Characteristics of self-management education and support programmes for people with chronic diseases delivered by primary care teams: a rapid review.

BACKGROUND: Primary care actors can play a major role in developing and promoting access to Self-Management Education and Support (SMES) programmes for people with chronic disease. We reviewed studies on SMES programmes in primary care by focusing on the following dimensions: models of SMES programmes in primary care, SMES team's composition, and participants' characteristics. METHODS: For this mixed-methods rapid review, we searched the PubMed and Cochrane Library databases to identify articles in English and French that assessed a SMES programme in primary care for four main chronic diseases (diabetes, cancer, cardiovascular disease and/or respiratory chronic disease) and published between 1 January 2013 and 31 December 2021. We excluded articles on non-original research and reviews. We evaluated the quality of the selected studies using the Mixed Methods Appraisal Tool. We reported the study results following the PRISMA guidelines. RESULTS: We included 68 studies in the analysis. In 46/68 studies, a SMES model was described by focusing mainly on the organisational dimension (n = 24). The Chronic Care Model was the most used organisational model (n = 9). Only three studies described a multi-dimension model. In general, the SMES team was composed of two healthcare providers (mainly nurses), and partnerships with community actors were rarely reported. Participants were mainly patients with only one chronic disease. Only 20% of the described programmes took into account multimorbidity. Our rapid review focused on two databases and did not identify the SMES programme outcomes. CONCLUSIONS: Our findings highlight the limited implication of community actors and the infrequent inclusion of multimorbidity in the SMES programmes, despite the recommendations to develop a more interdisciplinary approach in SMES programmes. This rapid review identified areas of improvement for SMES programme development in primary care, especially the privileged place of nurses in their promotion. TRIAL REGISTRATION: PROSPERO 2021 CRD42021268290 .

Lack of consideration of socioeconomic factors in transition programme of adolescents with type 1 diabetes: A systematic review.

The transition of adolescents with type 1 diabetes should be organized such that loss of follow-up and deterioration of patients' metabolic control are minimized. OBJECTIVE: Our study aimed to ascertain whether socioeconomic status is featured in the characteristics of adolescents with type 1 diabetes in transition programmes and their inclusion in transition programmes. RESEARCH DESIGN AND METHODS: A systematic review of the literature was performed according to PRISMA recommendations. All articles published between 2010 and 2023 were considered. Studies that described a transition programme for adolescents or young adults with T1DM were included. RESULTS: After screening, 18 studies were included. Different transition programmes were proposed (exchanges between professionals, coordinators, and transition clinics). Nine articles described socio-economic factors. The educational level was the most frequently reported. Only three studies evaluated the impact of one parameter on transition success: a lower education level was associated with more hospital visits for hyperglycaemia, and the other did not report any socioeconomic factor associated with clinic attendance. CONCLUSIONS: The socioeconomic status of type 1 diabetes is poorly described in transition programmes, and the few that do make mention of it, offer little information about patient management.

Monitoring Surveys in the Context of Covid-19, Published in Belgium and France, in the Light of Health Democracy.

Introduction: The management of a pandemic, such as COVID-19, requires the full participation of citizens. This recent situation has revealed the undermining of user participation in the decision-making process. Thus, this study aims to assess the involvement of users in the design and administration of surveys for health crisis monitoring and to stimulate reflection on information processes shared upstream during the decision-making process. Methods: A literature search was conducted on population monitoring surveys published during the first containment period in Belgium and France between April and May 2020. The selected studies were first analyzed according to a reading grid based on the criteria proposed by the World Health Organization (WHO) for monitoring populations and supplemented by data from a descriptive analysis of the selected studies. Second, with the objective of specifically evaluating the involvement of users in monitoring surveys, this study evaluated the surveys according to the following parameters: content of a study based on themes presented in surveys; inclusion of health literacy (HL); and factors of commitment of the respondents to the survey. Results: A total of 45 studies were selected for final analysis. The majority of the surveys focused on the effect of COVID-19 on well-being. Furthermore, analysis indicated that, in summary, the HL of people concerned as well as the involvement of respondents is poorly considered, which remains limited in terms of the design and administration of the surveys. Discussion: Although the principles of health democracy seemed to have been established, the exceptional regime induced by the epidemic overlooked the observance of such principles. This result indicates the need to reconsider the participation of citizens as real partners in care, including health crisis management.

Structural aging of human neurons is opposite of the changes in schizophrenia.

