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Saavedra-Mitjans M, Van der Maren S, Gosselin N, Duclos C, Frenette AJ, Arbour C, Burry L, Williams V, Bernard F, Williamson DR. Use of actigraphy for monitoring agitation and rest-activity cycles in patients with acute traumatic brain injury in the ICU. Brain Inj 2024:1-7. [PMID: 38635547 DOI: 10.1080/02699052.2024.2341323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/05/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND In traumatic brain injury patients (TBI) admitted to the intensive care unit (ICU), agitation can lead to accidental removal of catheters, devices as well as self-extubation and falls. Actigraphy could be a potential tool to continuously monitor agitation. The objectives of this study were to assess the feasibility of monitoring agitation with actigraphs and to compare activity levels in agitated and non-agitated critically ill TBI patients. METHODS Actigraphs were placed on patients' wrists; 24-hour monitoring was continued until ICU discharge or limitation of therapeutic efforts. Feasibility was assessed by actigraphy recording duration and missing activity count per day. RESULTS Data from 25 patients were analyzed. The mean number of completed day of actigraphy per patient was 6.5 ± 5.1. The mean missing activity count was 20.3 minutes (±81.7) per day. The mean level of activity measured by raw actigraphy counts per minute over 24 hours was higher in participants with agitation than without agitation. CONCLUSIONS This study supports the feasibility of actigraphy use in TBI patients in the ICU. In the acute phase of TBI, agitated patients have higher levels of activity, confirming the potential of actigraphy to monitor agitation.
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Affiliation(s)
- Mar Saavedra-Mitjans
- Faculté de Pharmacie, Université de Montréal, Montréal (Québec), Canada
- Research Centre, Centre intégré universitaire de Santé et de Services sociaux du Nord-de-l'île-de-Montréal, Montreal, Canada
| | - Solenne Van der Maren
- Center for Advanced Research in Sleep Medicine, Centre intégré universitaire de santé et de Services sociaux du Nord-de-l'île-de-Montréal, Montreal, Canada
- Département de Psychologie, Université de Montréal, Montréal (Québec), Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Centre intégré universitaire de santé et de Services sociaux du Nord-de-l'île-de-Montréal, Montreal, Canada
- Département de Psychologie, Université de Montréal, Montréal (Québec), Canada
| | - Catherine Duclos
- Center for Advanced Research in Sleep Medicine, Centre intégré universitaire de santé et de Services sociaux du Nord-de-l'île-de-Montréal, Montreal, Canada
- Department of Anesthesiology and Pain Medicine, Department of Neuroscience, Faculté de médecine, Université de Montréal, Montréal (Québec), Canada
- CIFAR Azrieli Global Scholars Program, Toronto, Canada
| | - Anne Julie Frenette
- Research Centre, Centre intégré universitaire de Santé et de Services sociaux du Nord-de-l'île-de-Montréal, Montreal, Canada
- Pharmacy Department, Centre intégré universitaire de santé et de Services sociaux du Nord-de-l'île-de-Montréal, Montreal, Canada
| | - Caroline Arbour
- Faculté de Pharmacie, Université de Montréal, Montréal (Québec), Canada
- Faculté de Sciences Infirmières, Université de Montréal, Montréal (Québec), Canada
| | - Lisa Burry
- Department of Pharmacy and Medicine, Sinai Health System, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Virginie Williams
- Faculté de Pharmacie, Université de Montréal, Montréal (Québec), Canada
| | - Francis Bernard
- Faculté de Pharmacie, Université de Montréal, Montréal (Québec), Canada
- Faculté de Médecine, Université de Montréal, Montréal (Québec), Canada
| | - David R Williamson
- Faculté de Pharmacie, Université de Montréal, Montréal (Québec), Canada
- Research Centre, Centre intégré universitaire de Santé et de Services sociaux du Nord-de-l'île-de-Montréal, Montreal, Canada
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Baril AA, Picard C, Labonté A, Sanchez E, Duclos C, Mohammediyan B, Breitner JCS, Villeneuve S, Poirier J. Longer sleep duration and neuroinflammation in at-risk elderly with a parental history of Alzheimer's disease. Sleep 2024:zsae081. [PMID: 38526098 DOI: 10.1093/sleep/zsae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Indexed: 03/26/2024] Open
Abstract
STUDY OBJECTIVES While short sleep could promote neurodegeneration, long sleep may be a marker of ongoing neurodegeneration, potentially as a result of neuroinflammation. The objective was to evaluate sleep patterns with age of expected Alzheimer's disease (AD) onset and neuroinflammation. METHODS We tested 203 dementia-free participants (68.5±5.4y/o, 78M). The PREVENT-AD cohort includes older persons with a parental history of AD whose age was nearing their expected AD onset. We estimated expected years to AD onset by subtracting the participant's age from their parent's at AD dementia onset. We extracted actigraphy sleep variables of interest (times of sleep onset and morning awakening, time in bed, sleep efficiency, sleep duration) and general profiles (sleep fragmentation, phase delay, hypersomnia). CSF inflammatory biomarkers were assessed with OLINK multiplex technology. RESULTS Proximity to, or exceeding, expected age of onset was associated with a sleep profile suggestive of hypersomnia (longer sleep, later morning awakening time). This hypersomnia sleep profile was associated with higher CSF neuroinflammatory biomarkers (IL-6, MCP-1, global score). Interactions analyses revealed that some of these sleep-neuroinflammation associations were present mostly in those closer/exceeding the age of expected AD onset, APOE4 carriers, and those with better memory performance. CONCLUSIONS Proximity to, or exceeding, parental AD dementia onset was associated with a longer sleep pattern, which was related to elevated proinflammatory CSF biomarkers. We speculate that longer sleep may serve a compensatory purpose potentially triggered by neuroinflammation as individuals are approaching AD onset. Further studies should investigate whether neuroinflammatory-triggered long sleep duration could mitigate cognitive deficits.
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Affiliation(s)
- Andrée-Ann Baril
- Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Canada
- Department of Medicine, Université de Montréal, Montréal, Canada
| | - Cynthia Picard
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Anne Labonté
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Erlan Sanchez
- Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Catherine Duclos
- Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Canada
- Department of Anesthesiology & Pain Medicine, Université de Montréal, Montréal, Canada
| | - Béry Mohammediyan
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - John C S Breitner
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Judes Poirier
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
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Laferrière-Langlois P, Morisson L, Jeffries S, Duclos C, Espitalier F, Richebé P. Depth of Anesthesia and Nociception Monitoring: Current State and Vision For 2050. Anesth Analg 2024; 138:295-307. [PMID: 38215709 DOI: 10.1213/ane.0000000000006860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
Anesthesia objectives have evolved into combining hypnosis, amnesia, analgesia, paralysis, and suppression of the sympathetic autonomic nervous system. Technological improvements have led to new monitoring strategies, aimed at translating a qualitative physiological state into quantitative metrics, but the optimal strategies for depth of anesthesia (DoA) and analgesia monitoring continue to stimulate debate. Historically, DoA monitoring used patient's movement as a surrogate of awareness. Pharmacokinetic models and metrics, including minimum alveolar concentration for inhaled anesthetics and target-controlled infusion models for intravenous anesthesia, provided further insights to clinicians, but electroencephalography and its derivatives (processed EEG; pEEG) offer the potential for personalization of anesthesia care. Current studies appear to affirm that pEEG monitoring decreases the quantity of anesthetics administered, diminishes postanesthesia care unit duration, and may reduce the occurrence of postoperative delirium (notwithstanding the difficulties of defining this condition). Major trials are underway to further elucidate the impact on postoperative cognitive dysfunction. In this manuscript, we discuss the Bispectral (BIS) index, Narcotrend monitor, Patient State Index, entropy-based monitoring, and Neurosense monitor, as well as middle latency evoked auditory potential, before exploring how these technologies could evolve in the upcoming years. In contrast to developments in pEEG monitors, nociception monitors remain by comparison underdeveloped and underutilized. Just as with anesthetic agents, excessive analgesia can lead to harmful side effects, whereas inadequate analgesia is associated with increased stress response, poorer hemodynamic conditions and coagulation, metabolic, and immune system dysregulation. Broadly, 3 distinct monitoring strategies have emerged: motor reflex, central nervous system, and autonomic nervous system monitoring. Generally, nociceptive monitors outperform basic clinical vital sign monitoring in reducing perioperative opioid use. This manuscript describes pupillometry, surgical pleth index, analgesia nociception index, and nociception level index, and suggest how future developments could impact their use. The final section of this review explores the profound implications of future monitoring technologies on anesthesiology practice and envisages 3 transformative scenarios: helping in creation of an optimal analgesic drug, the advent of bidirectional neuron-microelectronic interfaces, and the synergistic combination of hypnosis and virtual reality.
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Affiliation(s)
- Pascal Laferrière-Langlois
- From the Maisonneuve-Rosemont Research Center, CIUSSS de l'Est de L'Ile de Montréal, Montreal, Quebec, Canada
- Department of Anesthesiology and Pain Medicine, Montreal University, Montreal, Quebec, Canada
| | - Louis Morisson
- Department of Anesthesiology and Pain Medicine, Montreal University, Montreal, Quebec, Canada
| | - Sean Jeffries
- Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Catherine Duclos
- Department of Anesthesiology and Pain Medicine, Montreal University, Montreal, Quebec, Canada
| | - Fabien Espitalier
- Department of Anesthesia and Intensive Care, University Hospitals of Tours, Tours, France
| | - Philippe Richebé
- From the Maisonneuve-Rosemont Research Center, CIUSSS de l'Est de L'Ile de Montréal, Montreal, Quebec, Canada
- Department of Anesthesiology and Pain Medicine, Montreal University, Montreal, Quebec, Canada
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Baril A, Picard C, Labonté A, Sanchez E, Duclos C, Mohammediyan B, Ashton NJ, Zetterberg H, Blennow K, Breitner JCS, Villeneuve S, Poirier J. Day-to-day sleep variability with Alzheimer's biomarkers in at-risk elderly. Alzheimers Dement (Amst) 2024; 16:e12521. [PMID: 38371359 PMCID: PMC10870017 DOI: 10.1002/dad2.12521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Measuring day-to-day sleep variability might reveal unstable sleep-wake cycles reflecting neurodegenerative processes. We evaluated the association between Alzheimer's disease (AD) fluid biomarkers with day-to-day sleep variability. METHODS In the PREVENT-AD cohort, 203 dementia-free participants (age: 68.3 ± 5.4; 78 males) with a parental history of sporadic AD were tested with actigraphy and fluid biomarkers. Day-to-day variability (standard deviations over a week) was assessed for sleep midpoint, duration, efficiency, and nighttime activity count. RESULTS Lower cerebrospinal fluid (CSF) ApoE, higher CSF p-tau181/amyloid-β (Aβ)42, and higher plasma p-tau231/Aβ42 were associated with higher variability of sleep midpoint, sleep duration, and/or activity count. The associations between fluid biomarkers with greater sleep duration variability were especially observed in those that carried the APOE4 allele, mild cognitive impairment converters, or those with gray matter atrophy. DISCUSSION Day-to-day sleep variability were associated with biomarkers of AD in at-risk individuals, suggesting that unstable sleep promotes neurodegeneration or, conversely, that AD neuropathology disrupts sleep-wake cycles.
