Les futurs médecins généralistes pratiqueront-ils les sutures en cabinet de ville ?

Background: Stitches are part of the practice of GPs. However, there is a decrease in the practice of this technical gesture. The objective of this study is to identify obstacles to the practice of stitches by the future GPs. Methods: This is an epidemiological, descriptive and analytical study by numerical Internet questionnaire conducted among interns of general medicine in Ile-de-France registered in TCEM 3 during June 2015. Results: 227 interns responded, 104 (45.8%) had completed an additional education (DESC, DU, ...), 109 (48%) felt the training received in the DES of general medicine insufficient to learn sutures and 192 (84.6% ) were satisfied with the learning received during the internship. 169 (74.5%) wanted to have a GP practice in the future and 183 (80.6%) had the will to practice stitches, while 166 (73.1%) actually thought that they will really do stitches in their future practice. The main obstacles identified were too much time gesture (59.6%; p<0.01), difficulty of compliance with the rules of asepsis (18.7%; p=0.02) and the lack of training (7.2%; p=0.03). Conclusion: Despite the willingness to make stitches in their future practice, general medicine interns face barriers such as lack of training and time consuming aspect of the gesture, which tend to reduce this practice in town. Solutions can be proposed: theoretical lessons, continuing education, and patients information.Introduction : Les sutures font partie intégrante de la pratique des médecins généralistes. Cependant, on constate une diminution de la pratique de ce geste technique. L’objectif de cette étude est d’identifier les obstacles à la pratique des sutures par les internes de médecine générale. Matériel et méthodes : C’est une étude épidémiologique, descriptive et analytique par questionnaire numérique sur internet réalisée auprès des internes de médecine générale d’Ile-de-France inscrits en TCEM 3 en juin 2015. Résultats : 227 internes ont répondu : 104 (45.8%) avaient suivi un enseignement supplémentaire (DESC, DU, …), 109 (48%) trouvaient la formation reçue au cours du DES de médecine générale insuffisante à l’apprentissage des sutures et 192 (84.6%) la trouvaient suffisante au cours des stages réalisés. 169 (74.5%) s’orientaient vers une activité en cabinet de médecine générale et 183 (80.6%) avaient la volonté d’en pratiquer alors que 166 (73.1%) pensaient réellement en réaliser dans leur future pratique. Les principaux obstacles identifiés étaient le temps trop important du geste (59.6%; p<0.01), la difficulté de respect des règles d’asepsie (18.7%; p=0.02) et le manque de formation (7.2%; p=0.03). Conclusion : Malgré la volonté de réaliser des sutures dans leur future pratique, les internes de médecine générale font face à des obstacles, tel que le manque de formation et l’aspect chronophage du geste, qui tendent à diminuer cette pratique en ville. Des pistes d’aménagement peuvent être proposées: cours théoriques, formation continue, information des patients

AOP-helpFinder webserver: a tool for comprehensive analysis of the literature to support adverse outcome pathways development

Motivation: Adverse outcome pathways (AOPs) are a conceptual framework developed to support the use of alternative toxicology approaches in the risk assessment. AOPs are structured linear organizations of existing knowledge illustrating causal pathways from the initial molecular perturbation triggered by various stressors, through key events (KEs) at different levels of biology, to the ultimate health or ecotoxicological adverse outcome. Results: Artificial intelligence can be used to systematically explore available toxicological data that can be parsed in the scientific literature. Recently, a tool called AOP-helpFinder was developed to identify associations between stressors and KEs supporting thus documentation of AOPs. To facilitate the utilization of this advanced bioinformatics tool by the scientific and the regulatory community, a webserver was created. The proposed AOP-helpFinder webserver uses better performing version of the tool which reduces the need for manual curation of the obtained results. As an example, the server was successfully applied to explore relationships of a set of endocrine disruptors with metabolic-related events. The AOP-helpFinder webserver assists in a rapid evaluation of existing knowledge stored in the PubMed database, a global resource of scientific information, to build AOPs and Adverse Outcome Networks supporting the chemical risk assessment

