French academic physicians had a poor knowledge of terms used in clinical epidemiology

Objectives: To assess academic physicians' understanding and usage of basic epidemiological terms commonly used in medical journals. Study Design and Setting: Observational study. A total of 274 physicians, working in a teaching hospital in Paris, France were asked to answer a questionnaire including four vignettes presenting the results of a therapeutic, a diagnostic, a prognostic study and a meta-analysis of clinical trials. Results: A total of 130 (47%) questionnaires were returned. We observed the highest proportion of good answers for questions about absolute risk reduction (87.7%), sensitivity (84.6%), and specificity (80%); and the lowest for the calculation and use of the likelihood ratio (16.9% and 9.2%, respectively). The global mean score was 5.0/10 (95% confidence interval54.6e5.4, range 0e9.4). Physicians got higher scores for questions related to treatment than for questions related to diagnosis: mean scores 7.1 (6.6e7.6) vs. 4.2 (3.8e4.6). Regression analysis did not reveal any significant relationship between global performance and physicians' age (r250.002, not significant [NS]). Conclusion: Physicians demonstrated only moderate knowledge and usage of clinical epidemiology terms used in major medical journals. Their capacity to interpret quantitative data from medical scientific literature may be limited. [Authors]]]> Epidemiology ; Health Knowledge, Attitudes, Practice ; Medical Staff, Hospital ; Physicians oai:serval.unil.ch:BIB_470C9DE8C422 2022-05-07T01:17:02Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_470C9DE8C422 A neuron-specific deletion of the microRNA-processing enzyme DICER induces severe but transient obesity in mice. info:doi:10.1371/journal.pone.0116760 info:eu-repo/semantics/altIdentifier/doi/10.1371/journal.pone.0116760 info:eu-repo/semantics/altIdentifier/pmid/25629159 Mang, G.M. Pradervand, S. Du, N.H. Arpat, A.B. Preitner, F. Wigger, L. Gatfield, D. Franken, P. info:eu-repo/semantics/article article 2015 PLoS One, vol. 10, no. 1, pp. e0116760 info:eu-repo/semantics/altIdentifier/eissn/1932-6203 urn:issn:1932-6203 <![CDATA[MicroRNAs (miRNAs) are small, non-coding RNA molecules that regulate gene expression post-transcriptionally. MiRNAs are implicated in various biological processes associated with obesity, including adipocyte differentiation and lipid metabolism. We used a neuronal-specific inhibition of miRNA maturation in adult mice to study the consequences of miRNA loss on obesity development. Camk2a-CreERT2 (Cre+) and floxed Dicer (Dicerlox/lox) mice were crossed to generate tamoxifen-inducible conditional Dicer knockouts (cKO). Vehicle- and/or tamoxifen-injected Cre+;Dicerlox/lox and Cre+;Dicer+/+ served as controls. Four cohorts were used to a) measure body composition, b) follow food intake and body weight dynamics, c) evaluate basal metabolism and effects of food deprivation, and d) assess the brain transcriptome consequences of miRNA loss. cKO mice developed severe obesity and gained 18 g extra weight over the 5 weeks following tamoxifen injection, mainly due to increased fat mass. This phenotype was highly reproducible and observed in all 38 cKO mice recorded and in none of the controls, excluding possible effects of tamoxifen or the non-induced transgene. Development of obesity was concomitant with hyperphagia, increased food efficiency, and decreased activity. Surprisingly, after reaching maximum body weight, obese cKO mice spontaneously started losing weight as rapidly as it was gained. Weight loss was accompanied by lowered O2-consumption and respiratory-exchange ratio. Brain transcriptome analyses in obese mice identified several obesity-related pathways (e.g. leptin, somatostatin, and nemo-like kinase signaling), as well as genes involved in feeding and appetite (e.g. Pmch, Neurotensin) and in metabolism (e.g. Bmp4, Bmp7, Ptger1, Cox7a1). A gene cluster with anti-correlated expression in the cerebral cortex of post-obese compared to obese mice was enriched for synaptic plasticity pathways. While other studies have identified a role for miRNAs in obesity, we here present a unique model that allows for the study of processes involved in reversing obesity. Moreover, our study identified the cortex as a brain area important for body weight homeostasis