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Affiliation(s)
- Andrée‐Ann Baril
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Cynthia Picard
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Anne Labonté
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Erlan Sanchez
- Sunnybrook Research InstituteUniversity of TorontoTorontoOntarioCanada
| | - Catherine Duclos
- Hôpital du Sacré‐Coeur de MontréalCIUSSS‐NIMMontréalQuébecCanada
- Department of Anesthesiology and Pain MedicineUniversité de MontréalMontréalQuébecCanada
| | - Béry Mohammediyan
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Nicholas J. Ashton
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience & Physiologythe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- King's College LondonInstitute of PsychiatryPsychology and Neuroscience Maurice Wohl Institute Clinical Neuroscience InstituteLondonUK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS FoundationLondonUK
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience & Physiologythe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyQueen SquareLondonUK
- UK Dementia Research Institute at UCLLondonUK
- Hong Kong Center for Neurodegenerative DiseasesClear Water BayHong KongChina
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience & Physiologythe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - John C. S. Breitner
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Sylvia Villeneuve
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Judes Poirier
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
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Melot B, Drouet F, Alvarez C, Grimshaw C, Grosjean J, Duclos C. Automated ICD10-Coding of Teleconsultations Conclusions in Primary Care. Stud Health Technol Inform 2023; 309:135-136. [PMID: 37869824 DOI: 10.3233/shti230758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
The national teleconsultation platform Qare offers a promising tool to collect data in primary care by sharing the same EHR among teleconsultants. Conclusions for every teleconsultation are thus collected by a text using an ICD10 code or not. Nevertheless, the use of the ICD10 classification by primary care doctors is scarce. We developed an algorithm based on bags of words that associates an ICD10 code for each textual conclusion and evaluated it. It shows good performances (88 to 89% concordance) to assign ICD10 category. It could be used to enhance the volume of coded teleconsultations ready to be reused.
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Affiliation(s)
- Bénédicte Melot
- Qare, Paris, France
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, INSERM, F-93000, Bobigny, France
| | | | | | | | - Julie Grosjean
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, INSERM, F-93000, Bobigny, France
| | - Catherine Duclos
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, INSERM, F-93000, Bobigny, France
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Abstract
Organoids and specifically human cerebral organoids (HCOs) are one of the most relevant novelties in the field of biomedical research. Grown either from embryonic or induced pluripotent stem cells, HCOs can be used as in vitro three-dimensional models, mimicking the developmental process and organization of the developing human brain. Based on that, and despite their current limitations, it cannot be assumed that they will never at any stage of development manifest some rudimentary form of consciousness. In the absence of behavioral indicators of consciousness, the theoretical neurobiology of consciousness being applied to unresponsive brain-injured patients can be considered with respect to HCOs. In clinical neurology, it is difficult to discern a capacity for consciousness in unresponsive brain-injured patients who provide no behavioral indicators of consciousness. In such scenarios, a validated neurobiological theory of consciousness, which tells us what the neural mechanisms of consciousness are, could be used to identify a capacity for consciousness. Like the unresponsive patients that provide a diagnostic difficulty for neurologists, HCOs provide no behavioral indicators of consciousness. Therefore, this article discusses how three prominent neurobiological theories of consciousness apply to human cerebral organoids. From the perspective of the Temporal Circuit Hypothesis, the Global Neuronal Workspace Theory, and the Integrated Information Theory, we discuss what neuronal structures and functions might indicate that cerebral organoids have a neurobiological capacity to be conscious.
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Affiliation(s)
- Matthew Owen
- Philosophy Department, Yakima Valley College, Yakima, WA, USA
- Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA
| | - Zirui Huang
- Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Catherine Duclos
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montréal, QC, Canada
- Department of Neuroscience, Université de Montréal, Montréal, QC, Canada
- Centre for Advanced Research in Sleep Medicine, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Nord-de-l'île-de-Montréal, Montréal, QC, Canada
- CIFAR Azrieli Global Scholars Program, Toronto, ON, Canada
| | - Andrea Lavazza
- Centro Universitario Internazionale, Arezzo, Italy
- University of Pavia, Pavia, Italy
| | - Matteo Grasso
- Center for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Anthony G Hudetz
- Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
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Leclerc C, Gervais C, Hjeij D, Briand MM, Williamson D, Bernard F, Duclos C, Arbour C. Sleep Disruptions in Hospitalized Adults Sustaining a Traumatic Brain Injury: A Scoping Review. J Head Trauma Rehabil 2023:00001199-990000000-00108. [PMID: 37767918 DOI: 10.1097/htr.0000000000000899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
OBJECTIVE Adults sustaining a traumatic brain injury (TBI) are at risk of sleep disturbances during their recovery, including when such an injury requires hospitalization. However, the sleep-wake profile, and internal and external factors that may interfere with sleep initiation/maintenance in hospitalized TBI patients are poorly understood. This review aimed to: (1) identify/summarize the existing evidence regarding sleep and sleep measurements in TBI adults receiving around-the-clock care in a hospital or during inpatient rehabilitation, and (2) identify internal/external factors linked to poor sleep in this context. METHODS A scoping review was conducted in accordance with the PRISMA Scoping Review Extension guidelines. A search was conducted in MEDLINE, PsycINFO, CINAHL, and Web of Science databases. RESULTS Thirty relevant studies were identified. The most common sleep variables that were put forth in the studies to characterize sleep during hospitalization were nighttime sleep time (mean = 6.5 hours; range: 5.2-8.9 hours), wake after sleep onset (87.1 minutes; range: 30.4-180 minutes), and sleep efficiency (mean = 72.9%; range: 33%-96%) using mainly actigraphy, polysomnography, and questionnaires (eg, the sleep-wake disturbance item of the Delirium Rating Scale or the Pittsburgh Sleep Quality Index). Twenty-four studies (80%) suggested that hospitalized TBI patients do not get sufficient nighttime sleep, based on the general recommendations for adults (7-9 hours per night). Sleep disruptions during hospitalization were found to be associated to several internal factors including TBI severity, cognitive status, and analgesia intake. External and modifiable factors, such as noise, light, and patient care, were consistently associated with sleep disruptions in this context. CONCLUSION Although the literature on sleep disturbances in hospitalized TBI patients has been increasing in recent years, many gaps in knowledge remain, including phenotypes and risk factors. Identifying these factors could help clinicians better understand the multiple sources of TBI patients' sleep difficulties and intervene accordingly.
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Affiliation(s)
- Catherine Leclerc
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada (Mss Leclerc and Hjeij, Mr Gervais, and Drs Williamson, Bernard, Duclos, and Arbour); Department of Psychology, Université de Montréal, Montréal, Québec, Canada (Ms Leclerc and Mr Gervais); Faculty of Medicine (Drs Briand and Bernard), Faculty of Pharmacy (Dr Williamson), and Faculty of Nursing (Dr Arbour), Université de Montréal, Montréal, Québec, Canada; Division of Trauma Research, Departments of Surgery and of Neurological Sciences, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada (Drs Briand, Bernard, Duclos, and Arbour); and Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada (Dr Duclos)
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8
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Gervais C, Boucher LP, Villar GM, Lee U, Duclos C. A scoping review for building a criticality-based conceptual framework of altered states of consciousness. Front Syst Neurosci 2023; 17:1085902. [PMID: 37304151 PMCID: PMC10248073 DOI: 10.3389/fnsys.2023.1085902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
The healthy conscious brain is thought to operate near a critical state, reflecting optimal information processing and high susceptibility to external stimuli. Conversely, deviations from the critical state are hypothesized to give rise to altered states of consciousness (ASC). Measures of criticality could therefore be an effective way of establishing the conscious state of an individual. Furthermore, characterizing the direction of a deviation from criticality may enable the development of treatment strategies for pathological ASC. The aim of this scoping review is to assess the current evidence supporting the criticality hypothesis, and the use of criticality as a conceptual framework for ASC. Using the PRISMA guidelines, Web of Science and PubMed were searched from inception to February 7th 2022 to find articles relating to measures of criticality across ASC. N = 427 independent papers were initially found on the subject. N = 378 were excluded because they were either: not related to criticality; not related to consciousness; not presenting results from a primary study; presenting model data. N = 49 independent papers were included in the present research, separated in 7 sub-categories of ASC: disorders of consciousness (DOC) (n = 5); sleep (n = 13); anesthesia (n = 18); epilepsy (n = 12); psychedelics and shamanic state of consciousness (n = 4); delirium (n = 1); meditative state (n = 2). Each category included articles suggesting a deviation of the critical state. While most studies were only able to identify a deviation from criticality without being certain of its direction, the preliminary consensus arising from the literature is that non-rapid eye movement (NREM) sleep reflects a subcritical state, epileptic seizures reflect a supercritical state, and psychedelics are closer to the critical state than normal consciousness. This scoping review suggests that, though the literature is limited and methodologically inhomogeneous, ASC are characterized by a deviation from criticality, though its direction is not clearly reported in a majority of studies. Criticality could become, with more extensive research, an effective and objective way to characterize ASC, and help identify therapeutic avenues to improve criticality in pathological brain states. Furthermore, we suggest how anesthesia and psychedelics could potentially be used as neuromodulation techniques to restore criticality in DOC.
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Affiliation(s)
- Charles Gervais
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Centre for Advanced Research in Sleep Medicine & Integrated Trauma Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal, Montréal, QC, Canada
| | - Louis-Philippe Boucher
- Centre for Advanced Research in Sleep Medicine & Integrated Trauma Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal, Montréal, QC, Canada
- Department of Neuroscience, Université de Montréal, Montréal, QC, Canada
| | - Guillermo Martinez Villar
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Centre for Advanced Research in Sleep Medicine & Integrated Trauma Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal, Montréal, QC, Canada
- Department of Biomedical Sciences, Université de Montréal, Montréal, QC, Canada
| | - UnCheol Lee
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, United States
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Catherine Duclos
- Centre for Advanced Research in Sleep Medicine & Integrated Trauma Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal, Montréal, QC, Canada
- Department of Neuroscience, Université de Montréal, Montréal, QC, Canada
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montréal, QC, Canada
- CIFAR Azrieli Global Scholars Program, Toronto, ON, Canada
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9
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Maschke C, Duclos C, Owen AM, Jerbi K, Blain-Moraes S. Aperiodic brain activity and response to anesthesia vary in disorders of consciousness. Neuroimage 2023; 275:120154. [PMID: 37209758 DOI: 10.1016/j.neuroimage.2023.120154] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/28/2023] [Accepted: 05/02/2023] [Indexed: 05/22/2023] Open
Abstract
In the human electroencephalogram (EEG), oscillatory power peaks co-exist with non-oscillatory, aperiodic activity. Although EEG analysis has traditionally focused exclusively on oscillatory power, recent investigations have shown that the aperiodic EEG component can distinguish conscious wakefulness from sleep and anesthetic-induced unconsciousness. This study investigates the aperiodic EEG component of individuals in a disorder of consciousness (DOC); how it changes in response to exposure to anesthesia; and how it relates to the brain's information richness and criticality. High-density EEG was recorded from 43 individuals in a DOC, with 16 of these individuals undergoing a protocol of propofol anesthesia. The aperiodic component was defined by the spectral slope of the power spectral density. Our results demonstrate that the EEG aperiodic component is more informative about the participants' level of consciousness than the oscillatory component, especially for patients that suffered from a stroke. Importantly, the pharmacologically induced change in the spectral slope from 30-45 Hz positively correlated with individual's pre-anesthetic level of consciousness. The pharmacologically induced loss of information-richness and criticality was associated with individual's pre-anesthetic aperiodic component. During exposure to anesthesia, the aperiodic component was correlated with 3-month recovery status for individuals with DOC. The aperiodic EEG component has been historically neglected; this research highlights the necessity of considering this measure for the assessment of individuals in DOC and future research that seeks to understand the neurophysiological underpinnings of consciousness.
