Contexte : les règlements distinguent habituellement les médicaments prescrits uniquement (prescription only medicines POM) et les médicaments en vente libre (over-the-counter OTC). Les premiers nécessitent une prescription médicale et les derniers sont disponibles pour l'automédication sans ordonnance. Au Liban comme dans les autres pays de l’Est de la Méditerranée, les médicaments théoriquement prescrits peuvent facilement être achetés sans ordonnance. Les antibiotiques sont parmi les classes de médicaments les plus fréquemment vendus sans ordonnance. L'utilisation inappropriée d'antibiotiques augmente le taux de résistance bactérienne et la fréquence de l'échec du traitement. Cette étude est menée pour déterminer le mode d'emploi des antibiotiques disponibles en tant qu'automédication au Liban, en comparaison avec leur utilisation comme médicaments uniquement prescrits en France. Méthode : Tout d'abord, une revue approfondie de la littérature publiée (1990-2015) a été menée en utilisant les bases de données : Pubmed, Web of Science, Cochrane et Google Scholar, pour abus de médicamentsdisponibles sans ordonnance au Moyen-Orient ;les antibiotiques étaient parmi les médicaments les plus mal utilisés. Une étude prospective a ensuite été menée au Liban. Les données ont été collectées auprès de patients qui achetaient des antibiotiques avec ou sans ordonnance dans les officines sur une période d’un an (septembre 2015 à septembre 2016). En France, les données ont été extraites de la base de données Echantillon Généraliste de Bénéficiaires (EGB), contenant un échantillon représentatif permanent 1/97 du système d'assurance-maladie national français, qui contient toutes les prescriptions dispensées en France. Nous y avons mené des recherchespour identifier les modes d'utilisation des 5 antibiotiques les plus utilisés au Liban. Résultats : La distribution moyenne de ces antibiotiques était plus élevée en France (18,6 DDD) qu'au Liban (10.6DDD). Cependant, le nombre moyen de dérogations au Liban était de 3,39 par an, plus élevé qu'en France (2 par an). Ce n'était pas différent entre les participants avec ou sans ordonnance. Le coamoxiclav a été largement consommé au Liban à la fois sous ordonnance et par automédication, alors que l'amoxicilline était le principal antibiotique consommé en France.62,4% des patients ont utilisé le bon antibiotique et 80,1% l'ont utilisé dans le dosage correct. Dans la suivi, la durée du traitement était inappropriée dans la majorité des cas (68,6%). Lorsque tous ces trois facteurs ont été additionnés, il s'avère que 83,6% des antibiotiques ont été utilisés de manière inappropriée. La pertinence de l'utilisation a été observée chez 27,6% et 16,4% des antibiotiques prescrits et non prescrits, respectivement. Conclusion : Il est certain que l'automédication observée ou l'utilisation médicalement non surveillée d'antibiotiques est un risque majeur. Les premières mesures à prendre pour réduire celles-ci sont éducatives, pour les patients, les pharmaciens, les prescripteurs, l'industrie pharmaceutique et les autorités réglementaires. / Background: Regulations usually distinguish between prescription-only (POM) and over-the-counter (OTC) medicines. The former requires medical prescription; the latter are available for self-medication (SM) without a prescription. In Lebanon as in other Eastern Mediterranean countries, theoretically prescription medicines can easily be purchased without a prescription. Antibiotics are among the most commonly sold drug classes without prescription. The inappropriate use of antibiotics increases the rate of bacterial resistance and the frequency of treatment failure. This study is conducted to determine the usage pattern of antibiotics available as self-medication in Lebanon, compared with their use as prescription only drugs in France. Method: First, an extensive review of the published literature (1990–2015) was conducted using Pubmed, Web of Science, Cochrane and Google Scholar databases, for OTC medicine misuse and abuse in the Middle East. Antibiotics were among the most commonly misused medications. A cross sectional prospective field study was then conducted in Lebanon. Data was collected from patients seeking antibiotics with or without prescription in community pharmacies over a 1-year period (September 2015 to September 2016). In France, data was extracted from the EchantillonGénéraliste de Bénéficiaires (EGB) database, the permanent 1/97 representative sample from the French national healthcare insurance system which contains all dispensed prescriptions in France. It was searched in 2013 to identify usage patterns of antibiotics, of 5 antibiotics most commonly used in Lebanon. Results: The average dispensing for these antibiotics was higher in France (18.6 DDD) than that in Lebanon (10.6DDD). However, the average number of dispensings in Lebanon was 3.39 per year, higher than that in France (2 per year). It was not different between participants with or without prescription. Coamoxiclav was widely consumed in Lebanon as both prescription and self-medication, whereas amoxicillin was the main antibiotic in France. 62.4% of patients used the right antibiotic and 80.1% used it in correct dosage. The duration of treatment in the follow up was inappropriate in the majority of cases (68.6%). When all of these three factors were summed together, it turned out that 83.6% of antibiotics were utilized inappropriately. Appropriateness in use was seen in 27.6% and 16.4% of the prescribed and non-prescribed antibiotics respectively. Conclusion: Misuse of antibiotics is a major driver in the development of antibiotic resistance, an issue for individuals and for public health. Obviously the observed self-medication or medically unsupervised utilization of antibiotics is a major risk. The first measures to take to reduce this are educational, for patients, pharmacists, prescribers, the pharmaceutical industry and the regulatory authorities.

