Conception d'hypermédias en médecine : l'expérience du projet FORUM

L'activité médicale est directement concernée par les technologies de l'information aussi bien dans les phases d'apprentissage que dans la pratique quotidienne. Mais une des erreurs serait de se focaliser sur les outils et de minimiser l'importance des aspects organisationnels, sociaux, voire culturels dans l'intégration de ces technologies. La conception d'hypermédias, trop souvent abordée en Médecine uniquement sur le plan technologique, n'échappe pas à cette règle. Cette communication fait le point sur une expérience de développements d'hypermédias en Médecine dans le cadre du projet FORUM. Elle aborde les aspects techniques, méthodologiques et organisationnels qui se veulent contribuer à dynamiser l'implication des enseignants hospitalo-universitaires dans le développement de ce type d'applications

Hypermédias et apprentissage en médecine : le projet FORUM

We describe the FORUM hypermedia authoring system used to make educative medical applications. The lack of conceptual model for hypertext application makes it difficult to represent the mental model of the author and for the user to navigate. Handling information and knowledge is a way to reduce this risk. We present an approach to separate the levels of information and knowledge. In the first part, we describe the structure of FORUM. Medical applications of the system are presented in the second part.Cet article présente le générateur d'hypermédias FORUM utilisé pour développer des applications éducatives en Médecine. Les hypertextes et hypermédias sont souvent proposés en Médecine comme une solution pour venir en complément des modes d'apprentissages classiques. Pourtant, l'absence de modèles conceptuels rend difficile le développement d'applications concrètes et qui satisfassent l'enseignant et l'apprenant. Considérer les hypertextes en termes d'informations et de connaissances est une façon de limiter ces difficultés. La première partie de cet article décrit la structure de FORUM en mettant en évidence la séparation entre l'information et la connaissance. Cette séparation est une approche pour faciliter la représentation du modèle mental de l'auteur et la navigation de l'apprenant. Des expériences concrètes de réalisations médicales sont abordées dans la seconde partie.Soula Gérard, Bartoli Jean-Michel, Fieschi Mario. Hypermédias et apprentissage en médecine : le projet FORUM. In: Sciences et techniques éducatives, volume 1 n°4, 1994. pp. 521-538

Le paradoxe de la « T2A bibliométrique » SIGAPS : un risque d'effet délétère sur la recherche française ?

National audienc

Using Knowledge for Indexing Health Web Resources in a Quality-Controlled Gateway

International audienc

SMTS: a French Health Multi-terminology Server

International audienc

SMTS® : Un Serveur Multi-Terminologies de Santé

National audienc

Contribution to an automated indexing of French-language health web sites

International audienc

Identification of a promising multivalent inhibitor of the DC-SIGN dependent uptake of HIV-1 and Dengue virus

DC-SIGN is a C-type lectin receptor on antigen presenting cells (dendritic cells) which has an important role in some viral infection, notably by HIV and Dengue virus (DV). Multivalent presentation of carbohydrates on dendrimeric scaffolds has been shown to inhibit DC-SIGN binding to HIV envelope glycoprotein gp120, thus blocking viral entry. This approach has interesting potential applications for infection prophylaxis. In an effort to develop high affinity inhibitors of DC-SIGN mediated viral entry, we have synthesized a group of glycodendrimers of different valency that bear different carbohydrates or glycomimetic DC-SIGN ligands and have studied their DC-SIGN binding activity and antiviral properties both in an HIV and a Dengue infection model. Surface Plasmon Resonance (SPR) competition studies have demonstrated that the materials obtained bind efficiently to DC-SIGN with IC50s in the μm range, which depend on the nature of the ligand and on the valency of the scaffold. In particular, a hexavalent presentation of the DC-SIGN selective antagonist 4 displayed high potency, as well as improved accessibility and chemical stability relative to previously reported dendrimers. At low μm concentration the material was shown to block both DC-SIGN mediated uptake of DV by Raji cells and HIV trans-infection of T cells.Peer reviewe

Unique DC-SIGN clustering activity of a small glycomimetic: a lesson for ligand design

DC-SIGN is a dendritic cell-specific C-type lectin receptor that recognizes highly glycosylated ligands expressed on the surface of various pathogens. This receptor plays an important role in the early stages of many viral infections, including HIV, which makes it an interesting therapeutic target. Glycomimetic compounds are good drug candidates for DC-SIGN inhibition due to their high solubility, resistance to glycosidases, and nontoxicity. We studied the structural properties of the interaction of the tetrameric DC-SIGN extracellular domain (ECD), with two glycomimetic antagonists, a pseudomannobioside (1) and a linear pseudomannotrioside (2). Though the inhibitory potency of 2, as measured by SPR competition experiments, was 1 order of magnitude higher than that of 1, crystal structures of the complexes within the DC-SIGN carbohydrate recognition domain showed the same binding mode for both compounds. Moreover, when conjugated to multivalent scaffolds, the inhibitory potencies of these compounds became uniform. Combining isothermal titration microcalorimetry, analytical ultracentrifugation, and dynamic light scattering techniques to study DC-SIGN ECD interaction with these glycomimetics revealed that 2 is able, without any multivalent presentation, to cluster DC-SIGN tetramers leading to an artificially overestimated inhibitory potency. The use of multivalent scaffolds presenting 1 or 2 in HIV trans-infection inhibition assay confirms the loss of potency of 2 upon conjugation and the equal efficacy of chemically simpler compound 1. This study documents a unique case where, among two active compounds chemically derived, the compound with the lower apparent activity is the optimal lead for further drug developmentPeer reviewe