Human-centred Design Workshops in Collaborative Strategic Design Projects: An educational and professional comparison

It has been found that the implementation of Human-centred Design (HCD) methods in the Fuzzy Front-End is not likely to lead to diversification in educational product planning exercises, where time lines are short and executors lack experience. Companies, interested to collaborate with Master-level Industrial Design students on strategic design projects, should have realistic ambitions with respect to innovation and value creation. Moreover, diversification is not the only generic growth strategy to gain competitive advantage. Value can also be created from developing new products for existing markets, or creating new markets for existing products. On the contrary, companies who aim for diversification in their generic growth strategies, may not always end up with a complementary ‘high valued’ design outcome. From a learning perspective, the understanding of HCD methods created awareness among students and companies that respect and empathy for the end-user are important for enriching their design processes, and as such increasing the chances for diversification in subsequent projects with clients. This study also compares the implementation of Human-Centred Design (HCD) methods in a professional /collaborative and an educational/collaborative strategic design project

Addition of PEG-interferon to long-term nucleos(t)ide analogue therapy enhances HBsAg decline and clearance in HBeAg-negative chronic hepatitis B:Multicentre Randomized Trial (PAS Study)

We studied whether 48 weeks of PEG-IFN alfa-2a add-on increases HBsAg-decline and clearance in HBeAg-negative patients on long-term nucleo(s)tide analogue (NA) therapy. In this investigator-initiated, randomized, controlled trial conducted in Europe and Canada, HBeAg-negative patients treated with NA &gt; 12 months, with HBVDNA &lt; 200 IU/mL, were enrolled. Patients were randomized 2:1 to 48 weeks of PEG-IFN alfa-2a add-on (180 μg per week) or continued NA-monotherapy with subsequent follow-up to Week 72. Endpoints were HBsAg decline (≥1 log10 IU/mL) and HBsAg clearance at Week 48. Of the 86 patients in the modified-intention-to-treat analysis, 58 patients received PEG-IFN add-on, and 28 continued NA monotherapy. At Week 48, 16(28%) patients achieved HBsAg decline ≥1 log10 in the add-on arm versus none on NA-monotherapy (p &lt;.001), and HBsAg clearance was observed in 6 (10%) PEG-IFN add-on patients versus 0% NA-monotherapy (p =.01). HBVRNA was only detected in 2% after PEG-IFN treatment versus 19% in NA-monotherapy (p =.002) at Week 48. PEG-IFN add-on therapy was well tolerated in majority of patients. Low baseline HBsAg levels (&lt;10 IU/mL) identified patients most likely to achieve HBsAg loss with PEG-IFN add-on, whereas an HBsAg level &gt; 200 IU/mL at on-treatment Week 12 was highly predictive of non-response (NPV = 100%). Addition of PEG-IFN to long-term NA enhanced HBsAg decline and increased the chance of HBsAg clearance in HBeAg-negative patients on long-term NA. On-treatment HBsAg levels &gt;200 IU/mL identify patients unlikely to benefit from PEG-IFN add-on and could be used as a potential stopping-rule for PEG-IFN therapy. Our findings support further exploration of immune modulation add-on to antiviral therapy, preferably using response-guided strategies, to increase functional cure rates in patients with CHB.</p

Acetazolamide for the prophylaxis of migraine in CADASIL: a preliminary experience

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy caused by NOTCH3 mutations. It is characterized by migraine, with or without aura, ischemic events, psychiatric and cognitive disturbances. There is no approved treatment for migraine prophylaxis in CADASIL, but acetazolamide has been anecdotally reported to be effective. We retrospectively reviewed our database of patients with a genetic diagnosis of CADASIL to identify how many of them were treated with acetazolamide for the prophylaxis of migraine. The efficacy and the tolerability of this treatment were checked looking at the clinic reports. Acetazolamide was prescribed in seven patients; the mean duration of treatment was 6 months, and the daily dose ranged from 125 to 500 mg. Three patients had a total and sustained remission, while in two patients a reduction in attacks and an improvement of the headache intensity were recorded. In one of these, acetazolamide was deliberately taken only during the migraine attack and the beneficial effect started 1 h after administration. In two patients, the drug did not produce any beneficial effect. Mild side effects were recorded in two patients. Our preliminary experience expands previous reports and confirms the possible efficacy of acetazolamide in CADASIL migraine. Based on these data, a randomized controlled trial seems worthy to be carried out to test the efficacy and safety of this drug