京都大学 / 0048 / 新制・課程博士 / 博士(工学) / 甲第19979号 / 工博第4223号 / 新制||工||1653(附属図書館) / 33075 / 京都大学大学院工学研究科都市社会工学専攻 / (主査)教授 藤井 聡, 准教授 SCHMOECKER Jan-Dirk, 准教授 宇野 伸宏 / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DFAM

Nowadays, all software projects are based on a large number of libraries, so they do not have to start from scratch. These libraries evolve over time, whether to add functionality or to simplify their use. These updates are necessary to improve their libraries, but can lead to errors in their clients’ code. Developers are thus faced with the problem of breaking changes and need to be able to inform their clients as soon as possible of the arrival of these changes. To limit the impact of these breaking changes, this Master thesis presents UCov. UCov is a static analysis tool that gives library developers a quick overview of the usage coverage of their tests compared with the coverage of their clients. This lets them to compare which elements of their library are being tested with those being used by their clients and also how they are being used. This will enable developers to improve their test suite according to how their clients use their library, to get a better overview of how their library is used, and also to give their clients the best possible warning of changes that may impact their code, thanks to release notes. In this study, we explain the implementation of UCov and test it on various libraries. The results obtained on these libraries are satisfactory. They enable us to highlight potential breaking changes. They also show that there are elements of the libraries’ APIs that are used by clients but never tested. Finally, these results show that UCov offers developers a new tool enabling them to limit the impact of their breaking changes by gaining a better understanding of how clients use their libraries. / Numera baseras alla programvaruprojekt på ett stort antal bibliotek, så att man inte behöver börja från noll. Biblioteksutvecklare ställs därför allt oftare inför problemet med “breaking changes". Dessa är nödvändiga för att förbättra deras bibliotek, men kan leda till fel i deras kunders kod. Utvecklarna måste därför kunna ge sina kunder så mycket förvarning som möjligt om att det kommer att komma inbrytande ändringar. För att begränsa effekterna av dessa förändringar presenterar denna masteruppsats UCov. UCov är ett statiskt analysverktyg som ger biblioteksutvecklare en snabb överblick över användartäckningen för deras tester jämfört med täckningen för deras klienter. Detta gör det möjligt för dem att jämföra vilka element i deras bibliotek som testas med de som används av deras kunder, och även hur de används. Detta gör det möjligt för utvecklare att förbättra sin testsvit enligt hur deras kunder använder deras bibliotek, för att få en bättre överblick över hur deras bibliotek används, och även för att ge sina kunder bästa möjliga varning för ändringar som kan påverka deras kod, tack vare release notes. I den här studien förklarar vi implementeringen av UCov och testar den på olika bibliotek. Resultaten från dessa bibliotek är tillfredsställande. De gör det möjligt för oss att lyfta fram potentiella brytande ändringar. De visar också att det finns delar av bibliotekens API:er som används av klienter men som aldrig testas. Slutligen visar dessa resultat att UCov erbjuder utvecklare ett nytt verktyg som gör det möjligt för dem att begränsa effekterna av sina skadliga ändringar genom att få en bättre förståelse för hur kunderna använder sina bibliotek.

