La méthodologie utilisée pour débuter la numération chez les élèves entre 4 et 8 ans a-t-elle une incidence sur leurs résultats scolaires dans ce domaine ? :: comparaison de deux courants méthodologiques : le groupe ERMEL et Rémi Brissiaud

Dans ce travail, il sera abordé l’apprentissage de la numération chez les élèves entre 4 et 8 ans. Deux courants, qui au départ semblent en opposition, vont être comparés. Tout d’abord la méthodologie ERMEL dont les moyens d’enseignement de la partie francophone du canton de Berne sont inspirés, puis celle de Rémi Brissiaud, qui remet en question une partie des recommandations faites dans les moyens didactiques précités. Pour lui, le comptage-dénombrement est à la base de la numération, alors que pour le groupe ERMEL, le comptage-numérotage débute tout apprentissage numérique. Brissiaud invoque le besoin, chez les enfants, de pouvoir comprendre et appréhender la décomposition des nombres ainsi que l’utilisation des collections témoins de doigts pour saisir la notion de calcul, qui, selon lui, font défaut dans la méthodologie du courant ERMEL. Nous constaterons que ces deux courants ne sont pas si différents l’un de l’autre et que les résultats de ce travail ne nous permettent pas d’affirmer qu’une méthode est plus efficace que l’autre. Il sera aussi intéressant d’observer que les enseignantes interrogées dans ce travail de mémoire enseignent toutes en utilisant un peu des deux méthodologies précitées, même si elles n’en connaissent pas forcément les auteurs ou les concepts de base

Diabetes Update: Your Guide to the Latest ADA Standards

The authors highlight the latest changes in the ADA standards and review recommendations of particular relevance for family physicians

PCR detection and analyzis of potentially zoonotic Hepatitis E virus in French rats

BACKGROUND: Hepatitis E virus has been detected in a wide range of animals. While Genotypes 1-2 of this virus infect only humans, 3-4 can spread from animals to humans and cause sporadic cases of human disease. Pig, and possibly also rats, may act as a reservoir for virus. From a public health perspective it is important to clarify the role of rats for infection of humans. Rats often live close to humans and are therefore of special interest to public health. Rats live of waste and inside the sewage system and may become infected. Reports of hepatitis E virus in rats have been published but not from France. The possibility that rats in an urban area in France were Hepatitis E virus infected, with which type and relationship to other strains was investigated. This study provides information important to public health and better understanding the occurrence of hepatitis E virus in the environment. Eighty one rats (Rattus Norvegicus) were captured, euthanized, sampled (liver and faeces) and analyzed by real-time RT-PCR’s, one specific for Hepatitis E virus in rats and one specific for genotype 1-4 that that is known to infect humans. Positive samples were analyzed by a nested broad spectrum RT-PCR, sequenced and compared with sequences in Genbank. FINDINGS: Twelve liver and 11 faeces samples out of 81 liver and 81 faeces samples from 81 captured rats were positive in the PCR specific for Hepatitis E virus in rats and none in the PCR specific for genotype 1-4. Comparison by nucleotide BLAST showed a maximum of 87% similarity to Hepatitis E virus previously detected in rats and significantly less to genotype 1-4. CONCLUSIONS: This is the first study demonstrating that rats in France carries hepatitis E virus and provide information regarding its relation to other virus strains previously detected in rats and other host animals world-wide. Genotype 1-4 was not detected

Qualitative and quantitative comparison of the cytotoxic and apoptotic potential of phytosterol oxidation products with their corresponding cholesterol oxidation products