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Affiliation(s)
- Charlotte Maschke
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Canada
| | - Catherine Duclos
- Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de Santé et de Services Sociaux du Nord-de-l'île-de-Montréal, Montréal, Québec Canada; Department of Anesthesiology and Pain Medicine, Université de Montréal, Montréal, Québec Canada
| | - Adrian M Owen
- Department of Physiology and Pharmacology, Western University, London, Ontario, Canada; Western Institute for Neuroscience, Western University, London, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada
| | - Karim Jerbi
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Québec, Canada; MILA (Québec Artificial Intelligence Institute), Montréal, Québec, Canada; Centre UNIQUE (Union Neurosciences & Intelligence Artificielle), Montréal, Québec, Canada
| | - Stefanie Blain-Moraes
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
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10
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Koïvogui A, Benamouzig R, Duclos C. Refinement of the Target Population for Colorectal Cancer Screening in France, Inventory as a Prelude to the Use of Medico-Administrative Database. Stud Health Technol Inform 2023; 302:394-395. [PMID: 37203702 DOI: 10.3233/shti230157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The study describes the level of improvement in the risk of misclassification that would be achieved by refining the campaign target population using a query in the French medico-administrative database (SNDS). The SNDS's use requires other new strategies that can minimize the number of people wrongly included in the campaigns, because its accuracy is less than 100%.
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Affiliation(s)
- Akoi Koïvogui
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, UMLS 1142-INSERM, 93000, Bobigny, France
| | - Robert Benamouzig
- AP-HP, Avicenne, Service d'Hépato Gastro Entérologie, 93000, Bobigny, France
| | - Catherine Duclos
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, UMLS 1142-INSERM, 93000, Bobigny, France
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11
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Dupuy-Zini A, Audeh B, Gérardin C, Duclos C, Gagneux-Brunon A, Bousquet C. Users' Reactions to Announced Vaccines Against COVID-19 Before Marketing in France: Analysis of Twitter Posts. J Med Internet Res 2023; 25:e37237. [PMID: 36596215 PMCID: PMC10132828 DOI: 10.2196/37237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/17/2022] [Accepted: 08/09/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Within a few months, the COVID-19 pandemic had spread to many countries and had been a real challenge for health systems all around the world. This unprecedented crisis has led to a surge of online discussions about potential cures for the disease. Among them, vaccines have been at the heart of the debates and have faced lack of confidence before marketing in France. OBJECTIVE This study aims to identify and investigate the opinions of French Twitter users on the announced vaccines against COVID-19 through sentiment analysis. METHODS This study was conducted in 2 phases. First, we filtered a collection of tweets related to COVID-19 available on Twitter from February 2020 to August 2020 with a set of keywords associated with vaccine mistrust using word embeddings. Second, we performed sentiment analysis using deep learning to identify the characteristics of vaccine mistrust. The model was trained on a hand-labeled subset of 4548 tweets. RESULTS A set of 69 relevant keywords were identified as the semantic concept of the word "vaccin" (vaccine in French) and focused mainly on conspiracies, pharmaceutical companies, and alternative treatments. Those keywords enabled us to extract nearly 350,000 tweets in French. The sentiment analysis model achieved 0.75 accuracy. The model then predicted 16% of positive tweets, 41% of negative tweets, and 43% of neutral tweets. This allowed us to explore the semantic concepts of positive and negative tweets and to plot the trends of each sentiment. The main negative rhetoric identified from users' tweets was that vaccines are perceived as having a political purpose and that COVID-19 is a commercial argument for the pharmaceutical companies. CONCLUSIONS Twitter might be a useful tool to investigate the arguments for vaccine mistrust because it unveils political criticism contrasting with the usual concerns on adverse drug reactions. As the opposition rhetoric is more consistent and more widely spread than the positive rhetoric, we believe that this research provides effective tools to help health authorities better characterize the risk of vaccine mistrust.
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Affiliation(s)
- Alexandre Dupuy-Zini
- Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, Université Sorbonne Paris Nord, Institut national de la santé et de la recherche médicale, INSERM, Paris, France
| | - Bissan Audeh
- Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, Université Sorbonne Paris Nord, Institut national de la santé et de la recherche médicale, INSERM, Paris, France
| | - Christel Gérardin
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de médecine interne, Sorbonne Université, Paris, France
| | - Catherine Duclos
- Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, Université Sorbonne Paris Nord, Institut national de la santé et de la recherche médicale, INSERM, Paris, France
| | - Amandine Gagneux-Brunon
- Groupe sur l'Immunité des Muqueuses et Agents Pathogènes, Centre International de Recherche en Infectiologie, University of Lyon, Saint Etienne, France
- Vaccinologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint Etienne, France
| | - Cedric Bousquet
- Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, Université Sorbonne Paris Nord, Institut national de la santé et de la recherche médicale, INSERM, Paris, France
- Service de santé publique et information médicale, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
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12
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Maschke C, Duclos C, Blain-Moraes S. Paradoxical markers of conscious levels: Effects of propofol on patients in disorders of consciousness. Front Hum Neurosci 2022; 16:992649. [PMID: 36277055 PMCID: PMC9584648 DOI: 10.3389/fnhum.2022.992649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Human consciousness is widely understood to be underpinned by rich and diverse functional networks, whose breakdown results in unconsciousness. Candidate neural correlates of anesthetic-induced unconsciousness include: (1) disrupted frontoparietal functional connectivity; (2) disrupted brain network hubs; and (3) reduced spatiotemporal complexity. However, emerging counterexamples have revealed that these markers may appear outside of the state they are associated with, challenging both their inclusion as markers of conscious level, and the theories of consciousness that rely on their evidence. In this study, we present a case series of three individuals in disorders of consciousness (DOC) who exhibit paradoxical brain responses to exposure to anesthesia. High-density electroencephalographic data were recorded from three patients with unresponsive wakefulness syndrome (UWS) while they underwent a protocol of propofol anesthesia with a targeted effect site concentration of 2 μg/ml. Network hubs and directionality of functional connectivity in the alpha frequency band (8–13 Hz), were estimated using the weighted phase lag index (wPLI) and directed phase lag index (dPLI). The spatiotemporal signal complexity was estimated using three types of Lempel-Ziv complexity (LZC). Our results illustrate that exposure to propofol anesthesia can paradoxically result in: (1) increased frontoparietal feedback-dominant connectivity; (2) posterior network hubs; and (3) increased spatiotemporal complexity. The case examples presented in this paper challenge the role of functional connectivity and spatiotemporal complexity in theories of consciousness and for the clinical evaluation of levels of human consciousness.
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Affiliation(s)
- Charlotte Maschke
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Catherine Duclos
- Hôpital du Sacré-Cœur de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal, Montreal, QC, Canada
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montreal, QC, Canada
| | - Stefanie Blain-Moraes
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- *Correspondence: Stefanie Blain-Moraes,
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13
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Melot B, Amsilli M, Drouet F, Rodriguez L, Salomon J, Grosjean J, Duclos C. Appropriateness of Antibiotic Prescription During Teleconsultation. Stud Health Technol Inform 2022; 298:142-146. [PMID: 36073473 DOI: 10.3233/shti220924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Teleconsultation has become a new means of using care which has taken off significantly since the COVID crisis, The pooling of the technological environment within the TC makes it possible to set up practice reviews by reusing the data collected. Our aim was to evaluate the relevance of antibiotic therapy during teleconsultations carried out on the national teleconsultation platform "Qare" in 4 common infections. 143,428 TCs with structured prescriptions were analyzed, with an appropriate prescription in more than 82% of cases, higher than in the literature. The use of data makes it possible to quickly assess practices and inform doctors to improve their practices.
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Affiliation(s)
- B Melot
- Qare, Paris, France
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, INSERM, F-93000, Bobigny, France
| | | | | | | | | | - J Grosjean
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, INSERM, F-93000, Bobigny, France
- Department of Digital Health, Rouen University Hospital, Rouen France
| | - C Duclos
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Sorbonne Université, INSERM, F-93000, Bobigny, France
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14
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Sanchez E, Blais H, Duclos C, Arbour C, Van Der Maren S, El-Khatib H, Baril AA, Bernard F, Carrier J, Gosselin N. Sleep from acute to chronic traumatic brain injury and cognitive outcomes. Sleep 2022; 45:zsac123. [PMID: 35640250 PMCID: PMC9366647 DOI: 10.1093/sleep/zsac123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/13/2022] [Indexed: 09/29/2023] Open
Abstract
STUDY OBJECTIVES Traumatic brain injuries (TBIs) cause persistent cerebral damage and cognitive deficits. Because sleep may be a critical factor for brain recovery, we characterized the sleep of patients with TBI from early hospitalization to years post-injury and explored the hypothesis that better sleep during hospitalization predicts more favorable long-term cognitive outcomes. METHODS We tested patients with moderate-to-severe TBI in the hospitalized (n = 11) and chronic (n = 43) stages using full-night polysomnography, with 82% of the hospitalized group being retested years post-injury. Hospitalized patients with severe orthopedic and/or spinal cord injury (n = 14) and healthy participants (n = 36) were tested as controls for the hospitalized and chronic TBI groups, respectively. Groups had similar age and sex and were compared for sleep characteristics, including slow waves and spindles. For patients with TBI, associations between sleep during hospitalization and long-term memory and executive function were assessed. RESULTS Hospitalized patients with TBI or orthopedic injuries had lower sleep efficiency, higher wake after sleep onset, and lower spindle density than the chronic TBI and healthy control groups, but only hospitalized patients with brain injury had an increased proportion of slow-wave sleep. During hospitalization for TBI, less fragmented sleep, more slow-wave sleep, and higher spindle density were associated to more favorable cognitive outcomes years post-injury, while injury severity markers were not associated with these outcomes. CONCLUSION These findings highlight the importance of sleep following TBI, as it could be a strong predictor of neurological recovery, either as a promoter or an early marker of cognitive outcomes.