Effects of automated alerts on unnecessarily repeated serology tests in a cardiovascular surgery department: a time series analysis

<p>Abstract</p> <p>Background</p> <p>Laboratory testing is frequently unnecessary, particularly repetitive testing. Among the interventions proposed to reduce unnecessary testing, Computerized Decision Support Systems (CDSS) have been shown to be effective, but their impact depends on their technical characteristics. The objective of the study was to evaluate the impact of a Serology-CDSS providing point of care reminders of previous existing serology results, embedded in a Computerized Physician Order Entry at a university teaching hospital in Paris, France.</p> <p>Methods</p> <p>A CDSS was implemented in the Cardiovascular Surgery department of the hospital in order to decrease inappropriate repetitions of viral serology tests (HBV).</p> <p>A time series analysis was performed to assess the impact of the alert on physicians' practices. The study took place between January 2004 and December 2007. The primary outcome was the proportion of unnecessarily repeated HBs antigen tests over the periods of the study. A test was considered unnecessary when it was ordered within 90 days after a previous test for the same patient. A secondary outcome was the proportion of potentially unnecessary HBs antigen test orders cancelled after an alert display.</p> <p>Results</p> <p>In the pre-intervention period, 3,480 viral serology tests were ordered, of which 538 (15.5%) were unnecessarily repeated. During the intervention period, of the 2,095 HBs antigen tests performed, 330 unnecessary repetitions (15.8%) were observed. Before the intervention, the mean proportion of unnecessarily repeated HBs antigen tests increased by 0.4% per month (absolute increase, 95% CI 0.2% to 0.6%, <it>p </it>< 0.001). After the intervention, a significant trend change occurred, with a monthly difference estimated at -0.4% (95% CI -0.7% to -0.1%, <it>p </it>= 0.02) resulting in a stable proportion of unnecessarily repeated HBs antigen tests. A total of 380 unnecessary tests were ordered among 500 alerts displayed (compliance rate 24%).</p> <p>Conclusions</p> <p>The proportion of unnecessarily repeated tests immediately dropped after CDSS implementation and remained stable, contrasting with the significant continuous increase observed before. The compliance rate confirmed the effect of the alerts. It is necessary to continue experimentation with dedicated systems in order to improve understanding of the diversity of CDSS and their impact on clinical practice.</p

Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis

<p>Abstract</p> <p>Background</p> <p>Drug prescribing errors are frequent in the hospital setting and pharmacists play an important role in detection of these errors. The objectives of this study are (1) to describe the drug prescribing errors rate during the patient's stay, (2) to find which characteristics for a prescribing error are the most predictive of their reproduction the next day despite pharmacist's alert (<it>i.e</it>. override the alert).</p> <p>Methods</p> <p>We prospectively collected all medication order lines and prescribing errors during 18 days in 7 medical wards' using computerized physician order entry. We described and modelled the errors rate according to the chronology of hospital stay. We performed a classification and regression tree analysis to find which characteristics of alerts were predictive of their overriding (<it>i.e</it>. prescribing error repeated).</p> <p>Results</p> <p>12 533 order lines were reviewed, 117 errors (errors rate 0.9%) were observed and 51% of these errors occurred on the first day of the hospital stay. The risk of a prescribing error decreased over time. 52% of the alerts were overridden (<it>i.e </it>error uncorrected by prescribers on the following day. Drug omissions were the most frequently taken into account by prescribers. The classification and regression tree analysis showed that overriding pharmacist's alerts is first related to the ward of the prescriber and then to either Anatomical Therapeutic Chemical class of the drug or the type of error.</p> <p>Conclusions</p> <p>Since 51% of prescribing errors occurred on the first day of stay, pharmacist should concentrate his analysis of drug prescriptions on this day. The difference of overriding behavior between wards and according drug Anatomical Therapeutic Chemical class or type of error could also guide the validation tasks and programming of electronic alerts.</p

Effect of temperature and daylength on phenology for contrasted soybean genotypes grown in Europe

