Savoir détecter l'exposition des enfants à la violence entre partenaires intimes, qu'elle soit présumée ou divulguée, et savoir intervenir.

L'exposition des enfants à la violence entre partenaires intimes (EEVPI), qu'il s'agisse des parents ou d'autres proches, représente près de la moitié de tous les cas qui font l'objet d'une enquête et sont corroborés par les services de protection de l'enfance du Canada. Les atteintes affectives, physiques et comportementales associées à l'EEVPI sont semblables aux effets d'autres formes de maltraitance envers les enfants. Il peut être difficile d'établir quels enfants et adolescents sont exposés à la violence entre partenaires intimes (VPI) en raison des comportements non spécifiques parfois associés à une telle exposition, de même que de la stigmatisation et du secret entourant souvent ce type de violence. Par ailleurs, une intervention en toute sécurité auprès des enfants et des adolescents chez qui on présume une exposition à la VPI peut être compliquée par la nécessité d'également tenir compte de la sécurité et du bien-être d'un proche non contrevenant. Le présent document de principes propose une approche fondée sur des données probantes mise au point par le projet VEGA (Violence, Evidence, Guidance, Action ou violence, données probantes, conseils, action) pour détecter l'exposition des enfants et des adolescents à la VPI et intervenir en toute sécurité auprès d'eux.

Surgical management of orbital implant exposures after evisceration or enucleation: Retrospective study - Limoges University Hospital.

INTRODUCTION: Implant exposure is the most frequent complication after evisceration or enucleation, and multiple surgical techniques for the management of orbital implant exposure. The goal of our study is to investigate the success rate and risk factors for failure of various surgical procedures. METHODS: This was a retrospective study performed at the University Hospital of Limoges. We collected data from the files of every patient operated on for implant exposure between January 2005 and December 2020. The main criterion was the percentage of success for each procedure. Secondary objectives were to identify risk factors for failure of Müller's muscle flaps and to determine the incidence of post-enucleation socket syndrome depending on whether the orbital implant was maintained. RESULTS: Fifty-one patients were included: 26 patients who underwent Müller's muscle flap, 16 dermis-fat graft, 3 conjunctival flap, 2 amniotic membrane graft, 1 temporalis fascia graft, 1 buccal mucosa graft, 1 implant rotation, and 1 implant exchange. The dermis-fat grafts were more successful (87.5%) than the Müller's muscle flaps (52.2%) (P=0.0213). The study highlighted the importance of good vascularization of the implant (OR=32.00, P-value=0.0245) for the success of Müller's muscle flaps, and we found no statistically significant difference between the patients who maintained their implants and those who did not (P=0.3865) with regard to the incidence of post-enucleation socket syndrome. CONCLUSION: Müller's muscle flap may remain a reasonable option in the management of medium-sized implant exposures of well-vascularized implants confirmed on MRI in patients with no systemic healing disorders. Dermis-fat graft remains the option of choice in other cases, especially in large exposures or complicated orbits.

Interplay among Anxiety, Digital Environmental Exposure, and Cognitive Control: Implications of Natural Settings.

Inhibitory control performance may differ greatly as a function of individual differences such as anxiety. Nonetheless, how cognitive control proficiency might be influenced by exposure to various environments and how anxiety traits might impact these effects remain unexplored. A cohort of thirty healthy volunteers participated in the study. Participants performed a Go/No-Go task before exposure to a 'forest' and 'urban' virtual environment, in a counterbalanced design, before repeating the GNG task. The State-Trait Anxiety Inventory (STAI) was finally filled-in. Our findings unveiled an initial negative correlation between anxiety trait levels and GNG task performance, consistent with the established literature attributing difficulties in inhibitory functionality to anxiety. Additionally, different environmental exposures reported opposite trends. Exposure to the 'forest' environment distinctly improved the GNG performance in relation to anxiety traits, while the 'urban' setting demonstrated adverse effects on task performance. These results underscore the intricate relationship among cognitive control, environmental exposure, and trait anxiety. In particular, our findings highlight the potential of natural settings, such as forests, to mitigate the impact of anxiety on inhibition. This might have implications for interventions aimed at improving cognitive control.

