Dried Blood Spot Test for Glycated Hemoglobin Measurement in Pediatric Diabetes Care.

BACKGROUND: The dried blood spot (DBS) card is a novel collection method for measuring glycated hemoglobin (A1C) in individuals with diabetes mellitus. The potential benefits of DBS specimens compared with traditional phlebotomy include a reduction in required total blood volume, reduced procedural pain, and an ability for self-initiated collection. DBS cards for A1C measurement have been validated in the adult population, but there is a paucity of pediatric data. METHODS: The aim of this study was to validate the use of A1C measurement by DBS cards in comparison to venous A1C and to identify potential barriers to implementing this novel approach. Venous and DBS card A1C samples were collected simultaneously from 62 patients at their local laboratory and transported to the central provincial lab for analysis. Correlation analyses compared venous and DBS A1C with data rescaling performed to account for the DBS-venous interassay difference. RESULTS: Mean venous A1C was 7.49% and DBS A1C was 7.26%, with an interassay difference of 0.23%. Data showed a strong, positive correlation between A1C collection methods (r=0.86, p<0.001); this was further strengthened at lower A1C values (A1C <7.5%, r=0.87, p<0.0001). A stronger relationship emerged when the data were rescaled to account for the DBS-venous interassay difference (r=0.8935, p<0.0001). CONCLUSIONS: Given the potential feasibility, practicality, accessibility, cost-effectiveness, and performance characteristics of the DBS A1C, especially at lower A1C values hovering around the diagnostic threshold for diabetes, this study provides supporting evidence for consideration of the use of DBS A1C testing in pediatric diabetes care.

Rickettsial Infection in the COVID-19 Era: The Correlation between the Detection of Rickettsia aeschlimannii in Ticks and Storytelling Photography of a Presumable Human Rickettsiosis Case.

Rickettsia aeschlimannii infection is an emerging human tick-borne disease with only a few recorded cases. We reported a presumable autochthonous case of rickettsiosis in an Italian cattle breeder associated with a Hyalomma marginatum bite. Rickettsia aeschlimannii DNA was detected in both the tick specimen from the patient and the grazing cattle close to his farm.

[Survey by SFRO, SNRO and AFPPE about the evolution of the radiation therapist profession in France]. / Enquête SFRO­SNRO­AFPPE sur l'évolution du métier de manipulateur exerçant en radiothérapie en France.

PURPOSE: As part of the multidisciplinary team, radiation therapists are in charge of elements of treatment preparation and delivery of radiotherapy to cancer patients. Helping scientific and technological improvements, more and more patients with cancer were treated with radiotherapy including hypofractionnated radiotherapy, that explain the increase of demands on services. The professional impacted by this increase of demands are radiation oncologists and medical physicists. The opportunity to push forward the radiation therapist's competencies appears with the possibility to shift them some tasks. In this context, a first work was performed with objectives to have an overview of the tasks shifted to radiation therapists in France, the tasks that they could perform but also to evaluate some criteria of job satisfaction. MATERIAL AND METHODS: The committee of "new status and value of status" including six radiation oncologists (the French society of radiation oncology [SFRO] et national union of radiation oncologists [SNRO]) and six radiation therapists committee members of the French association of radiation therapists (AFPPE), built a questionnaire including three parts: demographic characteristics, tasks shifted and job satisfaction criteria. In total, the questionnaire included 19 questions and 24 items assessed with a four point-Likert scale (ranging from "completely disagree" to "completely agree"). This survey, formatting with google form, was tested by the committee members and the final version was sent to the SFRO, AFPPE and SNRO members, before being disseminated on the social networks. RESULTS: From November 18th 2022 to December 31st 2022, 492 responses were received (response rate=18.3%): 55 % of the respondents had at least 11 years of experience in radiotherapy. The respondents worked in different type of health facilities (36 % in specialized cancer centres, 19.5 % in private centers, 17.5% in university and general hospital, 10.2% in general hospital). More than » of the respondents had a teaching lecturer activity, 20% had a management team activity and a research activity for 18%. Less than 10% of the respondents had another degree than that of radiation therapist: university degree (n=27), degree in dosimetry (n=11) and master (n=3). More than 76% would like to be trained and to have access to the advanced practice, more than 50% would like expend competencies with a university degree, 30% with a master and 67% would like to participate in research. Forty-two percent of the respondents were involved in a task shifting (excluding decree relating to acts and activities carried out by radiation therapists) and among the radiation therapists non-involved, 63% would be interested in being. Regarding job satisfaction, 53% of the respondents were satisfied with their job and their salary and 68% believed that their job occupation is in line with their professional aspirations. More than 2/3 of the respondents described a significant workload and mental load, 53% thought to have time for their patient care and 70% felt some organisational difficulties. CONCLUSION: This survey shows: (i) A significant involvement of radiation therapists in the task shifting; (ii) A very strong demand for career development, in particular with existing degrees or to be created degree such as advanced practice; and (iii) The need to reinforce a job satisfaction for almost the half of the respondents, linked to a workload, a mental load and some organisational difficulties.

