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Resume Introduction La duree de psychose non traitee est un facteur important de mauvais pronostic, toutefois il manque des outils pour faciliter le reperage des situations a risque d’evolution vers la psychose. Nous presentons ici la validation d’une version francaise de l’auto-questionnaire 16-items Prodromal Questionnaire (fPQ16). Methodes Entre novembre 2016 et mai 2018, le fPQ16 a ete propose a tous les patients d’une consultation pour adolescents et jeunes adultes. La « comprehensive assesment of at-risk mental state » (CAARMS) permettait de determiner si la personne atteint les criteres d’etat a ultra haut risque (UHR) ou de psychose. L’analyse de la validite concurrentielle du fPQ16 avec la CAARMS a ete realisee au moyen de courbes ROC. Resultats Cent sujets ont ete inclus. La moyenne d’âge etait de 19,85 ans (± 3,3 ans). Cinquante-huit pour cent des patients inclus presentaient un etat UHR (40 %) ou de psychose (18 %) a la CAARMS. Le score cut-off retenu en faveur d’un etat UHR ou de psychose etait a 4 items cotes positivement, avec une sensibilite a 91 % et une specificite a 60 %. La valeur predictive positive du fPQ16 etait de 76 %. L’aire sous la courbe etait de 0,85 (p Discussion Le fPQ16 montre de bonnes performances de screening dans notre population, avec un cut-off de 4, plus bas que lors de precedentes etudes. Sa bonne acceptabilite et sa brievete en font un outil pertinent de screening a evaluer maintenant dans des services de soin de premiere ligne. L’adjonction d’items testant la desorganisation pourrait ameliorer sa specificite.

International audience; Background and context: Problematic use of physical activity is frequent in subjects with anorexia nervosa (AN). Although it increases resistance to therapeutic treatment, paradoxically, physical activity in AN can also improve mental and physical health. Based on the literature review we hypothesized that adding an adapted physical activity (APA) program to treatment programs could be more beneficial than a total suppression of physical activities. We designed this open study to evaluate the outcome of AN inpatients after an APA program implementation as well as the perceived effect of APA. Method: Forty-one women with AN (17.2 (±2.5) years old, BMI of 16.86 (±2.0)) were included. An eight-session (1 h30/session/week) standardized APA program was delivered and evaluated by structured questionnaires assessing exercise dependence, perceived physical activity, eating disorder (ED) symptoms, body mass index (BMI), along with an interview before and after the APA program. Results: Twenty-nine women complete the PA program and evaluation. BMI and perceived PA score significantly increased, ED and exercise dependence scores significantly decreased (p

Purpose The study estimates the prevalence of probable psychiatric disorder in the working population, determines the proportion of people presenting a probable psychiatric disorder among people exposed to work-related psychosocial risk factors (PSRFs), and identifies which PSRF has the strongest association with having a probable psychiatric disorder. Methods A cross-sectional study conducted in March 2018 involved a representative sample of the French working population. The General Health Questionnaire 28 (GHQ-28) was used to estimate the prevalence of probable psychiatric disorder and 44 items were gathered from theoretical models of PSRFs. We used multiple logistic regression to estimate the association of each PSRF with having a probable psychiatric disorder, adjusted on individual, health, and job confounders. Results This study involved 3200 French participants. The proportion of probable psychiatric disorder was 22.2% [20.6; 24.0]. Ten PSRFs were significantly associated with it. The strongest association was for having problems handling professional and personal responsibilities (reported by 15% of the study population) (OR = 1.97 [1.52; 2.54]), with 45% pathological GHQ-28 scores (potential psychiatric cases) for people exposed to this PSRF versus 18% non-exposed. The next strongest association was lack of support of colleagues (reported by 28%) (OR = 1.63 [1.29; 2.06]). The third strongest association was feeling sometimes afraid when doing the job (reported by 63%) (OR = 1.53, [1.21; 1.93]). Conclusions Our study identified 10 PSRFs associated with psychiatric disorder, with substantial exposure rate among the population. The results of our research could help develop recommendations to improve work environment.