Human mentality develops with age and is altered in psychiatric disorders, though their underlying mechanism is unknown. In this study, we analyzed nanometer-scale three-dimensional structures of brain tissues of the anterior cingulate cortex from eight schizophrenia and eight control cases. The distribution profiles of neurite curvature of the control cases showed a trend depending on their age, resulting in an age-correlated decrease in the standard deviation of neurite curvature (Pearson's r = -0.80, p = 0.018). In contrast to the control cases, the schizophrenia cases deviate upward from this correlation, exhibiting a 60% higher neurite curvature compared with the controls (p = 7.8 × 10-4). The neurite curvature also showed a correlation with a hallucination score (Pearson's r = 0.80, p = 1.8 × 10-4), indicating that neurite structure is relevant to brain function. This report is based on our 3D analysis of human brain tissues over a decade and is unprecedented in terms of the number of cases. We suggest that neurite curvature plays a pivotal role in brain aging and can be used as a hallmark to exploit a novel treatment of schizophrenia.

Regional cytoarchitecture of the adult and developing mouse enteric nervous system.

The organization and cellular composition of tissues are key determinants of their biological function. In the mammalian gastrointestinal (GI) tract, the enteric nervous system (ENS) intercalates between muscular and epithelial layers of the gut wall and can control GI function independent of central nervous system (CNS) input.1 As in the CNS, distinct regions of the GI tract are highly specialized and support diverse functions, yet the regional and spatial organization of the ENS remains poorly characterized.2 Cellular arrangements,3,4 circuit connectivity patterns,5,6 and diverse cell types7-9 are known to underpin ENS functional complexity and GI function, but enteric neurons are most typically described only as a uniform meshwork of interconnected ganglia. Here, we present a bird's eye view of the mouse ENS, describing its previously underappreciated cytoarchitecture and regional variation. We visually and computationally demonstrate that enteric neurons are organized in circumferential neuronal stripes. This organization emerges gradually during the perinatal period, with neuronal stripe formation in the small intestine (SI) preceding that in the colon. The width of neuronal stripes varies throughout the length of the GI tract, and distinct neuronal subtypes differentially populate specific regions of the GI tract, with stark contrasts between SI and colon as well as within subregions of each. This characterization provides a blueprint for future understanding of region-specific GI function and identifying ENS structural correlates of diverse GI disorders.

Besoins éducatifs en santé en Appartement de Coordination Thérapeutique.

OBJECTIVE: The aim of this study was to identify the health education needs of people suffering from several pathologies including HIV and/or hepatitis, living in vulnerable conditions in Therapeutic Coordination Apartments (known in French as Appartements de Coordination Thérapeutique under the acronym ACT). METHOD: This article is based on a qualitative and collaborative study involving in research team people living in ACT, professionals of ACT and academics. Interview guides based on the literature were developed. Nine ACTs participated: there were interviews with 36 people with chronic conditions, 9 focus groups with staff members and 9 additional interviews with ACT managers. RESULTS: Health education needs were identified. These involved: managing one's multiple conditions, managing certain diseases in particular, daily life with multiple chronic conditions, the connections and origins of the diseases. Factors influencing how they deal with one disease rather than another were expressed. The educational needs of people with HIV and/or hepatitis have been highlighted. CONCLUSION: Health education needs still exist despite the care that people living in ACTs receive. The study makes it possible to put forward proposals for improving support and, more specifically, health education interventions implemented in ACTs: asking additional questions to identify health education needs more precisely, providing polypathology therapeutic patient education (TPE) training to the teams, involving the affected populations, taking into account health literacy levels.

A scoping review of education and training interventions in Autism Spectrum Disorder.

OBJECTIVE: Autism Spectrum Disorder (ASD) is a chronic neurodevelopmental disorder. Living with ASD requires that individuals and parents develop skills in order to cope with daily life. Education interventions are recommended to support them. This study aims to get an overview of education and training interventions in ASD. METHODS: A scoping review of international literature was conducted. RESULTS: 43 articles were analyzed. Four main types of intervention stand out: support groups, parental training; psychoeducation; therapeutic patient education. However, the majority of publications is focused on the parents rather than on individuals living with ASD, and the needs assessments identified focused on general needs rather than educational needs. CONCLUSION: While educational interventions for parents and individuals with ASD are now encouraged, considerable heterogeneity is observed. But this variety is not based on a reasoned approach to matching supply and needs. Future studies could focus more on the educational needs of individuals with ASD. PRACTICE IMPLICATIONS: Overview of education and training interventions in ASD help health care providers to better understand the strengths and limitations of their interventions.

