Exogenous orienting of attention in hearing: a virtual reality paradigm to assess auditory attention in neglect patients.

While mechanisms of orienting attention in unilateral spatial neglect (USN) have frequently been studied in the visual domain, these mechanisms remain relatively unexplored in the auditory domain. Our first goal was to replicate Spence and Driver's (J Exp Psychol Hum 22:1005-1030, 1994) results with a virtual reality paradigm. This paradigm simulated a 3-dimensional auditory space with headphones. Our second aim was to study auditory profiles of orienting attention in USN. In a first experiment, 18 healthy participants performed an auditory cueing spatial paradigm (either a target-detection task or a target-lateralization task). In a second experiment, 14 right-stroke patients (10 with USN and 4 without USN) performed these two same tasks. As in Spence and Driver's (J Exp Psychol Hum 22:1005-1030, 1994), our first experiment showed that spatial representations are not utilized for the detection of auditory stimuli. However, during the lateralization task, participants were quicker to detect targets preceded by a spatially congruent cue, which suggests that our paradigm could be suitable for studying orienting attention in hearing. Our second experiment found that patients with USN also needed an explicit spatial task to be sensitive to auditory spatial cueing. In the target-lateralization task, they showed effects lateralized only to one side of space, whereas patients without USN did not. Although our paradigm needs replications to better understand orienting attention impairments in hearing in USN, this study could have implications for the development of clinical tasks that could assess auditory spatial attention in USN syndrome.

Controlling the hospital aquatic reservoir of multidrug-resistant organisms: a cross-sectional study followed by a nested randomized trial of sink decontamination.

OBJECTIVES: The hospital water environment is an important reservoir of multidrug-resistant organisms (MDROs) and presents a risk for patient safety. We assessed the effectiveness of thermal and chemical interventions on sinks contaminated with MDRO in the hospital setting. METHODS: We conducted a cross-sectional assessment of MDRO contamination of sinks and toilets in 26 clinical wards of a tertiary care hospital. MDRO-contaminated sink traps were then replaced and randomized (1:1:1) to receive chemical (sodium hypochlorite), thermal disinfection (steam), or no intervention. Interventions were repeated weekly for 4 weeks. Sinks were resampled 7 days after the last intervention. The primary outcome was the proportion of decontaminated sinks. MDROs of interest were extended spectrum beta-lactamase (ESBL) producing and carbapenemase-producing Enterobacterales, and non-fermentative Gram-negative bacilli. RESULTS: In the cross-sectional assessment, at least one MDRO was identified in 258 (36%) of the 748 samples and in 91 (47%) of the 192 water sources. In total, 57 (42%) of the 137 sinks and 34 (62%) of the 55 toilets were contaminated with 137 different MDROs. The most common MDRO were ESBL Enterobacterales (69%, 95/137), followed by Verona Integron-Borne Metallo-ß-Lactamase (VIM) carbapenemase producing Pseudomonas aeruginosa (9%, 12/137) and Citrobacter spp. (6%, 5/137). In the nested randomized trial, five of the 16 sinks (31%) in the chemical disinfection group were decontaminated, compared with 8 of 18 (44%) in the control group (OR 0.58; 95% CI, 0.14-2.32) and 9 of 17 (53%) in the thermal disinfection group (OR 1.40; 95% CI, 0.37-5.32). DISCUSSION: Our study failed to demonstrate an added benefit of repeated chemical or thermal disinfection, beyond changing sink traps, in the MDRO decontamination of sinks. Routine chlorine-based disinfection of sinks may need to be reconsidered.

High-performance superconducting quantum processors via laser annealing of transmon qubits.

Scaling the number of qubits while maintaining high-fidelity quantum gates remains a key challenge for quantum computing. Presently, superconducting quantum processors with >50 qubits are actively available. For these systems, fixed-frequency transmons are attractive because of their long coherence and noise immunity. However, scaling fixed-frequency architectures proves challenging because of precise relative frequency requirements. Here, we use laser annealing to selectively tune transmon qubits into desired frequency patterns. Statistics over hundreds of annealed qubits demonstrate an empirical tuning precision of 18.5 MHz, with no measurable impact on qubit coherence. We quantify gate error statistics on a tuned 65-qubit processor, with median two-qubit gate fidelity of 98.7%. Baseline tuning statistics yield a frequency-equivalent resistance precision of 4.7 MHz, sufficient for high-yield scaling beyond 103 qubit levels. Moving forward, we anticipate selective laser annealing to play a central role in scaling fixed-frequency architectures.