Mediterranean spotted fever as a non-endemic disease in the southeast of Iran: Diagnosis and treatment based on specific skin lesion.

Key Clinical Message: Rickettsia spp. should be investigated if Tache Noire, as a dark plaque covering a superficial ulcer surrounded by scale, edema, and erythema, are observed, even in non-endemic areas of Rickettsia spp. Abstract: A 31-year-old man with fever, dyspnea, abdominal pain, and jaundice has been admitted to the hospital in the southeast of Iran. Due to the presence of a pathognomonic skin lesion (Tache noire), the patient was diagnosed with Mediterranean spotted fever (MSF) and was treated with doxycycline, without waiting for PCR and IFA findings.

A função da mancha no caso Hans: da falta à presença do objeto / La función de la mancha en el Juanito: de la falta a la presencia del objeto / The function of the stain in little Hans: from lack to presence of the object / La fonction de la tache dans le petit Hans: du manque à la présence de l'objet

O artigo desenvolve a hipótese de que o trabalho de releitura do caso Hans, realizado por Lacan no Seminário 4, A relação de objeto (1956-1957), antecipa a formulação do conceito de objeto a em seu ensino. Dois pontos cruciais em relação ao objeto são destacados em um trabalho de leitura próxima e atenta ao texto do Seminário. Nesse percurso, a introdução da falta de objeto, modulada pelas operações de privação, frustração e castração, se contrapõe à noção de uma certa presença do objeto. O artigo propõe que em sua teorização sobre a angústia do pequeno Hans, Lacan introduz a função da mancha operando como objeto a, situando-a como um resíduo impossível de ser simbolizado, a coisa preta na boca do cavalo, objeto da fobia de Hans

El artículo desarrolla la hipótesis de que la relectura del caso Juanito realizada por Lacan en el Seminario 4, La relación de objeto (1956-1957) presenta una primera versión del concepto de objeto a en su enseñanza. Del trabajo de lectura cercana del texto del Seminario se destacan dos puntos cruciales con relación al objeto. En este recorrido, la introducción de la falta de objeto, modulada por las operaciones de privación, frustración y castración, admite la noción paradójica de una cierta presencia del objeto. El artículo propone que, a partir del desarrollo de su teorización sobre la angustia del Juanito, Lacan introduce la función de la mancha operando como objeto a, ubicándola como un residuo imposible de simbolizar, la cosa negra en la boca del caballo, objeto de la fobia de Juanito

The article develops the hypothesis that the re-reading of little Hans, carried out by Lacan in Seminar 4, The Object Relation (1956-1957), presents a primary version of the objet petit a in his teaching. In this course, two crucial points concerning the object are emphasized in a close reading of the Seminar's text. The introduction of the notion of lack of object, modulated by the operations of deprivation, frustration and castration, is then opposed to the notion of a certain presence of the object. The article proposes that with the development of a theorization on little Hans' anxiety, Lacan introduces the function of the stain working as na object a, a residue impossible to be symbolized, located in the black spot in the horse's mouth, object of Hans' phobia

