Septal flash : at the heart of cardiac dyssynchrony

Cardiac resynchronization therapy (CRT) has been a major step in the treatment of heart failure patients and intraventricular conduction delay. As a considerable number of patients do not respond adequately to CRT, echocardiographic dyssynchrony selection criteria have been proposed to improve CRT response, but these parameters eventually failed to provide superior selection of CRT candidates. In the last decade, an echo-dyssynchrony parameter called "septal flash" was been reported by several investigators and opinion leaders in the field of CRT. This parameter has a strong pathophysiological rationale and was shown to be a robust and predominant predictor of CRT response in recent observational and retrospective studies. We here provide a comprehensive and balanced overview of septa! flash and address several important aspects, questions and potential future implications of septal flash in cardiomyopathy and CRT. (C) 2019 The Authors. Published by Elsevier Inc

Activité physique et événements de vie : transition entre les études secondaires et les études supérieures

L’entrée dans l’enseignement supérieur est un événement de vie marquant souvent associé à une réduction de l’activité physique (AP). Ce passage est ici étudié grâce au modèle de l’autodétermination enrichi des conflits de rôles.L’étude de suivi est réalisée auprès de 76 jeunes. En fin d’enseignement secondaire ainsi qu’à la fin de leur première année d’études supérieures (un an après) le volume de pratique d’AP autonome auto-rapportée est évalué. Les jeunes complètent également un questionnaire de motivation pour l’éducation physique et sportive (EPS) scolaire (temps 1) ou l’AP (temps 2) et de conception des liens en conflit ou en instrumentalité entre l’AP et les études (temps 1 et 2). Sur la base de l’évolution du volume de pratique hors scolaire, l’analyse fait apparaitre 4 groupes : maintien ou augmentation de l’AP ; diminution ; décrochage ; sédentarité prolongée.Une motivation autodéterminée pour l’AP n’est pas suffisante pour expliquer le maintien de l’AP à l’entrée au supérieur. Une pratique autonome présente dès les études secondaires et une conception instrumentale de l’AP pour les études supérieures sont des éléments explicatifs majeurs du maintien de l’AP à l’entrée au supérieur. Il convient d’en tenir compte dans l’intervention en EPS pour faciliter le prolongement de l’AP par-delà la scolarité obligatoire.Studies has shown that life-changing events have an impact on health behaviours such as physical activity. For example, moving into higher education is a life-changing event often associated with a physical activity decrease. The purpose of this study is to consider this transition using the Self-determination theory enriched with the role Conflict-instrumentality theory. A longitudinal study was conducted amongst 76 students in two phases. At the end of their secondary school, the students filled out a questionnaire on their physical education motivations and their conception of the conflict-instrumentality between physical activity and the secondary school. After the first year in higher education, students from the longitudinal study sample completed a questionnaire on their physical activity motivations and their conception of the conflict-instrumentality between physical activity and higher education. The volume of leisure-time physical activity was evaluated in the two phases. The analysis brought to the surface four profile types: students increasing or maintaining their physical activity, decreasing without dropping out, abandoning and prolonging a more sedentarity lifestyle. An autonomous activity during secondary school and an instrumental conception of the physical activity during higher education are the main factors that explain physical activity maintenance in higher education. Such findings need to be considered in physical education in order to facilitate the continuity of physical activity after secondary school

Stéréotypes de genre des parents d’enfants pratiquant une activité physique et sportive à forte connotation masculine ou féminine : interpellation pour l’éducation physique