International audienceEuropean Union (EU-28) needs to import about 40 million tons of soybean (seed equivalent.year-1) to feed livestock and population to a lesser extent. Since a few years, soybean production in Europe bas largely încreased but remains still insufficient. In a context of climate change, southem areas tend to face more drought and heat waves while northem ones will benefit from higher temperatures in late season. Three other cropping strategies could be considered to grow soybean under these conditions: early sowing to escape drought, north\vard expansion of the crop, or double cropping. This witl change decply the photoperiod and temperature conditions during the crop season. As soybean is a tropical short-day plant, it is important to understand the temperature-photoperiod interactions on phenology for current genotypes gro\vn in Europe (under long daylengths and contrasted temperatures). For that, a study was conducted in INRA Toulouse (SVl France), combining fine phenotyping on an outdoor platform and in controlled conditions. In 2017, two experiments were carried out using 10 contrasted genotypes from maturity groups 000 to II : 1-A pot experiment on the Heliaphen platform in natural climatic conditions \.vhere germinated plants were transplanted at 6 dates (17-march, 6-april, 16-may, 26-june, 24-july, lst-september). Pots were fully fertilized and irrigated during ail the experiment. Development stages \Vere recorded once or twice a week (BBCH scale). 2- A germination experiment in cold chamber/incubator. 1 OO seeds by genotype were incubated at 10 temperatures (from 4 to 43°C) in Petri dishes on moist paper. The germinating seeds were counted tv-iice a day. Gennination results were used to calculate the base temperature of each genotype (Tb from 4.6 to 6.7°C). This information was essential for the relevant calculation of the onset of each development stage and the duration of phases expressed in growing degree days (GDD). For most stages, ANOVA analysis pointed out a highly significant effect of genotype by planting date interaction on GDD accumulation. The results showed that GDD accumulation from cotyledon stage to maturity (BBCI! stage 10 to 80) was impacted more by planting date (cv ~ 16%, p < 0,001) than by genotype (cv ~ 10 %, p < 0,001). In addition, the difference across genotypes steadily decreased when daylenght \Vas reduced by later sowing dates (from 14.5 to 12.5 h). These results will be used first to calibrate phenological models then different crop gro\vth models, These models will be necessary to test a wider range of "genotype x environment x management" combinations with the perspective of designing suitable cropping areas and ideotypes for soybean in France and Europe

Effect of temperature and daylength on phenology for contrasted soybean genotypes grown in Europe

European Union (EU-28) needs to import about 40 million tons of soybean (seed equivalent.year-1) to feed livestock and population to a lesser extent. Since a few years, soybean production in Europe bas largely încreased but remains still insufficient. In a context of climate change, southem areas tend to face more drought and heat waves while northem ones will benefit from higher temperatures in late season. Three other cropping strategies could be considered to grow soybean under these conditions: early sowing to escape drought, north\vard expansion of the crop, or double cropping. This witl change decply the photoperiod and temperature conditions during the crop season. As soybean is a tropical short-day plant, it is important to understand the temperature-photoperiod interactions on phenology for current genotypes gro\vn in Europe (under long daylengths and contrasted temperatures). For that, a study was conducted in INRA Toulouse (SVl France), combining fine phenotyping on an outdoor platform and in controlled conditions. In 2017, two experiments were carried out using 10 contrasted genotypes from maturity groups 000 to II : 1-A pot experiment on the Heliaphen platform in natural climatic conditions \.vhere germinated plants were transplanted at 6 dates (17-march, 6-april, 16-may, 26-june, 24-july, lst-september). Pots were fully fertilized and irrigated during ail the experiment. Development stages \Vere recorded once or twice a week (BBCH scale). 2- A germination experiment in cold chamber/incubator. 1 OO seeds by genotype were incubated at 10 temperatures (from 4 to 43°C) in Petri dishes on moist paper. The germinating seeds were counted tv-iice a day. Gennination results were used to calculate the base temperature of each genotype (Tb from 4.6 to 6.7°C). This information was essential for the relevant calculation of the onset of each development stage and the duration of phases expressed in growing degree days (GDD). For most stages, ANOVA analysis pointed out a highly significant effect of genotype by planting date interaction on GDD accumulation. The results showed that GDD accumulation from cotyledon stage to maturity (BBCI! stage 10 to 80) was impacted more by planting date (cv ~ 16%, p < 0,001) than by genotype (cv ~ 10 %, p < 0,001). In addition, the difference across genotypes steadily decreased when daylenght \Vas reduced by later sowing dates (from 14.5 to 12.5 h). These results will be used first to calibrate phenological models then different crop gro\vth models, These models will be necessary to test a wider range of "genotype x environment x management" combinations with the perspective of designing suitable cropping areas and ideotypes for soybean in France and Europe

