Overlap and Mutual Distinctions between Clinical Recovery and Personal Recovery in People with Schizophrenia in a One-Year Study

Recovery is a multidimensional construct that can be defined either from a clinical perspective or from a consumer-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. We aimed to longitudinally examine the overlap and mutual distinctions between clinical and personal recovery. Of 1239 people with schizophrenia consecutively recruited from the FondaMental Advanced Centers of Expertise for SZ network, the 507 present at one-year did not differ from those lost to follow-up. Clinical recovery was defined as the combination of clinical remission and functional remission. Personal recovery was defined as being in the rebuilding or in the growth stage of the Stages of Recovery Instrument (STORI). Full recovery was defined as the combination of clinical recovery and personal recovery. First, we examined the factors at baseline associated with each aspect of recovery. Then, we conducted multivariable models on the correlates of stable clinical recovery, stable personal recovery, and stable full recovery after one year. At baseline, clinical recovery and personal recovery were characterized by distinct patterns of outcome (i.e. better objective outcomes but no difference in subjective outcomes for clinical recovery, the opposite pattern for personal recovery, and better overall outcomes for full recovery). We found that clinical recovery and personal recovery predicted each other over time (baseline personal recovery for stable clinical recovery at one year; P =. 026, OR = 4.94 [1.30-23.0]; baseline clinical recovery for stable personal recovery at one year; P =. 016, OR = 3.64 [1.31-11.2]). In short, given the interaction but also the degree of difference between clinical recovery and personal recovery, psychosocial treatment should target, beyond clinical recovery, subjective aspects such as personal recovery and depression to reach full recovery. © 2021 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.Sorbonne Universités à Paris pour l'Enseignement et la RechercheFondaMental-Cohorte

Schizophrenia Bulletin Open

Treatment-resistant schizophrenia (TRS) affects around 30% of patients with schizophrenia (SZ) resulting in poor functioning, relapses, and reduced quality of life. Convergent findings show that inflammation could contribute to resistance. We thus search for immune signatures of patients with TRS/ultra TRS (UTRS) in a sample of community-dwelling outpatients with SZ. In total, 195 stabilized SZ patients (mean age = 31.2 years, 73% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. At inclusion, psychotic symptomatology was evaluated by the Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Circulating serum/plasma levels of a large panel of markers reflecting the main inflammatory pathways were evaluated. TRS was defined by current treatment by clozapine (CLZ) and UTRS by current CLZ treatment + PANSS total score ≥ 70. The frequency of TRS and UTRS patients was, respectively, 20% and 7.7% and was defined using multivariable analysis elevated by high levels of interleukin (IL)-12/IL-23p40, IL-17A, IL-10, and beta 2 microglobulin (B2M) and IL-12/IL-23p40, IL-17A, IL-6, IL-10, IFNγ, and B2M, respectively. These observations suggest that resistance and ultra resistance to CLZ treatment are underpinned by pro-inflammatory molecules mainly belonging to the T helper 17 pathway, a finding making sense given the interplay between inflammation and antipsychotic treatment responses. If confirmed, our findings may allow us to consider IL-23/IL-17 pathway as a therapeutic target for patients with resistance to antipsychotics.Sorbonne Universités à Paris pour l'Enseignement et la RechercheFondaMental-Cohorte

Intérêt prophylactique et thérapeutique des chewing-gums sans sucre en orthodontie. Une étude menée auprès de professionnels de santé et de patients [Preventive and therapeutic advantages of sugar-free chewing gums in orthodontics. A study conducted on practitioners and patients]

OBJECTIVE: The objective of this study is to assess the level of knowledge in a cohort of oral health professionals and patients about preventive and therapeutic actions of sugar-free chewing gums. MATERIALS AND METHODS: A forward-looking monocentric study of perception regarding the level of information about the effects of sugar-free chewing gums consumption was conducted on 135 young patients, from 11 to 17 years old, carriers of fixed orthodontic appliances and treated in the Department of Orthodontics in the Oral Medicine and Surgery Center of the University Hospitals of Strasbourg. Besides, 34 practitioners in the Department of Orthodontics and Pediatric Dentistry were also included. Data were collected between May 2016 and July 2016. A specific questionnaire, using the adapted terminology and dealing with the same items was developed for each studied population. RESULTS: The majority of the individuals of both studied populations believe that the consumption of sugar-free chewing gum leads to a greater risk of orthodontic device unsticking or fracture and that it is not associated to a decrease of the orthodontic pain. DISCUSSION: Our results confirm the fact that the knowledge, mainly acquired in an empirical way, is against the data of the current literature. The evaluation of the level of knowledge demonstrated that there is a real lack of information about the preventive interests of the consumption of sugar-free chewing gums during orthodontic treatment. CONCLUSIONS: This study highlights the need for information campaigns and oral prevention in general population, as well as in healthcare professionals, concerning the preventive and analgesic interests of sugar-free chewing gums during orthodontic treatments

