11 research outputs found

    Intégration des véhicules intelligents dans un contexte multimodal

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    L’automatisation des vĂ©hicules (privĂ©s ou publics) est aujourd'hui devenue un enjeu majeur pour faire face aux besoins de mobilitĂ© de demain. L'automatisation ne cesse de croĂźtre et d'apporter davantage de confort aux utilisateurs (rĂ©gulation de vitesse, correction de trajectoire). "L'assistance Ă  la conduite” rime de plus en plus avec “conduite automatisĂ©e”, qui permet entre autres, d’assurer un certain niveau de sĂ©curitĂ© tout en fluidifiant le trafic grĂące Ă  l’anticipation des phases d’accĂ©lĂ©ration et de ralentissement. Le service de mobilitĂ© associĂ© s’en trouve ainsi plus fiable (ex: rĂ©duction des accidents grĂące Ă  des systĂšmes collaboratifs de dĂ©tection d’obstacle), plus respectueux de son environnement (ex: rĂ©duction des Ă©missions CO2 grĂące Ă  certains modes d’assistance Ă  la conduite) et plus efficace (ex: rĂ©duction des perturbations et des retards associĂ©s en limitant les facteurs humains). Le dĂ©veloppement et l’intĂ©gration de nombreux capteurs sont naturellement essentiels pour rendre ces vĂ©hicules plus intelligents, dans la mesure oĂč ces derniers peuvent communiquer entre eux ainsi qu’avec les infrastructures avoisinantes. Cette Ă©volution nĂ©cessite l'intĂ©gration de ces vĂ©hicules connectĂ©s, Ă  un systĂšme de transport multimodal afin d’exploiter au mieux leur performance et leur interaction. L’objet de notre intervention sera de prĂ©senter diffĂ©rents aspects d’intĂ©gration de vĂ©hicules intelligents dans un contexte multimodal. Nous Ă©voquerons dans un premier temps un projet de recherche rĂ©alisĂ© Ă  l’EPFL visant Ă  coordonner efficacement des vĂ©hicules autonomes aux carrefours en combinant des mĂ©thodes prĂ©dictives et rĂ©actives. Les approches de coordination seront validĂ©es sur des voitures rĂ©elles, avec un accent particulier portĂ© sur la cohabitation entre vĂ©hicules autonomes et traditionnels engagĂ©s dans les carrefours ou ronds-points engorgĂ©s. Dans un second temps, nous Ă©voquerons un projet de gestion de flotte pour la planification et l'exploitation de vĂ©hicules sans conducteur afin d’ĂȘtre intĂ©grĂ©s dans une plate-forme de logiciels et de coopĂ©rer avec des systĂšmes de transport existants. Une flotte de deux vĂ©hicules autonomes est actuellement exploitĂ©e en ville de Sion pour tester les algorithmes dĂ©veloppĂ©s par le laboratoire de systĂšme de transport urbain de l'EPFL. Ces algorithmes seront par la suite en mesure de fonctionner efficacement pour un grand nombre de vĂ©hicules autonomes dans de grands rĂ©seaux et Ă  plus grande Ă©chelle

    Digitizing Travel Experience: Assessing, Modeling and Visualizing the Experiences of Travelers in Shared Mobility Services

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    During shared travel, humans regularly have negative experiences resulting from unmet needs in terms of safety, comfort, accessibility, efficiency, reliability or information. Frequent negative travel experiences motivate travelers to use private motorized transport instead of more sustainable, shared mobility services. It is difficult for shared transport providers to react to such negative experiences, as these mostly depend on individual needs and situational factors and can therefore rarely be counteracted with static one-size-fits-all solutions. Additionally, (real-time) information about a traveler’s experience is not (digitally) available to providers and thus a situation-adapted reaction is often not possible. Therefore, methods to assess travel experience and make travel experience digitally available are highly important for enabling means to render shared transport more attractive. Here, we present initial research on digitizing travel experience exemplified by an envisioned automated shuttle line

    Interventions for preventing ophthalmia neonatorum.