L'article développe l'hypothèse qui la relecture du cas le petit Hans effectuée par Lacan dans le Séminaire 4, La relation d'objet(1956-1957) anticipe la formulation du concept d'objet (a) dans son enseignement. Deux points cruciaux par rapport à l'objet sont mis en évidence dans un travail de lecture attentive du texte du Séminaire. Dans ce parcours, l'introduction de la notion de manque d'objet, modulée par les opérations de privation, frustration et castration, s'oppose à la notion d'une certaine présence de l'objet. L'article soutient qui depuis sa théorisation sur l'angoisse du petit Hans, Lacan introduit la fonction de la tache comme un résidu impossible à symboliser, la chose noire dans la bouche du cheval, objet de la phobie de Hans. Et comme tel, la tache noire opère la fonction d'(a)

[Improvement of the impulsive control in adolescents with attention deficit hyperactivity disorder (ADHD) after a cognitive behavioral therapy]. / Amélioration du contrôle impulsif chez les adolescents avec un trouble de l'attention avec hyperactivité (TDAH) ayant suivi une thérapie cognitive comportementale.

AIM: MPH is the more often prescribed stimulant for Attention Deficit Hyperactivity Disorder (ADHD), but it has been estimated that 30% of patients do not adequately respond or cannot tolerate it. Therefore, some other therapies are needed, such as cognitive behavioral therapy. Cognitive behavioral therapy is an intervention proposed over several sessions and aimed at modifying behavior by teaching different techniques that participants can re-use to control their symptoms. In our Institute, we used a program centered on attentional and metacognitive functions. It consists of a series of workshops performed in group at the rate of one workshop of 90minutes per week for 12 weeks. Positive effects on the behavior of adolescents with ADHD have been reported by parents and educators, but the effects of the program on specific cognitive processes have never been precisely investigated. METHOD: In the present study, we evaluated the impact of the program on impulsive control in adolescents with ADHD who are known to present impaired impulsive control. Impulsive control is required each time there is a conflict between an inappropriate prepotent action and a goal-directed action. At an experimental level, impulsive control can be studied with conflict tasks, such as the Simon reaction time task. Interpreted within the theoretical framework of the so-called « Dual-process activation suppression ¼ (DPAS) model, this task is a powerful conceptual and experimental tool to separately investigate the activation and inhibition of impulsive actions, which is almost never done in studies about impulsive control. Twenty adolescents followed the program and were tested before and at the end of the program by using dynamic analyses of performance associated with DPAS model. RESULTS: The results have shown an improvement of the impulsive control after three months of cognitive behavioral therapy, and this improvement was due to both a decrease of the propensity to trigger impulsive actions and an improvement of inhibitory processes efficiency. CONCLUSION: This program could be a relevant alternative to the stimulant medication, more particularly when parents are reluctant with medication or when the adolescent suffers from important side effects.

[Work interruptions among nurses, experience of a hospital]. / Interruptions de tâches chez les infirmières, expérience d'un centre hospitalier.

The objectives of this study were to map task interruptions (TIs), to measure the impact of corrective measures and to compare nurses' perceptions with observations. It was found that nurses' aides were the main initiators of task interruptions, which were generally brief, for information purposes; and that task interruptions were more frequent in the 14-bed wards than in the 28-bed wards and during the visit.

Phytotoxin of rice aggregate sheath spot pathogen Rhizoctonia oryzae-sativae and its biological activities.

Rice aggregate sheath spot disease occurs in many countries and causes serious yield losses. In China, the disease-causing fungus Rhizoctonia oryzae-sativae was reported in 1985, and since then, it has rarely been reported in major rice-growing areas after almost 30 years. Compared with Rhizoctonia solani, R. oryzae-sativae has a significantly different physiological morphology and growth status, although both fungi affect rice leaves in very similar ways. The optimum temperature for the suitable growth of R. oryzae-sativae is 31 °C, which is consistent with previous reports. We extracted phytotoxins from R. oryzae-sativae and analyzed its biological activity via the detached leaf and radicle inhibition methods. Rhizoctonia solani and R. oryzae-sativae exhibit differences in terms of pathogenicity and toxin activity, which indicates that these fungi may produce different toxin components. Based on gas chromatography-mass spectrometry data, esters, phenols, and other components were present in the crude toxin extract of R. oryzae-sativae. Our research provides a new method for studying the phytotoxins of R. oryzae-sativae. However, further studies are needed to elucidate the pathogenic mechanisms responsible for aggregate sheath spot disease in rice.