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Affiliation(s)
- Erlan Sanchez
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l’Île-de-Montréal, Montreal, Quebec, Canada
- Department of Neuroscience, Université de Montréal, Montreal, Quebec, Canada
| | - Hélène Blais
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Catherine Duclos
- Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Caroline Arbour
- Centre Intégré de Traumatologie, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l’Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Solenne Van Der Maren
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l’Île-de-Montréal, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Héjar El-Khatib
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l’Île-de-Montréal, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Andrée-Ann Baril
- Douglas Mental Health University Institute, Montréal, Quebec, Canada
- Department of Psychiatry, McGill University, Montréal, Quebec, Canada
| | - Francis Bernard
- Centre Intégré de Traumatologie, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l’Île-de-Montréal, Montreal, Quebec, Canada
- Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l’Île-de-Montréal, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et Services Sociaux du Nord de l’Île-de-Montréal, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
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15
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Zana I, Grosjean J, Letord C, Charlet J, Rio J, Darmoni ETN, Duclos C, Darmoni SJ. Qualitative Evaluation of a Drug Terminology Server. Stud Health Technol Inform 2022; 290:1002-1003. [PMID: 35673176 DOI: 10.3233/shti220238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although the drug is finished, identifiable, there is no universally accepted standard for naming them. The objective of this work is to evaluate qualitatively the HeTOP drug terminology server by two categories of students: (a) pharmacy students and (b) a control group. METHODS A formal evaluation was built to measure the perception of users about the HeTOP drug server, using the three mains questions about "teaching interest", "skill interest" (or competence) and "ergonomics". RESULTS The three pharmacy student subgroups gave the best and the worst score to the same categories. CONCLUSION All three criteria are rated above 6.5 out of 10. The HeTOP drug terminology server is freely available to "non drug" specialists (URL: www.hetop.eu/hetop/drugs/).
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Affiliation(s)
- Ilan Zana
- Faculty of pharmacy, Université de Paris, Paris
| | - Julien Grosjean
- Department of Biomedical Informatics, Rouen University Hospital, 76031 Rouen Cedex, France
- Sorbonne Université, INSERM, Université Paris 13, LIMICS, Paris, France
| | - Catherine Letord
- Department of Biomedical Informatics, Rouen University Hospital, 76031 Rouen Cedex, France
- Sorbonne Université, INSERM, Université Paris 13, LIMICS, Paris, France
| | - Jean Charlet
- Sorbonne Université, INSERM, Université Paris 13, LIMICS, Paris, France
- Assistance Publique-Hôpitaux de Paris, DRCI, Paris, France
| | - Julien Rio
- Department of Biomedical Informatics, Rouen University Hospital, 76031 Rouen Cedex, France
| | | | - Catherine Duclos
- Sorbonne Université, INSERM, Université Paris 13, LIMICS, Paris, France
- Assistance Publique-Hôpitaux de Paris, DRCI, Paris, France
| | - Stéfan J Darmoni
- Department of Biomedical Informatics, Rouen University Hospital, 76031 Rouen Cedex, France
- Sorbonne Université, INSERM, Université Paris 13, LIMICS, Paris, France
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16
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Duclos C, Griffon N, Daniel C, Bouzillé G, Delamarre D, Darmoni S, Toubiana L, Grosjean J. Reliability of Drug-Drug Interaction Measurement on Real-Word Data: The ReMIAMes Project. Stud Health Technol Inform 2022; 294:151-152. [PMID: 35612045 DOI: 10.3233/shti220425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The ReMIAMes project proposes a methodological framework to provide a reliable and reproducible measurement of the frequency of drug-drug interactions (DDI) when performed on real-world data. This framework relies on (i) a fine-grained and contextualized definition of DDIs, (ii) a shared minimum information model to select the appropriate data for the correct interpretation of potential DDIs, (iii) an ontology-based inference module able to handle missing data to classify prescription lines with potential DDIs, (iv) a report generator giving the value of the measurement and explanations when potential false positive are detected due to a lack of available data. All the tools developed are intended to be publicly shared under open license.
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Affiliation(s)
- Catherine Duclos
- Sorbonne Université, Université Sorbonne Paris Nord, INSERM, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, F-75006 Paris, France
| | - Nicolas Griffon
- Sorbonne Université, Université Sorbonne Paris Nord, INSERM, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, F-75006 Paris, France
- Innovation and Data, IT Department, AP-HP, Paris, France
| | - Christel Daniel
- Sorbonne Université, Université Sorbonne Paris Nord, INSERM, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, F-75006 Paris, France
- Innovation and Data, IT Department, AP-HP, Paris, France
| | - Guillaume Bouzillé
- Inserm, Laboratoire Traitement du Signal et de l'Image - UMR 1099, Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Denis Delamarre
- Inserm, Laboratoire Traitement du Signal et de l'Image - UMR 1099, Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Stefan Darmoni
- Sorbonne Université, Université Sorbonne Paris Nord, INSERM, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, F-75006 Paris, France
- Department of Digital Health, Rouen University Hospital, France
| | - Laurent Toubiana
- Sorbonne Université, Université Sorbonne Paris Nord, INSERM, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, F-75006 Paris, France
| | - Julien Grosjean
- Sorbonne Université, Université Sorbonne Paris Nord, INSERM, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, F-75006 Paris, France
- Department of Digital Health, Rouen University Hospital, France
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17
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Lelong R, Dahamna B, Berthelot H, Duville W, Letord C, Grosjean J, Duclos C. When Context Matters for Credible Measurement of Drug-Drug Interactions Based on Real-World Data. Stud Health Technol Inform 2022; 294:38-42. [PMID: 35612012 DOI: 10.3233/shti220392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The frequency of potential drug-drug interactions (DDI) in published studies on real world data considerably varies due to the methodological framework. Contextualization of DDI has a proven effect in limiting false positives. In this paper, we experimented with the application of various DDIs contexts elements to see their impact on the frequency of potential DDIs measured on the same set of prescription data collected in EDSaN, the clinical data warehouse of Rouen University Hospital. Depending on the context applied, the frequency of daily prescriptions with potential DDI ranged from 0.89% to 3.90%. Substance-level analysis accounted for 48% of false positives because it did not account for some drug-related attributes. Consideration of the patient's context could eliminate up to an additional 29% of false positives.
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Affiliation(s)
- Romain Lelong
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, SorbonneUniversité, INSERM, F-93000, Bobigny, France.,Department of Digital Health, Rouen University Hospital, Rouen, France
| | - Badisse Dahamna
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, SorbonneUniversité, INSERM, F-93000, Bobigny, France.,Department of Digital Health, Rouen University Hospital, Rouen, France
| | - Hélène Berthelot
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, SorbonneUniversité, INSERM, F-93000, Bobigny, France
| | - Willy Duville
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, SorbonneUniversité, INSERM, F-93000, Bobigny, France
| | - Catherine Letord
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, SorbonneUniversité, INSERM, F-93000, Bobigny, France.,Department of Digital Health, Rouen University Hospital, Rouen, France
| | - Julien Grosjean
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, SorbonneUniversité, INSERM, F-93000, Bobigny, France.,Department of Digital Health, Rouen University Hospital, Rouen, France
| | - Catherine Duclos
- Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, SorbonneUniversité, INSERM, F-93000, Bobigny, France
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18
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Duclos C, Maschke C, Mahdid Y, Nadin D, Rokos A, Arbour C, Badawy M, Létourneau J, Owen AM, Plourde G, Blain-Moraes S. Brain Responses to Propofol in Advance of Recovery From Coma and Disorders of Consciousness: A Preliminary Study. Am J Respir Crit Care Med 2021; 205:171-182. [PMID: 34748722 DOI: 10.1164/rccm.202105-1223oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Predicting recovery of consciousness in unresponsive, brain-injured individuals has crucial implications for clinical decision-making. Propofol induces distinctive brain network reconfiguration in the healthy brain as it loses consciousness. In patients with disorders of consciousness, the brain network's reconfiguration to propofol may reveal the patient's underlying capacity for consciousness. OBJECTIVE To design and test a new metric for the prognostication of consciousness recovery in disorders of consciousness. METHODS Using a within-subject design, we conducted an anesthetic protocol with concomitant high-density EEG in 12 patients in a disorder of consciousness following a brain injury. We quantified the reconfiguration of EEG network hubs and directed functional connectivity before, during, and after propofol exposure, and obtained an index of propofol-induced network reconfiguration: the Adaptive Reconfiguration Index. We compared the index of patients who recovered consciousness 3 months post-EEG (n = 3) to that of patients who did not recover or remained in a chronic disorder of consciousness (n = 7), and conducted a logistic regression to assess prognostic accuracy. MEASUREMENTS AND MAIN RESULTS The Adaptive Reconfiguration Index was significantly higher in patients who later recovered full consciousness (U-value=21, p=0.008), and able to discriminate with 100% accuracy whether the patient recovered consciousness. CONCLUSIONS The Adaptive Reconfiguration Index of patients who recovered from a disorder of consciousness at 3-month follow-up was linearly separable from that of patients who did not recover or remained in a chronic disorder of consciousness, on the single-subject level. EEG and propofol can be administered at the bedside with few contraindications, affording the Adaptive Reconfiguration Index tremendous translational potential as a prognostic measure of consciousness recovery in acute clinical settings.
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Affiliation(s)
| | | | | | | | | | | | - Mohamed Badawy
- Montreal Neurological Institute and Hospital, 55981, Montreal, Quebec, Canada
| | - Justin Létourneau
- Montreal Neurological Institute and Hospital, 55981, Montreal, Quebec, Canada
| | - Adrian M Owen
- Western University Schulich School of Medicine and Dentistry, 70384, Brain and Mind Institute, London, Ontario, Canada.,Western University Schulich School of Medicine and Dentistry, 70384, Department of Physiology and Pharmacology, London, Ontario, Canada
| | - Gilles Plourde
- Montreal Neurological Institute and Hospital, 55981, Montreal, Quebec, Canada
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19
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Rokos A, Mišić B, Berkun K, Duclos C, Tarnal V, Janke E, Picton P, Golmirzaie G, Basner M, Avidan MS, Kelz MB, Mashour GA, Blain-Moraes S. Distinct and Dissociable EEG Networks Are Associated With Recovery of Cognitive Function Following Anesthesia-Induced Unconsciousness. Front Hum Neurosci 2021; 15:706693. [PMID: 34594193 PMCID: PMC8477048 DOI: 10.3389/fnhum.2021.706693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/20/2021] [Indexed: 01/02/2023] Open
Abstract
The temporal trajectories and neural mechanisms of recovery of cognitive function after a major perturbation of consciousness is of both clinical and neuroscientific interest. The purpose of the present study was to investigate network-level changes in functional brain connectivity associated with the recovery and return of six cognitive functions after general anesthesia. High-density electroencephalograms (EEG) were recorded from healthy volunteers undergoing a clinically relevant anesthesia protocol (propofol induction and isoflurane maintenance), and age-matched healthy controls. A battery of cognitive tests (motor praxis, visual object learning test, fractal-2-back, abstract matching, psychomotor vigilance test, digital symbol substitution test) was administered at baseline, upon recovery of consciousness (ROC), and at half-hour intervals up to 3 h following ROC. EEG networks were derived using the strength of functional connectivity measured through the weighted phase lag index (wPLI). A partial least squares (PLS) analysis was conducted to assess changes in these networks: (1) between anesthesia and control groups; (2) during the 3-h recovery from anesthesia; and (3) for each cognitive test during recovery from anesthesia. Networks were maximally perturbed upon ROC but returned to baseline 30-60 min following ROC, despite deficits in cognitive performance that persisted up to 3 h following ROC. Additionally, during recovery from anesthesia, cognitive tests conducted at the same time-point activated distinct and dissociable functional connectivity networks across all frequency bands. The results highlight that the return of cognitive function after anesthetic-induced unconsciousness is task-specific, with unique behavioral and brain network trajectories of recovery.