Improving Behavioral-Based Safety Training in Using Verbal Commands Through a Theory-Driven and Feedback-Based Nonimmersive Virtual Reality Game: Development and Usability Study.

BACKGROUND: The construction, chemical, aviation, medical, and health care industries have used serious games for safety training. To our knowledge, serious games have not been developed focusing on behavioral change to improve safety through the use of verbal commands and instilling players with heightened awareness of their spatial proximity to other people in their surroundings. OBJECTIVE: We aimed to develop a theory-driven serious game for improving safety behavior using verbal commands and validate the implementation of the theoretical frameworks used for game development. The game developed, KitchenSpeak, was a first-person character (FPC) game where users respond to in-game prompts to use loud verbal commands when they are approaching another employee's blind spot. METHODS: In addition to using the SERES framework in guiding the general game design and development, and the Reflection, Engagement, Choice, Information, Play, Exposition (RECIPE) framework to inform the design of the game mechanics, we also applied gestalt laws of perception for graphic design to guide the design of the game's user interface. We conducted 2 evaluative tests (alpha and beta) to collect end user and stakeholder feedback on the implementation of the theoretical frameworks, as well as to collect relevant information for full-scale implementation and a future validation study. RESULTS: The alpha and beta tests had 8 and 40 participants, respectively. The alpha test results revealed that the theoretical frameworks were adequately applied; however, suggestions were also made to modify and improve the game. The beta test results suggested further improvements for the game design and found no differences in the perception of ease of play between participants with and without previous FPC gaming experience (P=.47; Kruskal-Wallis). Results suggested that the game met its design and theoretical requirements, and it would be easily playable by all players regardless of their previous experience in FPC games. CONCLUSIONS: A theory-driven and evidence-based FPC game titled KitchenSpeak was developed to teach the use of kitchen-speak terms in commercial kitchens. Evaluative tests were conducted to validate the implementation of the theoretical frameworks. Our main contributions are creating and validating game-based training to improve behavioral-based safety in the workplace and the incorporation of gestalt laws of perception for graphic design in the game's user interface.

Physiologically-based pharmacokinetic models to predict drug exposure during pregnancy.

As pregnant women are constantly exposed to drugs during pregnancy, either to treat long-term conditions or acute illnesses, drug safety is a major concern for the fetus and the mother. Clinical trials are rarely made in this population due to strict regulation and ethical reasons. However, drug pharmacokinetic (PK) parameters vary during pregnancy with an increase in distribution volume, renal clearance and more. In addition, the fetal distribution should be evaluated with the importance of placental diffusion, both active and passive. Therefore, there is a recent interest in the use of physiologically-based pharmacokinetic (PBPK) modeling to characterize these changes and complete the sparse data available on drug PK during pregnancy. Indeed, PBPK models integrate drug physicochemical and physiological parameters corresponding to each compartment of the body to estimate drug concentrations. This review establishes an overview on the current use of PBPK models in drug dosage determination for the pregnant woman, fetal exposure and drug interactions in the fetal compartment.

Regina Elena Institute (R.E.I.) Protocol for Breast Implant Salvage: Preliminary Results.

INTRODUCTION: implants are the most popular means of restoring the breast mound after mastectomy; the most feared complication is implant infection accounting for 4.8% to 35.4% of cases. Various antibiotic regimens or other surgical revisions to treat implant infections have been reported, but their failure rates are unacceptable. Implant removal is subsequently the most common recourse for managing prosthesis infections. we report preliminary results of infected breast implant salvage using our Regina Elena Institute (REI) protocol. METHODS: Since June 2021, a prospective single-centre study has been ongoing for patients burdened by implant infection or exposure. All qualifying participants underwent our REI protocol. They receive a temporary smooth implant and 1 week of implant's pocket irrigation with antibiotic solution along with systemic antibiotic and then a new permanent prosthesis positioning. RESULTS: Ten of whom completed at least 6 months of follow-up and were eligible for this preliminary analysis. Overall, the REI protocol was applied to 13 breasts. No infections relapsed during the 6-month minimum follow-up intervals; and no early capsular contraction was evident, resulting in good cosmetic outcomes for every treated breast. DISCUSSION: The smooth-surfaced implant's sizer helps maintain tissue expansion, preventing skin retraction; and the slightly smaller diameters used (compared with originals) facilitate antibiotic wash distribution. Combining a targeted systemic antibiotic and a topical agent is the best way to optimise infection resolution. This preliminary analysis has clear limitations. A larger population is warranted to increase the level of evidence. Longer follow-up is also advisable to monitor for delayed infection recurrence.