Postmortem Ocular Findings in the Optical Coherence Tomography Era: A Proof of Concept Study Based on Six Forensic Cases.

Postmortem analysis of the ocular globe is an important topic for forensic pathology and transplantology. Although crucial elements may be gathered from examining cadaveric eyes, the latter do not routinely undergo in-depth analysis. The paucity of quantitative and objective data that are obtainable using current, invasive necroscopic techniques is the main reason for the limited interest in this highly specialized procedure. The aim of the current study is to describe and to object for the first time the postmortem ocular changes by mean of portable optical coherence tomography for evaluating ocular tissues postmortem. The design involved the postmortem analysis (in situ, and without enucleation) of 12 eyes by portable spectral-domain Optical Coherence Tomography. The scans were performed, in corneal, retinal and angle modality at different intervals: <6 h, 6th, 12th, and 24th hour and after autopsy (25th-72nd hour). The morphological changes in the cornea, sclera, vitreous humor and aqueous humor were easy to explore and objectify in these tissues in first 72 h postmortem. On the other hand, the "in situ" observation of the retina was difficult due to the opacification of the lenses in the first 24 h after death.

Prior exercise impairs subsequent performance in an intensity- and duration-dependent manner.

Prior constant-load exercise performed for 30-min at or above maximal lactate steady state (MLSSp) significantly impairs subsequent time-to-task failure (TTF) compared with TTF performed without prior exercise. We tested the hypothesis that TTF would decrease in relation to the intensity and the duration of prior exercise compared with a baseline TTF trial. Eleven individuals (6 males, 5 females, aged 28 ± 8 yrs) completed the following tests on a cycle ergometer (randomly assigned after MLSSp was determined): (i) a ramp-incremental test; (ii) a baseline TTF trial performed at 80% of peak power (TTFb); (iii) five 30-min constant-PO rides at 5% below lactate threshold (LT-5%), halfway between LT and MLSSp (Delta50), 5% below MLSSp (MLSS-5%), MLSSp, and 5% above MLSSp (MLSS+5%); and (iv) 15- and 45-min rides at MLSSp (MLSS15 and MLSS45, respectively). Each condition was immediately followed by a TTF trial at 80% of peak power. Compared with TTFb (330 ± 52 s), there was 8.0 ± 24.1, 23.6 ± 20.2, 41.0 ± 14.8, 52.2 ± 18.9, and 75.4 ± 7.4% reduction in TTF following LT-5%, Delta50, MLSS-5%, MLSSp, and MLSS+5%, respectively. Following MLSS15 and MLSS45 there were 29.0 ± 20.1 and 69.4 ± 19.6% reductions in TTF, respectively (P < 0.05). It is concluded that TTF is reduced following prior exercise of varying duration at MLSSp and at submaximal intensities below MLSS. Novelty: Prior constant-PO exercise, performed at intensities below MLSSp, reduces subsequent TTF performance. Subsequent TTF performance is reduced in a linear fashion following an increase in the duration of constant-PO exercise at MLSSp.

A Collaborative and Cognitive-based Intervention for Young People with Cerebral Palsy.

BACKGROUND.: Evidence-based approaches to improve function in individuals with cerebral palsy are needed. PURPOSE.: To investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance approach™ (CO-OP) to improve performance on self-chosen, functional goals as compared to traditional occupational therapy for cerebral palsy. METHOD.: Crossover design with 12 participants, aged 6-15 years, randomly assigned to CO-OP and traditional intervention groups, followed by crossover and a 3-month follow-up. The participants identified three occupation-based goals for CO-OP and each group received ten 45-minutes intervention twice weekly in clinical context. Occupational performance, manual dexterity and Gross Motor Function Measures were analysed using generalized estimating equations. FINDINGS.: There were clinical and statistically significant improvements in functional goals following CO-OP and not traditional therapy. There were gains in dexterity but not in gross motor skills. IMPLICATIONS.: CO-OP was effective to improve functional performance in young people with cerebral palsy and should be more utilized.