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Affiliation(s)
- Alexander Rokos
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Bratislav Mišić
- Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | | | - Catherine Duclos
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Vijay Tarnal
- Department of Anesthesiology, Center of Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Ellen Janke
- Department of Anesthesiology, Center of Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Paul Picton
- Department of Anesthesiology, Center of Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Goodarz Golmirzaie
- Department of Anesthesiology, Center of Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Mathias Basner
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michael S. Avidan
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, WA, United States
| | - Max B. Kelz
- Deparment of Anesthesiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - George A. Mashour
- Department of Anesthesiology, Center of Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Stefanie Blain-Moraes
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
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20
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El-Khatib H, Sanchez E, Arbour C, Van Der Maren S, Duclos C, Blais H, Carrier J, Simonelli G, Hendryckx C, Paquet J, Gosselin N. Slow wave activity moderates the association between new learning and traumatic brain injury severity. Sleep 2021; 44:5992297. [PMID: 33211874 DOI: 10.1093/sleep/zsaa242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/16/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Sleep-wake complaints and difficulties in making new learning are among the most persistent and challenging long-term sequelea following moderate to severe traumatic brain injury (TBI). Yet, it is unclear whether, and to what extent, sleep characteristics during the chronic stage of TBI contribute to sleep-wake and cognitive complaints. We aimed to characterize sleep architecture in chronic moderate to severe TBI adults and assess whether non-rapid eye movement slow wave activity (SWA) is associated to next day performance in episodic memory tasks according to TBI severity. METHODS Forty-two moderate to severe TBI participants, 12-47 months post-injury, and 38 healthy controls were tested with one night of in-laboratory polysomnography, followed the next morning by questionnaires (sleep quality, fatigue, and sleepiness) and neuropsychological assessment. We used multiple regression analyses to assess the moderator effect of SWA power on TBI severity and next-day memory performance. RESULTS We found that TBI participants reported worse sleep quality and fatigue, and had worse cognitive performance than controls. No between group differences were found on macro- and micro-architecture of sleep. However, SWA significantly interacted with TBI severity to explain next-day memory performance: higher SWA was more strongly associated to better memory performance in more severe TBI compared to milder TBI. CONCLUSIONS This study provides evidence that the injured brain is able to produce macro- and micro-architecture of sleep comparable to what is seen in healthy controls. However, with increasing TBI severity, lower non-rapid eye movement SWA power is associated with reduced ability to learn and memorise new information the following day.
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Affiliation(s)
- Héjar El-Khatib
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Erlan Sanchez
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Department of Neurosciences, Université de Montréal, Montreal, Quebec, Canada
| | - Caroline Arbour
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Solenne Van Der Maren
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Catherine Duclos
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
| | - Hélène Blais
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Guido Simonelli
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Charlotte Hendryckx
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Jean Paquet
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche du CIUSSS NIM, Montreal, Quebec, Canada.,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
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21
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Duclos C, Norton L, Laforge G, Frantz A, Maschke C, Badawy M, Letourneau J, Slessarev M, Gofton T, Debicki D, Owen AM, Blain-Moraes S. Protocol for the Prognostication of Consciousness Recovery Following a Brain Injury. Front Hum Neurosci 2020; 14:582125. [PMID: 33281582 PMCID: PMC7690215 DOI: 10.3389/fnhum.2020.582125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/20/2020] [Indexed: 11/13/2022] Open
Abstract
Individuals who have suffered a severe brain injury typically require extensive hospitalization in intensive care units (ICUs), where critical treatment decisions are made to maximize their likelihood of recovering consciousness and cognitive function. These treatment decisions can be difficult when the neurological assessment of the patient is limited by unreliable behavioral responses. Reliable objective and quantifiable markers are lacking and there is both (1) a poor understanding of the mechanisms underlying the brain's ability to reconstitute consciousness and cognition after an injury and (2) the absence of a reliable and clinically feasible method of tracking cognitive recovery in ICU survivors. Our goal is to develop and validate a clinically relevant EEG paradigm that can inform the prognosis of unresponsive, brain-injured patients in the ICU. This protocol describes a study to develop a point-of-care system intended to accurately predict outcomes of unresponsive, brain-injured patients in the ICU. We will recruit 200 continuously-sedated brain-injured patients across five ICUs. Between 24 h and 7 days post-ICU admission, high-density EEG will be recorded from behaviorally unresponsive patients before, during and after a brief cessation of pharmacological sedation. Once patients have reached the waking stage, they will be asked to complete an abridged Cambridge Brain Sciences battery, a web-based series of neurocognitive tests. The test series will be repeated every day during acute admission (ICU, ward), or as often as possible given the constraints of ICU and ward care. Following discharge, patients will continue to complete the same test series on weekly, and then monthly basis, for up to 12 months following injury. Functional outcomes will also be assessed up to 12 months post-injury. We anticipate our findings will lead to an increased ability to identify patients, as soon as possible after their brain injury, who are most likely to survive, and to make accurate predictions about their long-term cognitive and functional outcome. In addition to providing critically needed support for clinical decision-making, this study has the potential to transform our understanding of key functional EEG networks associated with consciousness and cognition.
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Affiliation(s)
- Catherine Duclos
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Loretta Norton
- Department of Psychology, King’s University College at Western University, London, ON, Canada
- The Brain and Mind Institute, Western University, London, ON, Canada
| | - Geoffrey Laforge
- The Brain and Mind Institute, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Allison Frantz
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Charlotte Maschke
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Mohamed Badawy
- Department of Anesthesia, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Division of Neurocritical Care, McGill University Health Center, Montreal, QC, Canada
- Montreal Neurological Hospital, McGill University Health Center, Montreal, QC, Canada
| | - Justin Letourneau
- Department of Anesthesia, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Division of Neurocritical Care, McGill University Health Center, Montreal, QC, Canada
- Montreal Neurological Hospital, McGill University Health Center, Montreal, QC, Canada
| | - Marat Slessarev
- The Brain and Mind Institute, Western University, London, ON, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Teneille Gofton
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Derek Debicki
- The Brain and Mind Institute, Western University, London, ON, Canada
- Neurocritical Care Program, Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Adrian M. Owen
- The Brain and Mind Institute, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
- Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - Stefanie Blain-Moraes
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
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22
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Wojcik M, Doussot A, Manfredelli S, Duclos C, Paquette B, Turco C, Heyd B, Lakkis Z. Intra-operative fluorescence angiography is reproducible and reduces the rate of anastomotic leak after colorectal resection for cancer: a prospective case-matched study. Colorectal Dis 2020; 22:1263-1270. [PMID: 32306516 DOI: 10.1111/codi.15076] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/03/2020] [Indexed: 02/08/2023]
Abstract
AIM Intra-operative fluorescence angiography (IOFA) with indocyanine green provides information on tissue perfusion that may help prevent an anastomotic leak (AL). The aim of this study was to assess the impact of IOFA on outcomes after left-sided colonic or low anterior resection with anastomosis for colorectal cancer. METHODS All patients with left-sided colonic or rectal cancer, operated between June 2017 and December 2018, were prospectively included. IOFA has been routinely implemented since May 2018. Reproducibility of IOFA, after a 1:1 matching for relevant clinical risk factors of AL, was studied in patients with IOFA (IOFA+) and without IOFA (IOFA-). Outcomes were compared in terms of postoperative events such as clinically relevant AL as the primary end-point. RESULTS In the IOFA+ group, changing of the initially planned colon transection due to inadequate perfusion occurred in five out of 46 patients (10.9%). Agreement between intra-operative assessment and postoperative blind review of IOFA was deemed strong (Cohen's kappa index 0.893, 95% CI 0.788-0.998, P < 0.001). Among 111 patients, 42 matched patients were included in each group. There was significantly more clinically relevant AL in the IOFA- group compared to the IOFA+ group (16.7% vs 2.4%, P = 0.026) involving significantly more anastomotic dehiscence which required re-intervention (19% vs 2.4%, P = 0.014). Additionally, more descending colon ischaemia/necrosis was observed in the IOFA- group compared with the IOFA+ group (9.5% vs 0%, P = 0.040). CONCLUSION In this prospective case-matched study, IOFA decreased the occurrence of clinically relevant AL due to necrosis of the descending colon or anastomosis. Upon blind review, perfusion assessment using IOFA was reproducible.
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Affiliation(s)
- M Wojcik
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
| | - A Doussot
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
| | - S Manfredelli
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
| | - C Duclos
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
| | - B Paquette
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
| | - C Turco
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
| | - B Heyd
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
| | - Z Lakkis
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
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Chalfouh C, Guillou C, Hardouin J, Delarue Q, Li X, Duclos C, Schapman D, Marie JP, Cosette P, Guérout N. The Regenerative Effect of Trans-spinal Magnetic Stimulation After Spinal Cord Injury: Mechanisms and Pathways Underlying the Effect. Neurotherapeutics 2020; 17:2069-2088. [PMID: 32856173 PMCID: PMC7851265 DOI: 10.1007/s13311-020-00915-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Spinal cord injury (SCI) leads to a loss of sensitive and motor functions. Currently, there is no therapeutic intervention offering a complete recovery. Here, we report that repetitive trans-spinal magnetic stimulation (rTSMS) can be a noninvasive SCI treatment that enhances tissue repair and functional recovery. Several techniques including immunohistochemical, behavioral, cells cultures, and proteomics have been performed. Moreover, different lesion paradigms, such as acute and chronic phase following SCI in wild-type and transgenic animals at different ages (juvenile, adult, and aged), have been used. We demonstrate that rTSMS modulates the lesion scar by decreasing fibrosis and inflammation and increases proliferation of spinal cord stem cells. Our results demonstrate also that rTSMS decreases demyelination, which contributes to axonal regrowth, neuronal survival, and locomotor recovery after SCI. This research provides evidence that rTSMS induces therapeutic effects in a preclinical rodent model and suggests possible translation to clinical application in humans.
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Affiliation(s)
- C Chalfouh
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France.
| | - C Guillou
- PISSARO Proteomic Facility, Normandie Univ, UNIROUEN, 76821, Mont-Saint-Aignan, France
- Institute for Research and Innovation in Biomedicine (IRIB), Mont-Saint-Aignan, France
| | - J Hardouin
- PISSARO Proteomic Facility, Normandie Univ, UNIROUEN, 76821, Mont-Saint-Aignan, France
- Institute for Research and Innovation in Biomedicine (IRIB), Mont-Saint-Aignan, France
| | - Q Delarue
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France
| | - X Li
- Department of Neurobiology, Care sciences and Society, BioClinicum, Karolinska Institutet, 17164, Stockholm, Sweden
| | - C Duclos
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France
| | - D Schapman
- Institute for Research and Innovation in Biomedicine (IRIB), Mont-Saint-Aignan, France
- Normandie Univ, UNIROUEN, SFR IRIB, Plateau PRIMACEN, F-76821, Mont-Saint-Aignan, France
| | - J-P Marie
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France
| | - P Cosette
- PISSARO Proteomic Facility, Normandie Univ, UNIROUEN, 76821, Mont-Saint-Aignan, France
- Institute for Research and Innovation in Biomedicine (IRIB), Mont-Saint-Aignan, France
| | - N Guérout
- Normandie Univ, UNIROUEN, EA3830 GRHV, 76000, Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), 76000, Rouen, France.