The overarching theme of the thesis was to investigate the association between smart device use and computer vision syndrome. The initial study designed and developed the Open Field Tear film Analyser (OFTA) enabling a continuous, real-time assessment of the tear film and blink characteristics during smart device use. The monocular OFTA prototype was validated and showed good intra- and inter-observer repeatability relative to the Oculus Keratograph 5M and Bausch and Lomb one position keratometer. Subsequently, tear osmolarity following engagement with reading and gaming tasks on smart device and paper platforms was investigated. Discrete measures of osmolarity pre- and post-engagement with the tasks were obtained with the TearLab osmometer; osmolarity values differed between platforms when participants were engaged in a gaming task but no such difference was observed with the reading task. In addition, the influence of repeated measurements on tear osmolarity was also explored. To simulate the habitual binocular viewing conditions normally associated with smart device use, the binocular OFTA was developed. The device was used to assess the tear film and blink characteristics whilst engaging with reading and gaming tasks on smart device and paper platforms. The results revealed differences in blink characteristics and non-invasive tear break up time between the different platforms and tasks assessed. In addition, the thesis also reports on an investigation examining the real-time accommodative response to various targets displayed on smart devices using an open-field autorefractor with a Badal lens system adaptation. The results showed that accommodative latency, accommodative lag, mean velocity of accommodation, speed of disaccommodation and mean velocity of disaccommodation varied across the different platforms. Through the use of validated subjective questionnaires and smartphone apps, the relationship between duration of smartphone use and symptoms of dry eye were examined. The findings of this study demonstrated that longer duration of smartphone and personal computer use were associated with higher risk of dry eyes as indicated by subjective questionnaire outcomes.

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Les systèmes logiciels dépendent de plus en plus des librairies et des frameworks logiciels. Les programmeurs réutilisent les fonctionnalités offertes par ces librairies à travers une interface de programmation (API). Par conséquent, ils doivent faire face à la complexité des APIs nécessaires pour accomplir leurs tâches, tout en surmontant l’absence de directive sur l’utilisation de ces API dans leur documentation. Dans cette thèse, nous proposons une approche holistique qui cible le problème de réutilisation des librairies, à trois niveaux. En premier lieu, nous nous sommes intéressés à la réutilisation d’une seule méthode d’une API. À ce niveau, nous proposons d’identifier les contraintes d’utilisation liées aux paramètres de la méthode, en analysant uniquement le code source de la librairie. Nous avons appliqué plusieurs analyses de programme pour détecter quatre types de contraintes d’utilisation considérées critiques. Dans un deuxième temps, nous changeons l’échelle pour nous focaliser sur l’inférence des patrons d’utilisation d’une API. Ces patrons sont utiles pour aider les développeurs à apprendre les façons courantes d’utiliser des méthodes complémentaires de l’API. Nous proposons d’abord une technique basée sur l’analyse des programmes clients de l’API. Cette technique permet l’inférence de patrons multi-niveaux. Ces derniers présentent des relations de co-utilisation entre les méthodes de l’API à travers des scénarios d’utilisation entremêlés. Ensuite, nous proposons une technique basée uniquement sur l’analyse du code de la librairie, pour surmonter la contrainte de l’existence des programmes clients de l‘API. Cette technique infère les patrons par analyse des relations structurelles et sémantiques entre les méthodes. Finalement, nous proposons une technique coopérative pour l’inférence des patrons d’utilisation. Cette technique est axée sur la combinaison des heuristiques basées respectivement sur les clients et sur le code de la librairie. Cette combinaison permet de profiter à la fois de la précision des techniques basées sur les clients et de la généralisabilité des techniques basées sur les librairies. Pour la dernière contribution de notre thèse, nous visons un plus haut niveau de réutilisation des librairies. Nous présentons une nouvelle approche, pour identifier automatiquement les patrons d’utilisation de plusieurs librairies, couramment utilisées ensemble, et généralement développées par différentes tierces parties. Ces patrons permettent de découvrir les possibilités de réutilisation de plusieurs librairies pour réaliser diverses fonctionnalités du projets. / Software systems increasingly depend on external library and frameworks. Software developers need to reuse functionalities provided by these libraries through their Application Programming Interfaces (APIs). Hence, software developers have to cope with the complexity of existing APIs needed to accomplish their work, and overcome the lack of usage directive in the API documentation. In this thesis, we propose a holistic approach that deals with the library usability problem at three levels of granularity. In the first step, we focus on the method level. We propose to identify usage constraints related to method parameters, by analyzing only the library source code. We applied program analysis strategies to detect four critical usage constraint types. At the second step, we change the scale to focus on API usage pattern mining in order to help developers to better learn common ways to use the API complementary methods. We first propose a client-based technique for mining multilevel API usage patterns to exhibit the co-usage relationships between API methods across interfering usage scenarios. Then, we proposed a library-based technique to overcome the strong constraint of client programs’ selection. Our technique infers API usage patterns through the analysis of structural and semantic relationships between API methods. Finally, we proposed a cooperative usage pattern mining technique that combines client-based and library-based usage pattern mining. Our technique takes advantage at the same time from the precision of the client-based technique and from the generalizability of the library-based technique. As a last contribution of this thesis, we target a higher level of library usability. We present a novel approach, to automatically identify third-party library usage patterns, of libraries that are commonly used together. This aims to help developers to discover reuse opportunities, and pick complementary libraries that may be relevant for their projects.

