Inadequate conflit of interest policies at most French teaching hospitals : a survey and web analysis

Background. There are 32 teaching hospitals in France, including 30 University hospitals and 2 Regional teachinghospitals. Teaching hospitals have three roles: health care provision, training of healthcare professionals, and medicalresearch. These roles lead to frequent interactions with pharmaceutical and medical device companies, inevitably raisingmajor risks of conflicts of interests. Therefore, policies to manage conflict of interests (COI) are crucial. This study aimsto examine COI policies in French teaching hospitals..Methods. All French teaching hospitals (n=32) were included in this study. All hospitals websites were screened forinstitutional COI policies and curriculum on COI, using standardized keyword searches. More data were collected througha questionnaire addressed to each chief executive officer (CEO) of the teaching hospital. We used predefined criteria (n=20) inspired by similar surveys on COI policies in French, US and Canadian medical schools, with some additions toreflect the local hospital context. A global score for each hospital, ranging from 0 to 58 (higher scores denoting strongerpolicies) was calculated by summing points obtained for each criterion.Results. Three out of 32 (9%) CEOs replied to the questionnaire. All 32 hospitals had websites; 16 hospitals listed policiesor regulations on their websites or provided them on request. In December 2017, among the 32 hospitals, we foundthat 17 (53.1%) had rules and regulations for some items only, 4 (12.5%) have considered implementing a policy, two ofwhich (6.3%) have begun implementation. and 15 (46.9%) had no evidence of COI policies and a null score. The maximumglobal score was 24 out of 58, with a mean of 3.50 ± 5.72.Conclusion. This is the first systematic assessment of COI policies in teaching hospitals in France. Such policies areneeded to protect patients, clinicians and students from undue commercial influence. Despite public and political pressurefor better management of COI since France’s benfluorex (Mediator) scandal of 2010, few teaching hospitals haveimplemented comprehensive and protective policies. We hope that periodic ranking of hospitals will contribute to raiseawareness of the importance of COI policy and speed introduction

Screening for cardiovascular risk in the general population: The SPICES implementation survey

BackgroundIn 2019, cardiovascular diseases (CVD) caused 32% of deaths worldwide. The SPICES survey involved five countries in an international primary CVD prevention implementation study in the general population. The French SPICES survey was implemented in the Centre Ouest Bretagne area (COB), which is a rural, economically deprived, medically underserved territory with high cardiovascular mortality. A CVD screening in the general population was needed to select the implementation population without overburdening family practitioner (FP) workforces. The efficacy and the replicability of such a screening were unknown. The aims of this study were to identify the characteristics of the individuals undergoing CVD risk assessment with the Non-Laboratory Interheart risk score (NL-IHRS), and to identify barriers and explore facilitators when screening the general population.MethodsAn implementation study combining a cross-sectional descriptive study with qualitative interviews was undertaken. The NL-IHRS was completed by trained screeners selected from health students, pharmacists, nurses, and physiotherapists in the area with a dedicated e-tool in sport and cultural events and public places. After the screening, all screener groups were interviewed until theoretical saturation for each group. Thematic analysis was performed using double-blind coding.ResultsIn 5 months, 3,384 assessments were undertaken in 60 different places, mostly by health students. A total of 1,587, 1,309, and 488 individuals were at low, moderate, and high CVD risk. Stressed or depressed individuals were remarkably numerous (40.1 and 24.5% of the population, respectively). Forty-seven interviews were conducted. The main facilitators were willingness of the population, trust between screeners and the research team, and media publicity. The main barriers were lack of motivation of some screeners, some individuals at risk, some stakeholders and difficulties in handling the e-tool.ConclusionThe efficacy of CVD risk screening while using mostly health students was excellent and preserved the FP workforce. Replicability was highly feasible if research teams took great care to establish and maintain trust between screeners and researchers. The e-tools should be more user-friendly

Projet sunshine : 10 ans de recherche et 6 publications autour de la relation médecin-industrie en France

International audiencePROJET SUNSHINE 10 ans de recherche et 6 publications autour de la relation médecin-industrie en France. Les conflits d'intérêt sont un problème sociétal plus qu'individuel

An in silico approach for evaluating the antitumor and epigenetic modulating potential of phenolic compounds occurring in edible and medicinal mushrooms