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24
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Koïvogui A, Levi S, Finkler M, Lewkowicz S, Gombeaud T, Sabate JM, Duclos C, Benamouzig R. Feasibility of encouraging participation in colorectal cancer screening campaigns by motivating people through the social network, Facebook. Colorectal Dis 2020; 22:1325-1335. [PMID: 32397003 DOI: 10.1111/codi.15121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
Abstract
AIM To describe the results of a feasibility phase and the expected results of a new approach to increase the participation rate in a Colorectal Cancer Organized Screening Program (CRCSP) through Facebook awareness messages. METHOD This approach targets people aged 50-74 years, who reside in an urban deprived area and regularly connect to Facebook. The feasibility phase ran over 2 months (December 2018 and January 2019) in six municipalities (Seine-Saint-Denis, France). The full provisional campaign will run over a year. The approach consists of sending electronic awareness messages on the importance of screening for colorectal cancer using a specific Facebook module. Subjects who consent to screening complete a test-kit application form. The eligibility of each subject to participate in screening is determined by a doctor before the kit is sent out. RESULTS A total of 39 900 people were reached by the feasibility phase campaign, and 9200 were able to watch at least one Facebook message/video. Of those, 4450 people logged to learn more about the CRCSP, 298 applied for a test kit, 160 test kit applicants were eligible to participate and the test completion rate was 41.9%. According to these feasibility results, 366 120 targeted people would connect regularly in the tested area, 141 541 of whom would be interested in a specific promotional message posted on Facebook. Requests could be made for 9770 kits, with 5246 people being eligible to participate in screening. The expected test-completion rate is estimated at 42%-89%. This would represent 5%-11% of the tests carried out in the area during the same period by 'classical' CRCSP. CONCLUSION Implementation of the Facebook strategy would significantly improve the rate of participation in the CRCSP by mobilizing people with no previous participation, including younger subjects.
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Affiliation(s)
- A Koïvogui
- CRCDC-IDF, Site de Seine-Saint-Denis, Bondy, France
| | - S Levi
- Medorion Technologies Ltd, Tel Aviv, Israel
| | - M Finkler
- Medorion Technologies Ltd, Tel Aviv, Israel
| | | | - T Gombeaud
- Association de Dépistage du Cancer Colorectal (ADCCR), Clinique d'Hépato-Gastro-Entérologie, Les Lilas, France
| | - J M Sabate
- Service d'Hépato-Gastro-Entérologie, Hôpital Avicenne (AP-HP), Bobigny, France
| | - C Duclos
- Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé (LIMICS), INSERM 1142, Univesité Paris 13, Bobigny, France.,Unité d'Informatique Hospitalière et de Traitement de l'Information Médicale - Service de de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France
| | - R Benamouzig
- Service d'Hépato-Gastro-Entérologie, Hôpital Avicenne (AP-HP), Bobigny, France
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Abstract
Objectives
: To summarize significant research contributions published in 2019 in the field of computerized clinical decision support and select the best papers for the Decision Support section of the International Medical Informatics Association (IMIA) Yearbook.
Methods
: Two bibliographic databases were searched for papers referring to clinical decision support systems (CDSSs) and computerized provider order entry (CPOE) systems. From search results, section editors established a list of candidate best papers, which were then peer-reviewed by external reviewers. The IMIA Yearbook editorial committee finally selected the best papers on the basis of all reviews including the section editors’ evaluation.
Results
: A total of 1,378 articles were retrieved. Fifteen best paper candidates were selected, the reviews of which resulted in the selection of three best papers. One paper reports on a guideline modeling approach based on clinical decision trees, both clinically interpretable and suitable for implementation in CDSSs. In another paper, authors promote the use of extended Timed Transition Diagrams in CDSSs to formalize consistently recurrent medical processes for chronic diseases management. The third paper proposes a conceptual framework and a grid for assessing the performance of predictive tools based on the critical appraisal of published evidence.
Conclusions
: As showed by the number and the variety of works related to decision support, research in the field is very active. This year’s selection highlighted pragmatic works that promote transparency and trust required by decision support tools.
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Affiliation(s)
- C Duclos
- Université Sorbonne Paris Nord, Sorbonne Université, INSERM, UMR_S 1142, LIMICS, Paris, France.,AP-HP, Hôpital Avicenne, Bobigny, France
| | - J Bouaud
- AP-HP, Delegation for Clinical Research and Innovation, Paris, France.,Université Sorbonne Paris Nord, Sorbonne Université, INSERM, UMR_S 1142, LIMICS, Paris, France
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Nadin D, Duclos C, Mahdid Y, Rokos A, Badawy M, Létourneau J, Arbour C, Plourde G, Blain-Moraes S. Brain network motif topography may predict emergence from disorders of consciousness: a case series. Neurosci Conscious 2020; 2020:niaa017. [PMID: 33376599 PMCID: PMC7751128 DOI: 10.1093/nc/niaa017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/18/2020] [Accepted: 06/03/2020] [Indexed: 11/16/2022] Open
Abstract
Neuroimaging methods have improved the accuracy of diagnosis in patients with disorders of consciousness (DOC), but novel, clinically translatable methods for prognosticating this population are still needed. In this case series, we explored the association between topographic and global brain network properties and prognosis in patients with DOC. We recorded high-density electroencephalograms in three patients with acute or chronic DOC, two of whom also underwent an anesthetic protocol. In these two cases, we compared functional network motifs, network hubs and power topography (i.e. topographic network properties), as well as relative power and graph theoretical measures (i.e. global network properties), at baseline, during exposure to anesthesia and after recovery from anesthesia. We also compared these properties to a group of healthy, conscious controls. At baseline, the topographic distribution of nodes participating in alpha motifs resembled conscious controls in patients who later recovered consciousness and high relative power in the delta band was associated with a negative outcome. Strikingly, the reorganization of network motifs, network hubs and power topography under anesthesia followed by their return to a baseline patterns upon recovery from anesthesia, was associated with recovery of consciousness. Our findings suggest that topographic network properties measured at the single-electrode level might provide more prognostic information than global network properties that are averaged across the brain network. In addition, we propose that the brain network's capacity to reorganize in response to a perturbation is a precursor to the recovery of consciousness in DOC patients.
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Affiliation(s)
- Danielle Nadin
- Montreal General Hospital, McGill University Health Center Research Institute, Montreal, QC, Canada
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Catherine Duclos
- Montreal General Hospital, McGill University Health Center Research Institute, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Yacine Mahdid
- Montreal General Hospital, McGill University Health Center Research Institute, Montreal, QC, Canada
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Alexander Rokos
- Montreal General Hospital, McGill University Health Center Research Institute, Montreal, QC, Canada
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Mohamed Badawy
- Montreal Neurological Hospital and Institute, McGill University Health Center, Montreal, QC, Canada
- Department of Anesthesia, McGill University, Montreal, QC, Canada
| | - Justin Létourneau
- Montreal Neurological Hospital and Institute, McGill University Health Center, Montreal, QC, Canada
- Department of Anesthesia, McGill University, Montreal, QC, Canada
| | - Caroline Arbour
- Centre de recherche, CIUSSS du-Nord-de-l’Île-de-Montréal, Montreal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Gilles Plourde
- Montreal Neurological Hospital and Institute, McGill University Health Center, Montreal, QC, Canada
- Department of Anesthesia, McGill University, Montreal, QC, Canada
| | - Stefanie Blain-Moraes
- Montreal General Hospital, McGill University Health Center Research Institute, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Duclos C, Dumont M, Paquet J, Blais H, Van der Maren S, Menon DK, Bernard F, Gosselin N. Sleep-wake disturbances in hospitalized patients with traumatic brain injury: association with brain trauma but not with an abnormal melatonin circadian rhythm. Sleep 2020; 43:5575663. [PMID: 31562742 DOI: 10.1093/sleep/zsz191] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/08/2019] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES To test whether the sleep-wake cycle disruption in patients hospitalized with traumatic brain injury (TBI) (1) is also found in patients with traumatic injuries other than TBI (non-TBI) and (2) is associated with a weaker or abnormal circadian clock signal. METHODS Forty-two non-mechanically ventilated and non-sedated patients hospitalized for moderate-to-severe TBI were compared to 34 non-TBI patients. They wore wrist actigraphs for 9.4 ± 4.2 days, starting 19.3 ± 12.6 days post-injury. Of these, 17 TBI and 14 non-TBI patients had their urine collected every hour for 25 hours, starting 18.3 ± 12.3 days post-injury. We calculated urinary 6-sulfatoxymelatonin concentration to obtain total 24-hour excretion, excretion onset, offset, duration, amplitude, and acrophase. Using Student's t-tests, we compared groups on actigraphy (daytime activity ratio, nighttime total sleep time, and fragmentation index) and melatonin variables. We investigated associations between melatonin and actigraphy variables using Pearson's correlations. RESULTS TBI patients had poorer daytime activity ratio (TBI: 77.5 ± 9.4%; non-TBI: 84.6 ± 6.9%), shorter nighttime total sleep time (TBI: 353.5 ± 96.6 min; non-TBI: 421.2 ± 72.2 min), and higher fragmentation index (TBI: 72.2 ± 30.0; non-TBI: 53.5 ± 23.6) (all p-values < 0.01). A melatonin rhythm was present in both groups, and no group differences were found on melatonin variables. No associations were found between melatonin and actigraphy variables in TBI patients. CONCLUSION Moderate-to-severe TBI patients have more serious sleep-wake disturbances than non-TBI patients hospitalized in the same environment, suggesting that the brain injury itself alters the sleep-wake cycle. Despite their deregulated 24-hour sleep-wake cycle, TBI patients have a normal circadian clock signal.
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Affiliation(s)
- Catherine Duclos
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Canada
| | - Marie Dumont
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Canada
| | - Jean Paquet
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Canada
| | - Hélène Blais
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Canada
| | - Solenne Van der Maren
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
| | - David K Menon
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Francis Bernard
- Department of Intensive Care, Hôpital du Sacré-Coeur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
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Sanchez E, Duclos C, Van Der Maren S, El-Khatib H, Arbour C, Baril A, Blais H, Carrier J, Gosselin N. 1133 The Recovery of Sleep Oscillations in Acute to Chronic Traumatic Brain Injury. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Slow waves and spindles are essential oscillations occurring during NREM sleep that may be disrupted by moderate to severe traumatic brain injury (TBI). We investigated these oscillations in the acute and chronic trauma stage.
Methods
Four groups were tested with whole-night polysomnography: hospitalized patients with acute TBI (n=10, 29.7±13.8y) or severe orthopedic injuries (n=15, 39.9±17.1y), chronic TBI including 9 returning from the acute TBI group (n=43, 31.9±13.5y), and healthy controls (n=36, 30.5±12.7y). Characteristics for slow waves (density, amplitude, slope, frequency, duration) and spindles (density, amplitude, frequency, duration) were quantified over N2 and N3 sleep for the first three sleep cycles, and groups were compared using one-way ANOVAs.