Assessing the accuracy of a new hand hygiene monitoring device (SmartRub®): from the laboratory to clinical practice.

BACKGROUND: We developed SmartRub® powered by iQati®, an electronic device composed of a wristband and an alcohol-based handrub pocket-sized dispenser that measures and provides feedback on the duration of hand friction and the volume poured during each hand hygiene action. We aimed to assess the accuracy of SmartRub®. METHODS: The specificity, sensitivity, positive and negative predictive values (PPV and NPV) of SmartRub® were assessed in a 3-phased experiment: (1) laboratory-controlled conditions with volunteers; (2) pre-planned clinical path with volunteers and (3) real clinical conditions with healthcare workers. The accuracy of SmartRub® was evaluated by quantifying its ability to correctly capture true hand hygiene actions and to not record other actions performed while wearing the device. RESULTS: In the laboratory, 7 volunteers performed 816 actions. Overall sensitivity was 94.1% (95% CI 91.4-96.2%) with a PPV of 99.0% (95% CI 97.3-99.6%) and specificity was 99.0% (95% CI 97.5-99.7%) with a NPV of 94.4% (95% CI 91.9-96.1%). During the pre-planned clinical path phase, 13 volunteers performed 98 planned paths and a total of 967 actions were performed. Overall sensitivity was 94.6% (95% CI 92.2-96.5%) with a PPV of 84.3% (95% CI 81.6-86.7%) and specificity was 82.4% (95% CI 78.7-85.7%) with a NPV of 93.9% (95% CI 91.3-95.7%). During the real clinical conditions phase, 17 healthcare workers were observed for a total of 15 h and 3 min while they performed 485 actions. Sensitivity was 96.8% (95% CI 93.8-98.6%) with a PPV of 98.3% (95% CI 95.6-99.3%) and specificity was 98.3% (95% CI 95.7-99.5%) with a NPV of 96.8% (95% CI 93.9-98.4%). CONCLUSIONS: Smartrub® is a highly reliable device for capturing hand hygiene actions under a range of conditions, from the laboratory to clinical care activities.

Effect of Wearing a Novel Electronic Wearable Device on Hand Hygiene Compliance Among Health Care Workers: A Stepped-Wedge Cluster Randomized Clinical Trial.

Importance: Hand hygiene (HH) is essential to prevent hospital-acquired infections. Objective: To determine whether providing real-time feedback on a simplified HH action improves compliance with the World Health Organization's "5 Moments" and the quality of the HH action. Design, Setting, and Participants: This open-label, cluster randomized, stepped-wedge clinical trial was conducted between June 1, 2017, and January 6, 2018 (with a follow-up in March 2018), in a geriatric hospital of the University of Geneva Hospitals, Switzerland. All 12 wards and 97 of 306 eligible health care workers (HCWs) volunteered to wear a novel electronic wearable device that delivered real-time feedback on duration of hand rubbing and application of a hand-sized customized volume of alcohol-based handrub (ABHR). Interventions: This study had 3 sequential periods: baseline (no device), transition (device monitoring without feedback), and intervention (device monitoring and feedback). The start of the transition period was randomly allocated based on a computer-generated block randomization. Main Outcomes and Measures: The primary outcome was HH compliance, according to the direct observation method during intervention as compared with baseline. Secondary outcomes included the volume of ABHR and duration of hand rubbing measured by the device during intervention as compared with transition. Results: All wards and respective HCWs were evenly assigned to group 1 (26 participants), 2 (22 participants), 3 (25 participants), or 4 (24 participants). Twelve HCWs did not fully complete the intervention but were included in the analysis. During 759 observation sessions, 6878 HH opportunities were observed. HH compliance at intervention (62.9%; 95% CI, 61.1%-64.7%) was lower than at baseline (66.6%; 95% CI, 64.8%-68.4%). After adjusting for covariates, HH compliance was not different between periods (odds ratio, 1.03; 95% CI, 0.75-1.42; P = .85). Days since study onset (OR, 0.997; 95% CI, 0.994-0.998; P < .001), older age (OR, 0.97; 95% CI, 0.95-0.99; P = .015), and workload (OR, 0.29; 95% CI, 0.20-0.41; P < .001) were independently associated with reduced HH compliance. The median (interquartile range) volume of ABHR and duration of hand rubbing in transition and intervention increased from 1.12 (0.76-1.68) mL to 1.71 (1.01-2.76) mL and from 6.5 (4.5-10.5) seconds to 8 (4.5-15.5) seconds, respectively. There were no serious adverse events. Conclusions and Relevance: The use of this device did not change HH compliance, but increased the duration of hand rubbing and volume of ABHR used by HCWs. Trial Registration: isrctn.org Identifier: ISRCTN25430066.