International audienceIntroduction: As part of cancer research, mycotherapy is a relatively new and promissory source of agents with immunomodulating and antitumor properties. Ongoing research projects are aiming to provide mushrooms as a new generation of "biotherapeutics". In addition to high-molecular weight polysaccharides, efforts should be made to find new anticancer drugs using low-molecular weight secondary metabolites, e.g. phenolic compounds that can inhibit or trigger specific biochemical signals leading to cancer.Methods: An in silico approach based on the structural similarity of low-molecular weight myco-compounds (phenolics) with respect to antitumor substances and molecules with modulatory effects on epigenetic events was used. For the screening of mushroom molecules with potential regulatory effects on epigenome (obtained on Web of Science, August 2015), the enzymes histone acetyltransferase (HAT), histone deacetylase (HDAC) and DNA methyltransferase (DNMT) were chosen as targets. Similarity analysis were performed with the software Saranea. Moreover, the determination of the chemical structural similitude between phenolic compounds of Pleurotus ostreatus (oyster mushroom) and antitumor reference compounds was carried out with the software Power MV 0.61. Tanimoto’s coefficients (Tc) similar or higher to 0.90 were considered as significant.Results: Seven mushroom compounds with high structural similarity to reference substances with modulatory activity on epigenetic events (Tc ≥0.90) were identified: 5 with a potential effect on histone acetylation/deacetylation, and 3 acting on the enzyme DNMT. Twenty antitumor reference compounds showed structural similarity to 3 phenols occurring in P. ostreatus, corresponding the largest number to protocatechuic acid and the flavonoids myricetin and naringin. According to its similarity to the antitumor compounds, they would act as DNA antimetabolites, antimitotic, and/or alkylating agents.Conclusion: It seems feasible to harness the natural pool of mushrooms secondary metabolites and to predict by in silico approaches their potential modulatory effects on epigenetic events and antitumor activity, in special phenolics occurring in P. ostreatus. This is an exciting advance for developing nutraceuticals/ cosmeceuticals and innovative drugs

Explorando nuevas facetas en el papel de los alimentos funcionales/ nutracéuticos en la salud humana: una mirada a las setas comestibles-medicinales

International audienc

Mycelia from Pleurotus sp. (oyster mushroom): a new wave of antimicrobials, anticancer and antioxidant bio-ingredients

International audienceBackground-There has been an upsurge of interest in mushrooms, such as Pleurotus species, as an important source of bioactive compounds. Mycelia-submerged culture represents a promising approach to search new safe and healthy myco-products with standardized quality in addition to mushroom fruiting bodies. Methods-The study examined the in vitro antimicrobial, antitumor and antioxidant activities of a hot-water extract from Pleurotus sp. mycelium. The antimicrobial activity was screened through the activation of the microbial autolytic system of four bacteria and four yeast strains. The anti-proliferative effects on NB4 human leukemia cells were measured by flow-cytometry analyses. The antioxidant activity was investigated by the scavenging of DPPH and ABTS radicals, the reducing power and the inhibition of lipid peroxidation. Results and discussion-The extract activated the microbial autolytic system of eight strains: seven autolyzing strains with intensity values (Is) ranging from 2.7% in Candida sp. to 36.1% in Saccharomyces cerevisiae. Thus, the microbial autolytic system of the strains tested (including Gram-positive and Gram-negative bacteria as well as yeasts) could be activated in vitro by mycelial extract. Pleurotus extract reduced the viability of NB4 leukemia cells, particularly at the concentration of 200 μg/mL to 82% compared to control cells, and induced apoptosis demonstrated by an increase in annexin V-FITC+ cells (25% at 200 μg/mL). At 10 mg/mL, the extract showed the most potent scavenging effects for DPPH and ABTS radicals (96% and 55%, respectively) and the inhibition of lipid peroxidation (52%). The mushroom extract at 5 mg/mL manifested reducing power of 1.105. Although carbohydrates (76.8%, w/w) appear to be the most important bioactive compounds, secondary metabolites, like phenolics, would also contribute to the antioxidant, antimicrobial and anti-proliferative activities. Conclusions-The hot-water extract obtained from Pleurotus mycelium, in light of its in vitro antimicrobial, antitumor and antioxidant effects could be considered a good candidate for developing nutraceuticals and for designing innovative myco-therapeutics and phytocosmetics applications

Evaluación de la actividad inmunomoduladora de bioproductos obtenidos de la seta comestible-medicinal Pleurotus ostreatus

