Influence of “relation with learning” on a situation of communication teaching-learning for different Scholar pupils

International audienceCommunication can be understood as the set of relations between two people interacting. Between learners and teachers, the relationship is induced by a situation of communication teaching-learning. In this constructivism theory, Chevallard and Charlot [1,2] make the hypotesis that learning requires a factor commonly underestimated: the “relation with learning”. This study surveys the impact of the “relation with learning” of pupils under a situation of communication teaching-learning. The evolution of conceptions among learners had been studied in parallel of pedagogical method proposed by teacher.The necessity to change the conceptions in scientific learning is claimed by Giordan’s allosteric model and KVP model of Clement [3,4]. We surveyed and compared qualitatively a population of primary school pupils (n = 24), high school pupils (n= 25), and university students (n= 20) about a usual topic (blood circulation). One questionnaire enabled to determine a set of relations with learning profiles. Besides, another questionnaire for identifying the conceptions was distributed one month before the learning sequence (phase 1), and again one month after the learning sequence (phase 2) and once again six months after the learning sequence (phase 3). In parallel, the pedagogical method for each teaching sequence were defined using Bell criteria [5].Our first results show that two factors are correlated, like shown in our quantitative last research on gymnasium pupils [6]: utilitarian profile (U) and pleasure profile (P) both improve in the short run the evolution of the scientific conceptions in phase 2. Moreover, these data show same results for phase 3 for primary school pupils, university students and partly for high school pupils. Nevertheless, few conceptions decline between phase 2 and phase 3, specially for high school and primary school pupils. Analysis of different pedagogical methods used in this study shows that inquiry methods proposed for primary school and high school pupils and transmissive/explicit method proposed for university students are not correlated with a better elaboration of conceptions. Moreover, university students have more elaborated their conceptions in phase 3 than other scholar pupils.We can propose that independantly of pedagogical methods, “resonance” of learner with learning defined in partly by his “relation with learning” would be an important factor to create good conditions of communication under a situation teaching-learning

L’incidence du « rapport à l’apprendre » sur l’évolution des conceptions scientifiques

National audienceThis research surveys the impact of the « relation with learning » on the evolution of scientific conceptions among gymnasium pupils. According to Charlot and Chevallard, learning mobilizes the « relation with learning ».Our results confirm that it exists a positive correlation between these two parameters: profiles indicating a positive relation with learning – namely Utilitarian Profile (U) and Pleasure Profile (P) – reinforce in the short run the evolution of science conceptions.These data show with statistic values that the « relation with learning » may influence science learning and have a positive impact on its dynamic.Cette étude traite de l’incidence du « rapport à l’apprendre » sur l’évolution des conceptions scientifiques chez des collégiens. Elle entend tester l’hypothèse de Charlot et Chevallard selon laquelle l’entrée dans l’apprentissage requiert de prendre en compte le rapport qu’ont les apprenants sur l’apprendre.Nos résultats confirment une corrélation positive entre les deux paramètres : les profils « Utilitariste » (U) et « Plaisir » (P) – caractéristiques d’un rapport favorable au savoir - renforcent à court terme l’évolution des conceptions scientifiques.Ces données montrent statistiquement que le facteur “rapport à l’apprendre” peut influencer l’apprentissage des notions scientifiques et avoir une incidence bénéfique sur sa dynamique

Multimodality Imaging of Cardiac Transthyretin Amyloidosis 16 Years After a Domino Liver Transplantation

International audienceWe report the case of a 62-year-old man hospitalized in May 2015 for symptomatic heart failure. His medical history included two liver transplantations. The first liver transplantation was performed in 1999 for a mixed alcoholic and hepatitis C-related cirrhosis and the patient received the liver of another patient with Val30Met transthyretin amyloidosis using the domino technique. In 2008, he complained of neuropathic pains and an iatrogenic-acquired transthyretin amyloidosis was diagnosed. On cardiac evaluation, amyloidosis was suspected. In March 2010, a second liver transplantation was performed with a deceased donor without complication. In May 2015, a first episode of symptomatic heart failure occurred and cardiac amyloidosis was investigated by a multimodality evaluation. Electrocardiogram, cardiac biomarkers, echocardiography, and cardiac MRI were in favor of the diagnosis of amyloidosis, whereas 99m Tc-dicarboxypropane diphosphonate scintigraphy was not. Endomyocardial biopsy finally confirmed the positive diagnosis of iatrogenic-acquired cardiac amyloidosis. This case is, to the best of our knowledge, the first to report biopsy-proven cardiac amyloidosis induced by domino liver transplantation and progressing heart failure in spite of retransplantation. The diagnostic modalities are discussed. This case should alert physicians to the cardiac risk in domino liver transplanted patients

