Design of the Observing System Simulation Experiments with multi-platform in situ data and impact on fine- scale structures

This report presents the work plan of the Task 2.3: Observing System Simulation Experiments: impact of multi-platform observations for the validation of satellite observation

Dermatoses neutrophiliques du dos des mains

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Feasibility of Automated Propofol Sedation for Transcatheter Aortic Valve Implantation

International audienceBACKGROUND:Recently, several trials have shown that closed-loop sedation is feasible. No study has used automated sedation in extremely frail patients, such as those scheduled for transcatheter aortic valve implantation (TAVI). We developed and tested a novel automated sedation system for this kind of population and surgery. The system integrates a decision support system that detects respiratory and hemodynamic events via smart alarms, which provide pertinent/related clinical suggestions and treatment options. The main objective was the feasibility of closed-loop sedation, defined as successful automated sedation without manual override. Secondary qualitative observations were clinical and controller performance.METHODS:Twenty patients scheduled for elective TAVI were enrolled. Sedation was administered via a closed-loop delivery system designed for propofol. The clinical performance of sedation was the efficacy to maintain a bispectral index (BIS) of 65. To evaluate the sedation performance, BIS values were stratified into 4 categories: excellent, very good, good, and inadequate sedation control, defined as BIS values within 10%, ranging from 11% to 20%, ranging from 21% to 30%, or >30% from the target value, respectively. The controller performance was calculated using Varvel parameters. Critical respiratory and hemodynamic events were documented. The former was defined as peripheral oxygen saturation <92% and/or respiratory rate <8/min, whereas the latter was considered a mean arterial pressure <60 mm Hg and/or heart rate <40 bpm.RESULTS:Automated sedation was successful in 19 patients undergoing TAVI. One patient was excluded from the final analysis because of conversion to general anesthesia. The secondary observations revealed that the clinical performance allowed an excellent to good control during 69% (99% confidence interval, 53%-77%; interquartile range, 59%-79%) of the sedation time. Fifteen patients presented critical respiratory episodes, with a median of 3 events per hour of sedation. Six patients presented critical hemodynamic episodes, with a median of 2 events per hour of procedure.CONCLUSIONS:The automated closed-loop sedation system tested could be used successfully for patients scheduled for a TAVI procedure. The results showed a satisfactory clinical performance of sedation control

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International audienc

Atrial Natriuretic Peptide as an indicator of the severity of valvular regurgitation and heart failure in horses

peer reviewedNatriuretic peptides are cardiac biomarkers, routinely used for diagnosis, prognosis, and guidance for treatment in human and small animal cardiology. However, their diagnostic and prognostic value in horses has received little study. The aim of this study was to investigate the plasma atrial natriuretic concentration (ANPPl) in a large group of horses with various degrees of valvular regurgitation (VR) and congestive heart failure (CHF). Clinical examination and two-dimensional, time-motion mode and Doppler echocardiography were performed on 91 horses admitted to the Equine Teaching Hospital of Liege University, with either no, mild, moderate or severe VR and presenting various stages of CHF. ANPPl was measured using a commercially available human RIA test. Mean values of body weight, age, ANPPl and echocardiographic parameters were compared between horses with no, mild, moderate and severe VR and between horses in different CHF stages. Correlation and linear regression of ANPPl with each echocardiographic parameter and with the percentage of dilation of each of cardiac chambers were assessed. Horses with severe or moderate VR had significantly higher ANPPl than horses with mild or no VR. ANPPl was significantly higher in horses presenting CHF than in horses without CHF. ANPPl was significantly correlated with the left atrial diameter and its percentage of dilation. These results suggest a diagnostic value of ANPPl in horses with VR, especially with tricuspid or mitral insufficiency with dilation of the atria