The other great imitator among infectious diseases: Leptospirosis.

INTRODUCTION: Leptospirosis is a worldwide zoonosis responsible for highly diverse clinical presentations with a wide range of severity. Variable environment exposures to infected urines of rodents have been described. OBSERVATION: We report five cases of serologically confirmed leptospirosis leading to hospitalization in an intensive care unit (ICU) of a French center. These patients displayed neurological, respiratory, and abdominal presentation of leptospirosis with variable level of severity. Either professional, leisure related, or daily living exposures have been retrieved. CONCLUSION: These cases underline the diversity of clinical presentation and environmental exposure of this infectious disease. They highlight the interest of an exhaustive anamnesis with collection of professional activity, environmental exposures, and leisure activities.

Rates of Seroprotection against Vaccine-Preventable Infectious Diseases in HIV-Exposed and -Unexposed Malawian Infants.

BACKGROUND: The evaluation of seroprotection rates against vaccine-preventable infectious diseases allows for the identification of risk populations. HIV-exposed infants, even if not infected with HIV, have higher morbidity and mortality in comparison to unexposed counterparts. The aim of this study was to compare the specific IgG levels against Haemophilus influenzae type-B (HiB), Hepatitis-B (HBV), and Streptococcus pneumoniae (Spn) in two groups of infants (HIV-exposed and HIV-unexposed) living in Malawi. METHODS: Blood samples from 62 infants, 49 HIV-exposed, uninfected (HEU), and born to women living with HIV and 13 HIV-unexposed and uninfected (HUU), were collected at 6 months, and specific IgG levels were determined using ELISA tests. RESULTS: The antibody levels against HiB, HBV, and Spn were similar in the two groups. At six months, all HUU infants and 81.6% of HEU infants showed seroprotective levels against HiB, while a percentage of protection varying from 80.6 to 84.6% was observed for HBV and Spn regardless of HIV exposure. Only 59.2% of HEU and 69.2% of HUU infants showed antibody protection against all three pathogens. CONCLUSIONS: These results indicate similar rates of seroprotection among HEU and HUU infants but also suggest that a consistent fraction of infants received incomplete vaccinations. Strategies to enforce participation in immunization programs in Malawi should be a health priority.

Performance analysis of innovative cleaning and soiling mitigation solutions in the semi-arid climate of Benguerir Morocco.

The objective of this paper is to evaluate the performance of the hydrophobic coatings and detergent cleaning & antistatic protection for photovoltaic solar panels in semi-arid weather conditions in Benguerir Morocco. Various coating and cleaning strategies were tested on five photovoltaic (PV) systems with the same PV panels and electrical configurations. The first PV system (uncleaned) was not subject to any coatings or cleaning solutions. The second PV system (Water Cleaned) was periodically cleaned with raw water. The third PV system: solar wash protects (SWP) made use of a cleaning solution. The fourth:D solar defender (DSS) and fifth: industrial glass protect (IGP) PV systems each had a unique combination of the two hydrophobic coatings. The results demonstrated that after 9 months of operation, in the first 3 months (cleaning period) the average efficiency gain of the coated PV panels is around 10% compared to the reference system. Whereas in the non-cleaning period after 6 months of exposure, the efficiency gain is around 5%. After the outdoor exposure period, the cumulative energy gain of the coated systems compared to the water-cleaned reference reaches an average of 3%. It has been found that the SWP used 50% less water to clean the PV panels than the system cleaned without a cleaning solution, which made the panels harder to clean. The SWP is more successful at dust removal during the dry season (August-February) with low rain rates. However, during the rainy season (March-April), IGP outperformed SWP and DSD, with a small difference in PV performance. This study demonstrates the significance of using new cleaning strategies such as anti-soling coatings in dry areas to enhance the performance of photovoltaic systems, which may be useful for investors, researchers, and engineers interested in grid-connected photovoltaic and self-cleaning technology.