Il existe de multiples formes par lesquelles un parent peut influencer la pratique physique de son enfant (Bois & Sarrazin, 2006). Parmi celles-ci, les stéréotypes de genre jouent un rôle important dans le choix d’une activité physique et sportive (Alley & Hicks, 2005). Cette étude s’intéresse aux stéréotypes de genre des parents et au rôle qu’ils sont susceptibles de jouer dans la socialisation à l’activité physique et sportive. Le cadre conceptuel approfondit le modèle adapté d’Eccles et al. (Bois & Sarrazin, 2006) en se focalisant sur les stéréotypes de genre liés à l’activité physique et sportive. L’approche empirique qualitative est construite autour des entretiens semi-directifs de douze parents d’enfants âgés de 7 à 12 ans participant à des activités stéréotypées masculines (football) ou féminines (danse). Les résultats montrent le lien entre stéréotypes parentaux et activité physique et sportive de l’enfant. Malgré la volonté de la plupart des parents de ne pas véhiculer de stéréotypes, leur discours en est empreint. Une réflexion plus marquée concernant les stéréotypes de genre se distingue chez les parents d’enfants pratiquant une activité physique et sportive contre-stéréotypée, et plus particulièrement chez les parents de danseurs. Pour finir, des pistes de réflexion sont proposées pour une intervention favorisant une ouverture sur la diversité des pratiques possibles, indépendamment du genre. Des conclusions sont également formulées concernant l’éducation physique et ses objectifs pédagogiques, à travers les valeurs et les activités stéréotypiquement associées aux genres.There are multiple ways in which parents can influence the physical activity of their children (Bois & Sarrazin, 2006). Among these are the gender stereotypes which play an important role in the choice of sports and physical activities (Alley & Hicks, 2005). This study focuses on parents’ gender stereotypes and their role in the socialization of physical activity and sport. The conceptual framework used here extends a model adapted from Eccles et al. (Bois & Sarrazin, 2006) by focusing on gender stereotypes associated with physical activity and sport. The empirical approach is built around qualitative semi-structured interviews with 12 parents of children aged 7 to 12 years who take part in male (football) or female (dance) stereotyped activities. The results show the link between stereotypes and parental physical activity and the sport of the child. Despite the desire of most parents to avoid conveying stereotypes, their speech is still characterized by strong stereotypes. A more elaborated thinking about gender stereotypes appears among parents of children involved in counter-stereotyped physical activities and sports, especially among parents of dancers. In conclusion, some suggestions are made to design an intervention that promotes the openness to the diversity of possible practices, regardless of gender. Conclusions are also made concerning physical education and its educational objectives thanks to the values and activities stereotypically associated with gender

Characteristics of Nycthemeral Rhythm of Urinary and Solute Excretion in Children with Enuresis Referred to a Tertiary Center

Nocturnal enuresis is caused by a mismatch between nocturnal diuresis and functional bladder volume. Increased nocturnal diuresis is classically described in monosymptomatic nocturnal enuresis (without bladder dysfunction = LUTS) and attributed to abnormal circadian rhythm of vasopressin: low nocturnal vasopressin levels result in high diuresis and low urinary osmolality, and by definition a good response to desmopressin (Rittig et al. ). But only 30% of patients with nocturnal polyuria are full responders to desmopressin, suggesting that nocturnal polyuria is more than increased water diuresis. Kamperis et al (Am J Physiol Renal Physiol 2006, J Urol. 2004), Vande Walle et al (J Urol. 2007) and Raes et al (J Urol. 2006) documented in pilot studies that desmopressin resistance correlates with abnormal circadian rhythms of different renal functions (glomerular (GFR) and tubular (water, solute and salt excretion)). These findings are very similar to what Goessaert and Everaert found in adults with nocturia. They documented that not only the increased water but also the high solute excretion os mainly present early in the night. In addition, nocturnal polyuria occurs not only in monosymptomatic (MNE) but also in non-monosymptomatic (NMNE), something that has been inadequately studied in the literature and most of these studies were conducted using the old NMNE/MNE definitions and not the new ones. The aim of this study is to document the incidence, severity and timing of nocturnal polyuria and to analyze the circadian rhythm of GFR, water diuresis, and salt and osmotic excretion. And this both in children with MNE and NMNE (where we will use the different definitions). Study population is a large anonymized database of children with enuresis, in which a standardized screening was done at inclusion: Standardized enuresis history, clinical examination CMT, ultrasound, uroflow and 24h urine concentration profile validated. All this data was processed in a large, fully anonymized database

Styles de supervision de maîtres de stage en éducation physique : prise en compte du vécu émotionnel des stagiaires lors d’un entretien post-leçon

