICU-related self-perceived discomforts, immediate and monthly feedback to healthcare teams, and site-specific tailored interventions. The primary outcome was the overall discomfort score derived from the 16-item IPREA questionnaire (0, minimal, 100, maximal overall discomfort) and the secondary outcomes were the discomfort scores of each IPREA item. IPREA was administered on the day of ICU discharge with a considered timeframe from the ICU admission until ICU discharge.Results: During a 1-month assessment period, 398 and 360 patients were included in the experimental group and the control group, respectively. The difference (experimental minus control) of the overall discomfort score between groups was - 7.00 (95% CI - 9.89 to - 4.11, p < 0.001). After adjustment (age, gender, ICU duration, mechanical ventilation duration, and type of admission), the program effect was still positive for the overall discomfort score (difference - 6.35, SE 1.23, p < 0.001) and for 12 out of 16 items.Conclusions: This tailored multicomponent program decreased self-perceived discomfort in adult critically ill patients

Non-invasive ventilation alternating with high-flow nasal oxygen versus high-flow nasal oxygen alone after extubation in COPD patients: a post hoc analysis of a randomized controlled trial

International audienceAbstract Background Several randomized clinical trials have shown that non-invasive ventilation (NIV) applied immediately after extubation may prevent reintubation in patients at high-risk of extubation failure. However, most of studies included patients with chronic respiratory disorders as well as patients without underlying respiratory disease. To date, no study has shown decreased risk of reintubation with prophylactic NIV after extubation among patients with chronic obstructive pulmonary disease (COPD). We hypothesized that prophylactic NIV after extubation may decrease the risk of reintubation in COPD patients as compared with high-flow nasal oxygen. We performed a post hoc subgroup analysis of COPD patients included in a multicenter, randomized, controlled trial comparing prophylactic use of NIV alternating with high-flow nasal oxygen versus high-flow nasal oxygen alone immediately after extubation. Results Among the 651 patients included in the original study, 150 (23%) had underlying COPD including 86 patients treated with NIV alternating with high-flow nasal oxygen and 64 patients treated with high-flow nasal oxygen alone . The reintubation rate was 13% (11 out of 86 patients) with NIV and 27% (17 out of 64 patients) with high-flow nasal oxygen alone [difference, − 14% (95% CI − 27% to − 1%); p = 0.03]. Whereas reintubation rates were significantly lower with NIV than with high-flow nasal oxygen alone at 72 h and until ICU discharge, mortality in ICU did not differ between groups: 6% (5/86) with NIV vs. 9% (6/64) with high-flow nasal oxygen alone [difference − 4% (95% CI − 14% to 5%); p = 0.40]. Conclusions In COPD patients, prophylactic NIV alternating with high-flow nasal oxygen significantly decreased the risk of reintubation compared with high-flow nasal oxygen alone. Trial registration The study was registered at http://www.clinicaltrials.gov with the trial registration number NCT03121482 (20 April 2017