[Combination of ketamine and esketamine with Exposure and Response Prevention (ERP) therapy for Obsessive-Compulsive Disorder]. / Combinaison de la kétamine et de l'eskétamine avec la thérapie d'exposition avec prévention de la réponse (EPR) dans le trouble obsessionnel-compulsif.

Obsessive-Compulsive Disorder (OCD), characterized by the combination of obsession and compulsion, is a clinical and therapeutic challenge. Many patients with OCD do not respond to first-line treatments such as serotonin selective reuptake inhibitors (SSRIs) and exposure and response prevention psychotherapy (ERP). For these resistant patients, some preliminary studies have shown that ketamine, a non-selective glutamatergic NMDA receptors antagonist, could improve the obsessive symptoms. A number of these studies have also suggested that the combination of ketamine with ERP psychotherapy may jointly potentiate the effectiveness of ketamine and ERP. In this paper, we present the existing data on the combined use of ketamine with ERP psychotherapy for OCD. We suggest that modulation of NMDA receptor activity and glutamatergic signaling by ketamine may promote the therapeutic mechanisms involved in ERP such as fear extinction and brain plasticity mechanisms. Finally, we propose a ketamine-augmented ERP psychotherapy (KAP-ERP) protocol in OCD, and we present the limitations associated with its application in clinical practice.

Airo® navigation versus freehand fluoroscopy technique: A comparative study of accuracy and radiological exposure for thoracolumbar screws placement.

PURPOSE: The aim was to compare the accuracy of freehand fluoroscopy and CT based navigation on thoracolumbar screws placement and their respective effects on radiological exposure to the patient. No previous study directly compared the Airo® navigation system to freehand technique. METHODS: In this monocentric retrospective study, 156 consecutive patients who underwent thoracolumbar spine surgery were included. Epidemiological data and surgical indications were noted. Heary classification was used for thoracic screws and Gertzbein-Robbins classification for lumbar screws. Radiological exposure was collected for each surgery. RESULTS: A total of 918 screws were implanted. We analyzed 725 lumbar screws (Airo® 287; freehand fluoroscopy 438) and 193 thoracic screws (Airo® 49; freehand fluoroscopy 144). Overall, lumbar screws accuracy (Gertzbein-Robbins grade A and B) was good in both groups (freehand fluoroscopy 91.3%; Airo® 97.6%; P<0.05). We found significantly less Grade B and C in the Airo® group. Thoracic accuracy was also good in both groups (Heary 1 and 2; freehand fluoroscopy 77.8%; Airo® 93.9%), without reaching statistical significance. Radiological exposure was significantly higher in the Airo® group with a mean effective dose of 9.69 mSv versus 0.71mSv for freehand fluoroscopy. CONCLUSION: Our study confirmed that the use of Airo® navigation yielded good accuracy. It however exposed the patient to higher radiological exposure compared with freehand fluoroscopy technique. LEVEL OF EVIDENCE: Level 3.

Preclinical Assessment of Tissue Effects by Gastrointestinal Endoscope Tip Temperature.