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    BACKGROUND: Ophthalmia neonatorum is an infection of the eyes in newborns that can lead to blindness, particularly if the infection is caused by Neisseria gonorrhoeae. Antiseptic or antibiotic medication is dispensed into the eyes of newborns, or dispensed systemically, soon after delivery to prevent neonatal conjunctivitis and potential vision impairment. OBJECTIVES: 1. To determine if any type of systemic or topical eye medication is better than placebo or no prophylaxis in preventing ophthalmia neonatorum. 2. To determine if any one systemic or topical eye medication is better than any other medication in preventing ophthalmia neonatorum. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, LILACS, and three trials registers, date of last search 4 October 2019. We also searched references of included studies and contacted pharmaceutical companies.  SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials of any topical, systemic, or combination medical interventions used to prevent ophthalmia neonatorum in newborns compared with placebo, no prophylaxis, or with each other. DATA COLLECTION AND ANALYSIS: We used standard methods expected by Cochrane. Outcomes were: blindness or any adverse visual outcome at 12 months, conjunctivitis at 1 month (gonococcal (GC), chlamydial (CC), bacterial (BC), any aetiology (ACAE), or unknown aetiology (CUE)), and adverse effects.  MAIN RESULTS: We included 30 trials with a total of 79,198 neonates. Eighteen studies were conducted in high-income settings (the USA, Europe, Israel, Canada), and 12 were conducted in low- and middle-income settings (Africa, Iran, China, Indonesia, Mexico). Fifteen of the 30 studies were quasi-randomised. We judged every study to be at high risk of bias in at least one domain. Ten studies included a comparison arm with no prophylaxis. There were 14 different prophylactic regimens and 12 different medications in the 30 included studies. Any prophylaxis compared to no prophylaxis  Unless otherwise indicated, the following evidence comes from studies assessing one or more of the following interventions: tetracycline 1%, erythromycin 0.5%, povidone-iodine 2.5%, silver nitrate 1%. None of the studies reported data on the primary outcomes: blindness or any adverse visual outcome at any time point. There was only very low-certainty evidence on the risk of GC with prophylaxis (4/5340 newborns) compared to no prophylaxis (5/2889) at one month (risk ratio (RR) 0.79, 95% confidence interval (CI) 0.24 to 2.65, 3 studies). Low-certainty evidence suggested there may be little or no difference in effect on CC (RR 0.96, 95% CI 0.57 to 1.61, 4874 newborns, 2 studies) and BC (RR 0.84, 95% CI 0.37 to 1.93, 3685 newborns, 2 studies). Moderate-certainty evidence suggested a probable reduction in risk of ACAE at one month (RR 0.65, 95% 0.54 to 0.78, 9666 newborns, 8 studies assessing tetracycline 1%, erythromycin 0.5%, povidone-iodine 2.5%, silver nitrate 1%, colostrum, bacitracin-phenacaine ointment). There was only very low-certainty evidence on CUE  (RR 1.75, 95% CI 0.37 to 8.28, 330 newborns, 1 study). Very low-certainty evidence on adverse effects suggested no increased nasolacrimal duct obstruction (RR 0.93, 95% CI 0.68 to 1.28, 404 newborns, 1 study of erythromycin 0.5% and silver nitrate 1%) and no increased keratitis (single study of 40 newborns assessing silver nitrate 1% with no events).    Any prophylaxis compared to another prophylaxis Overall, evidence comparing different interventions did not suggest any consistently superior intervention. However, most of this evidence was of low-certainty and was extremely limited. AUTHORS' CONCLUSIONS: There are no data on whether prophylaxis for ophthalmia neonatorum prevents serious outcomes such as blindness or any adverse visual outcome. Moderate-certainty evidence suggests that the use of prophylaxis may lead to a reduction in the incidence of ACAE in newborns but the evidence for effect on GC, CC or BC was less certain. Comparison of individual interventions did not suggest any consistently superior intervention, but data were limited. A trial comparing tetracycline, povidone-iodine (single administration), and chloramphenicol for GC and CC could potentially provide the community with an effective, universally applicable prophylaxis against ophthalmia neonatorum

    Biomarkers of stroke recovery: consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable

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    The most difficult clinical questions in stroke rehabilitation are ‘‘What is this patient’s potential for recovery?’’ and ‘‘What is the best rehabilitation strategy for this person, given her/his clinical profile?’’ Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke

    Long-term randomized clinical trial evaluating the effects of fixture surface acid-etching and machined collar design on bone healing