Energy dissipation in graphene field-effect transistors.

We measure the temperature distribution in a biased single-layer graphene transistor using Raman scattering microscopy of the 2D-phonon band. Peak operating temperatures of 1050 K are reached in the middle of the graphene sheet at 210 kW cm(-2) of dissipated electric power. The metallic contacts act as heat sinks, but not in a dominant fashion. To explain the observed temperature profile and heating rate, we have to include heat flow from the graphene to the gate oxide underneath, especially at elevated temperatures, where the graphene thermal conductivity is lowered due to umklapp scattering. Velocity saturation due to phonons with about 50-60 meV energy is inferred from the measured charge density via shifts in the Raman G-phonon band, suggesting that remote scattering (through field coupling) by substrate polar surface phonons increases the energy transfer to the substrate and at the same time limits the high-bias electronic conduction of graphene.

Audiovisual speech segmentation in post-stroke aphasia: a pilot study.

Background: Stroke may cause sentence comprehension disorders. Speech segmentation, i.e. the ability to detect word boundaries while listening to continuous speech, is an initial step allowing the successful identification of words and the accurate understanding of meaning within sentences. It has received little attention in people with post-stroke aphasia (PWA).Objectives: Our goal was to study speech segmentation in PWA and examine the potential benefit of seeing the speakers' articulatory gestures while segmenting sentences.Methods: Fourteen PWA and twelve healthy controls participated in this pilot study. Performance was measured with a word-monitoring task. In the auditory-only modality, participants were presented with auditory-only stimuli while in the audiovisual modality, visual speech cues (i.e. speaker's articulatory gestures) accompanied the auditory input. The proportion of correct responses was calculated for each participant and each modality. Visual enhancement was then calculated in order to estimate the potential benefit of seeing the speaker's articulatory gestures.Results: Both in auditory-only and audiovisual modalities, PWA performed significantly less well than controls, who had 100% correct performance in both modalities. The performance of PWA was correlated with their phonological ability. Six PWA used the visual cues. Group level analysis performed on PWA did not show any reliable difference between the auditory-only and audiovisual modalities (median of visual enhancement = 7% [Q1 - Q3: -5 - 39]).Conclusion: Our findings show that speech segmentation disorder may exist in PWA. This points to the importance of assessing and training speech segmentation after stroke. Further studies should investigate the characteristics of PWA who use visual speech cues during sentence processing.

Development of a mass spectrometry method for the determination of a melanoma biomarker, 5-S-cysteinyldopa, in human plasma using solid phase extraction for sample clean-up.

5-S-cysteinyldopa is a well-known pigment intermediate and analysis of its plasma concentration is interesting for the early diagnosis, as well as for evaluation of treatment and follow-up of malignant melanoma. A determination method of 5-SCD in human plasma was developed using solid phase extraction (SPE) on disposable cartridges and liquid chromatography electrospray mass spectrometry (LC-ESI-MS-MS). Compound's sensitivity to light and oxidation requires the addition of anti-oxidative agents (AO), to work in acidic media at 4 degrees C and to avoid light exposure of samples since blood collection. Different solid phases involving covalent binding to phenylboronic groups or dual retention mechanisms were evaluated and extraction cartridges containing both hydrophobic and strong cation exchange functionalities were finally selected. The LC separation of 5-SCD from endogenous catecholamines was achieved by gradient elution on a C18 stationary phase. 5-SCD was detected by multiple reaction monitoring (MRM) performed on ES(+) generated ions. Finally, the method was prevalidated in the lower ng/ml range. Good results with respect to accuracy, trueness and precision were obtained.

Fabrication and characterization of contact lenses bearing surface-immobilized layers of intact liposomes.