Collaborative Annotation for Person Identification in TV Shows

International audienceThis paper presents a collaborative annotation framework for person identification in TV shows. The web annotation front-end will be demonstrated during the Show and Tell session. All the code for annotation is made available on github. The tool can also be used in a crowd-sourcing environment

Decentralized Execution of P2P Collaborative Processes

The growing importance of exchanges and collaborations in all business areas calls for fast, efficient, and flexible models of computersupported cooperation. As the traditionnal client-server paradigm is hampered by its structural limitations, the interest of the Information System Community is aroused by the promises of alternatives known as peerto- peer approaches. This paper introduces a generic architecture, P2P Coop, designed for the execution of collaborative business processes. Basic motivations of the model are discussed, as well as major contributions notably in terms of service-oriented routing and failure handling

Agreement in the scoring of respiratory events and sleep among international sleep centers.

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.Abstract STUDY OBJECTIVES: The American Academy of Sleep Medicine (AASM) guidelines for polysomnography (PSG) scoring are increasingly being adopted worldwide, but the agreement among international centers in scoring respiratory events and sleep stages using these guidelines is unknown. We sought to determine the interrater agreement of PSG scoring among international sleep centers. DESIGN: Prospective study of interrater agreement of PSG scoring. SETTING: Nine center-members of the Sleep Apnea Genetics International Consortium (SAGIC). MEASUREMENTS AND RESULTS: Fifteen previously recorded deidentified PSGs, in European Data Format, were scored by an experienced technologist at each site after they were imported into the locally used analysis software. Each 30-sec epoch was manually scored for sleep stage, arousals, apneas, and hypopneas using the AASM recommended criteria. The computer-derived oxygen desaturation index (ODI) was also recorded. The primary outcome for analysis was the intraclass correlation coefficient (ICC) of the apnea-hypopnea index (AHI). The ICCs of the respiratory variables were: AHI = 0.95 (95% confidence interval: 0.91-0.98), total apneas = 0.77 (0.56-0.87), total hypopneas = 0.80 (0.66-0.91), and ODI = 0.97 (0.93-0.99). The kappa statistics for sleep stages were: wake = 0.78 (0.77-0.79), nonrapid eye movement = 0.77 (0.76-0.78), N1 = 0.31 (0.30-0.32), N2 = 0.60 (0.59-0.61), N3 = 0.67 (0.65-0.69), and rapid eye movement = 0.78 (0.77-0.79). The ICC of the arousal index was 0.68 (0.50-0.85). CONCLUSION: There is strong agreement in the scoring of respiratory events among the SAGIC centers. There is also substantial epoch-by-epoch agreement in scoring sleep variables. Our results suggest that centralized scoring of PSGs may not be necessary in future research collaboration among international sites where experienced, well-trained scorers are involved.NHLBI P01 HL094307 HL093463 Tzagournis Medical Research Endowment Funds of The Ohio State Universit

The CAMOMILE Collaborative Annotation Platform for Multi-modal, Multi-lingual and Multi-media Documents

International audienceIn this paper, we describe the organization and the implementation of the CAMOMILE collaborative annotation framework for multimodal, multimedia, multilingual (3M) data. Given the versatile nature of the analysis which can be performed on 3M data, the structure of the server was kept intentionally simple in order to preserve its genericity, relying on standard Web technologies. Layers of annotations, defined as data associated to a media fragment from the corpus, are stored in a database and can be managed through standard interfaces with authentication. Interfaces tailored specifically to the needed task can then be developed in an agile way, relying on simple but reliable services for the management of the centralized annotations. We then present our implementation of an active learning scenario for person annotation in video, relying on the CAMOMILE server; during a dry run experiment, the manual annotation of 716 speech segments was thus propagated to 3504 labeled tracks. The code of the CAMOMILE framework is distributed in open source

