[Improving test-taking conditions: An analysis from Lille]. / Aménagements des conditions de passation d'examens : analyse dans l'académie de Lille.

INTRODUCTION: Based on an analysis of test-taking conditions in 2015/2016, our aim is to focus on the use of additional time allowances in 2017 and to propose improvement measures that would reduce existing inequalities. METHODS: Data collection from the National Education Departmental Services for the analysis of test-taking conditions in 2015/2016 and random selection of 5% of the requests for the 2016/2017 school year (193 files). Information collection on the use of additional time allowances for the exam centers from June 2017.Letter submitted to the legal guardians of the sample of the 193 files. RESULTS: The main part of the 2015/2016 requests was for the Diplôme National du Brevet (Junior School Certificate), 31% from the private school sector, 11% from schools in priority educational areas (REP). In the sampling, 80.35% of the files include a request for additional time allowances. Among these, 76.43% are for "Dys-type" pathologies. 8881 datasheets were sent back to us from exam centers. The granted additional time allowance was not used in almost 60% of the cases. It is used among approximately 15% of the students. DISCUSSION: The present system seems to reinforce social inequalities of health and the suggested improvement measures are provided for identification, informational, accompanying, and intermediary evaluative purposes.

Very early hallucinatory experiences: a school-based study.

BACKGROUND: The prevalence and clinical significance of hallucinatory experiences among children below 7 years of age remain unknown. We aimed to determine the independent influences of sensory deficits, the presence of an imaginary companion and metacognition on hallucinatory experiences. We assumed that hallucinatory experiences were associated with (a) sensory deficits, (b) the presence of an imaginary companion (IC) and (c) metacognition defaults (i.e. first- and second-order theory of mind default). METHODS: All children in the third year of preschool from a region of Northern France underwent medical screening. We compared the prevalence rates of visual, auditory and audio-visual hallucinatory experiences based on (a) the presence of visual or auditory deficits, (b) the actual presence of an IC and (c) metacognition. The analyses were adjusted for age. RESULTS: A total of 1,087 children aged between 5 and 7 years were included. The prevalence rates of auditory, visual and audio-visual hallucinatory experiences were 15.8%, 12.5% and 5.8%, respectively. The prevalences of different types of hallucinatory experiences were not significantly different according to sensory deficit. The prevalences of all types of hallucinatory experiences were significantly higher among children with an IC and among children with metacognition defaults. CONCLUSIONS: The association between hallucinatory experiences and sensory deficits might concern only long-lasting deficits. The association with the presence of an IC confirms experimental findings of the likelihood of perceiving words among meaningless auditory stimuli. Relations between hallucinatory experiences and theory of mind need to be addressed in longitudinal studies.

Ischemia injury alters endothelial cell properties of kidney cortex: stimulation of MMP-9.

Although ischemia is the leading cause of acute renal failure in human, there is little information on the remodeling the kidney endothelium matrix during ischemic injury. In this study, we investigated the activity and expression of MMP-2 and MMP-9, in an isolated endothelial fraction following an acute in vivo reversible ischemia induced in rats by vascular clamping. Ischemia increased serum creatinine levels 1.4-fold, hallmark of acute renal failure. Isolation of the endothelial cell fraction was performed by affinity chromatography using an anti-PECAM-1 antibody. The isolated fraction was assessed by Western blotting analysis of endothelial cell markers. The positively selected fractions were enriched in the endothelial markers eNOS and PECAM-1 by 128-fold and 44-fold, respectively. Gelatin zymography showed that ischemia strongly stimulated proteolytic activity of proMMP-2 (1.8-fold), proMMP-9 (3-fold) and MMP-9 (4-fold) in the endothelial fractions. Western blot analysis indicated that TIMP-2 protein level increased by 3.2-fold in the endothelial fractions during ischemia. Surprisingly, TIMP-1 was absent from the endothelial preparations but was easily detected in the non-endothelial cells. Levels of the endocytic receptor LRP were increased by 2-fold during ischemia in the endothelial fractions. Occludin, a known in vivo MMP-9 substrate, was partly degraded in the endothelial fractions during ischemia, suggesting that the MMP-9 which was upregulated during ischemia was functional. These data suggest that ischemia in kidney could lead to the degradation of the vascular basement membrane and to increased permeability. This suggests new therapeutic approaches for ischemic pathologies by targeting MMP-9 and its regulators.

Ischemia-reperfusion injury stimulates gelatinase expression and activity in kidney glomeruli.

Although ischemia remains the leading cause of acute renal failure in humans, there is little information on the expression and activities of gelatinases of kidney glomeruli during ischemia-reperfusion injury. In this study, we used a unilateral ischemia-reperfusion model to investigate the activity and expression of gelatinases in glomeruli during acute ischemia. Unilateral ischemia was induced in rats by vascular clamping (30 min) followed by reperfusion (60 min) and isolation of glomeruli. The activity and expression of gelatinase proteins were determined by gelatin zymography and Western blotting. Gelatinase mRNA levels were evaluated by reverse transcriptase-PCR. Ischemia and reperfusion increased serum creatinine levels, hallmark of acute renal failure. Ischemia induced mRNA and protein MMP-2 expression. There was strong stimulation of MMP-9 mRNA, both forms of dimeric MMP-9, and active monomeric MMP-9. In contrast to TIMP-1 decreasing, TIMP-2 protein and mRNA increased during ischemia. During reperfusion, there was a gradual reversal of the MMP-2 and MMP-9 levels and a strong inhibition of TIMP-1 and TIMP-2 at the protein and mRNA levels. Endocytic receptor LRP was increased during ischemia and returned to normal during reperfusion. Expression of MMP-9 docking receptor CD-44 was increased during reperfusion. Finally, ZO-1, an in vivo MMP-9 substrate, was degraded during ischemia, revealing that MMP-9 upregulated during ischemia was functional. Our data suggest that stimulation of gelatinase activity during ischemia could contribute to glomeruli injury, providing new therapeutic targets for acute renal failure in humans. In contrast, elevated monomeric MMP-9 activity due to TIMP-1 decrease during reperfusion may participate to glomerular recovery.

Kidney ischemia-reperfusion regulates expression and distribution of tubulin subunits, beta-actin and rho GTPases in proximal tubules.

Ischemic injury is characterized by a loss of cell polarity and a release of proximal tubule epithelial cells resulting from cytoskeletal reorganization. This study used a reversible unilateral renal ischemia-reperfusion model to investigate the expression and distribution of cytoskeletal components and Rho GTPases at protein and mRNA levels in proximal tubule fractions. Ischemia strongly increased beta-actin and alpha-tubulin expressions that were predominantly found in nuclear fractions. Rho GTPases and caveolin-1 expression were upregulated by ischemia and were enriched mainly in Triton-soluble membranes. Rac1 expression was stimulated in the soluble fractions during reperfusion. Rho GTPases mRNA levels were similarly regulated by ischemia-reperfusion suggesting that changes in their expressions could occur at gene or mRNA levels. ERM protein expression and distribution were unaffected by ischemia-reperfusion. Together, these data show that renal ischemia-reperfusion induced expression and redistribution of actin and microtubule cytoskeleton components in addition to Rho GTPases in proximal tubules, suggesting that they participate in an adaptive response to cellular lesions.