Emojis can be ambiguous, even when used within one and the same language and geographic region, but they are also a globally accessible language in computer-mediated communication. This paper aims to examine if emoji usage across five different national varieties of English (American, English, Australian, Indian, and Nigerian), geographically located on five different continents, exhibits similar pragmatic functionality and sentiment. To achieve this aim, an analysis was made into the usage of three of the most frequently used emojis in tweets written by users from these five English-speaking countries. The number of tweets analyzed is 50 per selected emoji per selected variety of English, for a total of 750 tweets. The analytical process was to qualitatively determine the pragmatic function and sentiment the selected emoji exhibited in tweets. The results indicated that the pragmatic functionality and sentiment of the targeted emojis across the samples were generally similar, especially for Loudly Crying Face, but also for Face with Tears of Joy, whereas Sparkles showed more individual differences across the samples. A substantial finding was that it was possible to analyze facial and non-facial emojis in the same way. / Emojis kan vara tvetydliga, även inom samma språk och geografiska region, men de utgör också ett globalt tillgängligt språk inom datorförmedlad kommunikation. Syftet med uppsatsen är att fastställa om användningen av emojis inom fem olika nationella varianter av engelska (amerikansk, engelsk, australiensk, indisk, och nigeriansk), geografiskt lokaliserade på fem olika kontinenter, uppvisar liknande pragmatisk funktionalitet och attityd. För att uppnå syftet analyserades användningen av tre av de mest använda emojisarna i tweets skrivna av användare från dessa fem engelsktalande länder. Antalet tweets som har analyserats är 50 per utvald emoji per nationell variant av engelska, sammanlagt 750 tweets. Den analytiska processen var baserad kring att bestämma den pragmatiska funktionen och den attityd som de utvalda emojisarna uppvisade i tweets. Resultatet indikerade att den pragmatiska funktionaliteten och attityden hos de utvalda emojisarna var generellt sett snarlika över urvalen, speciellt för Ljudligt gråtande ansikte, men även för Ansikte med tårar av skratt, medan Glitter påvisade mer individuella skillnader över urvalen. En betydande upptäckt var att det var möjligt att analysera faciala och icke-faciala emojisar på samma sätt.