Addition of PEG-interferon to long-term nucleos(t)ide analogue therapy enhances HBsAg decline and clearance in HBeAg-negative chronic hepatitis B: Multicentre Randomized Trial (PAS Study)

We studied whether 48 weeks of PEG-IFN alfa-2a add-on increases HBsAg-decline and clearance in HBeAg-negative patients on long-term nucleo(s)tide analogue (NA) therapy. In this investigator-initiated, randomized, controlled trial conducted in Europe and Canada, HBeAg-negative patients treated with NA > 12 months, with HBVDNA 200 IU/mL at on-treatment Week 12 was highly predictive of non-response (NPV = 100%). Addition of PEG-IFN to long-term NA enhanced HBsAg decline and increased the chance of HBsAg clearance in HBeAg-negative patients on long-term NA. On-treatment HBsAg levels >200 IU/mL identify patients unlikely to benefit from PEG-IFN add-on and could be used as a potential stopping-rule for PEG-IFN therapy. Our findings support further exploration of immune modulation add-on to antiviral therapy, preferably using response-guided strategies, to increase functional cure rates in patients with CHB

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

A framework for prospective ergonomics : comparative studies of strategic design and prospective ergonomics based on 12 cases

Cette thèse sur travaux traite des différences, similarités et relations entre l'ergonomie prospective (EP) et le Design Stratégique (DS). Son cadre théorique met en relation de l'EP et le DS à travers différents prismes d'analyse: des théories de gestion, des modèles d'innovation, des stratégies de raisonnement en design, des démarches et interventions en ergonomie. Ce cadre de comparaison cherche à définir les modes de raisonnement en œuvre en conception (normatif, par résolution de problème, herméneutique, réflexif, participatif, social) qui contribuent à la compréhension des pratiques et à la création de valeur. Puis viennent les questions de recherche qui visent à positionner l'EP par apport aux sciences du design d'une part, et, à en préciser les contours par rapport aux autres formes d'interventions ergonomiques, d'autre part. Les résultats portent sur une analyse comparée de 12 cas d'intervention en ergonomie corrective, préventive et prospective dans les domaines du transport, de la vie quotidienne, de l'enseignement, des systèmes d'aménagement intérieur, d'élevage des poissons, et plus globalement de projets d'innovation. Les résultats indiquent que l'innovation fondée sur l'EP cherche à mettre l'accent sur un équilibre entre, à la fois, la recherche de la rentabilité et du profit, la réalisation du bien-être social et humain, ainsi que la satisfaction des intérêts personnels et collectifs. Les résultats montrent également que l'ergonomie prospective amène les entreprises à plus se connecter aux stratégies « push-pull » que ne le fait l'ergonomie corrective ou préventive. Enfin, les résultats tendent à souligner que les approches normative et positiviste devraient être complétées par des approches plus constructivistes, créatives et réflexives, qui prennent en considération la création de valeur proposée par l'EP. La discussion suggère des améliorations pour les pratiques d’EP et DSThis dissertation argues for a prospective turn in ergonomics to challenge the established fields of strategic design (SD) and management. Differences, similarities and relationships between strategic design and prospective ergonomics are being reviewed using existing theories and frameworks from design, ergonomics, strategic and innovation management. To complement the theoretical part, 12 cases have been analysed in greater depth according to 4 main dimensions of analysis. Outcomes have ishown that innovating through PE approach is about finding the right balance between on one hand meeting primary objectives, such as profit maximisation or solving the design problem, and on the other hand achieving social and human well-being, personal interest and ambitions, family relations, etc. Intervention of prospective ergonomics within a classical strategy perspective requires organizations to couple push-pull market strategies while considering the interest of different stakeholders throughout all stages of the development process. This means that prescriptive approaches, methods and tools in the positivist mode should be complemented with constructive modes of reasoning and designing as well as reflective methods and tools, while taking into consideration all levels and perspectives of value creation. From an educational perspective, the transfer of design knowledge and skills requires a mentorship and scholarship approach in research-, or practice-based learning, which implies a hermeneutic, reflective and participatory mode of design reasoning within a constructivist worldvie