Eigenvalue pinching and application to the stability and the almost umbilicity of hypersurfaces

In this paper we give pinching theorems for the first nonzero eigenvalue of the Laplacian on the compact hypersurfaces of ambient spaces with bounded sectional curvature. As application we deduce rigidity results for stable constant mean curvature hypersurfaces $M$ of these spaces $N$. Indeed, we prove that if $M$ is included in a ball of radius small enough then the Hausdorff-distance between $M$ and a geodesic sphere $S$ of $N$ is small. Moreover $M$ is diffeomorphic and quasi-isometric to $S$. As other application, we give rigidity results for almost umbilic hypersurfaces

Hypersurfaces with small extrinsic radius or large λ1\lambda_1 in Euclidean spaces

We prove that hypersurfaces of $\R^{n+1}$ which are almost extremal for the Reilly inequality on $\lambda_1$ and have $L^p$-bounded mean curvature ($p>n$) are Hausdorff close to a sphere, have almost constant mean curvature and have a spectrum which asymptotically contains the spectrum of the sphere. We prove the same result for the Hasanis-Koutroufiotis inequality on extrinsic radius. We also prove that when a supplementary $L^q$ bound on the second fundamental is assumed, the almost extremal manifolds are Lipschitz close to a sphere when $q>n$, but not necessarily diffeomorphic to a sphere when $q\leqslant n$.Comment: 24 page

Clinical Knowledge Platform (CKP): a collaborative ecosystem to share interoperable clinical forms, viewers, and order sets with various EMRs

International audienceA large number of Electronic Medical Records (EMR) are currently available with a variety of features and architectures. Existing studies and frameworks presented some solutions to overcome the problem of specification and application of clinical guidelines toward the automation of their use at the point of care. However, they could not yet support thoroughly the dynamic use of medical knowledge in EMRs according to the clinical contexts and provide local application of international recommendations. This study presents the development of the Clinical Knowledge Platform (CKP): a collaborative interoperable environment to create, use, and share sets of information elements that we entitled Clinical Use Contexts (CUCs). A CUC could include medical forms, patient dashboards, and order sets that are usable in various EMRs. For this purpose, we have identified and developed three basic requirements: an interoperable, inter-mapped dictionary of concepts leaning on standard terminologies, the possibility to define relevant clinical contexts, and an interface for collaborative content production via communities of professionals. Community members work together to create and/or modify, CUCs based on different clinical contexts. These CUCs will then be uploaded to be used in clinical applications in various EMRs. With this method, each CUC is, on the one hand, specific to a clinical context and on the other hand, could be adapted to the local practice conditions and constraints. Once a CUC has been developed, it could be shared with other potential users that can consume it directly or modify it according to their needs

Indexing grey multilingual literature in General Practice: Family medicine in the era of semantic web

peer reviewedProblem/Goal: Sharing the results of research with General Practitioners (GPs) is crucial for the survival of the discipline of General Practice / Family Medicine (GP/FM). The production of abstracts in GP/FM probably exceeds 15,000 per year worldwide. Each abstract often represents two years of work for its authors and is expressed in local languages. Only 45% of them are published in indexed medical journals. Usual indexing systems like MeSH are not multilingual nor adapted to the particular field of GP/FM. Consequently, these abstracts are lacking bibliographic control and more than half of the research presented by GPs at congresses is lost. Considering the absence of appropriate domain-specific terminologies or classification systems, we propose a new multilingual indexing system. The existing International Classification of Primary Care (ICPC) is currently used for clinical purposes and has now been expanded with a taxonomy related to contextual aspects (called Q-Codes) such as education, research, practice organization, ethics or policy in GP/FM, currently not captured. The set is proposed under the name Core Content Classification in General Practice (3CGP). The aim is to facilitate indexing of GP/FM specific scientific work and to improve performance in information storage and retrieval for research purposes in this field. Research Method/Procedure: Using qualitative analysis, a corpus of 1,702 abstracts from six GP/FM- related European congresses was analyzed to identify main themes discussed by GPs (e.g., continuity, accessibility or medical ethics), handled in a domain-specific taxonomy called Q-Codes and translated in 8 languages. In addition, a methodology for building a lightweight ontology (in OWL-2) was applied to Q-Codes, adding object and datatype properties to the hierarchical relations, including mapping to the MeSH thesaurus, Babelnet (www.babelnet.org) and Dbpedia. Finally, the Q-Codes in 8 languages have been integrated healthcare terminology service (www.hetop.eu/q) with a companion website (http://3cgp.docpatient.net). Anticipated Results of the Research: The creation and the on-line publication of this multilingual terminological resource, for indexing abstracts and for facilitating Medline searches, could reduce loss of knowledge in the domain. In addition, through better indexing of the grey literature (congress abstracts, master’s and doctoral thesis), we hope to enhance the accessibility of research results of GP/FM domain and promote the emergence of networks of researchers. First result of experimental implementations of the new indexing system will be presented. Indication of costs related to the project: This project has not been funded. 3CGP is placed under Attribution-Non-Commercial-Share-Alike 4.0 International (CC BY-NC-SA 4.0). ICPC is copyrighted by WONCA. © 2018 Oriental Scientific Publishing Company. All rights reserved

