The Cost of Cochlear Implantation: A Review of Methodological Considerations

Objectives. Cost studies can provide useful guidance, so long as they adhere to accepted methodology. Cochlear implants (CIs) are electronic devices introduced surgically into the inner ear. It is a relevant example to review cost study analyses because of its costliness. The aim of this study was to review relevant published cost studies of CI to analyze the method used. Methods. First, we described the key points of cost study methodology. Cost studies relating to CI were systematically reviewed, focussing on an analysis of the different methods used. Results. The methods, data sources, and estimated cost categories in each study varied widely. The paper showed that cost studies adopted significantly different approaches to estimate costs of CI, reflecting a lack of consensus on the methodology of cost studies. Conclusion. To increase its credibility, closer agreement among researchers on the methodological principles of cost studies would be desirable

Analyse de variance à 2 facteurs imbriqués sur données de comptage - Application au contrôle de qualité

National audienceLe contrôle externe de qualité permet aux laboratoires chargés de l'analyse de l'environnement de vérifier, d'améliorer, et de maintenir en permanence un niveau optimal de leurs analyses. La méthode principalement utilisée pour la mise en oeuvre du contrôle externe de qualité est la comparaison interlaboratoires. En microbiologie, les mesures portent sur des dénombrements bactériens. Le caratère discret des données nécessite une méthode d'analyse de la variance spécifique. Nous proposons ici une méthode d'analyse de variance à deux facteurs fixes imbriqués sur données poissoniennes

Evaluation of reproducibility of tumor repositioning during multiple breathing cycles for liver stereotactic body radiotherapy treatment

AimTo evaluate the tumor repositioning during gated volumetric modulated arc therapy (VMAT) for liver stereotactic body radiotherapy(SBRT) treatment using implanted fiducial markers and intrafraction kilovoltage (kV) images acquired during dose delivery.Materials and methodsSince 2012, 47 liver cancer patients with implanted fiducial markers were treated using the gated VMAT technique with a Varian Truebeam STx linear accelerator. The fiducial markers were implanted inside or close to the tumor target before treatment simulation. They were defined at the maximum inhalation and exhalation phases on a 4-dimensionnal computed tomography (4DCT) acquisition. During the treatment, kV images were acquired just before the beam-on at each breathing cycle at maximum exhalation and inhalation phases to verify the fiducial markers positions. For the five first fractions of treatment in the first ten consecutive patients, a total of 2705 intrafraction kV images were retrospectively analyzed to assess the differences between expected and actual positions of the fiducial markers along the cranio-caudal (CC) direction during the exhalation phase.ResultsThe mean absolute intrafractional fiducial marker deviation along the CC direction was 1.0[[ce:hsp sp="0.25"/]]mm at the maximum exhalation phase. In 99%, 95% and 90% cases, the fiducial marker deviations were ≤4.5[[ce:hsp sp="0.25"/]]mm, 2.8[[ce:hsp sp="0.25"/]]mm and 2.2[[ce:hsp sp="0.25"/]]mm, respectively.ConclusionIntrafraction kV images allowed us to ensure the consistency of tumor repositioning during treatment. In 99% cases, the fiducial marker deviations were ≤4.5[[ce:hsp sp="0.25"/]]mm corresponding to our 5[[ce:hsp sp="0.25"/]]mm treatment margin. This margin seems to be well-adapted to the gated VMAT SBRT treatment in liver disease

Modified Vaccinia Virus Ankara Exerts Potent Immune Modulatory Activities in a Murine Model

Background: Modified vaccinia virus Ankara (MVA), a highly attenuated strain of vaccinia virus, has been used as vaccine delivery vector in preclinical and clinical studies against infectious diseases and malignancies. Here, we investigated whether an MVA which does not encode any antigen (Ag) could be exploited as adjuvant per se. Methodology/Principal Findings: We showed that dendritic cells infected in vitro with non-recombinant (nr) MVA expressed maturation and activation markers and were able to efficiently present exogenously pulsed Ag to T cells. In contrast to the dominant T helper (Th) 1 biased responses elicited against Ags produced by recombinant MVA vectors, the use of nrMVA as adjuvant for the co-administered soluble Ags resulted in a long lasting mixed Th1/Th2 responses. Conclusions/Significance: These findings open new ways to potentiate and modulate the immune responses to vaccin

La psychanalyse et Foucault, un chassé-croisé

Dans une journée d’études inauguratrice d’une recherche en commun, l’un d’entre nous se demandait si Foucault était incontournable pour les études sur le genre et les sexualités. D’un côté, bien qu’omniprésent, il ne l’est pas. D’autres approches des sexualités ont été développées, notamment dans le féminisme matérialiste, qui ne lui doivent rien – par exemple, les travaux de Monique Wittig sur La pensée Straight (1992) ou ceux de Gail Pheterson sur Le prisme de la prostitution (1996). Foucau..

Modèle Linéaire Généralisé Hiérarchique Gamma-Poisson à 3 facteurs aléatoires - Application au contrôle de qualité

National audienceIdeally, bacterial counts in an homogeneous phase is represented by the Poisson distribution. However, practicly, dispersion of results of counts have proved to be higher than the dispersion expected from the Poisson model. We propose here a Poisson-Gamma Hierarchical Generalized Linear Model, with three random factors, in order to estimate the amounts of dispersion induced by the different factors of a proficiency test.Le dénombrement de particules dans une phase homog ene est idéalement représenté par la loi de Poisson. En pratique, il s'av ere pourtant que la dispersion des résultats de dénombrements de germes est supérieurè a celle attendue d'apr es le mod ele de Poisson. Nous proposons dans ce travail un Mod ele Linéaire Généralisé Hiérarchique Gamma-Poisson a trois facteurs aléatoires permettant d'estimer les dispersions induites par les différents facteurs d'un essai interlaboratoires

L’immunité adaptative : activation et polarisation des lymphocytes T. Chapitre 11

International audienc