Intact liposomes were immobilized onto soft contact lenses. In the first step, polyethylenimine was covalently bounded onto the hydroxyl groups available on the surface of a commercial contact lens (Hioxifilcon B). Then, NHS-PEG-biotin molecules were bounded onto the surface amine groups by carbodiimide chemistry. NeutrAvidin were bounded onto the PEG-biotin layer. Liposomes containing PEG-biotinylated lipids were docked onto the surface-immobilized NeutrAvidin. Consecutive addition of further NeutrAvidin and liposome layers enabled fabrication of multilayers. Multilayers of liposomes were also produced by exposing contact lenses coated with NeutrAvidin to liposome aggregates produced by the addition of free biotin in solution. XPS revealed the immobilization of the different layers. By blocking with excess biotin surface-immobilized NeutrAvidin on contact lenses bearing PEG-biotin layers produced under cloud point conditions, ELISA showed that the docking of NeutrAvidin was dependent on biotin-NeutrAvidin affinity binding, with little evidence for nonspecific physisorption; however, it was not possible to differentiate specific versus nonspecific binding of NeutrAvidin attached onto PEG-biotin layers grafted without cloud point conditions. AFM imaging revealed liposome sizes of 106 and 155 nm for layers of liposomes produced (i) by the consecutive addition of further NeutrAvidin and liposomes and (ii) by the exposure of NeutrAvidin-coated contact lenses to liposome aggregates, respectively. The release kinetics of a fluorescent dye demonstrated that intact liposomes had been immobilized onto contact lens surfaces. The stability of surface-immobilized liposomes onto contact lens surfaces showed temperature dependence. Surface-bound liposomes can be stored up to 1 month at 4 degrees C with little release of their content.

Instrument and technique for the in vitro screening of platelet activation from whole blood samples.

The measurement of platelet activation is very difficult to accomplish clinically as platelets are readily activated by in vitro manipulations. Although techniques such as platelet aggregation and flow cytometry exist to estimate platelet function, important limitations prevent these techniques to be widely accepted. In this study, low-fouling surfaces used to limit ex vivo platelet activation were locally bioactivated to rapidly detect platelet activation from whole blood through the selective local adhesion and aggregation of artificially activated platelets. To achieve this result, a fabrication method was developed to create arrays of anti-CD62 and anti-CD61 proteins covalently immobilized on substrates covered by low-fouling graft layers. Moreover, to further limit ex vivo platelet activation and to obtain reproducible results, a custom-made flow chamber was designed and fabricated with the help of computer-assisted mathematical modeling to create defined shear environments. This diagnostic instrument has the potential to allow the rapid estimation of platelet activation levels in whole blood.

Outbreak of endophthalmitis after cataract surgery: the importance of the quality of the surgical wound.

Postoperative endophthalmitis is a rare but potentially devastating condition. We investigated an outbreak of 8 cases of endophthalmitis in patients who underwent phakectomy performed by a single surgeon from January through September 2004. The outbreak was traced to damaged surgical blades, and it highlights the importance of the quality of the surgical wound.

Auditory lateralisation deficits in neglect patients.

Although visual deficits due to unilateral spatial neglect (USN) have been frequently described in the literature, fewer studies have been interested in directional hearing impairment in USN. The aim of this study was to explore sound lateralisation deficits in USN. Using a paradigm inspired by Tanaka et al. (1999), interaural time differences (ITD) were presented over headphones to give the illusion of a leftward or a rightward movement of sound. Participants were asked to respond "right" and "left" as soon as possible to indicate whether they heard the sound moving to the right or to the left side of the auditory space. We additionally adopted a single-case method to analyse the performance of 15 patients with right-hemisphere (RH) stroke and added two additional measures to underline sound lateralisation on the left side and on the right side. We included 15 patients with RH stoke (5 with a severe USN, 5 with a mild USN and 5 without USN) and 11 healthy age-matched participants. We expected to replicate findings of abnormal sound lateralisation in USN. However, although a sound lateralisation deficit was observed in USN, two different deficit profiles were identified. Namely, patients with a severe USN seemed to have left sound lateralisation impairment whereas patients with a mild USN seemed to be more influenced by a systematic bias in auditory representation with respect to body meridian axis (egocentric deviation). This latter profile was unexpected as sounds were manipulated with ITD and, thus, would not be perceived as coming from an external source of the head. Future studies should use this paradigm in order to better understand these two distinct profiles.

Should Alcohol-Based Handrub Use Be Customized to Healthcare Workers' Hand Size?

We evaluated whether the volume of alcohol-based handrub used by healthcare workers affects the residual bacterial concentration on their hands according to hand size. Bacterial reduction was significantly lower for large hands compared with small hands, which suggests a need for customizing the volume of alcohol-based handrub for hand hygiene.

Bioreactors for tissue mass culture: design, characterization, and recent advances.