Cases of Mediterranean spotted fever in southeast of Iran.

In this study the clinical manifestations, laboratory findings, and management of five patients diagnosed with Mediterranean spotted fever (MSF) from southeast of Iran are presented. All patients but one had recent tick-bite histories which were noticeable as black eschars (tache noire). Patients' samples were tested by real-time PCR and serology (IFA). The disease was confirmed by fourfold rising of IgG antibodies against Rickettsia conorii. This is the first report of MSF cases in Iran.

[Reducing mid-task interruptions during medication preparation]. / Comment réduire les interruptions de tâches lors de la préparation des médicaments ?

Nurses are regularly interrupted when performing their tasks. Yet studies have shown that there is a link between the fact of being interrupted when preparing medication and the increased risk of making a mistake. Seeking to reinforce the safety of the medication preparation stage, a team in Normandy studied the benefit, for the nurse, of wearing ear plugs during this specific time.

Mental practice combined with repetitive task practice to rehabilitate handwriting in children.

BACKGROUND.: Handwriting dysfunction contributes to 40% of all school-based referrals to occupational therapy. Empirically based handwriting interventions are needed to remediate the negative effects of handwriting dysfunction on a child's occupational performance. PURPOSE.: This study examined the effectiveness of mental practice (MP) combined with repetitive task practice (RTP) to rehabilitate handwriting in children. METHOD.: Twenty typically developing first and second graders with impaired handwriting received RTP twice a week for 4 weeks, then engaged in MP combined with RTP for the same duration. Using the Minnesota Handwriting Assessment (MHA), they were assessed across four time points: baseline (1), after RTP (2), after MP combined with RTP (3), and follow-up (4). FINDINGS.: Children significantly improved and retained this increase on all variables of MHA ( p < .001) after MP combined with RTP. After RTP, the only significant improvement occurred in handwriting form ( p < .001). IMPLICATIONS.: MP may be a potential therapeutic addition to RTP in rehabilitating global handwriting dysfunction.

On task: Considerations and future directions for studies of corticospinal excitability in exercise neuroscience and related disciplines.

Over the last few decades, transcranial magnetic stimulation (TMS) has emerged as a conventional laboratory technique in human neurophysiological research. Exercise neuroscientists have used TMS to study central nervous system contributions to fatigue, training, and performance in health, injury, and disease. In such studies, corticospinal excitability is often assessed at rest or during simple isometric tasks with the implication that the results may be extrapolated to more functional and complex movement outside of the laboratory. However, the neural mechanisms that influence corticospinal excitability are both state- and task-dependent. Furthermore, there are many sites of modulation along the pathway from the motor cortex to the muscle; a fact that is somewhat obscured by the all-encompassing and poorly defined term "corticospinal excitability". Therefore, the tasks we use to assess corticospinal excitability and the conclusions that we draw from such a global measure of the motor pathway must be taken into consideration. The overall objective of this review is to highlight the task-dependent nature of corticospinal excitability and the tools used to assess modulation at cortical and spinal sites of modulation. By weighing the advantages and constraints of conventional approaches to studying corticospinal excitability, and considering some new and novel approaches, we will continue to advance our understanding of the neural control of movement during exercise.

ATTACHMENT IN INFANTS WITH CLEFT LIP AND/OR PALATE: MARGINAL SECURITY AND ITS CHANGES OVER TIME.