Results
One-way ANOVAs showed group effects only for slow wave density (F=4.11 to 6.04, p=0.009 to 0.0008)) and spindle density (F=3.3 to 8.8, p=0.02 to 0.00003). These effects were present for the 2nd and 3rd sleep cycles, but not the 1st. More specifically, slow wave density in acute TBI was higher than in controls, and returned to normal levels in the chronic stage. Conversely, spindle density in acute TBI was lower than in controls and returned to normal levels in the chronic stage. No group difference was observed for the orthopedic group.
Conclusion
Our results suggest that immediately after a severely disruptive event such as a TBI, the brain needs additional deeper sleep to recover, resulting in more slow waves but also in less spindles. These changes are only present in the 2nd and 3rd sleep cycles, reflecting an absence of the expected dissipation of slow waves, which may suggest increased homeostatic sleep pressure due to the brain injury. Limits to interpretation include the hospital environment and medication, but the absence of changes in the orthopedic group under similar conditions emphasizes the effect of the brain injury itself.
Support
Canadian Institutes of Health Research (CIHR) and Fonds de Recherche Québec-Santé (FRQS)
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Affiliation(s)
- E Sanchez
- Université de Montréal, Montréal, QC, CANADA
| | - C Duclos
- McGill University, Montreal, QC, CANADA
| | | | - H El-Khatib
- Université de Montréal, Montréal, QC, CANADA
| | - C Arbour
- Université de Montréal, Montréal, QC, CANADA
| | - A Baril
- Boston University, Boston, MA
| | - H Blais
- CIUSSS-NIM, Montréal, QC, CANADA
| | - J Carrier
- Université de Montréal, Montréal, QC, CANADA
| | - N Gosselin
- Université de Montréal, Montréal, QC, CANADA
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Bigué JL, Duclos C, Dumont M, Paquet J, Blais H, Menon DK, Bernard F, Gosselin N. Validity of actigraphy for nighttime sleep monitoring in hospitalized patients with traumatic injuries. J Clin Sleep Med 2020; 16:185-192. [PMID: 31992412 DOI: 10.5664/jcsm.8162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep-wake disturbances are frequent among patients hospitalized for traumatic injuries but remain poorly documented because of the lack of tools validated for hospitalized patients. This study aimed to validate actigraphy for nighttime sleep monitoring of hospitalized patients with severe traumatic injuries, using ambulatory polysomnography (PSG). METHODS We tested 17 patients (30.4 ± 14.7 years, 16.6 ± 8.2 days postinjury) who had severe orthopedic injuries and/or spinal cord injury, with or without traumatic brain injury. When medically stable, patients wore an actigraph on a nonparalyzed arm and underwent ambulatory PSG at the bedside. Data were converted to 1-minute epochs. The following parameters were calculated for the nighttime period: total sleep time, total wake time, sleep efficiency, and number of awakenings. Epoch-by-epoch concordance between actigraphy and PSG was analyzed to derive sensitivity, specificity, and accuracy. PSG sleep parameters were compared to those obtained from four actigraphy scoring algorithms by Bland-Altman plots. RESULTS Sensitivity to detect sleep was ≥ 92% and accuracy was > 85% for all four actigraphy algorithms used, whereas specificity varied from 48% to 60%. The low-activity wake threshold (20 activity counts per epoch) was most closely associated with PSG on all sleep parameters. This scoring algorithm also had the highest specificity (59.9%) and strong sensitivity (92.8%). CONCLUSIONS Actigraphy is valid for monitoring nighttime sleep and wakefulness in patients hospitalized with traumatic injuries, with sensitivity, specificity and accuracy comparable to actigraphic recordings in healthy individuals. A scoring algorithm using a low wake threshold is best suited for this population and setting.
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Affiliation(s)
- Julien Lauzier Bigué
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Department of Medicine, Université de Montréal, Montreal, Canada
| | - Catherine Duclos
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Marie Dumont
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Jean Paquet
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Hélène Blais
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - David K Menon
- Division of Anaesthesia, Cambridge University, Cambridge, United Kingdom
| | - Francis Bernard
- Department of Medicine, Université de Montréal, Montreal, Canada.,Critical Care, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
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Van der Maren S, Duclos C, Dumont M, Blais H, Daoust J, Lina JM, Bernard F, Menon D, Carrier J, Gosselin N. Sleep-wake cycle recovery after moderate to severe traumatic brain injury: are ultradian rhythms involved? Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Ternois I, Billard-Pomares T, Carbonelle E, Franchinard L, Duclos C. Using SNOMED-CT to Help the Transition from Microbiological Data to ICD-10 Sepsis Codes. Stud Health Technol Inform 2019; 264:1604-1605. [PMID: 31438253 DOI: 10.3233/shti190556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Assigning ICD-10 code of sepsis in regard of a pathogenic bacterium found in an haemoculture requires knowledge of microbiology because of the difference of granularity. The aim of this paper is to automate this coding thanks to the use of SNOMED-CT. A dichotomous classification of bacteria causing sepsis has been generated in respect of ICD-10. Our algorithm follows this and explores SNOMED-CT to assign the right ICD-10 code of the sepsis. Applied to a list of 164 bacteria, the system has an error rate of 1.22 %.
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Affiliation(s)
- Iris Ternois
- Univ Paris 13, Sorbonne Université, INSERM, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, F-93019 Bobigny, France
| | | | | | | | - Catherine Duclos
- Univ Paris 13, Sorbonne Université, INSERM, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, F-93019 Bobigny, France.,Hôpital Avicenne, AP-HP, Bobigny, France
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32
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Ghannouchi I, Marie JP, Duclos C, Verin E. Alteration of Swallowing and Ventilation Coordination in Respiratory Diseases in Small Mammals. Dysphagia 2019; 35:308-313. [DOI: 10.1007/s00455-019-10024-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/05/2019] [Accepted: 05/25/2019] [Indexed: 10/26/2022]
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33
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Duclos N, Parent G, Aissaoui R, Duclos C, Nadeau S. Using inertial signals to characterize main lower limb gait patterns in individuals post-stroke. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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34
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Tapin A, Barreau M, Jose-Escalona M, Vermette M, Gagnon D, Duclos C. Perception of gait movements induced during training with multiple patterned vibrations in individuals with incomplete spinal cord injury. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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35
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EsmaeiliMahani V, Bouyer L, Kairy D, Lamontagne A, Dyer J, Duclos C. Unpredictable gait perturbation training improves balance and gait abilities more than gait training without perturbations in individuals post-stroke. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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36
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Juneau A, Saade N, Kairy D, Fait P, Duclos C. Dynamic balance retraining using gait perturbations in individuals with moderate-to-severe traumatic brain injury. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Baron S, Diallo A, Duclos C. Comment s’assurer que le codage clinique est bien réalisé ? Une proposition méthodologique. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.01.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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38
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Van der Maren S, Moderie C, Duclos C, Paquet J, Daneault V, Dumont M. Daily Profiles of Light Exposure and Evening Use of Light-emitting Devices in Young Adults Complaining of a Delayed Sleep Schedule. J Biol Rhythms 2018; 33:192-202. [PMID: 29463186 DOI: 10.1177/0748730418757007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A number of factors can contribute to a delayed sleep schedule. An important factor could be a daily profile of light exposure favoring a later circadian phase. This study aimed to compare light exposure between 14 young adults complaining of a delayed sleep schedule and 14 matched controls and to identify possible associations between habitual light exposure and circadian phase. Exposure to white and blue light was recorded with ambulatory monitors for 7 consecutive days. Participants also noted their daily use of light-emitting devices before bedtime. Endogenous circadian phase was estimated with the dim light melatonin onset (DLMO) in the laboratory. The amplitude of the light-dark cycle to which the subjects were exposed was smaller in delayed than in control subjects, and smaller amplitude was associated with a later DLMO. Smaller amplitude was due to both decreased exposure in the daytime and increased exposure at night. Total exposure to blue light, but not to white light, was lower in delayed subjects, possibly due to lower exposure to blue-rich outdoor light. Lower daily exposure to blue light was associated with a later DLMO. Timing of relative increases and decreases of light exposure in relation to endogenous circadian phase was also compared between the 2 groups. In delayed subjects, there was a relatively higher exposure to white and blue light 2 h after DLMO, a circadian time with maximal phase-delaying effect. Delayed participants also had higher exposure to light 8 to 10 h after DLMO, which occurred mostly during their sleep episode but may have some phase-advancing effects. Self-reported use of light-emitting devices before bedtime was higher in delayed than in control subjects and was associated with a later DLMO. This study suggests that individuals complaining of a delayed sleep schedule engage in light-related behaviors favoring a later circadian phase and a later bedtime.
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Affiliation(s)
- Solenne Van der Maren
- Center for Advanced Research in Sleep Medicine, Sacre-Coeur Hospital of Montreal, Montreal, QC, Canada.,Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Christophe Moderie
- Center for Advanced Research in Sleep Medicine, Sacre-Coeur Hospital of Montreal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Catherine Duclos
- Center for Advanced Research in Sleep Medicine, Sacre-Coeur Hospital of Montreal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Jean Paquet
- Center for Advanced Research in Sleep Medicine, Sacre-Coeur Hospital of Montreal, Montreal, QC, Canada
| | - Véronique Daneault
- Center for Advanced Research in Sleep Medicine, Sacre-Coeur Hospital of Montreal, Montreal, QC, Canada
| | - Marie Dumont
- Center for Advanced Research in Sleep Medicine, Sacre-Coeur Hospital of Montreal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada
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Abstract
Abstract:No standardized representation of drug indications is currently available that could be used in drug knowledge bases. We describe an object-oriented representation of indications that should make it possible to develop new tools for selecting drugs and checking prescriptions in computerized drug prescription systems. The model was developed using the results of a lexical and semantic analysis of drug indications, collected into a single file and processed using natural language processing software. It distinguishes both the diseases for which the drug may be given and the efficiency of the drug for a given indication. Two aspects of the model were evaluated: the differences if two independent evaluators filled the attributes independently and the loss of information induced by the use of the model. A system based on this model, making it possible for the physician to select all the drugs satisfying various criteria, is also presented.
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Ugon A, Hadj Bouzid AI, Jaulent MC, Favre M, Duclos C, Jobez E, Falcoff H, Lamy JB, Tsopra R. Building a Knowledge-Based Tool for Auto-Assessing the Cardiovascular Risk. Stud Health Technol Inform 2018; 247:735-739. [PMID: 29678058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The prevention of cardiovascular diseases needs first to quantify the cardiovascular risk. To estimate this risk, French national health authorities provided clinical practice guidelines extending the existing European SCORE, which doesn't include all the cardiovascular risk factors (e.g. diabetes). Hence, French national clinical practice guidelines to quantify the cardiovascular risk is able to deal with more clinical situations than the SCORE. The goal of this paper is to formalize knowledge extracted from these guidelines and implement the rules so that they can be used into an auto-assessing tool of cardiovascular risk. Formalization followed five steps and was conducted under the guidance of medical experts. It resulted into a decision tree fed by eight decision variables. Evaluation of the accuracy of the decision tree showed 80% of agreement with an expert in medical informatics in predicting the cardiovascular risk level for 15 different clinical situations. Discrepancies correspond to the knowledge gaps within Clinical Practice Guidelines. We intend to extend the implementation of the decision tree to a complete tool, for allowing patient to auto-assess their cardiovascular risk. This tool will be integrated into a platform providing recommendations adapted to the calculated level of cardiovascular risk.