Phytosterols contain an unsaturated ring structure and therefore are susceptible to oxidation under certain conditions. Whilst the cytotoxicity of the analogous cholesterol oxidation products (COP) has been well documented, the biological effects of phytosterol oxidation products (POP)have not yet been fully ascertained. The objective of the present study was to examine the cytotoxicity of β-sitosterol oxides and their corresponding COP in a human monocytic cell line (U937), a colonic adenocarcinoma cell line (CaCo-2) and a hepatoma liver cell line (HepG2). 7β-Hydroxysitosterol, 7-ketositosterol, sitosterol-3β,5α,6β-triol and a sitosterol-5α,6α-epoxide sitosterol-5β,6β-epoxide (6:1) mixture were found to be cytotoxic to all three cell lines employed; the mode of cell death was by apoptosis in the U937 cell line and necrosis in the CaCo-2 and HepG2 cells. 7β-Hydroxysitosterol was the only β-sitosterol oxide to cause depletion in glutathione, indicating that POP-induced apoptosis may not be dependent on the generation of an oxidative stress. A further objective of this study was to assess the ability of the antioxidants α-tocopherol, γ-tocopherol and β-carotene to modulate POP-induced cytotoxicity in U937 cells. Whilst α/γ-tocopherol protected against 7β-hydroxycholesterol-induced apoptosis, they did not confer protection against 7β-hydroxysitosterol-or 7-ketositosterol-induced toxicity, indicating that perhaps COP provoke different apoptotic pathways than POP. β-Carotene did not protect against COP- or POP-induced toxicity. In general, results indicate that POP have qualitatively similar toxic effects to COP. However, higher concentrations of POP are required to elicit comparable levels of toxicity

The 6-minute walk test and other endpoints in Duchenne muscular dystrophy: longitudinal natural history observations over 48 weeks from a multicenter study.

IntroductionDuchenne muscular dystrophy (DMD) subjects ≥5 years with nonsense mutations were followed for 48 weeks in a multicenter, randomized, double-blind, placebo-controlled trial of ataluren. Placebo arm data (N = 57) provided insight into the natural history of the 6-minute walk test (6MWT) and other endpoints.MethodsEvaluations performed every 6 weeks included the 6-minute walk distance (6MWD), timed function tests (TFTs), and quantitative strength using hand-held myometry.ResultsBaseline age (≥7 years), 6MWD, and selected TFT performance are strong predictors of decline in ambulation (Δ6MWD) and time to 10% worsening in 6MWD. A baseline 6MWD of <350 meters was associated with greater functional decline, and loss of ambulation was only seen in those with baseline 6MWD <325 meters. Only 1 of 42 (2.3%) subjects able to stand from supine lost ambulation.ConclusionFindings confirm the clinical meaningfulness of the 6MWD as the most accepted primary clinical endpoint in ambulatory DMD trials

COURLIS (COURs en LIgne de Statistiques appliquées) Un MOOC francophone innovant

Introduction : Les universités numériques thématiques permettent un accès libre et gratuit à des ressources validées. Certaines de ces universités ont évolué vers des formations à distance permettant notamment la création de DIU internationaux ouverts à un grand nombre de pays francophones. L’enseignement en PACES est un exemple de pédagogie des grands groupes où dans certaines universités, l’utilisation d’un environnement numérique de travail permet de remplacer les méthodes traditionnelles d’enseignement. Les MOOC apportent une étape supplémentaire puisqu’il s’agit d’un enseignement gratuit, entièrement à distance destiné à un très grand nombre de participants, sans aucun prérequis. Le travail présenté décrit la mise en place d’un MOOC francophone transversal en statistiques appliquées, appelé COURLIS. Matériel et méthodes : La base de départ de COURLIS est représentée par les ressources développées par les UNT. La formation, gratuite, ouverte, entièrement à distance et tutorée est d’un niveau licence et peut donner lieu à une attestation de suivi payante. La certification payante est attribuée après un examen final. Les objectifs sont représentés par un socle commun de connaissances statistiques appliquées. La méthode pédagogique est active de type connectiviste avec une interactivité entre apprenants et enseignants, des devoirs personnels et des évaluations formatives. Résultats : Plusieurs universités font partie du consortium qui se met en place. Le travail étudiant est estimé à environ cent heures réparties sur 4 mois avec deux sessions de certification. Conclusion : Ce projet innovant permet d’être sur la scène des MOOC. Les valences professionnelle et académique apprécieront la réussite du projet

Genetic and Pharmacologic Manipulation of TLR4 Has Minimal Impact on Ethanol Consumption in Rodents

