Evaluating the Impact of Computerized Provider Order Entry on Medical Students Training at Bedside: A Randomized Controlled Trial

Objective: To evaluate the impact of computerized provider order entry (CPOE) at the bedside on medical students training. Materials and Methods We conducted a randomized cross-controlled educational trial on medical students during two clerkship rotations in three departments, assessing the impact of the use of CPOE on their ability to place adequate monitoring and therapeutic orders using a written test before and after each rotation. Students’ satisfaction with their practice and the order placement system was surveyed. A multivariate mixed model was used to take individual students and chief resident (CR) effects into account. Factorial analysis was applied on the satisfaction questionnaire to identify dimensions, and scores were compared on these dimensions. Results: Thirty-six students show no better progress (beginning and final test means = 69.87 and 80.98 points out of 176 for the control group, 64.60 and 78.11 for the CPOE group, p = 0.556) during their rotation in either group, even after adjusting for each student and CR, but show a better satisfaction with patient care and greater involvement in the medical team in the CPOE group (p = 0.035*). Both groups have a favorable opinion regarding CPOE as an educational tool, especially because of the order reviewing by the supervisor. Conclusion: This is the first randomized controlled trial assessing the performance of CPOE in both the progress in prescriptions ability and satisfaction of the students. The absence of effect on the medical skills must be weighted by the small time scale and low sample size. However, students are more satisfied when using CPOE rather than usual training

Drying colloidal systems: laboratory models for a wide range of applications

The drying of complex fluids provides a powerful insight into phenomena that take place on time and length scales not normally accessible. An important feature of complex fluids, colloidal dispersions and polymer solutions is their high sensitivity to weak external actions. Thus, the drying of complex fluids involves a large number of physical and chemical processes. The scope of this review is the capacity to tune such systems to reproduce and explore specific properties in a physics laboratory. A wide variety of systems are presented, ranging from functional coatings, food science, cosmetology, medical diagnostics and forensics to geophysics and art

Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes

publisher: Elsevier articletitle: Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes journaltitle: Cell articlelink: https://doi.org/10.1016/j.cell.2018.05.046 content_type: article copyright: © 2018 Elsevier Inc

Biostimulation de la vigne, l’action d’un filtrat d’algues. Évaluation et explication des effets du filtrat d’algues (GoActiv) à base d’Ascophyllum nodosum sur la qualité de la vendange.

Article dans une revue professionnelleContexte - Le biostimulant de Goëmar à base d’algues nommé « filtrat d’algues (GoActiv) » utilisé en encadrement de floraison de la vigne a des effets bénéfiques lors de sa période d’application. Mais des effets plus tardifs, jusqu’à la vendange, en particulier sur le taux d’anthocyanes du raisin noir, ont été rapportés. Ce point devait être élucidé. Travail - Une étude a donc été menée dans le Bordelais, sur cépage merlot, par l’université de Bordeaux, durant trois années. Elle a consisté à évaluer les effets du filtrat d’algues jusqu’à la vendange et à élucider leurs mécanismes au niveau de l’expression des gènes impliqués dans la synthèse des composés phénoliques, dont les anthocyanes. Résultats - Une accélération de la synthèse des anthocyanes a été démontrée. Elle facilite le choix de la date de vendange. Par ailleurs, la stimulation de l’expression de deux gènes a été mise en évidence. L’un d’eux intervient au début de la biosynthèse des composés phénoliques au stade bouton floral, le second agit sur la synthèse des anthocyanes à partir de la véraison

