Les phénomènes de dépendance à l’environnement: réflexions sur l’autonomie humaine à partir de la clinique neurologique

Dans cet article, nous proposons d’analyser la perte d’autonomie caractérisée par les phénomènes de dépendance à l’environnement observés chez certains patients neurologiques présentant des lésions des lobes frontaux. Des propositions théoriques issues de la neuropsychologie cognitive et de la théorie de la médiation sont développées et confrontées. La démarche offre l’occasion, au plan théorique, de questionner la détérioration possible du système de la personne suite à des lésions cérébrales et, au plan méthodologique, d’interroger notre manière d’examiner ces patients en confrontant les modèles théoriques aux observations clinique

Ergologie : développements théoriques et mise à l’épreuve clinique

The aim of this work is to propose a systematic synthesis of « Théorie De la Mediation’s » theoretical propositions on the « Tool model » and to take a few more steps forward. To do this, I propose a confrontation and a discussion of the « photofits pictures » resulting from theory with clinical observation of supposedly « atechnical  » patients

Apraxia and Alzheimer’s Disease: Review and Perspectives

Apraxia is one of the cognitive deficits that characterizes Alzheimer\u27s disease. Despite its prevalence and relevance to diagnosing Alzheimer\u27s disease, this topic has received little attention and is without comprehensive review. The review herein is aimed to fill this gap by first presenting an overview of the impairment caused in different clinical situations: pantomime of tool use, single tool use, real tool use, mechanical problem solving, function and manipulation knowledge tasks, and symbolic/meaningless gestures. On the basis of these results, we then propose alternative interpretations regarding the nature of the underlying mechanisms impaired by the disease. Also presented are principal methodological issues precluding firm conclusions from being drawn

Apraxia of tool use: more evidence for the technical reasoning hypothesis

Various distinct cognitive processes such as semantic memory, executive planning or technical reasoning have been shown to support tool use. The aim of this study is to investigate the relationship between these processes. To do so, a large apraxia battery was submitted to 16 patients with left brain-damage (LBD) and aphasia and 19 healthy controls. The battery included: classical apraxia tests (Pantomime of Tool Use and Single Tool Use), familiar and novel tool use tests (Tool-Object Pairs and Sequential Mechanical Problem-Solving), semantic memory tests (Recognition of tool utilization gestures and Functional and Categorical Associations) as well as the Tower Of London. The Sequential Mechanical Problem-Solving task is a new task which permits the evaluation of pre-planning in unusual tool use situations. In this task as well as in the Tool-Object Pairs task, participants solved a tool use problem in a Choice and a No-Choice condition to examine the effect of tool selection. Globally, left brain damaged patients were impaired as compared to controls. We found high correlations in left brain damaged patients between performances on classical apraxia tests, familiar and novel tool use tests and Functional and Categorical Associations but no significant association between these performances and Tower Of London or Recognition of tool utilization gestures. Furthermore, the two conditions (Choice and No-Choice) of Tool-Object Pairs and Sequential Mechanical Problem-Solving were associated. In sum, all tasks involving tool use are strongly associated in LBD patients. Moreover, the ability to solve sequential mechanical problems does not depend on executive planning. Also, tool use appears to be associated with knowledge about object function but not with knowledge about tool manipulation. Taken together, these findings indicate that technical reasoning and, to a lesser extent, semantic memory may both play an important role in tool use

Bt maize: a tool for improving food safety of grains at harvest

A new EU (European Union) regulation came into force in 2007 with Regulation (EC) No. 1126/2007 which established maximum levels for fumonisins B1 and B2 (4000 ppb), deoxynivalenol (1750 ppb) and zearalenone (350 ppb) in maize and maize products. In order to evaluate French maize food safety, studies were carried out by the national Biological Risk Monitoring (BRM) Network. In this study, field trials involving 84 plots were conducted with Bt maize (MON 810) and its isogenic non-Bt counterpart in 2005 and 2006 in South-western France. Mycotoxin levels were determined in grain at harvest. Fumonisins B1 and B2, deoxynivalenol, and zearalenone were analyzed by LC-MS-MS and the results treated statistically using non parametric tests for mycotoxins and analysis of variance test for weather variables. As the climate was homogenous inside the experimental area, the transgenic event introduced into the maize was the only key parameter which differed between Bt and non-Bt maize plots. Our results showed that all mycotoxin families were not impacted in the same way. The efficacy of Bt maize reduced mycotoxins more than 90% for fumonisins and more than 50% for zearalenone although deoxynivalenol was lightly increased. Therefore a competition between the different Fusarium spp. which produced fumonisins or trichothecenes is hypothesized. According to Regulation (EC) No. 1126/2007, 93% of the maize of Bt maize plots were able to be commercialized compared to only 45% for non-Bt maize plots. The results of this work showed that Bt maize improved food safety and constituted an useful tool to reduce significantly mycotoxin levels in harvested and stored grains. Keywords: Bt (MON810) maize, Fumonisins B1 and B2, Deoxynivalenol (DON), Zearalenone, EC regulation 1126/2007 threshold