3D LiMn2 O4 Thin Film Deposited by ALD: A Road toward High-Capacity Electrode for 3D Li-Ion Microbatteries.

Miniaturized electronics suffer from a lack of energy autonomy. In that context, the fabrication of lithium-ion solid-state microbatteries with high performance is mandatory for powering the next generation of portable electronic devices. Here, the fabrication of a thin film positive electrode for 3D Li-ion microbatteries made by the atomic layer deposition (ALD) method and in situ lithiation step is demonstrated. The 3D electrodes based on spinel LiMn2 O4 films operate at high working potential (4.1 V vs Li/Li+ ) and are capable of delivering a remarkable surface capacity (≈180 µAh cm-2 ) at low C-rate while maintaining more than 40 µAh cm-2 at C/2 (time constant = 2 h). Both the thickness of the electrode material and the 3D gain of the template are carefully tuned to maximize the electrode performance. Advanced characterization techniques such as transmission electron and X-ray transmission microscopies are proposed as perfect tools to study the conformality of the deposited films and the interfaces between each layer: no interdiffusion or segregation are observed. This work represents a major issue towards the fabrication of 3D-lithiated electrode by ALD-without any prelithiation step by electrochemical technique-making it an attractive solution for the fabrication of 3D Li-ion solid-state microbatteries with semiconductor processing methods.

Deep learning-based segmentation of lithium-ion battery microstructures enhanced by artificially generated electrodes.

Accurate 3D representations of lithium-ion battery electrodes, in which the active particles, binder and pore phases are distinguished and labeled, can assist in understanding and ultimately improving battery performance. Here, we demonstrate a methodology for using deep-learning tools to achieve reliable segmentations of volumetric images of electrodes on which standard segmentation approaches fail due to insufficient contrast. We implement the 3D U-Net architecture for segmentation, and, to overcome the limitations of training data obtained experimentally through imaging, we show how synthetic learning data, consisting of realistic artificial electrode structures and their tomographic reconstructions, can be generated and used to enhance network performance. We apply our method to segment x-ray tomographic microscopy images of graphite-silicon composite electrodes and show it is accurate across standard metrics. We then apply it to obtain a statistically meaningful analysis of the microstructural evolution of the carbon-black and binder domain during battery operation.

Reaction inhomogeneity coupling with metal rearrangement triggers electrochemical degradation in lithium-rich layered cathode.

High-energy density lithium-rich layered oxides are among the most promising candidates for next-generation energy storage. Unfortunately, these materials suffer from severe electrochemical degradation that includes capacity loss and voltage decay during long-term cycling. Present research efforts are primarily focused on understanding voltage decay phenomena while origins for capacity degradation have been largely ignored. Here, we thoroughly investigate causes for electrochemical performance decline with an emphasis on capacity loss in the lithium-rich layered oxides, as well as reaction pathways and kinetics. Advanced synchrotron-based X-ray two-dimensional and three-dimensional imaging techniques are combined with spectroscopic and scattering techniques to spatially visualize the reactivity at multiple length-scales on lithium- and manganese-rich layered oxides. These methods provide direct evidence for inhomogeneous manganese reactivity and ionic nickel rearrangement. Coupling deactivated manganese with nickel migration provides sluggish reaction kinetics and induces serious structural instability in the material. Our findings provide new insights and further understanding of electrochemical degradation, which serve to facilitate cathode material design improvements.

Multi-modal imaging of a single mouse brain over five orders of magnitude of resolution.

Mammalian neurons operate at length scales spanning six orders of magnitude; they project millimeters to centimeters across brain regions, are composed of micrometer-scale-diameter myelinated axons, and ultimately form nanometer scale synapses. Capturing these anatomical features across that breadth of scale has required imaging samples with multiple independent imaging modalities. Translating between the different modalities, however, requires imaging the same brain with each. Here, we imaged the same postmortem mouse brain over five orders of spatial resolution using MRI, whole brain micrometer-scale synchrotron x-ray tomography (µCT), and large volume automated serial electron microscopy. Using this pipeline, we can track individual myelinated axons previously relegated to axon bundles in diffusion tensor MRI or arbitrarily trace neurons and their processes brain-wide and identify individual synapses on them. This pipeline provides both an unprecedented look across a single brain's multi-scaled organization as well as a vehicle for studying the brain's multi-scale pathologies.

Fast X-ray Nanotomography with Sub-10 nm Resolution as a Powerful Imaging Tool for Nanotechnology and Energy Storage Applications.