Répartition du mollusque gastéropode nudibranche Dendrodoris limbata (Cuvier, 1804) le long des côtes métropolitaines françaises : apport de l’outil de sciences participatives BioObs

International audienceWe show distribution of the sea slug Dendrodoris limbata (Cuvier, 1804) (Mollusca, Gastropoda, Nudibranchia) along metropolitan French coasts. 82 records between 2010 and 2017 were extracted from the citizen science database BioObs. This species native to Mediterranean shows a discontinuous distribution, on one hand along Mediterranean coast from Var to Pyrénées-Orientales, mainly in Lagune de Thau; on the other hand in the Golfe Normand-Breton of the English Channel where it is introduced. We discuss the potential role of oyster transfer between shellfish ponds as a vector of this discontinuous distribution.Nous présentons les données de répartition le long des côtes françaises métropolitaines de la Dorisfrangée Dendrodoris limbata (Cuvier, 1804) (Mollusca, Gastropoda, Nudibranchia) issues de la basede sciences participatives BioObs, entre 2010 et 2017. Cette espèce native de Méditerranée présenteune répartition discontinue, le long des côtes méditerranéennes du Var aux Pyrénées-Orientales d’unepart, et dans le golfe normand-breton où elle a été introduite d’autre part. La possible implication dutransport de coquillages comme vecteur de cette répartition discontinue est discutée

Effect of temperature and daylength on phenology for contrasted soybean genotypes grown in Europe

International audienceEuropean Union (EU-28) needs to import about 40 million tons of soybean (seed equivalent.year-1) to feed livestock and population to a lesser extent. Since a few years, soybean production in Europe bas largely încreased but remains still insufficient. In a context of climate change, southem areas tend to face more drought and heat waves while northem ones will benefit from higher temperatures in late season. Three other cropping strategies could be considered to grow soybean under these conditions: early sowing to escape drought, north\vard expansion of the crop, or double cropping. This witl change decply the photoperiod and temperature conditions during the crop season. As soybean is a tropical short-day plant, it is important to understand the temperature-photoperiod interactions on phenology for current genotypes gro\vn in Europe (under long daylengths and contrasted temperatures). For that, a study was conducted in INRA Toulouse (SVl France), combining fine phenotyping on an outdoor platform and in controlled conditions. In 2017, two experiments were carried out using 10 contrasted genotypes from maturity groups 000 to II : 1-A pot experiment on the Heliaphen platform in natural climatic conditions \.vhere germinated plants were transplanted at 6 dates (17-march, 6-april, 16-may, 26-june, 24-july, lst-september). Pots were fully fertilized and irrigated during ail the experiment. Development stages \Vere recorded once or twice a week (BBCH scale). 2- A germination experiment in cold chamber/incubator. 1 OO seeds by genotype were incubated at 10 temperatures (from 4 to 43°C) in Petri dishes on moist paper. The germinating seeds were counted tv-iice a day. Gennination results were used to calculate the base temperature of each genotype (Tb from 4.6 to 6.7°C). This information was essential for the relevant calculation of the onset of each development stage and the duration of phases expressed in growing degree days (GDD). For most stages, ANOVA analysis pointed out a highly significant effect of genotype by planting date interaction on GDD accumulation. The results showed that GDD accumulation from cotyledon stage to maturity (BBCI! stage 10 to 80) was impacted more by planting date (cv ~ 16%, p < 0,001) than by genotype (cv ~ 10 %, p < 0,001). In addition, the difference across genotypes steadily decreased when daylenght \Vas reduced by later sowing dates (from 14.5 to 12.5 h). These results will be used first to calibrate phenological models then different crop gro\vth models, These models will be necessary to test a wider range of "genotype x environment x management" combinations with the perspective of designing suitable cropping areas and ideotypes for soybean in France and Europe