Réhabilitation esthétique d’un cas de dysplasie fibreuse maxillaire chez l’enfant

Fibrous dysplasia (FD) is a rare, congenital, benign bone dis- order in which healthy bone tissue is replaced by abnormal scar-like (fibrous) connective tissue. The lesions may affect one or more bones, including the jawbones. A 13-year-old girl vi- sited the dentist for failed eruption of her left maxillary perma- nent teeth and facial asymmetry. Radiological analysis revealed impactions of the permanent teeth in hypertrophic, hy- perdense, weakly trabeculated bone tissue. To restore the aes- thetics of the smile, a treatment combining decoronation and bonded restorations was performed. FD enlargement would slow down after puberty, allowing for long-term therapies. But there is no information about implantology in this type of bone lesion. The aesthetic and functional consequences of a maxillary FD should be managed as soon as possible. Treatment involves a multidisciplinary team and follow-up care into adulthood.La dysplasie fibreuse (DF) osseuse est une patho- logie osseuse rare, congénitale et bénigne dans laquelle le tissu osseux sain est remplacé par du tissu fibro-osseux. Les lésions peuvent affecter un ou plusieurs os, notamment les os des mâ- choires. Une adolescente de 13 ans a consulté pour des échecs d’éruption des dents perma- nentes maxillaires gauches et une asymétrie du tiers moyen de l’hémiface gauche. L’analyse ra- diologique a mis en évidence des inclusions des dents permanentes dans un tissu osseux hyper- trophique, hyperdense et faiblement trabéculé. Afin de restaurer l’esthétique du sourire, une prise en charge associant décoronation et res- taurations collées a été privilégiée. L’évolution de la DF aurait tendance à ralentir après la puberté, permettant ainsi de planifier des thérapeutiques à long terme dès la fin de la croissance. Cepen- dant, il existe peu de données sur le recours à l’implantologie dans le cas de lésions osseuses sclérotiques. Les conséquences esthétiques et fonctionnelles d’une DF maxillaire peuvent être majeures sur le plan bucco-dentaire. Leur prise en charge au cas par cas fait intervenir une équipe pluridisciplinaire, nécessitant un suivi de l’enfance jusqu’à l’âge adulte

Deciphering the Roles of Chemistry and Structure in Iridium Oxide Oxygen Evolution Nanocatalysts

International audienc

Deciphering the Roles of Chemistry and Structure in Iridium Oxide Oxygen Evolution Nanocatalysts

International audienc

Deciphering the Roles of Chemistry and Structure in Iridium Oxide Oxygen Evolution Catalysts Through the Study of Annealed Iridium Oxide Nanoparticles

International audienc

Deciphering the Roles of Chemistry and Structure in Iridium Oxide Oxygen Evolution Catalysts Through the Study of Annealed Iridium Oxide Nanoparticles

International audienc

Achieving Small IrOx Nanoparticles with Dual OER Activity and Stability via Thermal Annnealing

International audienceIridium oxide nanocatalysts (IrOx) show promise to lower the material cost of proton-exchange membrane water electrolyzers (PEMWE) owing to their high activity towards the oxygen evolution reaction (OER), and their good resistance to acidic and oxidative conditions. However, enhanced OER activity often comes at the expense of stability. Therefore, only a comprehensive understanding of how the structural, morphological, and chemical characteristics of IrOx nanoparticles influence these two conflicting properties will enable to achieve a delicate balance between them.To address these challenges, we synthesized IrOx nanoparticles (NPs) supported on carbon (IrOx/C), through a modified polyol process, and annealed them under air, at temperatures ranging from 340◦C to 670◦C. We obtained a material library with various properties ranging from small amorphous IrOx NPs supported on carbon to larger self-supported crystalline IrO2 (Figure 1a), which was used to deconvolute the effects of the oxidation state, the structure and the size of IrOx NPs and to tune their OER activity and stability1,2. To analyze the structure, morphology, and oxidation state of Ir in these catalysts, we used transmission electron microscopy TEM (Figure 1b-j.), X-ray photoelectron spectroscopy XPS (Figure 1l-m.), thermogravimetric analysis (TGA) and both laboratory-based and synchrotron-based X-ray diffraction (XRD) techniques (Figure 1k.).We assessed their electrocatalytic activity towards the OER and determined their stability number3 (S-number) using on-line inductively coupled plasma mass spectrometry and electrochemistry. We observed the decrease of activity and the increase of the stability with an increasing annealing temperature2. We successfully correlated certain physico-chemical properties (electronic structure, morphology, and size) with either the OER activity or the stability of the catalysts. Specifically, we identified certain thermal annealing conditions that achieved an optimal balance between OER activity and stability, and we were able to obtain small NPs (< 7 nm) even at temperature above 500°C4, with a good particle size control