This study examines the attachment quality and how this changed over time among infants who had cleft lip and palate (CLP), by conducting a prospective longitudinal study addressing the effects of this type of perinatal event on the parent-infant relationship and the emotional development of the infants. At 12 months of age, the Strange Situation Paradigm (SSP; M. Ainsworth, M.C. Blehar, E. Waters, & T. Wall, 1978) was administered to a sample of 38 CLP infants (born between 2003 and 2010) and 17 healthy controls. At 4 years of age, the Attachment Story Completion Task (ASCT; I. Bretherton, D. Ridgeway, & J. Cassidy, 1990) was administered to 32 individuals from the CLP sample and 14 from the control group. As reported in the literature, CLP infants display secure attachment behaviors as frequently as do control infants (55%). However, a more detailed analysis of the attachment scales revealed that CLP infants show more avoidance and less proximity seeking. In addition, a closer examination of the subcategories of attachment styles revealed that most CLP infants (71%) displayed distal attachment strategies such as the B1/B2 or A1/A2 subcategories. At 4 years old, CLP infants clearly displayed more deactivation and less security than did the control sample. Moreover, when detailing the evolution of attachment individually, almost 60% of the CLP children showing distal strategies at 12 months became deactivated or disorganized when they reached 4 years. Indeed, subtle differences in attachment behaviors at 12 months old-which can be considered marginally secure at that age-may reveal attachment vulnerabilities, which seem to be more apparent over the course of development.

Tache Noire in a Patient with Acute Q Fever.

OBJECTIVE: To describe a rare case of acute Q fever with tache noire. CLINICAL PRESENTATION AND INTERVENTION: A 51-year-old man experienced acute Q fever showing tache noire, generally considered a pathognomonic sign of Mediterranean spotted fever (MSF) and MSF-like illness, but not a clinical feature of Q fever. The patient was treated with doxycycline 100 mg every 12 h. CONCLUSION: In the Mediterranean area, tache noire should be considered pathognomonic of MSF but it should not rule out Q fever. Clinical diagnosis should be supported by accurate laboratory diagnostic tests to guide proper management.

Virtual Morris task responses in individuals in an abstinence phase from alcohol.

The present study was aimed at examining spatial learning and memory, in 33 men and 12 women with alcohol use disorder (AUD) undergoing ethanol detoxification, by using a virtual Morris task. As controls, we recruited 29 men and 10 women among episodic drinkers without a history of alcohol addiction or alcohol-related diseases. Elevated latency to the first movement in all trials was observed only in AUD persons; furthermore, control women had longer latencies compared with control men. Increased time spent to reach the hidden platform in the learning phase was found for women of both groups compared with men, in particular during trial 3. As predicted, AUD persons (more evident in men) spent less time in the target quadrant during the probe trial; however, AUD women had longer latencies to reach the platform in the visible condition during trials 6 and 7 that resulted in a greater distance moved. As for the probe trial, men of both groups showed increased virtual locomotion compared with the women of both groups. The present investigation confirms and extends previous studies showing (i) different gender responses in spatial learning tasks, (ii) some alterations due to alcohol addiction in virtual spatial learning, and (iii) differences between AUD men and AUD women in spatial-behaviour-related paradigms.

Intervention and management of developmental coordination disorder: Are we providing evidence-based services?: Intervention et traitement d'un trouble du développement de la coordination : Les ergothérapeutes fournissent-ils des services fondés sur les faits scientifiques?

BACKGROUND: Occupational therapists are well positioned to provide intervention to improve outcomes for children with developmental coordination disorder. However, little is known about what occupational therapy services are provided for these children. PURPOSE: As part of a larger study exploring service provision for children with developmental coordination disorder, the purpose of this study was to examine intervention and referral practices of occupational therapists in British Columbia, Canada. METHOD: An online survey was e-mailed to a convenience and snowball sample of paediatric occupational therapists, with 165 therapists responding. Descriptive statistics were used for the data analysis. FINDINGS: Results show that the type and duration of intervention varied greatly throughout the province, as well as within health regions. Although 70% (87/124) of therapists reported being at least moderately familiar with current evidence, only 47% to 59% selected task-based methods as their primary intervention approach. IMPLICATIONS: Findings provide a baseline for current intervention and an opportunity for targeted knowledge translation initiatives.