Why are people still dying of drug-susceptible TB in Paris in the 21st century?

BACKGROUND: Although the burden of TB is lower in France than in low-income countries, patients continue to die from TB in Paris. Our goal was to describe TB-related deaths and to identify associated risk factors.METHODS: We conducted a retrospective cohort study in two hospitals in Paris between 2013 and 2018. All patients with drug-susceptible TB were included and followed until end of treatment. The primary outcome was death. We performed univariate and multivariate analysis using Cox proportional hazard model.RESULTS: Of the 523 patients included, 362 were men (median age 37 years), of whom 24 patients died (4.5%). The final survival model concluded that age (HR 1.1 for each additional year), not living in one´s own accommodation (HR 5.9), being born in France (HR 8.0), being alcoholic (HR 4.2), having a history of cancer (HR 7.1) or meningeal or miliary TB (HR 8.2) were associated with a higher risk of death.CONCLUSION: The rate of TB-associated death is unacceptably high for a curable disease. To note, patients born in France were much more at risk of death than immigrants. We believe raising awareness among healthcare professionals is a potentially easy and efficient lever for improving care.

The emotional quality of speech in voice services.

The emotional quality of speech is defined as the global qualitative and hedonic impressions experienced by listeners. This research investigated the emotional quality of speech samples used in voice services. In a first experiment listening tests were conducted using 200 messages generated by 20 female speakers who pronounced two sentences in five elocution styles. Listeners grouped the messages according to similarities in terms of the impression of the messages. Verbal comments regarding hedonic effect on the listener and acoustic parameters of the voices' timbre and intonation were analysed. In a second experiment, the 200 messages were evaluated according to 20 criteria extracted from the first experiment. The results produced a precise perceptive portrait for each sequence, giving a full picture of the listeners' impressions of what they heard. The results can be applied to the design of voice services, as was done for the voicemail of France Telecom Orange.

The prospects for super-acuity: limits to visual performance after correction of monochromatic ocular aberration.

It has recently been suggested that correction of the monochromatic aberration of the eye could lead to substantial improvements in visual acuity and contrast sensitivity function. After consideration of the best-corrected visual acuity of normal eyes, the optical and neural limits to visual performance are reviewed. It is concluded that, even if current problems with the accuracy of the suggested techniques of aberration correction, through corneal excimer laser ablation or customised contact lenses, can be overcome, changes in monochromatic ocular aberration over time, the continuing presence of chromatic aberration, errors of focus associated with lags and leads in accommodation, and other factors, are likely to result in only minor improvements in the high-contrast acuity performance of most normal eyes being produced by attempted aberration control. Significant gains in contrast sensitivity might, however, be achievable, particularly under mesopic and scotopic conditions when the pupil is large, provided that correct focus can be maintained. In the immediate future, reduction of the high levels of aberration that are currently found in eyes that have undergone refractive surgery and in some abnormal eyes should bring useful benefits.

Effect of induced anisometropia on binocular through-focus contrast sensitivity.

PURPOSE: The aim of this study was to characterize binocular through-focus function in white light and to investigate the effect of induced anisometropia on binocular depth of focus. METHODS: The subjects viewed sine-wave gratings generated on a monitor through a modified Badal system that produced gradual changes in target vergence ranging from -4.00 to +2.00 D. Binocular through-focus contrast sensitivity curves were obtained at a spatial frequency of 11 cpd and for different levels of induced anisometropia. Subjective depths of focus were derived from the through-focus curves. RESULTS: An induced anisometropia lower than 1.00 D led to a monomodal through-focus curve involving a single depth of focus, whereas with higher anisometropia, the curves became bimodal indicating a lack of performance at intermediate distance. Binocular thresholds predicted by the quadratic summation model from our monocular measurements were well correlated to our binocular measurements. Predictions allowed us to estimate optimum levels of induced anisometropia.

Influence of myopia and aging on the optimal spherical aberration of soft contact lenses.