Background: Endoscope tips are heated by their electrical and illuminating components. During the procedure, they might get in close or even direct contact with intestinal tissues. Objective: To assess endoscope tip and tissue temperature as well as histopathologic changes of gastrointestinal (GI) tissues when exposed to the heated tip of GI endoscopes. Methods: The endoscope tip temperatures of four GI endoscopes were measured for 30 minutes in a temperature-controlled chamber. The temperature of ex vivo porcine GI tissues was measured for 5-, 15-, and 120-minute exposure to endoscope tips within a climate chamber to control environmental factors (simulation of fever as worst-case). Exposed tissues were histopathologically examined afterward. Control samples included untreated mucosa, tissue samples exposed to endoscope tips for 120 minutes, as well as tissue samples thermally coagulated with a bipolar high-frequency probe. Results: Actual endoscope tip temperatures of 59 to 86°C, dependent on the endoscope type, were measured. After 10 to 15 minutes, the maximum temperatures were reached. Maximum tissue temperatures of 44 to 46°C for 5 and 15 minutes, as well as up to 50°C for 120 minutes, were recorded dependent on tissue and endoscope type. No direct heat-induced histopathologic tissue alterations were observed in the 5- and 15-minute samples. Conclusions: Both clinically relevant and a worst-case control were tested. Even though elevated temperatures were recorded, no heat-related tissue alterations were detected. This overall supports the safety profile of GI endoscopy; however, the study findings are limited by the ex vivo setting (no metabolic tissue alterations accessible, no blood flow) and small sample number.

Webcam-Based Online Coaching with Children and Adolescents with Obsessive-Compulsive Disorders - A Single-Case Study.

Objective: Although there is clear evidence-based knowledge regarding state-of-the-art treatment for pediatric obsessive-compulsive disorder (OCD), two main issues remain in clinical practice: (1) Exposure-based cognitive behavioral therapy (CBT) is limited in terms of availability and accessibility or is not adequately provided, and (2) despite large effect sizes of exposure-based CBT, the achieved recovery rates of 50-60 % still show room for improvement. These issues have prompted an increasing focus on delivering exposure-based CBT in new and innovative ways. This study aims to evaluate an intensive therapist-administered online coaching program consisting of exposure with response prevention via video teleconferencing (VTC) as an add-on to weekly outpatient CBT (blended therapy). Method: The blended therapy is examined in n = 5 children and adolescents with OCD using an AB design and multi-informant ratings. Results: This single-case study shows promising results, indicating that a decrease in OCD severity and related functional impairment can be attributed to blended therapy. Moreover, satisfaction with online coaching was high. Conclusions: Despite some principal limitations, the results support the effectiveness and feasibility of blended therapy.

Notificação da COVID-19 como acidente laboral por trabalhadores da saúde: scoping review / Notification of COVID-19 as an occupational injury by health workers: scoping review / Notification of COVID-19 as an occupational injury by health workers: scoping review / Notificación de COVID-19 como accidente laboral por trabajadores de la salud: scoping review

Resumo Objetivo Identificar as publicações que discorreram sobre a COVID-19 como acidente laboral e sua notificação pelos trabalhadores da saúde. Métodos A busca para esta scoping review, explorou literatura nacional e internacional, no período de 2020 e 2021, em inglês, português e espanhol, nas bases de dados do Portal Regional da Biblioteca Virtual em Saúde, na MEDLINE por meio do PubMed e no Portal de Periódicos da Capes empregou-se: Embase, Scopus, Web of Science, CINAHL. Os textos foram importados para o EndNote, suprimido os duplicados e exportados para o aplicativo Rayyan, sendo feita a inclusão dos artigos em planilha Excel com os rótulos/etiquetas: COVID-19 como acidentes de trabalho e Notificação de COVID-19. Resultados Foram identificados 5.665 estudos, excluindo 2.088 duplicações, resultando 3.577 publicações, selecionadas por título e resumo. Destas, 3.280 não atendiam aos critérios de inclusão, resultando 297 artigos. Destes, 10 foram selecionados para análise completa do texto por tratarem da COVID-19 como acidente de trabalho e/ou notificação deste agravo pelos trabalhadores da saúde. Dois artigos foram excluídos por se tratar de revisão de literatura, permanecendo 8 como corpus do estudo. Conclusão Apesar de determinados países já reconhecerem a COVID-19 como doença ocupacional, alguns trabalhadores ainda apresentam dificuldades em relacionar a infecção pelo SARS-CoV-2 com o trabalho na assistência à saúde, caracterizando como acidente laboral. Todos devem ser orientados e capacitados quanto ao reconhecimento da COVID-19 como acidente laboral e notificar sua ocorrência, uma vez que já existe a definição da infecção como doença de notificação compulsória.