International audienceEdible mushrooms are an important source for obtaining novel substances of nutritional and biopharmaceutical interest. In this regard, in Cuba, the consumption of mushrooms of the genus Pleurotus spp. has been promoted as part of the Urban Agriculture Program. Taking advantage of its availability and considering previous reports on their content of compounds with potential application, in this work, there was investigated the immunomodulatory and immunonutrition properties of biopreparations from this mushroom. New methodologies were developed to generate biopreparations from the mycelium and fruiting bodies of Pleurotus ostreatus. The obtained bioproducts were generated by biomass aqueous extraction and/or drying, which led to the registration of the NutriSetas® tradename. The bioproducts contained mainly carbohydrates (including ß-glucans) and proteins, among other secondary metabolites with potential biological activity. They showed M1-polarizing effects on macrophage populations, and the aqueous fraction obtained from the mycelium by submerged fermentation was able to stimulate the complement system alternative pathway. Noteworthy, the aqueous extract displayed radioprotective effects on the hematopoietic and immunological parameters when administered in a mice biomodel of ionizing radiation-induced secondary immunodeficiency. Similar immunostimulatory effects, either in the humoral or cellular immune responses, were found with dry and powdered preparations from fruiting bodies. Their immunonutritional effect in an experimental model of protein-energetic malnutrition in Balb/c mice evidenced nutritional recovery and immunological improvement status. This provided the first report of such an effect for edible mushroom preparations. This work received the Annual Award of the Cuban Academy of Sciences for the year 2017.Los hongos comestibles son una fuente importante para la obtención de nuevas sustancias de interés nutricional y biofarmacéutico. En Cuba se ha promovido el consumo de hongos del género Pleurotus spp. como parte del Programa de Agricultura Urbana. En este trabajo se investigó las propiedades inmunomoduladoras e inmunonutricionales de preparaciones de este hongo, dada su disponibilidad y los informes previos sobre su contenido de compuestos con potencial aplicación para estos fines. Se establecieron nuevas metodologías para obtener biopreparaciones a partir del micelio y de los cuerpos fructíferos de Pleurotus spp., mediante la extracción acuosa de biomasa, el secado, o ambos, lo cual derivó en el registro de la marca comercial NutriSetas®. Los bioproductos contuvieron principalmente carbohidratos (incluidos los ß-glucanos) y proteínas, entre otros metabolitos secundarios con actividad biológica potencial. Las preparaciones tuvieron un efecto polarizador hacia fenotipo M1 en poblacionesde macrófagos, y la fracción acuosa obtenida del micelio mediante fermentación sumergida estimuló la ruta alternativa de activación del sistema del complemento. Notablemente, el extracto acuoso tuvo efecto radioprotector en los parámetros hematopoyéticos e inmunológicos al administrarlo en biomodelos de inmunodeficiencia secundaria inducida por radiación ionizante en ratones. Las preparaciones secas y en polvo de cuerpos fructíferos fueron igualmente inmunoestimuladoras de la respuesta inmune humoral y celular. Se evidenció su efecto inmunonutricional enun modelo de malnutrición proteica-energética en ratones Balb/c. Este fue el primer informe de tales efectos para preparaciones de hongos comestibles. Este trabajo mereció el Premio Anual de la Academia de Ciencias de Cuba para el año 201

Evaluación de la actividad inmunomoduladora de bioproductos obtenidos de la seta comestible-medicinal Pleurotus ostreatus

International audienceEdible mushrooms are an important source for obtaining novel substances of nutritional and biopharmaceutical interest. In this regard, in Cuba, the consumption of mushrooms of the genus Pleurotus spp. has been promoted as part of the Urban Agriculture Program. Taking advantage of its availability and considering previous reports on their content of compounds with potential application, in this work, there was investigated the immunomodulatory and immunonutrition properties of biopreparations from this mushroom. New methodologies were developed to generate biopreparations from the mycelium and fruiting bodies of Pleurotus ostreatus. The obtained bioproducts were generated by biomass aqueous extraction and/or drying, which led to the registration of the NutriSetas® tradename. The bioproducts contained mainly carbohydrates (including ß-glucans) and proteins, among other secondary metabolites with potential biological activity. They showed M1-polarizing effects on macrophage populations, and the aqueous fraction obtained from the mycelium by submerged fermentation was able to stimulate the complement system alternative pathway. Noteworthy, the aqueous extract displayed radioprotective effects on the hematopoietic and immunological parameters when administered in a mice biomodel of ionizing radiation-induced secondary immunodeficiency. Similar immunostimulatory effects, either in the humoral or cellular immune responses, were found with dry and powdered preparations from fruiting bodies. Their immunonutritional effect in an experimental model of protein-energetic malnutrition in Balb/c mice evidenced nutritional recovery and immunological improvement status. This provided the first report of such an effect for edible mushroom preparations. This work received the Annual Award of the Cuban Academy of Sciences for the year 2017.Los hongos comestibles son una fuente importante para la obtención de nuevas sustancias de interés nutricional y biofarmacéutico. En Cuba se ha promovido el consumo de hongos del género Pleurotus spp. como parte del Programa de Agricultura Urbana. En este trabajo se investigó las propiedades inmunomoduladoras e inmunonutricionales de preparaciones de este hongo, dada su disponibilidad y los informes previos sobre su contenido de compuestos con potencial aplicación para estos fines. Se establecieron nuevas metodologías para obtener biopreparaciones a partir del micelio y de los cuerpos fructíferos de Pleurotus spp., mediante la extracción acuosa de biomasa, el secado, o ambos, lo cual derivó en el registro de la marca comercial NutriSetas®. Los bioproductos contuvieron principalmente carbohidratos (incluidos los ß-glucanos) y proteínas, entre otros metabolitos secundarios con actividad biológica potencial. Las preparaciones tuvieron un efecto polarizador hacia fenotipo M1 en poblacionesde macrófagos, y la fracción acuosa obtenida del micelio mediante fermentación sumergida estimuló la ruta alternativa de activación del sistema del complemento. Notablemente, el extracto acuoso tuvo efecto radioprotector en los parámetros hematopoyéticos e inmunológicos al administrarlo en biomodelos de inmunodeficiencia secundaria inducida por radiación ionizante en ratones. Las preparaciones secas y en polvo de cuerpos fructíferos fueron igualmente inmunoestimuladoras de la respuesta inmune humoral y celular. Se evidenció su efecto inmunonutricional enun modelo de malnutrición proteica-energética en ratones Balb/c. Este fue el primer informe de tales efectos para preparaciones de hongos comestibles. Este trabajo mereció el Premio Anual de la Academia de Ciencias de Cuba para el año 201