This paper reviews reports on three-dimensional mammalian tissue growth in bioreactors and the corresponding mammalian tissue growth requirements. The needs for nutrient and waste removal of several mammalian tissues are reviewed and compared with the environment of many reactors currently in use such as the continuous stirred tank, the hollow fiber, the Couette-Taylor, the airlift, and the rotating-wall reactors developed by NASA. Many studies conclude that oxygen supply appears to be one of the most important factors limiting tissue growth. Various correlations to describe oxygen mass transfer are presented and discussed with the aim to provide some guidance to design, construct, and test reactors for tissue mass culture. To obtain tissue thickness clinically valuable, dimensionless and other types of analysis tend to point out that diffusive transport will have to be matched with an important convection to bring sufficient oxygen molecular flux to the growing cells located within a tissue mass. As learned from solid-state fermentation and hairy root culture, during the growth of large biomass, heterogeneity (i.e., channeling, temperature gradients, non-uniform cell growth, transfer gradients, etc.) can cause some important problems and these should be addressed in tissue engineering as well. Reactors (along with the scaffolds) should be designed to minimize these issues. The role of the uterus, the reactor built by Nature, is examined, and the environment provided to a growing embryo is reported, yielding possible paths for further reactor developments. Finally, the importance of cell seeding methods is also addressed.

Divided attention and mental effort after severe traumatic brain injury.

The aim of this study was to assess dual-task performance in TBI patients, under different experimental conditions, with or without explicit emphasis on one of two tasks. Results were compared with measurement of the subjective mental effort required to perform each task. Forty-three severe TBI patients at the subacute or chronic phase performed two tasks under single- and dual-task conditions: (a) random generation; (b) visual go-no go reaction time task. Three dual-task conditions were given, requiring either to consider both tasks as equally important or to focus preferentially on one of them. Patients were compared to matched controls. Subjective mental effort was rated on a visual analogic scale. TBI patients showed a disproportionate increase in reaction time in the go-no go task under the dual-task condition. However, they were just as able as controls to adapt performance to the specific instructions about the task to be emphasised. Patients reported significantly higher subjective mental effort, but the variation of mental effort according to task condition was similar to that of controls. These results suggest that the divided attention deficit of TBI patients is related to a reduction in available processing resources rather than an impairment of strategic processes responsible for attentional allocation and switching. The higher level of subjective mental effort may explain why TBI patients frequently complain of mental fatigue, although this subjective complaint seems to be relatively independent of cognitive impairment.

The perception of peripersonal space in right and left brain damage hemiplegic patients.

Peripersonal space, as opposed to extrapersonal space, is the space that contains reachable objects and in which multisensory and sensorimotor integration is enhanced. Thus, the perception of peripersonal space requires combining information on the spatial properties of the environment with information on the current capacity to act. In support of this, recent studies have provided converging evidences that perceiving objects in peripersonal space activates a neural network overlapping with that subtending voluntary motor action and motor imagery. Other studies have also underlined the dominant role of the right hemisphere (RH) in motor planning and of the left hemisphere (LH) in on-line motor guiding, respectively. In the present study, we investigated the effect of a right or left hemiplegia in the perception of peripersonal space. 16 hemiplegic patients with brain damage to the left (LH) or right (RH) hemisphere and eight matched healthy controls performed a color discrimination, a motor imagery and a reachability judgment task. Analyses of response times and accuracy revealed no variation among the three groups in the color discrimination task, suggesting the absence of any specific perceptual or decisional deficits in the patient groups. In contrast, the patient groups revealed longer response times in the motor imagery task when performed in reference to the hemiplegic arm (RH and LH) or to the healthy arm (RH). Moreover, RH group showed longer response times in the reachability judgment task, but only for stimuli located at the boundary of peripersonal space, which was furthermore significantly reduced in size. Considered together, these results confirm the crucial role of the motor system in motor imagery task and the perception of peripersonal space. They also revealed that RH damage has a more detrimental effect on reachability estimates, suggesting that motor planning processes contribute specifically to the perception of peripersonal space.

Ultra-high-density phase-change storage and memory.

Phase-change storage is widely used in optical information technologies (DVD, CD-ROM and so on), and recently it has also been considered for non-volatile memory applications. This work reports advances in thermal data recording of phase-change materials. Specifically, we show erasable thermal phase-change recording at a storage density of 3.3 Tb inch(-2), which is three orders of magnitude denser than that currently achievable with commercial optical storage technologies. We demonstrate the concept of a thin-film nanoheater to realize ultra-small heat spots with dimensions of less than 50 nm. Finally, we show in a proof-of-concept demonstration that an individual thin-film heater can write, erase and read the phase of these storage materials at competitive speeds. This work provides important stepping stones for a very-high-density storage or memory technology based on phase-change materials.