Background:Applying the concept of burnout to medical students before residency is relatively recent. Its estimated prevalence varies significantly between studies. Our objective was to estimate the prevalence of burnout in medical students worldwide.Methods:We systematically searched Medline for English-language articles published between January 1, 2010 and December 31, 2017. We selected all the original studies about the prevalence of burnout in medical students before residency, using validated questionnaires for burnout. Statistical analyses were conducted using the OpenMetaAnalyst software.Results:Prevalence of current burnout was extracted from 24 studies encompassing 17,431 medical students. Among them, 8060 suffered from burnout and we estimated the prevalence to be 44.2% [33.4%–55.0%]. The information about the prevalence of each subset of burnout dimensions was given in nine studies including 7588 students. Current prevalence was estimated to be 40.8% for ‘emotional exhaustion’ [32.8%–48.9%], 35.1% [27.2%–43.0%] for ‘depersonalization’ and 27.4% [20.5%–34.3%] for ‘personal accomplishment’. There is no significant gender difference in burnout. The prevalence of burnout is slightly different across countries with a higher prevalence in Oceania and the Middle East than in other continents.Conclusions:The results of this meta-analysis suggest that one student out of two is suffering from burnout, even before residency. Again, our findings highlight the high level of distress in the medical population. These results should encourage the development of preventive strategies.

Patient Specific Instruments (PSIs) have been introduced into the surgical workflow as a modern way to assist the surgeon in performing femur and tibia resection in Total Knee Arthroplasty (TKA). These PSIs are based on an accurate reconstruction of the surface of the knee’s bones.In this work, we propose two 3D-3D image-based registration methods to reconstruct an extended field-of-view of the knee joint using only a motorized ultrasound transducer. Those methods are: (1) a dense voxel-based registration method, which needs to preprocess the ultrasound images and form an ultrasound volume. Then, computing the Mutual Information (MI) for each relative displacement to align every pair of volumes, (2) a sparse point-based registration method, which takes into account the point set located on the surface of the bone in ultrasound images. This method detects bony features using ORB detector and matches the corresponding points to find the best transformation using Coherent Point Drift (CPD).The preliminary qualitative results performed in vitro show that from a set of consecutive ultrasound volumes, an extended field-of-view can be reconstructed using only ultrasound images without any external trackers. Results of the voxel-based approach show that MI is more robust against noise comparing to other similarity measures. On the other hand, results of point-based approach show that is much faster in computation with a low false-positive rate compared to other feature-detectors like SIFT and SURF. Furthermore, experiments show that CPD is less affected by noisy data compared to the classical ICP, which is promising to continue evaluating our work in vivo.

International audience; The 14-item Compulsive Internet Use Scale (CIUS) is one of the most frequently internationally adapted psychometric instruments developed to assess generalized problematic Internet use. Multiple adaptations of this instrument have led to versions in different languages (e.g., Arabic and French), and different numbers of items (e.g., from 5 to 16 items instead of the original 14). However, to date, the CIUS has never been simultaneously compared and validated in several languages and different versions. Consequently, the present study tested the psychometric properties of four CIUS versions (i.e., CIUS-14, CIUS-9, CIUS-7, and CIUS-5) across eight languages (i.e., German, French, English, Finnish, Spanish, Italian, Polish, and Hungarian) to (a) examine their psychometric properties, and (b) test their measurement invariance. These analyses also identified the optimal versions of the CIUS. The data were collected via online surveys administered to 4,226 voluntary participants from 15 countries, aged at least 18 years, and recruited from academic environments. All brief versions of the CIUS in all eight languages were validated. Dimensional, configural, and metric invariance were established across all languages for the CIUS-5, CIUS-7, and CIUS-9, but the CIUS-5 and CIUS-7 were slightly more suitable because their model fitted the ordinal estimate better, while for cross-comparisons, the CIUS-9 was slightly better. The brief versions of the CIUS are therefore reliable and structurally stable instruments that can be used for cross-cultural research across adult populations.

Unexplained pain and stiffness after total knee arthroplasty (TKA) often result from mismatch between implant geometry and knee morphology, which depends on patient size, sex, and ethnicity. This study aimed to determine whether size, sex, or ethnicity are independently associated with distal femoral morphology in healthy Caucasian and Asian knees, and to compare anatomic ratios to those of commercially available TKA implants. Two series of computed tomography (CT) angiograms from France (264 knees) and China (259 knees) were used to digitize osteometric landmarks at the level of the femoral epicondyles, to measure anteroposterior (AP) and mediolateral (ML) dimensions at the anterior, posterior, medial, and lateral zones. The aspect (ML/AP), trapezoidicity (MLp/MLa), and asymmetry (APl/APm) ratios, as well as the sulcus angle were calculated and compared to those of 9 TKA models. Multivariable analyses were performed to determine whether anatomic ratios were independently associated with sex, origin, or size. Multivariable analyses revealed that, independently from size, female knees were narrower (β = − 0.03; p