Toll-like receptor 4 (TLR4) is a critical component of innate immune signaling and has been implicated in alcohol responses in preclinical and clinical models. Members of the Integrative Neuroscience Initiative on Alcoholism (INIA-Neuroimmune) consortium tested the hypothesis that TLR4 mediates excessive ethanol drinking using the following models: (1) Tlr4 knock-out (KO) rats, (2) selective knockdown of Tlr4 mRNA in mouse nucleus accumbens (NAc), and (3) injection of the TLR4 antagonist (+)-naloxone in mice. Lipopolysaccharide (LPS) decreased food/water intake and body weight in ethanol-naive and ethanol-trained wild-type (WT), but not Tlr4 KO rats. There were no consistent genotypic differences in two-bottle choice chronic ethanol intake or operant self-administration in rats before or after dependence. In mice, (+)-naloxone did not decrease drinking-in-the-dark and only modestly inhibited dependence-driven consumption at the highest dose. Tlr4 knockdown in mouse NAc did not decrease drinking in the two-bottle choice continuous or intermittent access tests. However, the latency to ethanol-induced loss of righting reflex increased and the duration decreased in KO versus WT rats. In rat central amygdala neurons, deletion of Tlr4 altered GABAA receptor function, but not GABA release. Although there were no genotype differences in acute ethanol effects before or after chronic intermittent ethanol exposure, genotype differences were observed after LPS exposure. Using different species and sexes, different methods to inhibit TLR4 signaling, and different ethanol consumption tests, our comprehensive studies indicate that TLR4 may play a role in ethanol-induced sedation and GABAA receptor function, but does not regulate excessive drinking directly and would not be an effective therapeutic target., SIGNIFICANCE STATEMENT Toll-like receptor 4 (TLR4) is a key mediator of innate immune signaling and has been implicated in alcohol responses in animal models and human alcoholics. Members of the Integrative Neuroscience Initiative on Alcoholism (INIA-Neuroimmune) consortium participated in the first comprehensive study across multiple laboratories to test the hypothesis that TLR4 regulates excessive alcohol consumption in different species and different models of chronic, dependence-driven, and binge-like drinking. Although TLR4 was not a critical determinant of excessive drinking, it was important in the acute sedative effects of alcohol. Current research efforts are directed at determining which neuroimmune pathways mediate excessive alcohol drinking and these findings will help to prioritize relevant pathways and potential therapeutic targets

香港居家安老面對的挑戰 : 服務提供者及使用者之經驗

隨著人口老化，居家安老成為香港社會重大的挑戰。政府多年來提倡「居家安老為本，院舍照顧為後援」的政策方針，透過加強社區照顧服務，以減少院舍入住率。然而，政策需要由家居環境、以至社區支援互相配合，創造可供市民居家安老的先天條件方能成事。本研究旨在探討香港推行居家安老時所面對的困難與挑戰。研究團隊訪問了30名60歲或以上、曾經或正在使用長者服務的使用者和19名從事長者社區照顧及支援服務行業的服務提供者，從不同的角度探討長者居家安老的狀況和社區照顧及支援服務的成效。 研究團隊綜合了長者居家安老的狀況，提出了幾方面的改進建議。在家居環境和社區設施方面，建議 (1) 政府應主動協助長者改善「居住環境」和安裝「緊急呼叫系統」，並(2) 建設合適長者的公共交通工具和道路設施和交通配套。在醫療層面方面，建議 (3) 資助有緊急需要的長者使用私營醫療服務、(4) 擴展醫療券計劃至購買坊間藥物和 (5) 改善普通科門診醫療預約系統和公開長者預約專籌的數量及其使用狀況。在長者社區照顧及支援服務方面，建議 (6) 檢視社區照顧服務券的宣傳和使用狀況、(7) 對長者家庭進行家訪，及早識別有需要個案和 (8) 檢視未來各區長者比例，規劃長者設施服務。 研究團隊分析了社福機構人員在提供長者服務過程中所遇到的困難後，提出了四方面的建議，分別爲 (1) 改進安老服務人員資歷架構和服務外包、(2) 簡化並加強服務資訊的宣傳、(3) 優化一站式服務平台及個案管理和 (4) 制訂長遠的安老政策方向