Different constraints on grip selection in brain-damaged patients: Object use versus object transport

The present study discusses the presence of different constraints on action selection during object use versus object transport. Sixteen left brain-damaged (LBD) patients, 10 right brain-damaged (RBD) and 35 healthy controls were examined on a grip preference test consisting of a grasping-to-transport and a grasping-to-use condition. Assessment included a general praxis testing (pantomime production, object utilization gesture recognition and object use). We also reported the case of a close-head injury patient (DR) with an atypical behavioural pattern. Our results supported the different constraint hypothesis. While several LBD and RBD patients performed inappropriate grips in the grasping-to-transport condition, only two patients (L2 and DR) used inappropriate grips in the grasping-to-use condition. No correlation was found between the two conditions of the grip preference test and measures of the general praxis testing. The discussion focuses on the nature of constraints on grip selection during object use and object transport

Fast Monte Carlo Simulation for Patient-specific CT/CBCT Imaging Dose Calculation

Recently, X-ray imaging dose from computed tomography (CT) or cone beam CT (CBCT) scans has become a serious concern. Patient-specific imaging dose calculation has been proposed for the purpose of dose management. While Monte Carlo (MC) dose calculation can be quite accurate for this purpose, it suffers from low computational efficiency. In response to this problem, we have successfully developed a MC dose calculation package, gCTD, on GPU architecture under the NVIDIA CUDA platform for fast and accurate estimation of the x-ray imaging dose received by a patient during a CT or CBCT scan. Techniques have been developed particularly for the GPU architecture to achieve high computational efficiency. Dose calculations using CBCT scanning geometry in a homogeneous water phantom and a heterogeneous Zubal head phantom have shown good agreement between gCTD and EGSnrc, indicating the accuracy of our code. In terms of improved efficiency, it is found that gCTD attains a speed-up of ~400 times in the homogeneous water phantom and ~76.6 times in the Zubal phantom compared to EGSnrc. As for absolute computation time, imaging dose calculation for the Zubal phantom can be accomplished in ~17 sec with the average relative standard deviation of 0.4%. Though our gCTD code has been developed and tested in the context of CBCT scans, with simple modification of geometry it can be used for assessing imaging dose in CT scans as well.Comment: 18 pages, 7 figures, and 1 tabl

De l’instrument à l’outil. Réflexions sur les concepts d’improvisation et de pérennité

I- Introduction II- De l\u27instrument à l\u27Outil III- Utilisation d\u27objets et usage : une étude de cas IV- Utilisation non-usuelle d\u27objets et atechnie V- Techniques d\u27improvisation VI- L\u27Outil produit l\u27Ouvrage, la Personne conserve l\u27Usage VII- Pénomènes de fusion et acte d\u27improvisation VIII- Empirie et magie, des visées techniques IX- Conclusio

Item reduction of the patient-rated wrist evaluation using decision tree modelling

© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: The aim of this study is to assess the viability of a decision tree version of an often used questionnaire to measure wrist pain and disability, the Patient Rated Wrist Evaluation. Methods: Patient Rated Wrist Evaluation scores were collected from a cohort of 10394 patients who are part of a routine outcome measurement system. A decision tree version of the Patient Rated Wrist Evaluation (PRWE) was created. The intraclass correlation was used to evaluate the inter-version reliability between the original PRWE and the decision tree version. Results: The decision tree reduced the number of questions from 5 to 3 for the pain subscale, and from 10 to 3 for the disability subscale. The intraclass correlation between the original PRWE and the decision tree version was 0.97. The mean difference between the Patient Rated Wrist Evaluation and the decision tree Patient Rated Wrist Evaluation total sumscore was 0.35 (95% CI −9.92–10.62). Conclusions: We found that the decision tree was successful at reducing the items of the Patient Rated Wrist Evaluation from fifteen to only six questions with very high similarity to the scores of the full questionnaire.Implications for rehabilitation The Patient Rated Wrist Evaluation can reliably be used with 6 instead of 15 questions. Decision trees are useful statistical tools to shorten lengthy questionnaires, especially when large amounts of data are available. Having a shortened Patient Rated Wrist Evaluation saves patients and clinicians time in answering this specific questionnaire