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    Objectives: An implant with an acid-etched fixture surface and internal-hex collar may achieve greater osseointegration. The goal of this research was to study the effects on long-term bone healing of fixture surface acid-etching and machined collar design. Method and materials: Three two-part implant types were compared: standard BrĂ„nemark (with an external-hex 1.2 mm long machined flat collar), Swede-Vent (a copy of the BrĂ„nemark design, with an identical collar but a fixture surface acid-etched to 1 to 3 ”m), and Screw-Vent (with a fixture surface acid-etched identically to that of Swede-Vent, but a longer internal-hex machined flat collar that did not require countersinking). Fifty-eight subjects each received the three types in alternate fashion at five sites between mental foramen, and a fixed full-arch prosthesis. Abutment-implant interface/microgap (MG) was placed at the crest, and first bone-to-implant contact point-to microgap (fBIC-MG) was measured at mesial and distal sides of each implant. Mean fBIC-MG values were compared after 15 to 20 years of function. Statistical analysis was based on the mixed linear model with the level of significance set at P < .05 and Bonferroni correction for pairwise comparisons. Results: BrĂ„nemark had less mean marginal bone loss (-1.08 mm, standard error [SE] 0.20) compared with Swede-Vent (-1.28 mm, SE 0.20), but pairwise comparisons showed that the difference was not statistically significant (mean difference of 0.20 mm, P = .662). Screw-Vent had the greatest loss (-1.92 mm, SE 0.20), and pairwise comparisons showed that the difference was statistically significant compared with BrĂ„nemark and Swede-Vent (difference ≄ 0.64 mm, P < .001). Conclusion: According to accepted standards for osseointegration, all three implant types achieved very acceptable long-term results. However, while BrĂ„nemark had the least bone loss, the implant with the acid-etched fixture surface and longer internal-hex collar design had the greatest loss. Within the confines of this study, shorter collar length of 1.2 mm may be more important to limit long-term bone loss with microgap placed at the crest

    The end of an old hypothesis: the pseudomonas signaling molecules 4-hydroxy-2-alkylquinolines derive from fatty acids, not 3-ketofatty acids.

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    International audienceGroups of pathogenic bacteria use diffusible signals to regulate their virulence in a concerted manner. Pseudomonas aeruginosa uses 4-hydroxy-2-alkylquinolines (HAQs), including 4-hydroxy-2-heptylquinoline (HHQ) and 3,4-dihydroxy-2-heptylquinoline (PQS), as unique signals. We demonstrate that octanoic acid is directly incorporated into HHQ. This finding rules out the long-standing hypothesis that 3-ketofatty acids are the precursors of HAQs. We found that HAQ biosynthesis, which requires the PqsABCD enzymes, proceeds by a two-step pathway: (1) PqsD mediates the synthesis of 2-aminobenzoylacetate (2-ABA) from anthraniloyl-coenzyme A (CoA) and malonyl-CoA, then (2) the decarboxylating coupling of 2-ABA to an octanoate group linked to PqsC produces HHQ, the direct precursor of PQS. PqsB is tightly associated with PqsC and required for the second step. This finding uncovers promising targets for the development of specific antivirulence drugs to combat this opportunistic pathogen

    Characterization of high-grade prostate cancer at multiparametric MRI: assessment of PI-RADS version 2.1 and version 2 descriptors across 21 readers with varying experience (MULTI study)

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    International audienceAbstract Objective To assess PI-RADSv2.1 and PI-RADSv2 descriptors across readers with varying experience. Methods Twenty-one radiologists (7 experienced (≄ 5 years) seniors, 7 less experienced seniors and 7 juniors) assessed 240 ‘predefined’ lesions from 159 pre-biopsy multiparametric prostate MRIs. They specified their location (peripheral, transition or central zone) and size, and scored them using PI-RADSv2.1 and PI-RADSv2 descriptors. They also described and scored ‘additional’ lesions if needed. Per-lesion analysis assessed the ‘predefined’ lesions, using targeted biopsy as reference; per-lobe analysis included ‘predefined’ and ‘additional’ lesions, using combined systematic and targeted biopsy as reference. Areas under the curve (AUCs) quantified the performance in diagnosing clinically significant cancer (csPCa; ISUP ≄ 2 cancer). Kappa coefficients ( Îș ) or concordance correlation coefficients (CCC) assessed inter-reader agreement. Results At per-lesion analysis, inter-reader agreement on location and size was moderate-to-good ( Îș = 0.60–0.73) and excellent (CCC ≄ 0.80), respectively. Agreement on PI-RADSv2.1 scoring was moderate ( Îș = 0.43–0.47) for seniors and fair ( Îș = 0.39) for juniors. Using PI-RADSv2.1, juniors obtained a significantly lower AUC (0.74; 95% confidence interval [95%CI]: 0.70–0.79) than experienced seniors (0.80; 95%CI 0.76–0.84; p = 0.008) but not than less experienced seniors (0.74; 95%CI 0.70–0.78; p = 0.75). As compared to PI-RADSv2, PI-RADSv2.1 downgraded 17 lesions/reader (interquartile range [IQR]: 6–29), of which 2 (IQR: 1–3) were csPCa; it upgraded 4 lesions/reader (IQR: 2–7), of which 1 (IQR: 0–2) was csPCa. Per-lobe analysis, which included 60 (IQR: 25–73) ‘additional’ lesions/reader, yielded similar results. Conclusions Experience significantly impacted lesion characterization using PI-RADSv2.1 descriptors. As compared to PI-RADSv2, PI-RADSv2.1 tended to downgrade non-csPCa lesions, but this effect was small and variable across readers
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