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Posture and ventilation in the playing of wind musical instruments: a pilot experiment
No full textPerformance sportive et musicale : geste, contrôle, perception; GSAM - Acoustique Musicale: GAP - Voix et ParoleNational audienceFor wind instrumentalists, breath control is essential for sound production. It requires a "non-respiratory" use of muscles whose primary function is respiratory. These muscles also contribute to maintaining posture, resulting in a interaction between the ventilatory and postural systems. Observing that wind instrumentalists move to varying degrees while playing, depending on the instrument and the musical instruction, we aim to investigate the relationships between the musical task, breathing strategies, and movement, which involve temporal variations in posture. Are the musicians’ movements intended to emphasize musical expression independently of the respiratory cycle ? To explore this, we record various instrumental control parameters, acoustic signals, and biomechanical data during musical performance : mouth and instrumental pressure using pressure sensors, mouth position and opening area with a camera-mirror system attached to the instrument, radiated acoustic pressure using two microphones, and thoracic volume variations and postural oscillations of body segments with an optoelectronic motion capture system. We will present the results obtained during the musical performance on the transverse flute. The selected musical excerpt comes from an Etude chosen for its simple and regular musical structure, allowing the imposition of specific breathing instructions that alter the respiratory cycle period. The analyses will integrate instrumental control, the use of the respiratory and postural systems, and the musical structure
Mass-independent fractionation of oxygen isotopes during high-temperature condensation in cosmochemical plasmas
No full textInternational audienceContrary to all terrestrial rocks, planets and meteorites exhibit oxygen isotope variations decorrelated with the mass difference of their atomic nuclei. It has been proposed that, in the protosolar nebula (PSN), these variations could result from mass independent isotopic fractionation (MIF) either during specific chemical reactions similar to those responsible for the formation of ozone in the Earth’s atmosphere or during ultraviolet (UV)-photolysis of carbon monoxide (CO) gas in the PSN. However, these potential chemical MIF reactions (Chem-MIFs) are not identified in conditions close to the PSN, and there is no experimental demonstration that large MIF signature can be transferred to solids forming in the PSN. Here, we show that MIFs, up to 60‰ depletion in 16O, are produced by high-temperature reactions in a plasma during the condensation of carbonaceous solids from a gas containing two of the most abundant PSN molecular species (H2O and CH4 ). This effect is attributed to the formation in the plasma of the activated complex H2O2* followed by its stabilization by reactions with CHx• radicals. Although it is premature to assert that this reaction represents the main process resulting in MIF of oxygen isotopes in the solar system, our result demonstrates the potential importance of a Chem-MIF effect in a PSN where plasma zones develop
Advantages and Inconveniences of a Multi-Agent Large Language Model System to Mitigate Cognitive Biases in Diagnostic Challenges
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Effect of RSV Vaccine on Heart Failure Hospitalizations
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Nationwide implementation of heart failure therapies: National Heart Failure Center Accreditation Program ( HF ‐ CAP ) in China
No full textInternational audienceAims Implementing optimal guideline‐directed medical therapy is still challenging in patients with heart failure (HF). This prospective study assessed the benefits of large‐scale, nationwide, multi‐annual implementation of HF therapies in China. Methods and results This longitudinal, pre‐post comparison design included patients in hospitals accredited by the National Heart Failure Center Accreditation Program (HF‐CAP). Patients were divided into four groups: 6–12 months before accreditation (Pre); >0 –≤12 months after accreditation (Y1); >12–≤24 months after accreditation (Y2), and >24 months after accreditation (Y2+). The primary endpoint was 1‐year composite HF readmission and/or cardiovascular death. Secondary endpoints included 1‐year HF readmission alone, 1‐year cardiovascular death alone, and association between phone calls and/or visits and outcomes. Overall, 408 073 patients with HF from 646 centres were included. After HF‐CAP accreditation, more patients with HF were treated following discharge. Compared with the Pre group, risk of meeting the primary endpoint decreased in Y1 and was incrementally lower in Y2 and Y2+: fully adjusted odds ratios (OR) and 95% confidence intervals (CIs) were 0.893 (0.871–0.916), 0.855 (0.830–0.880) and 0.720 (0.695–0.745), respectively (all p < 0.0001). Risk of HF readmission alone reduced from Y1 onwards (OR 0.865 [95% CI 0.841–0.891]). Risk of cardiovascular death reduced from Y2 onwards (OR 0.942 [95% CI 0.904–0.983]). Phone calls had little association with patient outcomes; however, face‐to‐face visits reduced risk of cardiovascular death (OR 0.624 [95% CI 0.597–0.651]). Conclusions Guideline‐directed medical therapy implementation and follow‐up after HF hospitalization was achievable in ~400 000 patients and was associated with cardiovascular benefits 1‐year post‐initiation
Des genres insaisissables. Les bricolages catégoriels du rapport aux séries
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An Intelligent and Visual Clinical Decision Support System for Medication Reconciliation at Admission in a Hospital Setting
No full textInternational audienceMedication reconciliation (MR) aims to prevent medication errors during transitions of care, particularly at hospital admission. Despite its importance, MR remains time-consuming, and existing electronic tools lack collaborative features and visual approaches. This study describes the design of a new electronic tool for MR, developed within ABiMed, a clinical decision support system for medication review and polypharmacy management. The tool follows the main steps of the MR process: the best possible medication history (BPMH) elaborated by the pharmacist is compared to the admission medication order (AMO), and discrepancies are semi-automatically identified and classified. Unresolved discrepancies can be directly sent to the prescriber. The tool builds on features included in ABiMed, such as an ontology-based structure allowing for integration in other tools, real-time collaboration between pharmacists and prescribers, visual drug data specific to the patient, and automatic execution of STOPP/START clinical guidelines. These approaches encourage shared responsibility, and support more clinically relevant and useful pharmacist interventions. The tool has yet to undergo clinical evaluation. Future work will assess usability and impact on outcomes such as time spent on MR, prescriber acceptance of interventions, and the tool will further be expanded to include more clinical guidelines