International audience; RésuméObjectif L'objectif de cette étude est de décrire le fonctionnement du dispositif Fil Harmonie, ligne téléphonique réservée aux professionnels de l'Académie de Paris faisant face à une situation d'un élève en souffrance psychologique ou psychiatrique. Méthodes Il s'agit d'une étude descriptive observationnelle réalisée entre le 18 septembre 2013 et le 12 mai 2014. Les informations transmises lors des 68 appels téléphoniques ont été recueillies, formalisées puis analysées. Nous avons utilisé une méthodologie mixte, associant des analyses de données quantitatives et de données textuelles. Résultats La profession de l'appelant était dans plus de 70 % des cas celle d'infirmière scolaire. L'âge moyen des élèves concernés était de 17,3 ans. Les deux classes les plus représentées étaient la seconde et la classe préparatoire (19,7 % dans les deux cas). Plus de la moitié des jeunes étaient déclarés comme n'ayant jamais eu de prise en charge psychologique antérieure (52,5 %). Les jeunes étaient décrits majoritairement comme isolés socialement (67,2 %), tristes ou anhédoniques (48,2 %). Plus d'un quart (26,7 %) avait déjà redoublé au moins une fois et la majorité (55,9 %) faisait preuve d'absentéisme. L'analyse qualitative a mis en évidence la complexité de la collaboration entre la famille de l'élève et l'établissement scolaire. Conclusion Fil Harmonie propose une nouvelle modalité pour favoriser le dépistage des difficultés psychiques chez les jeunes en milieu scolaire. Ce dispositif aide à la résolution de problème et si nécessaire l'orientation vers des professionnels de santé adéquats grâce à l'intervention d'un professionnel relais. Cette étude de terrain pointe la nécessaire articulation entre professionnels de l'Éducation, professionnels de santé et entourage proche. AbstractObjective Most psychiatric disorders arise during adolescence, a period of life during which school takes an important place. School in France has an official mission of health education and prevention, and early detection of mental disorders is part of these goals. The aim of this study is to describe an innovative service operating in Paris that helps educational staff to deal with students having psychological or psychiatric symptoms. The Fil Harmonie program was launched in 2011. It consists of a telephone line available to all educational staff working for high schools in Paris. Methods When in need of assistance, a member of the educational staff can call the dedicated hotline and expose the situation of their student to a trained psychologist. Over the course of the study, data concerning these phone calls were collected such as: socio-demographic characteristics of the student, the reason behind the call, the caller's professional role within the school, and care pathway information. All data collected during the phone calls were anonymized and computerized. We performed an observational descriptive study based on this data by using mixed methods: we integrated quantitative analysis and qualitative research in order to provide a better understanding of the Fil Harmonie program. Results Between 18 September 2013 and 12 May 2014, the Fil Harmonie program handled 68 calls from educational staff. Students concerned by the calls were aged between 11 and 22 and the average age was 17.3 years. Over half (52.5%) of the pupils concerned had never seen a mental health professional before the call. In more than 70% of cases, the caller was a school nurse while other professionals such as teachers or headmasters represented only a minority of the callers. Approximately two thirds (67.2%) of students were described by the caller as socially isolated and 48.2% were described as sad or anhedonic. One out of four (26.7%) had repeated a school year at least once, and 55.9% of young people for whom a member of staff contacted Fil Harmonie had been missing class. In 56.7% of cases, there had been no contact with the student's family about the psychological situation. The qualitative analysis particularly highlighted the complexity of the collaboration between the family and the educational staff. Conclusion Schooling is an important opportunity to seize in mental health regarding early detection and access to care. By fostering collaboration between educational professionals and mental health services, Fil Harmonie meets a public health objective of prevention and should contribute to the reduction of care delays thus leading to better treatment outcome. Our study shows that such programs are feasible and answer a real need in our current health care system.

Background and aims: Despite many positive benefits, mobile phone use can be associated with harmful and detrimental behaviors. The aim of this study was twofold: to examine (a) cross-cultural patterns of perceived dependence on mobile phones in ten European countries, first, grouped in four different regions (North: Finland and UK; South: Spain and Italy; East: Hungary and Poland; West: France, Belgium, Germany, and Switzerland), and second by country, and (b) how socio-demographics, geographic differences, mobile phone usage patterns, and associated activities predicted this perceived dependence.\ud \ud Methods: A sample of 2,775 young adults (aged 18–29 years) were recruited in different European Universities who participated in an online survey. Measures included socio-demographic variables, patterns of mobile phone use, and the dependence subscale of a short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ; Billieux, Van der Linden, & Rochat, 2008).\ud \ud Results: The young adults from the Northern and Southern regions reported the heaviest use of mobile phones, whereas perceived dependence was less prevalent in the Eastern region. However, the proportion of highly dependent mobile phone users was more elevated in Belgium, UK, and France. Regression analysis identified several risk factors for increased scores on the PMPUQ dependence subscale, namely using mobile phones daily, being female, engaging in social networking, playing video games, shopping and viewing TV shows through the Internet, chatting and messaging, and using mobile phones for downloading-related activities.\ud \ud Discussion and conclusions: Self-reported dependence on mobile phone use is influenced by frequency and specific application usage.