Diagnostic value of bone scintigraphy in cardiac amyloidosis after domino liver transplantation

International audienc

Cardiac Dysautonomia Predicts Long-Term Survival in Hereditary Transthyretin Amyloidosis After Liver Transplantation

International audienceOBJECTIVES This study sought to compare techniques evaluating cardiac dysautonomia and predicting the risk of death of patients with hereditary transthyretin amyloidosis (mATTR) after liver transplantation (LT). BACKGROUND mATTR is a multisystemic disease involving mainly the heart and the peripheral nervous system. LT is the reference treatment, and pre-operative detection of high-risk patients is critical. Cardiovascular dysautonomia is commonly encountered in ATTR and may affect patient outcome, although it is not known yet which technique should be used in the field to evaluate it. METHODS In a series of 215 consecutive mATTR patients who underwent LT, cardiac dysautonomia was assessed by a dedicated clinical score, time-domain heart rate variability, (123)-meta-iodobenzylguanidine heart/mediastinum ((123)-MIBG H/M) ratio on scintigraphy, and heart rate response to atropine (HRRA). RESULTS Patient median age was 43 years, 62% were male and 69% carried the Val30Met mutation. Cardiac dysautonomia was documented by at least 1 technique for all patients but 6 (97%). In univariate analysis, clinical score, (123)-MIBG H/M ratio and HRRA were associated with mortality but not heart rate variability. The (123)-MIBG H/M ratio and HRRA had greater area under the curve (AUC) of receiver-operating characteristic curves than clinical score and heart rate variability (AUC: 0.787, 0.748, 0.656, and 0.523, respectively). Multivariate score models were then built using the following variables: New York Heart Association functional class, interventricular septum thickness, and either (123)-MIBG H/M ratio (SMIBG) or HRRA (S-atropine). AUC of S-MIBG and S-atropine were greater than AUC of univariate models, although nonsignificantly (AUC: 0.798 and 0.799, respectively). Predictive powers of S-MIBG, S-atropine, and a reference clinical model (AUC: 0.785) were similar. CONCLUSIONS Evaluation of cardiac dysautonomia is a valuable addition for predicting survival of mATTR patients following LT. Among the different techniques that evaluate cardiac dysautonomia, (123)-MIBG scintigraphy and heart rate response to atropine had better prognostic accuracy. Multivariate models did not improve significantly prediction of outcome. (C) 2016 by the American College of Cardiology Foundation

Autonomic dysfunction and prediction of long term survival in transthyretin amyloidosis

Congress of the European-Society-of-Cardiology (ESC), Rome, ITALY, AUG 27-31, 2016International audienc

Autonomic dysfunction and prediction of long term survival in transthyretin amyloidosis

Congress of the European-Society-of-Cardiology (ESC), Rome, ITALY, AUG 27-31, 2016International audienc

Head-to-head comparison of the diagnostic performances of Rubidium-PET and SPECT with CZT camera for the detection of myocardial ischemia in a population of women and overweight individuals

International audienceBackground: The aim of this study was to compare the diagnostic performances for the detection of myocardial ischemia of 82-Rb-PET-MPS and 99m-Tc-SPECT-MPS in overweight individuals and women.Methods and results: Men with BMI ≥ 25 and women referred for MPS were considered for inclusion. All individuals underwent 99m-Tc-SPECT-MPS with CZT cameras and 82-Rb-PET-MPS in 3D-mode. Individuals with at least one positive MPS were referred for coronary angiography (CA) with FFR measurements. A criterion for positivity was a composite endpoint including significant stenosis on CA or, in the absence of CA, the occurrence of acute coronary event during the following year. 313 patients (46% women) with mean BMI of 31.8 ± 6.5 were included. Sensitivity for the detection of myocardial ischemia was higher with 82-Rb-PET-MPS compared with 99m-Tc-SPECT-MPS (85% vs. 57%, P .05). 82-Rb-PET allowed for a more accurate detection of patients with a high-risk coronary artery disease (HR-CAD) than 99m-Tc-SPECT-MPS (AUC = 0.86 vs. 0.75, respectively; P = .04).Conclusions: In women and overweight individuals, 82-Rb-PET-MPS provides higher sensitivity for the detection of myocardial ischemia than 99m-Tc-SPECT-MPS thanks to a better image quality and an improved detection of HR-CAD