Using Estimated On-Site Ambient Temperature Has Uncertain Benefit When Estimating Postmortem Interval

The forensic entomologist uses weather station data as part of the calculation when estimating the postmortem interval (PMI). To reduce the potential inaccuracies of this method caused by the distance between the crime scene and the meteorological station, temperature correlation data from the site of the corpse may be used. This experiment simulated the impact of retrospective weather data correction using linear regression between seven stations and sites in three climatic exposure groups during three different seasons as part of the accumulated degree days calculation for three necrophagous species (Diptera: Calliphoridae). No consistent benefit in the use of correlation or the original data from the meteorological stations was observed. In nine cases out of 12, the data from the weather station network limited the risk of a deviation from reality. The forensic entomologist should be cautious when using this correlation model

Prospective study on a fast-track training in psychiatry for medical students: the psychiatric hat game

Abstract: Background: While medical students are losing interest in lectures in favor of other educational materials, many studies suggest the benefit of active learning, combined with gamified educational tools. The authors developed a psychiatric adaptation of the « Hat Game ». It was hypothesised that this game would increase both knowledge and motivation in medical students toward psychiatric semiology. The aim of the study was to assess the benefit of a Psychiatric Hat Game session for learning psychiatric symptoms in third-year medical students. Student performance was also evaluated at 3 months. Methods: This gamified fast-track training consists of two teams and each team has to guess as many psychiatric semiology terms as possible using different techniques (i.e. speech, mime). The study involved a pre- and post-evaluation of knowledge (Multiple Choice Questions) and a satisfaction survey. Baseline, post-immediate, and three-months scores were compared by using Friedman analysis for paired samples. Comparisons of mean scores at two different times were performed by using Wilcoxon test for paired samples. Results: One hundred and sixty-six students were proposed to take part in the study. Among them 129 completed the whole program (response rate = 77.7%). Mean scores measured at the three points in time were significantly different (p < 0.001, N = 129). Knowledge mean scores were significantly higher after the game than before (+ 28.6%, p < 0.001). Improvement was maintained 3 months after the game (+ 18.9%, p < 0.001). Satisfaction survey items highlighted that students enjoyed and would recommend this type of gamified training. Conclusions: The Psychiatric Hat Game improved knowledge of psychiatric semiology in medical students. Results suggest that it is a promising and efficient tool to playfully teach medical semiology, with transferable features, utility and acceptability from one medical field to another. This study contributes to the growing body of knowledge advocating for serious games and gamified training in medical education.Version of Recor

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Polypropylene reinforcement with flax or jute fibre; Influence of microstructure and constituents properties on the performance of composite

International audienceThe aim of this paper is to analyze the relationship between the tensile properties of flax and jute fibres and the mechanical performance of associated grafted polypropylene (PP-MAPP) biocomposites. Firstly, we analyzed the differences of the morphological and mechanical properties of these two types of fibres. Flax fibres demonstrated better mechanical properties. Secondly, polypropylene matrix unidirectional (UD) composites were manufactured and tensile tested. We noticed a strong correlation between the experimental Young's modulus and the estimated modulus with the rule of mixtures. Finally, short fibre PP-MAPP composites were extruded and injected and their tensile behavior was analyzed. Despite the lower tensile properties of the jute fibres, the PP-MAPP/jute composite exhibited better mechanical performances. A detailed analysis of the microstructure was conducted; it highlighted the preponderant role of fibre orientation on the mechanical properties of injected composites

Effect of low temperature in the development cycle of Lucilia sericata (Meigen) (Diptera, Calliphoridae): implications for the minimum postmortem interval estimation

Knowledge of necrophagous insects’ developmental data is necessary for the forensic entomologist to estimate a reliable minimum postmortem interval (PMImin). Among the most represented necrophagous species, Lucilia sericata (Diptera, Calliphoridae) is particularly interesting. It is regularly identified in samples, with a predominance in summer, and is commonly used by analysts of our entomology department (Institut de Recherche Criminelle de la Gendarmerie Nationale) to estimate the PMImin with the accumulated degree days (ADD) method. This method requires the mathematical lower thermal threshold to be known. This value dictates the quality of the applied ADD method but cannot be considered as fixed, especially when insect development occurs at temperatures close to the biological threshold. In such conditions, it is necessary to study the influence of such temperatures on development rate, as well as the consequences of estimating the period of first oviposition on cadavers, when using the ADD method. Seven replicate rearings were conducted at six different temperatures: 30 °C, 24 °C, 18 °C, 15 °C, 12 °C and 10 °C. Time of development and time of emergence were recorded. The effect of low temperature on the development cycle and the reliability of the ADD method under this entire temperature spectrum were studied using different linear regression models. Calculated durations of total insect time development and experimental rearing duration were then compared. A global linear model cannot be used on the whole temperature spectrum experienced by L. sericata without resulting in an overestimation at some temperatures. We found a combination of two linear regression models to be suitable for the estimation of the total development time, depending on the temperature experienced by L. sericata. This approach allowed us to obtain a variation lower than 2% at 12 °C and 10 °C between the calculated duration and experimental duration of development. In comparison, the results obtained with a global model show a variation higher than 3% at 12 °C and 10% at 10 °C

Modelling and Characterization of an Instrumented Medical Needle in Sight of New Microsensor Design for its Insertion Guidance

ISBN 978-1-4244-4123-5International audienceA needle used in in-vivo medical percutaneous procedures is subject to auto-deflection coming from its interactions with inhomogeneous and anisotropic tissues and organs in human body. In this paper we present the modelling and the characterization of microsensors glued on a medical needle in order to detect its real-time deflection by measuring strain variations on the needle. A first prototype has been developed by gluing metal foil strain gauges to the surface of a biopsy needle. The characterization of this prototype is carried out in comparison with theoretical analysis and finite element method (FEM) modelling. Results acquired through these different methods show an excellent conformity and confirm the feasibility of an instrumented medical device

Strain Gauges Based 3D Shape Monitoring of Beam Structures Using Finite Width Gauge Model

International audienceThis paper presents a new approach validated experimentally to reconstruct with strain gauges the deformed shape of a straight beam with circular cross section. It is based on a novel beam-specific strain gauge model that improves the strain measurement by taking into account the width of the gauges. These improved strain measurements are used by a 3D finite strain large displacement beam shape reconstruction method to recover the deformed shape iteratively. The whole reconstruction approach has been validated experimentally with 3D deformations of a beam instru-mented with strain gauges. Results show that the strain gauge model developed improves reconstruction accuracy and that beam reconstruction can be achieved effectively