Ancrée dans le contexte de l’intervention en éducation physique, la présente recherche vise à comprendre les pratiques d’accompagnement des maîtres du stage à travers leur prise en compte des émotions vécues par les stagiaires. A la lumière de la typologie de Brûlé (1983), l’objectif est de mettre en évidence les objets, les comportements et les styles de supervision de deux maîtres de stage au profil contrasté. Cette typologie distingue trois grands styles de supervision, non mutuellement exclusifs : directif, démocratique et expérientiel. À partir d’entretiens d’autoconfrontation croisés, l’analyse du discours post-leçon des maîtres de stage révèle certains invariants : un style directif, des comportements d’évaluation et d’instruction ainsi que les techniques de la communication comme objet principal de supervision. L’analyse dégage également le profil singulier de chacun d’eux, issu de la combinaison originale des trois styles. Les résultats montrent que le vécu émotionnel du stagiaire n’est pas abordé de manière frontale, mais plutôt de manière discrète ou détournée, en mettant l’accent sur d’autres objets de supervision. Finalement, cette étude souligne l’importance des émotions dans la formation des futurs enseignants, considérées comme source de développement professionnel.In the context of research in physical education, the present study aims to understanding the practices of associate teachers through their consideration of the pre-service teachers’ emotional experience. From the typology of Brûlé (1983), themes, skills and styles of supervision are highlighted from a debriefing session of two associate teachers contrasted. This typology distinguishes three important styles of supervision, not mutually exclusive: directive, democratic and experiential. The analysis of autoconfrontation interview reveals certain similar elements: directive style, evaluation and instruction behaviors as well as communications’ skills as main themes. The analysis also shows the singular profile of each of them, stemming of the original combination of the three styles. Results indicate that the emotional experience lived by pre-service teachers is not approached in a frontal way, but rather than in a discreet way, emphasizing the other themes of supervision. Finally, this study underlines the importance of consideration of emotions experienced by future teachers during the practicum, because their feelings can be considered as source of professional development

Les éducateurs physiques et leur développement professionnel : analyse d’une activité de formation continue du Centre universitaire pour la formation continuée en éducation physique (CUFOCEP)

Depuis 32 ans, le Centre universitaire pour la formation continuée en éducation physique (CUFOCEP) en Belgique francophone répond à un besoin de formation continue, et aussi à une obligation institutionnelle d’actualisation du corps enseignant dans le domaine de l’éducation physique (ÉP). Chaque année, il attire un grand nombre de collègues auxquels les organisateurs proposent un nombre élevé et diversifié d’activités de formation. Pendant trois jours, les éducateurs physiques deviennent des stagiaires et suivent une formation de quinze heures sous la forme d’ateliers. Qu’est-ce qui fait le succès de cette activité de formation, unique en son genre ? Y a-t-il une spécificité propre à l’ÉP, par exemple, effet de groupe, identité disciplinaire, nature des savoirs professionnels ou type de formule, capable de rendre compte de l’engouement des participants ? Cet article cherche à décrire et à comprendre la nature de cette activité de formation, en considérant les rapports aux savoirs et au métier, la dimension identitaire qui lui est reliée, ainsi que les liens tissés entre les participants appartenant à diverses générations d’enseignants. La démarche méthodologique comprend : 1) l’observation des activités de formation aussi bien formelles qu’informelles, 2) des entrevues semi-structurées (n =48, durée 15 à 20 minutes chacune) conduites « à chaud », c’est-à-dire dans le feu de l’action immédiatement après les ateliers lors les pauses et 3) l’étude de plusieurs documents produits au long de dernières années sur le CUFOCEP. Les résultats de notre analyse indiquent que le CUFOCEP contribue à la mise à niveau des enseignants et à leur développement professionnel et personnel, tout en soutenant la construction d’une base toujours évolutive de savoirs professionnels, ainsi que le renforcement des liens entre les participants.For 32 years, the CUFOCEP answers a need for in-service training, but also an institutional obligation for updating the teachers' staff in the field of the physical education (PE) in French-speaking Belgium. It attracts a large number of colleagues (almost 800 in 2012) to whom the organizers propose a high and diversified number of activities of training. During three days, the PE become learners and receive a 15-hour training in the form of of workshops. What makes the success of this training activity? Is there a specificity in PE, e.g. group effect, disciplinary identity, nature of knowledges or training formula capable of explaining the interest of the participants to do it? This article tries to describe and to understand the nature of this activity of training by considering the teachers’ professional knowledge, the identity dimension which is connected there, as well as the links weaved among the participants during intergenerational relationships. The methodological approach includes: 1) the observation of the activities of training and informal activities, 2) semi-structured interviews, n=48, duration 15, 20 min, « under heat », that is, in the heat of the action, after workshops, during the breaks and 3) the study of several documents produced during the last years about the CUFOCEP. The results of our analysis point the aspects which happen during this in servive training activity. Besides helping the upgrade of teachers, it contributes to their professional and personal development, the construction of an always-evolving basis of professional knowledge, as well as in the strengthening of an identity and connections among the professionals