Spread of Avian Influenza Viruses by Common Teal (Anas crecca) in Europe

Since the recent spread of highly pathogenic (HP) H5N1 subtypes, avian influenza virus (AIV) dispersal has become an increasing focus of research. As for any other bird-borne pathogen, dispersal of these viruses is related to local and migratory movements of their hosts. In this study, we investigated potential AIV spread by Common Teal (Anas crecca) from the Camargue area, in the South of France, across Europe. Based on bird-ring recoveries, local duck population sizes and prevalence of infection with these viruses, we built an individual-based spatially explicit model describing bird movements, both locally (between wintering areas) and at the flyway scale. We investigated the effects of viral excretion duration and inactivation rate in water by simulating AIV spread with varying values for these two parameters. The results indicate that an efficient AIV dispersal in space is possible only for excretion durations longer than 7 days. Virus inactivation rate in the environment appears as a key parameter in the model because it allows local persistence of AIV over several months, the interval between two migratory periods. Virus persistence in water thus represents an important component of contamination risk as ducks migrate along their flyway. Based on the present modelling exercise, we also argue that HP H5N1 AIV is unlikely to be efficiently spread by Common Teal dispersal only

Management of obstructive sleep apnea in Europe – A 10-year follow-up

Funding Information: Sleep medicine has been further established and recognized in the past 10 years. This is also shown by the fact that sleep-related diseases may receive a separate chapter in the new ICD-11 (International Classification of Diseases 11th Revision) [11]. However, the initial expansion in sleep laboratories and sleep centers seems to be over, at least in Europe, which stands in contradiction to the growing need. While sleep medical care still seems to be secured by the established structures, the gap between the increasing need and existing structures is still widening [ 12–14]. There is a lack of sleep medicine specialists, new outpatient structures, and new billing models with the sponsoring institutions. Approaches to solve these problems include the establishment and expansion of home sleep apnea testing (HSAT) [15] and telemedicine-based technologies in the diagnosis and treatment of OSA [16,17]. Telemedicine found its way into sleep medicine around 10 years ago [ 18–20]. One of the very first approaches as early as 1994 used a telephone circuit and a computer-controlled support system to improve OSA treatment by improving lifestyle through tele-guidance on nutrition and exercise [21]. Publisher Copyright: © 2022 The Authors Copyright © 2022 Elsevier B.V. All rights reserved.Objective: In 2010, a questionnaire-based study on obstructive sleep apnea (OSA) management in Europe identified differences regarding reimbursement, sleep specialist qualification, and titration procedures. Now, 10 years later, a follow-up study was conducted as part of the ESADA (European Sleep Apnea Database) network to explore the development of OSA management over time. Methods: The 2010 questionnaire including questions on sleep diagnostic, reimbursement, treatment, and certification was updated with questions on telemedicine and distributed to European Sleep Centers to reflect European OSA management practice. Results: 26 countries (36 sleep centers) participated, representing 20 ESADA and 6 non-ESADA countries. All 21 countries from the 2010 survey participated. In 2010, OSA diagnostic procedures were performed mainly by specialized physicians (86%), whereas now mainly by certified sleep specialists and specialized physicians (69%). Treatment and titration procedures are currently quite homogenous, with a strong trend towards more Autotitrating Positive Airway Pressure treatment (in hospital 73%, at home 62%). From 2010 to 2020, home sleep apnea testing use increased (76%–89%) and polysomnography as sole diagnostic procedure decreased (24%–12%). Availability of a sleep specialist qualification increased (52%–65%) as well as the number of certified polysomnography scorers (certified physicians: 36%–79%; certified technicians: 20%–62%). Telemedicine, not surveyed in 2010, is now in 2020 used in diagnostics (8%), treatment (50%), and follow-up (73%). Conclusion: In the past decade, formal qualification of sleep center personnel increased, OSA diagnostic and treatment procedures shifted towards a more automatic approach, and telemedicine became more prominent.Peer reviewe

A Data Model for Knowledge Representation in Collaborative Systems

Decision support systems are nowadays used to disentangle all kinds of intricate situations and perform sophisticated analysis. Moreover, they are applied in areas where the knowledge can be heterogeneous, partially un-formalized, implicit, or diffuse. The representation and management of this knowledge becomes the key point to ensure the proper functioning of the system and to keep an intuitive view upon its expected behavior. This paper presents a generic architecture for implementing knowledge-base systems used in collaborative businesses, where the knowledge is organized into different databases, according to the usage, persistence, and quality of the information. This approach is illustrated with Cadral, a customizable automated tool built on this architecture and used for processing family benefits applications at the National Family Benefits Fund of the Grand-Duchy of Luxembourg