Resume La proportion de traitement non adequat parmi les personnes presentant un episode depressif majeur (EDM) est importante d’apres les etudes disponibles. L’objectif de cet article est d’identifier quels sont les facteurs associes a l’adequation des traitements de la depression en France. On cherchera en particulier a savoir si le fait de recevoir un traitement adequat est associe au fait d’avoir recours a un type de professionnel donne et a mettre en evidence l’effet specifique du type de recours sur l’adequation des traitements en controlant l’effet des variables sociodemographiques et cliniques. Les donnees sont issues d’une enquete epidemiologique nationale en population generale realisee en 2005 (Barometre sante 2005, n = 16 883) par l’Institut national de prevention et d’education pour la sante. Le niveau d’adequation des traitements est plus elevee chez les femmes, les troubles severes, les personnes habitant en region parisienne ou Centre-Est et plus faible chez les etudiants. En controlant l’effet des variables sociodemographiques et cliniques, la probabilite de recevoir un traitement adequat augmente avec le recours au secteur specialise, uniquement ou conjoint a un recours au generaliste. Les personnes en retraite et les autres inactifs ont une probabilite plus elevee de recevoir un traitement adequat. Habiter dans les regions mediterranee, parisienne ou Centre-Est est significativement associe au fait de recevoir un traitement adequat de la depression. Enfin, la severite des troubles depressifs augmente egalement la probabilite de recevoir un traitement adequat.

This paper presents a system architecture of an acquisition, compression and rendering system for 3D- TV and free-viewpoint video applications. We show that the proposed system yields two distinct advantages. First, it achieves an efficient compression of 3D/multi-view video by extending a standard H.264 encoder such that near backward compatibility is retained. Second, the proposed system can efficiently compress both 3D-TV and free- viewpoint multi-view video datasets using the single proposed system architecture.

Heterogeneity image-derived features of Glioblastoma multiforme (GBM) tumors from multimodal MRI sequences may provide higher prognostic value than standard parameters used in routine clinical practice. We previously developed a framework for automatic extraction and combination of image-derived features (also called “Radiomics”) through support vector machines (SVM) for predictive model building. The results we obtained in a cohort of 40 GBM suggested these features could be used to identify patients with poorer outcome. However, extraction of these features is a delicate multi-step process and their values may therefore depend on the pre-processing of images. The original developed workflow included skull removal, bias homogeneity correction, and multimodal tumor segmentation, followed by textural features computation, and lastly ranking, selection and combination through a SVM-based classifier. The goal of the present work was to specifically investigate the potential benefit and respective impact of the addition of several MRI pre-processing steps (spatial resampling for isotropic voxels, intensities quantization and normalization) before textural features computation, on the resulting accuracy of the classifier. Eighteen patients datasets were also added for the present work (58 patients in total). A classification accuracy of 83% (sensitivity 79%, specificity 85%) was obtained using the original framework. The addition of the new pre-processing steps increased it to 93% (sensitivity 93%, specificity 93%) in identifying patients with poorer survival (below the median of 12 months). Among the three considered pre-processing steps, spatial resampling was found to have the most important impact. This shows the crucial importance of investigating appropriate image pre-processing steps to be used for methodologies based on textural features extraction in medical imaging.

International audience; In Glioblastoma Multiforme (GBM) image-derived features (“radiomics”) could help in individualizing patient management. Simple geometric features of tumors (necrosis, edema, active tumor) and first-order statistics in Magnetic Resonance Imaging (MRI) are used in clinical practice. However, these features provide limited characterization power because they do not incorporate spatial information and thus cannot differentiate patterns. The aim of this work is to develop and evaluate a methodological framework dedicated to building a prognostic model based on heterogeneity textural features of multimodal MRI sequences (T1, T1-contrast, T2 and FLAIR) in GBM. The proposed workflow consists in i) registering the available 3D multimodal MR images and segmenting the tumor volume, ii) extracting image features such as heterogeneity metrics and iii) building a prognostic model by selecting, ranking and combining optimal features through machine learning (Support Vector Machine). This framework was applied to 40 histologically proven GBM patients with the endpoint being overall survival (OS) classified as above or below the median survival (15 months). The models combining features from a maximum of two modalities were evaluated using leave-one-out cross-validation (LOOCV). A classification accuracy of 90% (sensitivity 85%, specificity 95%) was obtained by combining features from T1 pre-contrast and T1 post-contrast sequences. Our results suggest that several textural features in each MR sequence have prognostic value in GBM.