Trends in computerized provider order entry: 20-year bibliometric overview

BackgroundDrug-related problems (DRPs) can lead to serious health issues and have significant economic impacts on healthcare systems. One solution to address this issue is the use of computerized physician order entry systems (CPOE), which can help prevent DRPs by reducing the risk of medication errors.ObjectiveThe purpose of this study is to provide an analysis on scientific production of the past 20 years in order to describe trends in academic publishing on CPOE and to identify the major topics as well as the predominant actors (journals, countries) involved in this field.MethodsA PubMed search was carried out to extract articles related to computerized provider order entry during the period January 1st 2003– December 31st 2022 using a specific query. Data were downloaded from PubMed in Extensible Markup Language (XML) and were processed through a dedicated parser.ResultsA total of 2,946 articles were retrieved among 623 journals. One third of these articles were published in eight journals. Publications grew strongly from 2002 to 2006, with a dip in 2008 followed by an increase again in 2009. After 2009, there follows a decreasing until 2022.The most producing countries are the USA with 51.39% of the publication over the period by France (3.80%), and Canada (3.77%). About disciplines, the top 3 is: “medical informatics” (21.62% of articles), “pharmacy” (19.04%), and “pediatrics” (6.56%).DiscussionThis study provides an overview of publication trends related to CPOE, which exhibited a significant increase in the first decade of the 21st century followed by a decline after 2009. Possible reasons for this decline include the emergence of digital health tools beyond CPOE, as well as healthcare professionals experiencing alert fatigue of the current system.ConclusionFuture research should focus on analyzing publication trends in the field of medical informatics and decision-making tools to identify other areas of interest that may have surpassed the development of CPOE

Tape casting of proton conducting ceramic material

International audienceThis work explores experimental procedures for tape-cast proton conducting ceramic fuel cells (PCFC) based on Yttrium-doped Barium Cerate (BCY10). The work is based on several years experience on aqueous tape-casting applied to the shaping of YSZ-based SOFC: however, water-based tape casting of BCY10 appeared to be impracticable for reasons associated with the high basicity of this material that results in rapid hydrolysis when in contact with water. Organic tape casting was therefore developed for BCY10, but only on Electrolyte (BCY10)/Anode (BCY10 + NiO) half cells since up to now no cathode material is available. Planar 20 mm diameter circular half-cells were obtained with the aid of a small load on top of the bi-layer to counterbalance the inevitable warping of the samples. Back-scattered SEM and X-Ray computer-controlled microtomography showed sedimentation of some large grains in the green tapes which are believed to have formed by a mechanism associated with a porosity gradient. The deformation occurring during sintering was modelled taking into account the elastic, thermal, viscoplastic and sintering components of the total deformation. 2D and 3D Finite Element numerical simulations showed that the driving force for deformation is associated with this porosity gradient

ABiMed: An intelligent and visual clinical decision support system for medication reviews and polypharmacy management

Background: Polypharmacy, i.e. taking five drugs or more, is both a public health and an economic issue. Medication reviews are structured interviews of the patient by the community pharmacist, aiming at optimizing the drug treatment and deprescribing useless, redundant or dangerous drugs. However, they remain difficult to perform and time-consuming. Several clinical decision support systems were developed for helping clinicians to manage polypharmacy. However, most were limited to the implementation of clinical practice guidelines. In this work, our objective is to design an innovative clinical decision support system for medication reviews and polypharmacy management, named ABiMed. Methods: ABiMed associates several approaches: guidelines implementation, but the automatic extraction of patient data from the GP's electronic health record and its transfer to the pharmacist, and the visual presentation of contextualized drug knowledge using visual analytics. We performed an ergonomic assessment and qualitative evaluations involving pharmacists and GPs during focus groups and workshops. Results: We describe the proposed architecture, which allows a collaborative multi-user usage. We present the various screens of ABiMed for entering or verifying patient data, for accessing drug knowledge (posology, adverse effects, interactions), for viewing STOPP/START rules and for suggesting modification to the treatment. Qualitative evaluations showed that health professionals were highly interested by our approach, associating the automatic guidelines execution with the visual presentation of drug knowledge. Conclusions: The association of guidelines implementation with visual presentation of knowledge is a promising approach for managing polypharmacy. Future works will focus on the improvement and the evaluation of ABiMed.Comment: 10 pages, 7 figure