Soft contact lenses with different levels of third-order spherical aberration were tested in two samples of subjects aged between 20 and 45 years: 18 emmetropes and 19 myopes. Contrast sensitivity was measured at 12 cycles/degree to determine the optimal lens spherical aberration required by each individual. The optimal third-order coefficient was found to be negative on average in both refractive error groups. Myopic subjects required contact lenses with more negative spherical aberration than did emmetropes. The optimal aberration was also found to become increasingly negative with aging. The rate of this age-related change was faster in the myopic group. In comparison with aberration-free soft contact lenses, an improvement in contrast detection threshold of more than 25% was observed with optimal spherical aberration in half of the myopic subjects.

Contrast sensitivity with soft contact lenses compensated for spherical aberration in high ametropia.

BACKGROUND: In optical systems, it is usual to compensate for longitudinal spherical aberration. In order to increase image quality, lens surfaces can be made aspheric to bring all object light rays into focus at the image plane. Theoretically, soft contact lenses with high power and spherical surfaces show significant amounts of spherical aberration. The use of spherical aberration-free soft contact lenses could therefore improve retinal image quality in the case of high ametropia. However, because of ocular aberration, accommodation effects, pupil dynamics, contact lens flexure, and positioning, the computation of the spherical aberration induced when a contact lens is placed on the eye is complicated. METHODS: In this study, the spatial contrast sensitivity (CS) of 61 high ametropes wearing soft contact lenses with, and without, in-air spherical aberration compensation is measured. RESULTS: A slightly better overall performance was found with the standard lenses. There was no significant influence by the type of ametropia, age, and gender. If individual results are considered, clinically significant differences between the two lens groups are observed in approximately 30% of the cases. CONCLUSIONS: It seems that correcting in-air soft contact lens spherical aberration systematically is of no clinical interest. However, selective manipulation of spherical aberration could, in high power soft contact lenses, significantly improve CS in individuals.

Simulated in situ optical performance of bifocal contact lenses.

A model of the presbyopic eye in various viewing conditions is derived as a combination of average clinical data with a monochromatic eye model. The modulation transfer function (MTF), obtained through Fourier optics calculations, is used to define new metrics, which help to predict the visual performance of multifocal contact lenses. The model is applied to the optimization of concentric bifocal contact lenses (BCLs): the optimal center optimal zone diameter (COZD) is determined as a function of the lens addition and decentration, in order to achieve similar average performance in distance and near vision. Calculations predict a decrease of the overall visual performance of optimized bifocal lenses with increasing addition. They also show that a lens shift relative to the pupil has opposite effects on the performance of center near (CN) and center distance (CD) designs. The comparison between these two types of bifocals suggests that better overall performance is obtained when the near correction is supported by the center optical zone. These theoretical predictions are found to be compatible with anterior clinical results obtained with BCLs.

Infrared pupillometry in presbyopes fitted with soft contact lenses.

The influence of pupil size, lens centration, and translation on multifocal contact lens performance suggests that these parameters should be accounted for in the optical design of presbyopic contact lenses. The purpose of the present article is to complete the existing experimental data with clinical measurements of pupil diameter and lens position relative to the pupil in a group of presbyopes, with controlled target luminance, stimulus distance, gaze angle, and convergence. The experiments involve an infrared video-pupillometer and ring-marked contact lenses. Results on pupil aperture show that the effect of changing target distance is comparable in magnitude to that of varying luminance within the photopic range. The measured data on lens position confirm that soft contact lenses are generally decentered from the pupillary axis, usually in inferior temporal direction, and that their average translation between primary and downward gaze is very small. It is also found that the average relative position between lens and pupil centers is slightly modified by changes of luminance in far vision. All these results provide characteristic values which are helpful for the optical modelling of presbyopic contact lenses.

Distribution of pathogen inhibition in the Lactobacillus isolates of a commercial probiotic consortium.

Pure strains of Lactobacillus ssp. isolated from a commercial probiotic consortium were checked in a double layer solid medium for their inhibition activities against selected pathogenic bacteria including serotypes of Listeria monocytogenes, Escherichia coli and Salmonella. The antagonistic properties of the Lactobacillus strains may be related to the production of bacteriocin-like compounds. All the pathogens tested were inhibited by one or a few strains of Lactobacillus, the best inhibition was observed against L. monocytogenes but the inhibition was also satisfactory against E. coli, Salm. typhimurium and Salm. enteritidis.