Atrial Natriuretic Peptide in cardiac horses

peer reviewedBackground: Natriuretic peptides are cardiac biomarkers that have been shown to have high potential for diagnosis, prognosis, and guidance of treatment in human and small animal cardiology. However, their diagnostic and prognosis value in the equine species has only been studied in a limited number of cases. Objective: To investigate the plasma atrial natriuretic peptide concentration (ANPPl) in a large group of horses with various degrees of valvular regurgitation (VR) and heart failure (HF). Animals: Ninety-one horses, admitted at the equine teaching hospital of the University of Liege, and with no, mild, moderate or severe VR and presenting various stages of HF, according to human and canine grading system (A: no VR, B1: asymptomatic VR without cardiac remodelling, B2: asymptomatic VR with cardiac remodelling, C: symptomatic VR). Methods: All horses underwent clinical and Doppler echocardiographic examination, which allowed determining the presence, nature, and severity of VR, and the HF stage. The ANPPl was measured using a commercially available human RIA test. The mean values of body weight, age, ANPPl and each echocardiographic parameter were compared between horses in stage A, B1, B2 or C of HF and between horses with no, mild, moderate or severe VR, using a one-way ANOVA test. Then, correlations between ANPPl and each echocardiographic parameter were assessed using a Pearson’s product-moment analysis. Results: Horses with severe and moderate VR had significantly higher ANPPl than horses with mild or no VR. ANPPl was significantly higher in horses at stage B2 and C of HF than horses at stage A and B1. Moreover, ANPPl was significantly correlated with most of the measured echocardiographic variables. This correlation was especially strong with the left atrial diameter and its percentage of dilation. Conclusions and Clinical Importance: Those results suggest that ANPPl in horses suffering from VR could have a high diagnostic value of HF, especially in horses with tricuspid or mitral insufficiency and with enlargement or dysfunction of the atria

ANSO study: Evaluation in an indoor environment of a mobile assistance robotic grasping arm

International audienceObjectiveTo evaluate the reliability and functional acceptability of the “Synthetic Autonomous Majordomo” (SAM) robotic aid system (a mobile Neobotix base equipped with a semi-automatic vision interface and a Manus robotic arm).Materials and methodsAn open, multicentre, controlled study. We included 29 tetraplegic patients (23 patients with spinal cord injuries, 3 with locked-in syndrome and 4 with other disorders; mean ± SD age: 37.83 ± 13.3) and 34 control participants (mean ± SD age: 32.44 ± 11.2). The reliability of the user interface was evaluated in three multi-step scenarios: selection of the room in which the object to be retrieved was located (in the presence or absence of visual control by the user), selection of the object to be retrieved, the grasping of the object itself and the robot's return to the user with the object. A questionnaire was used to assess the robot's user acceptability.ResultsThe SAM system was stable and reliable: both patients and control participants experienced few failures when completing the various stages of the scenarios. The graphic interface was effective for selecting and grasping the object – even in the absence of visual control. Users and carers were generally satisfied with SAM, although only a quarter of patients said that they would consider using the robot in their activities of daily living.ObjectifÉvaluation de la fiabilité et de l’acceptabilité de l’usage d’un robot mobile d’assistance, Synthetic Autonomous Majordomo (SAM) composé d’une base mobile Néobotix avec bras télémanipulateur Manus, doté d’une interface de saisie automatique d’objet.Patients et méthodesÉtude multicentrique ouverte contrôlée sous l’égide de l’association APPROCHE. Vingt-neuf patients tétraplégiques d’âge moyen 37,83 ± 13,3 : 23 blessés médullaires, 2 Locked In Syndrome, 4 autres pathologies. Trente-quatre sujets témoins d’âge moyen 32,44 ± 11,2. La fiabilité de l’interface graphique du système de commande a été évaluée à travers 3 scénarii comportant différentes étapes : désignation de la pièce où se trouve l’objet, déplacement de SAM vers l’objet, désignation de l’objet à saisir avec ou sans contrôle visuel, saisie automatique de l’objet, déclenchement du retour de SAM. L’usage du robot et son acceptabilité ont été évalués par un questionnaire.RésultatsLe système est stable et fiable : il y a peu d’échec dans la réalisation des différentes étapes des scénarii aussi bien pour les patients que pour les témoins. L’interface graphique est efficace pour la désignation et la saisie de l’objet. SAM a été bien accueilli par tous les utilisateurs patients et thérapeutes. Mais seuls les patients envisageraient un transfert de l’utilisation du robot en vie quotidienne