Hypopituitarism in Patients with Blepharophimosis and FOXL2 Mutations

International audienceBackground: FOXL2 is the gene involved in blepharophimosis, ptosis, and epicanthus inversus syndrome (BPES). There have been few single case reports of growth hormone deficiency (GHD) with this syndrome, and Foxl2 is known to be involved in pituitary development in mice. Our aim was to analyze the prevalence of FOXL2 gene alteration in a series of patients with congenital hypopituitarism and eyelid anomalies. Methods: FOXL2 was analyzed in 10 patients with hypopituitarism (ranging from isolated GHD to complete pituitary hormone deficiency) and eyelid anomalies (typical BPES in 4 patients and milder anomalies in 6 patients). In patients with an FOXL2 mutation, we ruled out other possible molecular explanations by analyzing a panel of 20 genes known to be associated with hypopituitarism, and a candidate gene approach was used for patients without an FOXL2mutation. Results: Three patients had an FOXL2mutation. All 3 had typical BPES. Their pituitary phenotype varied from GHD to complete pituitary hormone deficiency and their pituitary morphology ranged from normal to an interrupted pituitary stalk. No mutations were found in genes previously associated with hypopituitarism. Conclusion: Our study shows that some patients with BPES have hypopituitarism with no molecular explanation other than FOXL2 mutation. This points toward an involvement of FOXL2 in human pituitary development

Periodontitis induced by Porphyromonas gingivalis drives periodontal microbiota dysbiosis and insulin resistance via an impaired adaptive immune response

International audienceOBJECTIVE: To identify a causal mechanism responsible for the enhancement of insulin resistance and hyperglycaemia following periodontitis in mice fed a fat-enriched diet. DESIGN: We set-up a unique animal model of periodontitis in C57Bl/6 female mice by infecting the periodontal tissue with specific and alive pathogens like Porphyromonas gingivalis (Pg), Fusobacterium nucleatum and Prevotella intermedia. The mice were then fed with a diabetogenic/non-obesogenic fat-enriched diet for up to 3 months. Alveolar bone loss, periodontal microbiota dysbiosis and features of glucose metabolism were quantified. Eventually, adoptive transfer of cervical (regional) and systemic immune cells was performed to demonstrate the causal role of the cervical immune system. RESULTS: Periodontitis induced a periodontal microbiota dysbiosis without mainly affecting gut microbiota. The disease concomitantly impacted on the regional and systemic immune response impairing glucose metabolism. The transfer of cervical lymph-node cells from infected mice to naive recipients guarded against periodontitis-aggravated metabolic disease. A treatment with inactivated Pg prior to the periodontal infection induced specific antibodies against Pg and protected the mouse from periodontitis-induced dysmetabolism. Finally, a 1-month subcutaneous chronic infusion of low rates of lipopolysaccharides from Pg mimicked the impact of periodontitis on immune and metabolic parameters. CONCLUSIONS: We identified that insulin resistance in the high-fat fed mouse is enhanced by pathogen-induced periodontitis. This is caused by an adaptive immune response specifically directed against pathogens and associated with a periodontal dysbiosi

Gene transfer strategy to promote axonal regeneration in the injured spinal cord : towards clinical application

International audienceIn spinal cord injury (SCI), reactive astrocytes build-up a dense cellular structure, the glial scar, that forms both physical and chemical barriers considered to be detrimental for axonal regeneration. Reactive astrocytes present hypertrophic processes resulting mainly from increased expression of glial fibrillary acidic protein (GFAP) and vimentin, two astrocyte cytoskeletal intermediate filament proteins. It had been shown, in mice knockout for both GFAP and vimentin, that due to the absence of glial reactivity, reinnervation and partial motor recovery occurred after lateral spinal cord hemisection. In order to translate this proof of principle into a therapeutic strategy, we have developed an experimental approach based on the use of siRNA carried by lentiviral vectors. We have developed lentiviral vectors Lv-siGFAP and Lv-siVIM which inhibit the in vitro formation of a glial scar in a Scratch model of lesion. Here we report that in a mouse model of SCI, intraspinal application of Ientiviral vectors Lv-shGFAP and Lv-shVIM efficiently reduces glial reactivity by silencing GFAP alone or associated with vimentin, permits axonal regrowth and improves functional motor recovery. With the objective of translation to clinics, we are adapting the work performed on mice to a large animal model (domestic swine), in order to mimic the clinical settings. We thus first designed and generated lentiviral vectors Lv-siGFAPsw able to inhibit GFAP expression in swine astrocytes. In parallel, we started to define the experimental surgical procedures of lentiviral transduction in the swine injured spinal cord by hemisection

Cross-over schema and distribution of subjects.

<p>Cross-over schema and distribution of subjects.</p