Resumen Objetivo Identificar las publicaciones que abordaron el COVID-19 como accidente laboral y su notificación por parte de los trabajadores de la salud. Métodos La búsqueda para esta scoping review exploró la literatura nacional e internacional, durante el período de 2020 a 2021, en inglés, portugués y español, en las bases de datos del Portal Regional de la Biblioteca Virtual de Salud, en MEDLINE a través de PubMed, y en el Portal de Periódicos de Capes se utilizó Embase, Scopus, Web of Science, CINAHL. Los textos fueron importados a EndNote, se eliminaron los duplicados y se exportaron a la aplicación Rayyan, se incluyeron los artículos en una planilla de Excel con la clasificación/etiquetas: COVID-19 como accidente de trabajo y Notificación de COVID-19. Resultados Se identificaron 5.665 estudios, se excluyeron 2.088 duplicaciones, que dio como resultado 3.577 publicaciones, seleccionadas por título y resumen. De ellas, 3.280 no atendían los criterios de inclusión, por lo que se obtuvieron 297 artículos. De estos, 10 fueron seleccionados para análisis completo del texto porque trataban el COVID-19 como accidente de trabajo o notificación de este daño por parte de los trabajadores de la salud. Se excluyeron dos artículos porque se trataban de revisión de literatura, por lo cual permanecieron ocho como corpus de estudio. Conclusión Aunque determinados países ya reconocieron el COVID-19 como una enfermedad ocupacional, algunos trabajadores aún tienen dificultad de relacionar la infección por SARS-CoV-2 con el trabajo en la atención a la salud, caracterizándolo como un accidente laboral. Todos deben ser orientados y capacitados sobre el reconocimiento del COVID-19 como accidente laboral y notificar su ocurrencia, dado que ya existe la definición de la infección como enfermedad de notificación obligatoria.

Abstract Objective To identify the publications that discussed COVID-19 as an occupational injury and its notification by health workers. Methods The search for this scoping review explored national and international literature, between 2020 and 2021, in English, Portuguese and Spanish, in the databases of the Regional Portal of the Virtual Health Library, in MEDLINE through PubMed and in Capes Journal Portal used: Embase, Scopus, Web of Science, CINAHL. The texts were imported into EndNote, duplicates were removed and exported to the Rayyan application, and the articles were included in an Excel spreadsheet with the labels: COVID-19 as injuries at work and Notification of COVID-19. Results A total of 5665 studies were identified, excluding 2088 duplicates, resulting in 3577 publications, selected by title and abstract. Of these, 3280 did not meet the inclusion criteria, resulting in 297 articles. Of these, 10 were selected for full text analysis because they dealt with COVID-19 as an injury at work and/or notification of this condition by health workers. Two articles were excluded because they were a literature review, remaining 8 as the study's corpus. Conclusion Although certain countries already recognize COVID-19 as an occupational injury, some workers still have difficulties in relating the SARS-CoV-2 infection with work in health care, characterizing it as an occupational injured. Everyone should be guided and trained regarding the recognition of COVID-19 as an occupational injury and notify its occurrence, since the definition of the infection as a notifiable disease already exists.

[Incidence and risk factors of exposure keratopathy in intensive care units: About 91 patients]. / Incidence et facteurs de risque des kératopathies d'exposition en milieu de réanimation : à propos de 91 patients.