In the last decade, transmission X-ray microscopes (TXMs) have come into operation in most of the synchrotrons worldwide. They have proven to be outstanding tools for non-invasive ex and in situ 3D characterization of materials at the nanoscale across varying range of scientific applications. However, their spatial resolution has not improved in many years, while newly developed functional materials and microdevices with enhanced performances exhibit nanostructures always finer. Here, optomechanical breakthroughs leading to fast 3D tomographic acquisitions (85 min) with sub-10 nm spatial resolution, narrowing the gap between X-ray and electron microscopy, are reported. These new achievements are first validated with 3D characterizations of nanolithography objects corresponding to ultrahigh-aspect-ratio hard X-ray zone plates. Then, this powerful technique is used to investigate the morphology and conformality of nanometer-thick film electrodes synthesized by atomic layer deposition and magnetron sputtering deposition methods on 3D silicon scaffolds for electrochemical energy storage applications.

Adorym: a multi-platform generic X-ray image reconstruction framework based on automatic differentiation.

We describe and demonstrate an optimization-based X-ray image reconstruction framework called Adorym. Our framework provides a generic forward model, allowing one code framework to be used for a wide range of imaging methods ranging from near-field holography to fly-scan ptychographic tomography. By using automatic differentiation for optimization, Adorym has the flexibility to refine experimental parameters including probe positions, multiple hologram alignment, and object tilts. It is written with strong support for parallel processing, allowing large datasets to be processed on high-performance computing systems. We demonstrate its use on several experimental datasets to show improved image quality through parameter refinement.

Learnings from Health Behavioural Survey Practices in France and Belgium During the First COVID-19 Stay-at-Home Order.

The COVID-19 pandemic has compelled public authorities to establish preventive measures involving individual behaviour modification strategies (mask-wearing, social distancing, etc.) with a view to community protection. In this context, documenting people's behaviour changes, the impact of public health measures, and individuals' knowledge, motivations, and beliefs - even their perception of how the crisis is being managed - is essential for understanding the experience of the population and adapting the management approach accordingly. This article presents findings and lessons on how to monitor a population's behaviour during a crisis, obtained by reviewing forty-five surveys conducted in Belgium and France during the first Covid-19 stay-at-home order, from April to May 2020. The central message is to argue that the citizens' role in this type of survey - and in managing the crisis, more generally - should be reconsidered by thinking of them as true health partners and members of a community that could be mobilised to help.

Probing and Interpreting the Porosity and Tortuosity Evolution of Li-O2 Cathodes on Discharge through a Combined Experimental and Theoretical Approach.

Li-O2 batteries offer a high theoretical discharge capacity due to the formation of light discharged species such as Li2O2, which fill the porous positive electrode. However, in practice, it is challenging to reach the theoretical capacity and completely utilize the full electrode pore volume during discharge. With the formation of discharge products, the porous medium evolves, and the porosity and tortuosity factor of the positive electrode are altered through shrinkage and clogging of pores. A pore shrinks as solid discharge products accumulate, the pore clogging when it is filled (or when access is blocked). In this study, we investigate the structural evolution of the positive electrode through a combination of experimental and computational techniques. Pulsed field gradient nuclear magnetic resonance results show that the electrode tortuosity factor changes much faster than suggested by the Bruggeman relation (an equation that empirically links the tortuosity factor to the porosity) and that the electrolyte solvent affects the tortuosity factor evolution. The latter is ascribed to the different abilities of solvents to dissolve reaction intermediates, which leads to different discharge product particle sizes: on discharging using 0.5 M LiTFSI in dimethoxyethane, the tortuosity factor increases much faster than for discharging in 0.5 M LiTFSI in tetraglyme. The correlation between a discharge product size and tortuosity factor is studied using a pore network model, which shows that larger discharge products generate more pore clogging. The Knudsen diffusion effect, where collisions of diffusing molecules with pore walls reduce the effective diffusion coefficients, is investigated using a kinetic Monte Carlo model and is found to have an insignificant impact on the effective diffusion coefficient for molecules in pores with diameters above 5 nm, i.e., most of the pores present in the materials investigated here. As a consequence, pore clogging is thought to be the main origin of tortuosity factor evolution.

In-Situ Characterization of Dynamic Morphological and Phase Changes of Selenium-doped Germanium Using a Single Particle Cell and Synchrotron Transmission X-ray Microscopy.

