Importance of diagnostics in epidemic and pandemic preparedness.

Diagnostics are fundamental for successful outbreak containment. In this supplement, 'Diagnostic preparedness for WHO Blueprint pathogens', we describe specific diagnostic challenges presented by selected priority pathogens most likely to cause future epidemics. Some challenges to diagnostic preparedness are common to all outbreak situations, as highlighted by recent outbreaks of Ebola, Zika and yellow fever. In this article, we review these overarching challenges and explore potential solutions. Challenges include fragmented and unreliable funding pathways, limited access to specimens and reagents, inadequate diagnostic testing capacity at both national and community levels of healthcare and lack of incentives for companies to develop and manufacture diagnostics for priority pathogens during non-outbreak periods. Addressing these challenges in an efficient and effective way will require multiple stakeholders-public and private-coordinated in implementing a holistic approach to diagnostics preparedness. All require strengthening of healthcare system diagnostic capacity (including surveillance and education of healthcare workers), establishment of sustainable financing and market strategies and integration of diagnostics with existing mechanisms. Identifying overlaps in diagnostic development needs across different priority pathogens would allow more timely and cost-effective use of resources than a pathogen by pathogen approach; target product profiles for diagnostics should be refined accordingly. We recommend the establishment of a global forum to bring together representatives from all key stakeholders required for the response to develop a coordinated implementation plan. In addition, we should explore if and how existing mechanisms to address challenges to the vaccines sector, such as Coalition for Epidemic Preparedness Innovations and Gavi, could be expanded to cover diagnostics

Time events coding , about schizophrenic patients disorders

Certains psychiatres décrivent une fragmentation de la perception du temps chez les patients schizophrènes. Nous avons voulu objectiver dans notre travail leurs troubles de la perception du temps. Nous avons d'abord mesuré la fenêtre temporelle chez 18 patients et 18 contrôles. La fenêtre temporelle est définie comme l'intervalle de temps nécessaire pour percevoir que 2 stimuli sont séparés dans le temps. Nous avons montré que les patients ont une fenêtre temporelle élargie. Les patients présentent donc des altérations du jugement temporel explicite. Ces résultats sont indépendants d'un biais de décision et de la présentation des cibles dans deux hémichamps différents. Nous nous sommes intéressés par ailleurs aux réponses des sujets pour des asynchronies très faibles. A ces délais, les sujets ne peuvent pas rendre compte des asynchronies, mais nos résultats suggèrent qu il existe néanmoins un traitement du signal par les voies visuelles à un niveau implicite. Les deux stimuli seraient traités dans une succession temporelle par les volontaires sains alors que les patients traiteraient isolément le premier stimulus sans tenir compte de la présentation du second. Ce résultat semble être l'indice d'une fragmentation, et persiste en l'absence de fragmentation spatiale. Ces résultats suggèrent une fragmentation temporelle chez les patients qui pourrait être en lien avec des difficultés à anticiper les évènements dans le temps. En conclusion, nous avons montré une dissociation des troubles implicites et explicites du codage des évènements dans le temps, qui pourraient impliquer des troubles élémentaires de l'anticipation.Psychiatrists described a temporal fragmentation at a clinical level in patients with schizophrenia. In our work, we wanted to objectify such an alteration. We measured the temporal window in 18 patients versus 18 controls. The temporal window is defined as the interval needed to discriminate the onsets of two asynchronous stimuli. We found that patients with schizophrenia have an enlarged time window. Patients thus show temporal explicit judgments impairments. These results are independent of a decision bias and are similar when targets are located across hemifields or within the same hemifield. Furthermore, we focused on patients and healthy volunteers responses at very short asynchronies. At short asynchronies, subjects are not able to report the asynchrony between stimuli and give the same rate of simultaneous responses as for perfect synchrony. Despite this, our results suggest an implicit processing of the asynchrony. It is as if the two stimuli are processed relative to one another in healthy volunteers, whereas patients would process each stimulus in turn: patients would process the first stimulus as isolated without taking into account the second one. We proposed that this result indicates a fragmentation in time in patients with schizophrenia. We showed that this fragmentation persists in the absence of spatial fragmentation. This fragmentation in patients might be related to a difficulty in anticipating events in time. In conclusion, we showed a dissociation between implicit and explicit disorders related to the coding of temporal events in patients with schizophrenia. These disorders might involve elementary anticipation deficits

Études des mécanismes physiopathologiques cognitifs des troubles addictifs

Psychologi

Time events coding , about schizophrenic patients disorders

Certains psychiatres décrivent une fragmentation de la perception du temps chez les patients schizophrènes. Nous avons voulu objectiver dans notre travail leurs troubles de la perception du temps. Nous avons d'abord mesuré la fenêtre temporelle chez 18 paPsychiatrists described a temporal fragmentation at a clinical level in patients with schizophrenia. In our work, we wanted to objectify such an alteration. We measured the temporal window in 18 patients versus 18 controls. The temporal window is define