Psychosocial correlates of rehabilitation from stroke: a longitudinal study

The general aim of this dissertation was to uncover the association between psychosocial factors and rehabilitation outcome after stroke. METHOD. A sample of patients with stroke (n=40) and their caregivers (n=36) were assessed at admission to and six months after discharge from rehabilitation hospital, using the following instruments: Structured Clinical Interview for DSM-IV, structured interview based on Diagnostic Criteria for Psychosomatic Research, Symptom Questionnaire, Psychosocial Index, Psychological Well-Being Scales, and Family Assessment Device. 40 subjects from the general population underwent the same psychological assessment. In addition, patients' functional status was measured using the Functional Independence Measure. RESULTS. Stroke survivors reported lower education and higher alcohol consumption than controls. No significant differences emerged between the two groups in the prevalence of psychiatric diagnoses or psychosomatic syndromes, however patients reported significantly higher levels of anxiety, depression, somatic symptoms, and lower autonomy than controls. Caregivers reported significantly higher scores in anxiety, depression, and somatic symptoms compared to normative data, while no impairments emerged in psychological well-being and family functioning. At six-month follow-up, in patients a significant decrease in smoking habit and an increase in DSM diagnoses were reported. Both stroke survivors and caregivers showed significant reductions in anxiety, with patients displaying also a decrease in somatic symptoms, an increase in stress and a deterioration in quality of life. Significant deteriorations in several aspects of family functioning was perceived only by patients. An association between patients' functional recovery in the cognitive domain and family behavior control emerged. For caregivers, family functioning significantly predicted hostility and somatic symptoms were associated with family affective involvement. CONCLUSIONS. These data highlight the utility in the Italian setting of the adoption of a psychosocial assessment and a family-systems approach in stroke rehabilitation, in order to development interventions properly targeted to the characteristics of patients and their family members

Projet BoxOffice : une initiative de modernisation des cabinets médicaux

National audienceRésumé non disponibl

DiagnoseNET: Automatic Framework to Scale Neural Networks on Heterogeneous Systems Applied to Medical Diagnosis

International audienceDetermine an optimal generalization model with deep neu-ral networks for a medical task is an expensive process that generally requires large amounts of data and computing power. Furthermore, scale deep learning workflows over a wide range of emerging heterogeneous system architecture increases the programming expressiveness complexity for model training and the computing orchestration. We introduce Diag-noseNET, a programming framework designed for scaling deep learning models over heterogeneous systems applied to medical diagnosis. It is designed as a modular framework to enable the deep learning workflow management and allows the expressiveness of neural networks written in TensorFlow, while its runtime abstracts the data locality, micro batch-ing and the distributed orchestration to scale the neural network model from a GPU workstation to multi-nodes. The main approach is composed through a set of gradient computation modes to adapt the neural network according to the memory capacity, the workers' number, the coordination method and the communication protocol (GRPC or MPI) for achieving a balance between accuracy and energy consumption. The experiments carried out allow to evaluate the computational performance in terms of accuracy, convergence time and worker scalability to determine an optimal neural architecture over a mini-cluster of Jetson TX2 nodes. These experiments were performed using two medical cases of study, the former dataset is composed by clinical descriptors collected during the first week of hospitalization of patients in the Provence-Alpes-Côte d'Azur region; the second dataset uses a short ECG records between 30 and 60 seconds, obtained as part of the PhysioNet 2017 Challenge

Combining Advanced Networked Technology and Pedagogical Methods to Improve Collaborative Distance Learning

Abstrac

Contribution of vegetables and cured meat to dietary nitrate and nitrite intake in Italian population: Safe level for cured meat and controversial role of vegetables

Nitrate and nitrite content was determined on a total of 900 samples of vegetables and cured meat and the nitrite and nitrate exposure assessment was evaluated for central Italy population based on the food consumption data reported by the national dietary surveys. The highest average content of nitrate was detected in rocket salad (4415 mg/kg) and radish (3817 mg/kg) and for cured meat in “Bresaola” (188 mg/kg) and in Bacon (178 mg/kg). The nitrite content was negligible both in vegetables than in cured meat. The average consumption among population resulted 3.45 g/kg bw/die and 0.62 g/kg bw/die for vegetables and cured meat respectively. The obtained data confirm that nitrate ADI was higher than the limits of 3.7 mg/kg bw/die for infants and was the highest exposure level for people of all ages. Cured meat consumption did not contribute to nitrate ADI exceedance neither as a mean nor as 99th percentile of exposure

Modelling home care organisations from an operations management perspective

Home Care (HC) service consists of providing care to patients in their homes. During the last decade, the HC service industry experienced significant growth in many European countries. This growth stems from several factors, such as governmental pressure to reduce healthcare costs, demographic changes related to population ageing, social changes, an increase in the number of patients that suffer from chronic illnesses, and the development of new home-based services and technologies. This study proposes a framework that will enable HC service providers to better understand HC operations and their management. The study identifies the main processes and decisions that relate to the field of HC operations management. Hence, an IDEF0 (Integrated Definition for Function Modelling) activity-based model describes the most relevant clinical, logistical and organisational processes associated with HC operations. A hierarchical framework for operations management decisions is also proposed. This analysis is derived from data that was collected by nine HC service providers, which are located in France and Italy, and focuses on the manner in which operations are run, as well as associated constraints, inputs and outputs. The most challenging research areas in the field of HC operations management are also discussed

hMSH5 is a nucleocytoplasmic shuttling protein whose stability depends on its subcellular localization

MSH5 is a MutS-homologous protein required for meiotic DNA recombination. In addition, recent studies suggest that the human MSH5 protein (hMSH5) participates to mitotic recombination and to the cellular response to DNA damage and thus raise the possibility that a tight control of hMSH5 function(s) may be important for genomic stability. With the aim to characterize mechanisms potentially involved in the regulation of hMSH5 activity, we investigated its intracellular trafficking properties. We demonstrate that hMSH5 possesses a CRM1-dependent nuclear export signal (NES) and a nuclear localization signal that participates to its nuclear targeting. Localization analysis of various mutated forms of hMSH5 by confocal microscopy indicates that hMSH5 shuttles between the nucleus and the cytoplasm. We also provide evidence suggesting that hMSH5 stability depends on its subcellular compartmentalization, hMSH5 being much less stable in the nucleus than in the cytoplasm. Together, these data suggest that hMSH5 activity may be regulated by nucleocytoplasmic shuttling and nuclear proteasomal degradation, both of these mechanisms contributing to the control of nuclear hMSH5 content. Moreover, data herein also support that in tissues where both hMSH5 and hMSH4 proteins are expressed, hMSH5 might be retained in the nucleus through masking of its NES by binding of hMSH4