Esta dissertação de mestrado fez parte do projeto Qualipso (Quality Platform for Open Source Software) que teve como principal objetivo melhorar a confiabilidade de sistemas de software livre. Nesse contexto, o enfoque desta pesquisa é um dos atributos de qualidade de software: usabilidade. As práticas de usabilidade no desenvolvimento de software livre, são aplicadas na maioria das vezes, em projetos patrocinados por grandes empresas ou que possuam especialistas em usabilidade como membros da equipe. Mas, em projetos menores da comunidade, compostos geralmente por desenvolvedores, raramente ela é considerada. Porém, a usabilidade é um atributo fundamental para a qualidade durante o uso de um sistema. Com base em valores compartilhados entre as comunidades de métodos ágeis e de software livre, esta dissertação propõe a adaptação de práticas de usabilidade no contexto de métodos ágeis para o contexto de comunidades de software livre. Por meio de pesquisa bibliográfica, levantamos as principais práticas de usabilidade tanto no âmbito de métodos ágeis, quanto no âmbito de software livre, e as classificamos de acordo com as fases do Design Centrado em Usuário, descrevendo cada uma com o formato nome-contexto-problema-solução-exemplos. As práticas foram exploradas em projetos de software livre, o que possibilitou maior entendimento de problemas enfrentados em contextos reais. Essa experiência resultou na proposta de adaptação de práticas de usabilidade ágil no contexto de comunidades de software livre. Dessa forma, descrevemos a realização de uma pesquisa-ação no projeto Arquigrafia-Brasil, um estudo de caso no projeto Mezuro e a aplicação de práticas de usabilidade em quatro projetos do Centro de Competência em Software Livre do IME-USP. / This Masters thesis was part of the Qualipso project (Quality Platform for Open Source Software) whose main objective was to improve the reliability of free and open source software systems. Within such context, the focus of this research is one of the attributes of software quality: usability. The usability practices in free and open source software development are applied most often in projects sponsored by large companies or employing usability experts as team members. But on smaller projects in the community, generally composed by developers, it is rarely considered. However, usability is an essential attribute to the quality in use of a system. Based on values shared between the communities of agile methods and free and open source software, this thesis proposes the adaptation of usability practices in the context of agile methods to the context of free and open source software communities. Through the study of the literature in the field, we gathered the main usability practices both within agile methods, as in free and open source software, and we classified according to User-Centered Design phases, describing each one with the format name-context-problem-solution-examples. The practices were explored in free and open source software projects, which enabled greater understanding of problems faced in real contexts. This experience resulted in the adaptation proposal of agile usability practices into the context of free and open source software communities. We describe the implementation of an action research in the Arquigrafia-Brazil project, a case study in the Mezuro project and the application of usability practices in four projects of the IME-USP FLOSS Competence Center.

Esta dissertação de mestrado fez parte do projeto Qualipso (Quality Platform for Open Source Software) que teve como principal objetivo melhorar a confiabilidade de sistemas de software livre. Nesse contexto, o enfoque desta pesquisa é um dos atributos de qualidade de software: usabilidade. As práticas de usabilidade no desenvolvimento de software livre, são aplicadas na maioria das vezes, em projetos patrocinados por grandes empresas ou que possuam especialistas em usabilidade como membros da equipe. Mas, em projetos menores da comunidade, compostos geralmente por desenvolvedores, raramente ela é considerada. Porém, a usabilidade é um atributo fundamental para a qualidade durante o uso de um sistema. Com base em valores compartilhados entre as comunidades de métodos ágeis e de software livre, esta dissertação propõe a adaptação de práticas de usabilidade no contexto de métodos ágeis para o contexto de comunidades de software livre. Por meio de pesquisa bibliográfica, levantamos as principais práticas de usabilidade tanto no âmbito de métodos ágeis, quanto no âmbito de software livre, e as classificamos de acordo com as fases do Design Centrado em Usuário, descrevendo cada uma com o formato nome-contexto-problema-solução-exemplos. As práticas foram exploradas em projetos de software livre, o que possibilitou maior entendimento de problemas enfrentados em contextos reais. Essa experiência resultou na proposta de adaptação de práticas de usabilidade ágil no contexto de comunidades de software livre. Dessa forma, descrevemos a realização de uma pesquisa-ação no projeto Arquigrafia-Brasil, um estudo de caso no projeto Mezuro e a aplicação de práticas de usabilidade em quatro projetos do Centro de Competência em Software Livre do IME-USP. / This Masters thesis was part of the Qualipso project (Quality Platform for Open Source Software) whose main objective was to improve the reliability of free and open source software systems. Within such context, the focus of this research is one of the attributes of software quality: usability. The usability practices in free and open source software development are applied most often in projects sponsored by large companies or employing usability experts as team members. But on smaller projects in the community, generally composed by developers, it is rarely considered. However, usability is an essential attribute to the quality in use of a system. Based on values shared between the communities of agile methods and free and open source software, this thesis proposes the adaptation of usability practices in the context of agile methods to the context of free and open source software communities. Through the study of the literature in the field, we gathered the main usability practices both within agile methods, as in free and open source software, and we classified according to User-Centered Design phases, describing each one with the format name-context-problem-solution-examples. The practices were explored in free and open source software projects, which enabled greater understanding of problems faced in real contexts. This experience resulted in the adaptation proposal of agile usability practices into the context of free and open source software communities. We describe the implementation of an action research in the Arquigrafia-Brazil project, a case study in the Mezuro project and the application of usability practices in four projects of the IME-USP FLOSS Competence Center.