Exposure keratopathy is a sight-threatening complication which can occur in patients admitted to intensive care units. This is a prospective study over a period of 5 months in the intensive care unit of the specialty hospital of the IBN SINA medical center, with a capacity of 8 beds. The purpose of our study was to determine the incidence of and risk factors for exposure keratopathy in intensive care settings. Forty-two percent of patients developed exposure keratopathy, 48% exhibited chemosis, and 40% showed lagophthalmos with the cornea visible in 30% of cases. The frequency of keratopathy was significantly higher in patients with chemosis and lagophthalmos (P<0.0001). Lagophthalmos was significantly related to chemosis (P<0.0001). Chemosis in the ventilated patient, also known as "ventilator eye," is a serious complication leading to the risk of keratopathy. The risk factors for keratopathy found in our series were chemosis (OR=25.28, 95% CI=[3.339-191.52] P-value=0.002), lagophthalmos (OR=40.8, 95% CI=[4.347-383.666] P-value=0.001) and length of stay in intensive care (OR=12.28, 95% CI=[1.476-102.230] P-value=0.020). Several methods might be used and adapted to each case for prevention of exposure keratopathy, and we found that raising nursing staff awareness is of paramount importance.

Automatic Estimation of the Most Likely Drug Combination in Electronic Health Records Using the Smooth Algorithm: Development and Validation Study.

BACKGROUND: Since the use of electronic health records (EHRs) in an automated way, pharmacovigilance or pharmacoepidemiology studies have been used to characterize the therapy using different algorithms. Although progress has been made in this area for monotherapy, with combinations of 2 or more drugs the challenge to characterize the treatment increases significantly, and more research is needed. OBJECTIVE: The goal of the research was to develop and describe a novel algorithm that automatically returns the most likely therapy of one drug or combinations of 2 or more drugs over time. METHODS: We used the Information System for Research in Primary Care as our reference EHR platform for the smooth algorithm development. The algorithm was inspired by statistical methods based on moving averages and depends on a parameter Wt, a flexible window that determines the level of smoothing. The effect of Wt was evaluated in a simulation study on the same data set with different window lengths. To understand the algorithm performance in a clinical or pharmacological perspective, we conducted a validation study. We designed 4 pharmacological scenarios and asked 4 independent professionals to compare a traditional method against the smooth algorithm. Data from the simulation and validation studies were then analyzed. RESULTS: The Wt parameter had an impact over the raw data. As we increased the window length, more patient were modified and the number of smoothed patients augmented, although we rarely observed changes of more than 5% of the total data. In the validation study, significant differences were obtained in the performance of the smooth algorithm over the traditional method. These differences were consistent across pharmacological scenarios. CONCLUSIONS: The smooth algorithm is an automated approach that standardizes, simplifies, and improves data processing in drug exposition studies using EHRs. This algorithm can be generalized to almost any pharmacological medication and model the drug exposure to facilitate the detection of treatment switches, discontinuations, and terminations throughout the study period.

Prospective DNA Methylation Analysis of the CpG GABRA2 Receptor Subunit in Alcohol Dependence during Detoxification.

Background and Objectives: Variants of GABRA2 have been repeatedly associated with alcohol dependence risk. However, no study investigated potential epigenetic alterations in the GABRA2 gene in alcohol-dependent (AD) subjects during alcohol withdrawal. We investigated DNA methylation pattern in the regulatory region of GABRA2 gene in peripheral leukocytes of AD patients and controls. Further, GABRA2 methylation patterns were analysed in neuroblastoma cells under ethanol exposure and withdrawal. Materials and Methods: In the present study, blood samples were obtained from 41 AD subjects on the day of inpatient admission, after the first and second week of inpatient treatment. The comparison group included 47 healthy controls. GABRA2 methylation of 4 CpG sites in the CpG island was compared to neuroblastoma cells which were exposed to 100 mM of ethanol for 2, 5 and 9 days, followed by a withdrawal interval of 4 days. Results: no significant differences in GABRA2 methylation patterns were found in AD subjects over time and vs. controls, after controlling for age. Further, no influence of withdrawal severity, alcohol consumption before admission and other alcohol dependence characteristics were found. Conclusions: The results indicate that GABRA2 methylation in AD individuals and in a cell model is unaffected by alcohol exposition and withdrawal. Influences of GABRA2 on characteristics of alcohol dependence may be exerted by mechanisms other than epigenetic alterations related to alcohol intoxication or withdrawal.