Oleothorax

An 84-year-old woman presented with exertional dyspnoe, productive cough, but absence of chills, night sweats, or fever. Physical examination was unremarkable except for dullness and auscultatory absence of breath sounds over the right upper hemithorax. The patient’s previous medical history revealed the diagnosis of pulmonary tuberculosis at the age of 21. At that time, she was treated successfully with right artificial pneumothoraces and finally with “antiseptic oil”, but the patient was lost to follow-up thereafter

Azacytidine Enhances Regulatory T-Cells In Vivo and Prevents Experimental Xenogeneic Graft-Versus-Host Disease

Background The demethylating agent 5-azacytidine (AZA) has proven its efficacy as treatment for myelodysplastic syndrome and acute myeloid leukemia. In addition, AZA can demethylate FOXP3 intron 1 (FOXP3i1) leading to the generation of regulatory T cells (Tregs). Objective We investigated the impact of AZA on xenogeneic graft-versus-host disease (xGVHD) in a humanized murine model of transplantation, and described the impact of the drug on human T cells in vivo. Methods In order to induce xGVHD, human peripheral blood mononuclear cells (huPBMC) were administered intravenously in NOD-scid IL-2Rγnull (NSG) mice. Results AZA successfully improved both survival (p<0.0001) and xGVHD scores (p<0.0001). Further, AZA significantly decreased human T-cell proliferation as well as INF-γ and TNF-α serum levels, and reduced the expression of GRANZYME B and PERFORIN 1 by cytotoxic T cells. In addition, AZA administration significantly increased the function, proliferation and frequency of Tregs through demethylation of FOXP3i1 and higher secretion of IL-2 by conventional T cells due to IL2 gene promoter site 1 demethylation. Interestingly, among AZA-treated mice surviving the acute phase of xGVHD, there was an inverse correlation between the presence of Tregs and signs of chronic GVHD. Finally, Tregs harvested from the spleen of AZA-treated mice were suppressive and stable over time since they persisted at high frequency in secondary transplant experiments. Conclusion These findings emphasize a potential role for AZA as prevention or treatment of GVHD

The impact of overseas training on curriculum innovation and change in English language education in Western China

This article assesses the impact of a UK-based professional development programme on curriculum innovation and change in English Language Education (ELE) in Western China. Based on interviews, focus group discussions and observation of a total of 48 English teachers who had participated in an overseas professional development programme influenced by modern approaches to education and ELE, and 9 of their colleagues who had not taken part, it assesses the uptake of new approaches on teachers’ return to China. Interviews with 10 senior managers provided supplementary data. Using Diffusion of Innovations Theory as the conceptual framework, we examine those aspects of the Chinese situation that are supportive of change and those that constrain innovation. We offer evidence of innovation in classroom practice on the part of returnees and ‘reinvention’ of the innovation to ensure a better fit with local needs. The key role of course participants as opinion leaders in the diffusion of new ideas is also explored. We conclude that the selective uptake of this innovation is under way and likely to be sustained against a background of continued curriculum reform in China