Image-derived features (“radiomics”) are increasingly being considered for patient management in (neuro)oncology and radiotherapy. In Glioblastoma multiforme (GBM), simple features are often used by clinicians in clinical practice, such as the size of the tumor or the relative sizes of the necrosis and active tumor. First order statistics provide a limited characterization power because they do not incorporate spatial information and thus cannot differentiate patterns. In this work, we present the methodological framework for building a prognostic model based on heterogeneity textural features of multimodal MRI sequences (T1, T1-contrast, T2 and FLAIR) in GBM. The proposed workflow consists in i) registering the available 3D multimodal MR images and segmenting the tumor volume, ii) extracting image features such as heterogeneity metrics and shape indices, iii) building a prognostic model using Support Vector Machine by selecting, ranking and combining optimal features. We present preliminary results obtained for the classification of 40 patients into short (≤ 15 months) or long (> 15 months) overall survival, validated using leave-one-out cross-validation. Our results suggest that several textural features in each MR sequence have prognostic value in GBM, classification accuracy of 90% (sensitivity 85%, specificity 95%) being obtained by combining both T1 sequences. Future work will consist in i) adding more patients for validation using training and testing groups, ii) considering additional features, iii) building a fully multimodal MRI model by combining features from more than two sequences, iv) consider survival as a continuous variable and v) combine image-derived features with clinical and histopatholoigcal data to build an even more accurate model.

This paper evaluates our 3D view interpolation rendering algorithm and proposes a few performance improving techniques. We aim at developing a rendering method for free-viewpoint 3DTV, based on depth image warping from surrounding cameras. The key feature of our approach is warping texture and depth in the first stage simultaneously and postpone blending the new view to a later stage, thereby avoiding errors in the virtual depth map. We evaluate the rendering quality in two ways. Firstly, it is measured by varying the distance between the two nearest cameras. We have obtained a PSNR gain of 3 dB and 4.5 dB for the 'Breakdancers' and 'Ballet' sequences, respectively, compared to the performance of a recent algorithm. A second series of tests in measuring the rendering quality were performed using compressed video or images from surrounding cameras. The overall quality of the system is dominated by rendering quality and not by coding.

This paper presents a novel depth-image coding algorithm that concentrates on the special characteristics of depth images: smooth regions delineated by sharp edges. The algorithm models these smooth regions using piecewise-linear functions and sharp edges by a straight line. To define the area of support for each modeling function, we employ a quadtree decomposition that divides the image into blocks of variable size, each block being approximated by one modeling function containing one or two surfaces. The subdivision of the quadtree and the selection of the type of modeling function is optimized such that a global rate-distortion trade-off is realized. Additionally, we present a predictive coding scheme that improves the coding performance of the quadtree decomposition by exploiting the correlation between each block of the quadtree. Experimental results show that the described technique improves the resulting quality of compressed depth images by 1.5-4 dB when compared to a JPEG-2000 encoder.

We investigate the coding of multiview images obtained from a set of multiple cameras. To exploit the inter-view correlation, two view-prediction tools have been implemented and used in parallel: a block-based motion compensation scheme and a depth image based rendering technique (DIBR). Whereas DIBR relies on an accurate depth image, the block-based motion-compensation scheme can be performed without any geometry information. Our encoder adaptively selects the most appropriate prediction scheme using a rate-distortion criterion for an optimal prediction-mode selection. The attractiveness of the algorithm is that the compression algorithm is robust against inaccurately estimated depth images and requires only one single reference camera for fast random-access to different views. We present experimental results for several multiview sequences, that result in a quality improvement of up to 1.4 dB as compared to H.264 compression.

An efficient way to transmit multi-view images is to send the texture image together with a corresponding depth image. The depth image specifies the distance between each pixel and the camera. With this information, arbitrary views can be generated at the decoder. In this paper, we propose a new algorithm for the coding of depth images that provides an efficient representation of smooth regions as well as geometric features such as object contours. Our algorithm uses a segmentation procedure based on a quadtree decomposition and models the depth image content with piecewise linear functions. We achieved a bit-rate as low as 0.33 bit/pixel, without any entropy coding. The attractivity of the coding algorithm is that, by exploiting specific properties of depth images, no degradations are shown along discontinuities, which is important for perceived depth.