The dynamic information of lithium-ion battery active materials obtained from coin cell-based in-situ characterizations might not represent the properties of the active material itself because many other factors in the cell could have impacts on the cell performance. To address this problem, a single particle cell was developed to perform the in-situ characterization without the interference of inactive materials in the battery electrode as well as the X-ray-induced damage. In this study, the dynamic morphological and phase changes of selenium-doped germanium (Ge0.9 Se0.1 ) at the single particle level were investigated via synchrotron-based in-situ transmission X-ray microscopy. The results demonstrate the good reversibility of Ge0.9 Se0.1 at high cycling rate that helps understand its good cycling performance and rate capability. This in-situ and operando technique based on a single particle battery cell provides an approach to understanding the dynamic electrochemical processes of battery materials during charging and discharging at the particle level.

Structural diverseness of neurons between brain areas and between cases.

The cerebral cortex is composed of multiple cortical areas that exert a wide variety of brain functions. Although human brain neurons are genetically and areally mosaic, the three-dimensional structural differences between neurons in different brain areas or between the neurons of different individuals have not been delineated. Here we report a nanometer-scale geometric analysis of brain tissues of the superior temporal gyrus of schizophrenia and control cases. The results of the analysis and a comparison with results for the anterior cingulate cortex indicated that (1) neuron structures are significantly dissimilar between brain areas and that (2) the dissimilarity varies from case to case. The structural diverseness was mainly observed in terms of the neurite curvature that inversely correlates with the diameters of the neurites and spines. The analysis also revealed the geometric differences between the neurons of the schizophrenia and control cases. The schizophrenia cases showed a thin and tortuous neuronal network compared with the controls, suggesting that the neuron structure is associated with the disorder. The area dependency of the neuron structure and its diverseness between individuals should represent the individuality of brain functions.

Tunable hard x-ray nanofocusing with Fresnel zone plates fabricated using deep etching.

Fresnel zone plates are widely used for x-ray nanofocusing, due to their ease of alignment and energy tunability. Their spatial resolution is limited in part by their outermost zone width dr N , while their efficiency is limited in part by their thickness t zp. We demonstrate the use of Fresnel zone plate optics for x-ray nanofocusing with dr N = 16 nm outermost zone width and a thickness of about t zp = 1.8 µm (or an aspect ratio of 110) with an absolute focusing efficiency of 4.7% at 12 keV, and 6.2% at 10 keV. Using partially coherent illumination at 12 keV, the zone plate delivered a FWHM focus of 46 × 60 nm at 12 keV, with the first order coherent mode in a ptychographic reconstruction showing a probe size of 16 nm FWHM. These optics were fabricated using a combination of metal assisted chemical etching and atomic layer deposition for the diffracting structures, and silicon wafer back-thinning to produce optics useful for real applications. This approach should enable new higher resolution views of thick materials, especially when energy tunability is required.

A three-dimensional thalamocortical dataset for characterizing brain heterogeneity.

Neural microarchitecture is heterogeneous, varying both across and within brain regions. The consistent identification of regions of interest is one of the most critical aspects in examining neurocircuitry, as these structures serve as the vital landmarks with which to map brain pathways. Access to continuous, three-dimensional volumes that span multiple brain areas not only provides richer context for identifying such landmarks, but also enables a deeper probing of the microstructures within. Here, we describe a three-dimensional X-ray microtomography imaging dataset of a well-known and validated thalamocortical sample, encompassing a range of cortical and subcortical structures from the mouse brain . In doing so, we provide the field with access to a micron-scale anatomical imaging dataset ideal for studying heterogeneity of neural structure.

Nano- to microscale three-dimensional morphology relevant to transport properties in reactive porous composite paint films.

The quantitative evaluation of the three-dimensional (3D) morphology of porous composite materials is important for understanding mass transport phenomena, which further impact their functionalities and durability. Reactive porous paint materials are composites in nature and widely used in arts and technological applications. In artistic oil paintings, ambient moisture and water and organic solvents used in conservation treatments are known to trigger multiple physical and chemical degradation processes; however, there is no complete physical model that can quantitatively describe their transport in the paint films. In the present study, model oil paints with lead white (2PbCO3·Pb(OH)2) and zinc white (ZnO) pigments, which are frequently found in artistic oil paintings and are associated with the widespread heavy metal soap deterioration, were studied using synchrotron X-ray nano-tomography and unilateral nuclear magnetic resonance. This study aims to establish a relationship among the paints' compositions, the 3D morphological properties and degradation. This connection is crucial for establishing reliable models that can predict transport properties of solvents used in conservation treatments and of species involved in deterioration reactions, such as soap formation.