The Mental Health of Older Adults in the Densely Populated Areas of Tacna Region-Peru, 2021: Implications of the COVID-19 Information.

The purpose of this research was to analyze the implications of exposure to various news channels that broadcast information on COVID-19 and their impact on the mental health of older adults in the sparsely populated area of the Tacna Region during the year 2021. The present study used a descriptive correlational type of quantitative approach on a sample of 389 older adults aged 60 years and over, who were recruited by non-probabilistic convenience sampling. For the application of the survey technique, the instrument used was a questionnaire modified by the authors. In terms of research ethics for the development of the study, the respondents provided informed consent, and other ethical considerations were addressed. In relation to sociodemographic variables of mental health, it was found that women had a greater incidence of anxiety (p < 0.01) and that people with fewer years of study had a greater incidence of depression (p < 0.01) and anxiety in sparsely populated areas. Exposure to news through television was associated with depression, and news obtained from other people was associated with depression (p < 0.001). An association was also found between the number of hours of television news and stress (p < 0.05), and radio news was associated with anxiety (p < 0.05). In terms of psychological consequences, the highest mean for television exposure was fear, while the greatest psychological consequence of radio news was fear, followed by stress and awareness. Finally, negative, inverse, and significant relationships were found that indicate protective factors, such as depression with awareness and indignation, and anxiety was inversely related to awareness.

[Cancers induced by occupational exposure: What progress has been made?] / Les cancers induits par les expositions professionnelles : les progrès.

INTRODUCTION: In 2019, only 1,790 occupational cancers were recognized, i.e., less than 1% of estimated occupational cancers. Our study aims to expand the methodology of a French cancer center to improve the detection and compensation of occupational bronchopulmonary cancers. PATIENTS AND METHODS: Between November 2014 and December 2020, all patients diagnosed with primary bronchopulmonary cancer (including mesothelioma) received a free questionnaire (Curriculum Laboris) aimed at retracing their professional career but also socio-demographic data. After an initial analysis of the questionnaire, a consultation can be scheduled if exposures are suspected. They will then be confirmed or not, during a consultation of around 1hour 30minutes during which the patient's precise career path is explored. RESULTS: Among the 498 patient questionnaires received, 261 patients (52%) benefited from a consultation. Of all the patients seen in consultation, 198 (or 76%) had a proposal to declare an occupational disease. Among the 151 declarations of which the fate is known, 107 (i.e., 54% of the proposed declarations or 21% of the questionnaires concerning primary lung cancer) received an agreement of recognition. CONCLUSION: The massive underreporting of occupational cancers at present in France is a real public health problem. The two major issues in the recognition of occupational diseases are, on the one hand, reparation for the damage suffered by victims or their beneficiaries and, on the other hand, the adaptation of national prevention programs considering past, present and emerging.

Glyphosate-based herbicide exposure: effects on gill microbiota of rainbow trout (Oncorhynchus mykiss) and the aquatic bacterial ecosystem.

The herbicide glyphosate has been widely used in the past 40 years, under the assumption that side effects were minimal. In recent years, its impact on microbial compositions and potential indirect effects on plant, animal and human health have been strongly suspected. Glyphosate and co-formulates have been detected in various water sources, but our understanding of their potential effects on aquatic animals is still in its infancy compared with mammals. In this study, we investigated the effect of chronic exposure to an environmentally relevant concentration of glyphosate on bacterial communities of rainbow trout (Oncorhynchus mykiss). Gills, gut contents and gut epithelia were then analyzed by metabarcoding targeting the 16S rRNA gene. Our results revealed that rainbow trout has its own bacterial communities that differ from their surrounding habitats and possess microbiomes specific to these three compartments. The glyphosate-based herbicide treatment significantly affected the gill microbiome, with a decrease in diversity. Glyphosate treatments disrupted microbial taxonomic composition and some bacteria seem to be sensitive to this environmental pollutant. Lastly, co-occurrence networks showed that microbial interactions in gills tended to decrease with chemical exposure. These results demonstrate that glyphosate could affect microbiota associated with aquaculture fish.