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Affiliation(s)
- Adrien Ugon
- ESIEE-Paris, Cité Descartes, 2 Boulevard Blaise Pascal, 93160 Noisy-le-Grand
| | - Amel Imene Hadj Bouzid
- LIMICS, INSERM UMRS 1142, Université Paris 13, Sorbonne Paris Cité, 93017 Bobigny, France UPMC Université Paris 6, Sorbonne Universités, Paris
| | - Marie-Christine Jaulent
- LIMICS, INSERM UMRS 1142, Université Paris 13, Sorbonne Paris Cité, 93017 Bobigny, France UPMC Université Paris 6, Sorbonne Universités, Paris
| | | | - Catherine Duclos
- LIMICS, INSERM UMRS 1142, Université Paris 13, Sorbonne Paris Cité, 93017 Bobigny, France UPMC Université Paris 6, Sorbonne Universités, Paris
| | - Emmanuel Jobez
- Société de Formation Thérapeutique du Généraliste, France
| | - Hector Falcoff
- Société de Formation Thérapeutique du Généraliste, France
| | - Jean-Baptiste Lamy
- LIMICS, INSERM UMRS 1142, Université Paris 13, Sorbonne Paris Cité, 93017 Bobigny, France UPMC Université Paris 6, Sorbonne Universités, Paris
| | - Rosy Tsopra
- LIMICS, INSERM UMRS 1142, Université Paris 13, Sorbonne Paris Cité, 93017 Bobigny, France UPMC Université Paris 6, Sorbonne Universités, Paris
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Ternois I, Escudie JB, Benamouzig R, Duclos C. Development of an Automatic Coding System for Digestive Endoscopies. Stud Health Technol Inform 2018; 255:107-111. [PMID: 30306917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Digestive endoscopies, along with all medical procedures in France are coded with the CCAM. This task is done by the physicians, is time-consuming and requires a good knowledge of the terminology besides a medical knowledge. This method offers an automatic coding of endoscopic procedures from free-text reports. Thanks to a supervised learning method, the reports are coded with an average precision and recall of 0.92 on a 1639 texts corpus.
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Desombres AC, Duclos C, Ghannouchi I, Marie JP, Verin E. Effect of liquid properties on swallowing and ventilation coordination in rats. Neurogastroenterol Motil 2017; 29. [PMID: 28656710 DOI: 10.1111/nmo.13130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/17/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND One aspect of rehabilitation in swallowing disorders is to change liquid properties. The objective of our study was to test how liquid properties could improve oropharyngeal dysphagia and swallowing and ventilation coordination in an animal model. METHODS Forty-two healthy male rats were distributed in six groups, including a control group. Rats were deprived of water for 24 h and then each group was administered liquid with different properties: tap water, sugar water, sparkling water, salt water, cold water, and acidic water. Rats were studied without and with oropharyngeal dysphagia achieved by unilateral section of the hypoglossal nerve. Swallowing and ventilation were analyzed by barometric plethysmograph. KEY RESULTS In healthy rats, swallowing occurred during expiratory time for all liquid properties. Most deglutitions were during expiratory time for all liquid properties (88±12%) and were not modified. There was an increase in VT/TI during swallowing with sparkling water and cold water (P<.05). In the operated groups, rats had significantly fewer swallows with tap water (P<.05) and significantly more swallows with sparkling water (P<.001), sugar water (P<.001) and cold water (P<.001) during expiratory time. The mean inspiratory volume (VT/TI) increased with sparkling water (P<.05). CONCLUSION AND INFERENCES Sparkling water seemed to improve swallowing and ventilation coordination in an animal model, to be confirmed in a study including patients with oropharyngeal dysphagia.
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Affiliation(s)
- A C Desombres
- EA 3830, Research Group on Ventilatory Handicap, IRIB, Normandie Université, Rouen, France
| | - C Duclos
- EA 3830, Research Group on Ventilatory Handicap, IRIB, Normandie Université, Rouen, France
| | - I Ghannouchi
- EA 3830, Research Group on Ventilatory Handicap, IRIB, Normandie Université, Rouen, France
| | - J P Marie
- EA 3830, Research Group on Ventilatory Handicap, IRIB, Normandie Université, Rouen, France.,Department of Cervical and Facial Surgery, Rouen University Hospital, Rouen, France
| | - E Verin
- EA 3830, Research Group on Ventilatory Handicap, IRIB, Normandie Université, Rouen, France.,CRMPR, Center of Physical Medicine and Rehabilitation, Ugecam Group, Les Herbiers, Bois Guillaume, France.,Division of Reeducation, Rehabilitation and Reinsertion (3R), Rouen University Hospital, Rouen, France
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43
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Lamy JB, Berthelot H, Favre M, Ugon A, Duclos C, Venot A. Using visual analytics for presenting comparative information on new drugs. J Biomed Inform 2017; 71:58-69. [DOI: 10.1016/j.jbi.2017.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 04/26/2017] [Accepted: 04/27/2017] [Indexed: 10/19/2022]
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El-Khatib H, Arbour C, Sanchez-Gonzalez E, Duclos C, Blais H, Dumont M, Gosselin N. 1168 CHARACTERIZATION OF CHRONIC SLEEP-WAKE DISTURBANCES OCCURRING AFTER MODERATE TO SEVERE TRAUMATIC BRAIN INJURY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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45
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Van der Maren S, Duclos C, Arbour C, Pizzimenti L, Potvin M, Blais H, El-Khatib H, Bernard F, Menon D, Dumont M, Gosselin N. 1175 SLEEP-WAKE CYCLE AND EARLY NEUROLOGICAL RECOVERY AFTER MODERATE TO SEVERE TRAUMATIC BRAIN INJURY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Duclos C, Dumont M, Paquet J, Blais H, Quinn M, Menon DK, Bernard F, Gosselin N. 1144 PRESENCE OF MELATONIN RHYTHM IN ACUTE MODERATE-SEVERE TRAUMATIC BRAIN INJURY DESPITE SEVERE SLEEP-WAKE DISTURBANCES. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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47
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Duclos C, Lavoie C, Denault JB. Caspases rule the intracellular trafficking cartel. FEBS J 2017; 284:1394-1420. [PMID: 28371378 DOI: 10.1111/febs.14071] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/17/2017] [Accepted: 03/27/2017] [Indexed: 12/15/2022]
Abstract
During apoptosis, caspases feast on several hundreds of cellular proteins to orchestrate rapid cellular demise. Indeed, caspases are known to get a taste of every cellular process in one way or another, activating some, but most often shutting them down. Thus, it is not surprising that caspases proteolyze proteins involved in intracellular trafficking with particularly devastating consequences for this important process. This review article focuses on how caspases target the machinery responsible for smuggling goods within and outside the cell.
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Affiliation(s)
- Catherine Duclos
- Institut de Pharmacologie de Sherbrooke, Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, QC, Canada
| | - Christine Lavoie
- Institut de Pharmacologie de Sherbrooke, Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, QC, Canada
| | - Jean-Bernard Denault
- Institut de Pharmacologie de Sherbrooke, Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, QC, Canada
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Beddag M, Sedki K, Duclos C, Baron S, Tsopra R. Mieux comprendre les comptes rendus d’hospitalisation pour mieux les coder. Un exemple en cardiologie. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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49
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Ugon A, Duclos C, Konate S, Arnedos Lopez S, Yazidi H, Venot A, Jaulent MC, Tsopra R. Parallel Design of Browsing Scheme and Data Model for Multi-Level Hierarchical Application Devoted to Management of Patient with Infectious Disease in Primary Care. Stud Health Technol Inform 2017; 235:421-425. [PMID: 28423827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Many decision systems are based on a hierarchical approach, enriching the known context used to finally choose the right potential action. Designing the scheme for browsing the clinical guidelines is a task devoted to expert in infectious diseases. Designing the data model is a task devoted to the expert in data modeling. As a consequence, browsing scheme and data model generally differ in terms of abstraction levels. While the browsing scheme proposes to navigate into depth, the data model stays flat. We propose here a novel method to design in parallel the browsing scheme and the data model so that both of them reflect the different abstraction levels in decision process.
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Affiliation(s)
- Adrien Ugon
- Sorbonne Universités, UPMC Univ Paris 06, UMR 7606, LIP6, Paris, France
| | - Catherine Duclos
- Sorbonne Universités, UPMC Univ Paris 06, INSERM Sorbonne Paris Cité, Université Paris 13, LIMICS, UMR_S 1142, Paris, France
| | - Salamata Konate
- Sorbonne Universités, UPMC Univ Paris 06, INSERM Sorbonne Paris Cité, Université Paris 13, LIMICS, UMR_S 1142, Paris, France
| | - Sarah Arnedos Lopez
- Sorbonne Universités, UPMC Univ Paris 06, INSERM Sorbonne Paris Cité, Université Paris 13, LIMICS, UMR_S 1142, Paris, France
| | - Hechem Yazidi
- Sorbonne Universités, UPMC Univ Paris 06, INSERM Sorbonne Paris Cité, Université Paris 13, LIMICS, UMR_S 1142, Paris, France
| | - Alain Venot
- Sorbonne Universités, UPMC Univ Paris 06, INSERM Sorbonne Paris Cité, Université Paris 13, LIMICS, UMR_S 1142, Paris, France
| | - Marie-Christine Jaulent
- Sorbonne Universités, UPMC Univ Paris 06, INSERM Sorbonne Paris Cité, Université Paris 13, LIMICS, UMR_S 1142, Paris, France
| | - Rosy Tsopra
- Sorbonne Universités, UPMC Univ Paris 06, INSERM Sorbonne Paris Cité, Université Paris 13, LIMICS, UMR_S 1142, Paris, France
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Tsopra R, Kinouani S, Venot A, Jaulent MC, Duclos C, Lamy JB. Design of a Visual Interface for Comparing Antibiotics Using Rainbow Boxes. Stud Health Technol Inform 2017; 235:529-533. [PMID: 28423849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Non-optimal prescriptions of antibiotics have a negative impact on patients and population. Clinical practice guidelines are not always followed by doctors because the rationale of the recommendations is not always clear and can be difficult to understand. In this paper, we propose a new approach consisting in presenting the properties of antibiotics for allowing doctors to compare them and choose the most appropriate one. For that, we used and extended rainbow boxes, a new technique for overlapping set visualization. We tested our approach on 11 clinical situations related to urinary infections, and assessed the simplicity, the interest and utility with 11 doctors. 10 of them found that this approach was interesting and useful in clinical practice. Further studies are needed to confirm this preliminary work.
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Affiliation(s)
- Rosy Tsopra
- LIMICS, INSERM UMRS 1142, Université Paris 13, UPMC Université Paris 6, Paris, France
| | | | - Alain Venot
- LIMICS, INSERM UMRS 1142, Université Paris 13, UPMC Université Paris 6, Paris, France
| | | | - Catherine Duclos
- LIMICS, INSERM UMRS 1142, Université Paris 13, UPMC Université Paris 6, Paris, France
| | - Jean-Baptiste Lamy
- LIMICS, INSERM UMRS 1142, Université Paris 13, UPMC Université Paris 6, Paris, France
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