Designing a Massive Open Online Course (MOOC) in face-to-face sessions. A blended design to teach practical histology.

Teaching histology, through virtual microscopy in educational strategies, undeniably moved towards the digitization and distancing of teaching. The setting up of the Massive Open Online Course (MOOC) entitled "Introduction to Histology: exploring the tissues of the human body" made it possible to exploit the potential to share digital resources with a wider audience while being integrated into the teaching on-campus students. This article described the pedagogical choices prevailing during the design of the MOOC and its combination with face-to-face sessions to achieve specific learning outcomes. The pedagogical alignment of learning outcomes described according to their cognitive levels, with online and face-to-face learning activities and evaluation methods has been demonstrated. The impact of such a blended design into an academic program has been ascertained using perception and performance data. Student satisfaction and engagement as well as motivational cues were identified. The level of performance was maintained in the educational strategy implemented and made it possible to achieve the objectives expected by the teachers. The benefits of integrating a MOOC with classroom-based teaching were highlighted, as well as barriers that could hinder the successful implementation.

[stent thrombosis : A won battle ? (data from the France PCI registry)]. / Thrombose de stent : une bataille gagnée ? (Données du registre France PCI).

GOAL: The aim of the study is to assess the incidence, risk factors and prognosis of definite stent thrombosis (ST) at 1 year in the France PCI multicenter prospective registry. PATIENTS AND METHODS: Only patients who underwent coronary angioplasty with at least one stent implantation between 1st January 2014 and 31 December 2019 were included. The population was separated into 2 groups: the "ST" group with stent thrombosis and the "control" group without stent thrombosis. RESULTS: 35,435 patients were included. 256 patients (0.72%) presented a ST at 1 year. The rate of ST decreased significantly in acute coronary syndrome (1.5% in 2014 vs. 0.73% in 2019; p = 0.05) but not in chronic coronary syndrome (0.46% in 2014 vs 0.40%; p = 0.98). The risk factors are young age (65.8 years vs 68.2; p = 0.002), clinical context (35.27% vs 16.68%; p = 0.0001), diabetes (35.2 % vs 26.4%; p = 0.002), renal failure (11.7% vs 8%; p = 0.009) and history of coronary angioplasty (28.63% vs 21.86%; p = 0.009) and peripheral arterial disease (14.5% vs 10.1%; p = 0.021), LV dysfunction (37% vs 27.5%; p = 0.003), mean length (39.6 mm vs 31, 7mm; p <0.0001) and the mean number of stents per procedure (1.9 vs 1.6; p <0.0001), a TIMI flow ≤1 pre procedure (21.5% vs 12.4%; p <0.0001) and an intrastent restenosis (11% vs 6%; p <0.0001). The 1-year mortality of the ST group was significantly higher than that of the control group (19.14% vs 5.82%; p <0.0001). CONCLUSION: Since 2014, the incidence of ST at 1 year has been decreasing but remains stuck at a floor level of 0.54% in 2019. The battle for ST seems to have been partly won and its risk factors well identified, but its mortality is still high.

Animal board invited review: OneARK: Strengthening the links between animal production science and animal ecology.

Wild and farmed animals are key elements of natural and managed ecosystems that deliver functions such as pollination, pest control and nutrient cycling within the broader roles they play in contributing to biodiversity and to every category of ecosystem services. They are subjected to global changes with a profound impact on the natural range and viability of animal species, the emergence and spatial distribution of pathogens, land use, ecosystem services and farming sustainability. We urgently need to improve our understanding of how animal populations can respond adaptively and therefore sustainably to these new selective pressures. In this context, we explored the common points between animal production science and animal ecology to identify promising avenues of synergy between communities through the transfer of concepts and/or methodologies, focusing on seven concepts that link both disciplines. Animal adaptability, animal diversity (both within and between species), selection, animal management, animal monitoring, agroecology and viability risks were identified as key concepts that should serve the cross-fertilization of both fields to improve ecosystem resilience and farming sustainability. The need for breaking down interdisciplinary barriers is illustrated by two representative examples: i) the circulation and reassortment of pathogens between wild and domestic animals and ii) the role of animals in nutrient cycles, i.e. recycling nitrogen, phosphorus and carbon through, for example, contribution to soil fertility and carbon sequestration. Our synthesis identifies the need for knowledge integration techniques supported by programmes and policy tools that reverse the fragmentation of animal research toward a unification into a single Animal Research Kinship, OneARK, which sets new objectives for future science policy. At the interface of animal ecology and animal production science, our article promotes an effective application of the agroecology concept to animals and the use of functional diversity to increase resilience in both wild and farmed systems. It also promotes the use of novel monitoring technologies to quantify animal welfare and factors affecting fitness. These measures are needed to evaluate viability risk, predict and potentially increase animal adaptability and improve the management of wild and farmed systems, thereby responding to an increasing demand of society for the development of a sustainable management of systems.

[Exploration of urethral strictures : place of urethrocystography]. / Comment j'explore les sténoses urétrales : intérêt de l'urétrocystographie.

Stricture of the male urethra is a frequent and regularly iatrogenic pathology in industrialized countries. The urologist's surgical arsenal is wide and the choice of an operative technique is made at the end of an assessment where urethrocystography is the main radiological examination. The conditions to achieve the examination, its different stages, the normal aspects and anatomical variants as well as the limitations to its interpretation, should therefore be known by the urologist and the radiologist, in order to assess correctly this pathology.

La sténose de l'urètre masculin est une pathologie fréquente, régulièrement iatrogène dans les pays industrialisés. L'arsenal chirurgical de l'urologue face à celle-ci est large et le choix d'une technique opératoire est posé au terme d'un bilan dont l'urétrocystographie occupe une place centrale. Les conditions de réalisation de l'examen, ses étapes, les aspects normaux et les quelques variantes anatomiques ainsi que ses limites d'interprétation, doivent donc être connus de l'urologue et du radiologue, de manière à ne pas méconnaître ou, au contraire, surestimer une sténose urétrale.

Urological evaluation before kidney transplantation : recommendations for practice / Comment j'expore. Evaluation urologique des candidats à une transplantation rénale : recommandations pour la pratique.

Candidates for a kidney transplantation must undergo a complete evaluation, including a urological evaluation. This urological assessment should first of all exclude any pathology of the urinary tract likely to contraindicate a transplantation or to evolve under immunosuppression. Moreover, this assessment should evaluate the lower urinary tract that is to receive a kidney graft. It is therefore necessary to detect and possibly treat uro-genital cancers, benign uropathies of the native kidneys or abnormalities of the lower urinary tract. The basic evaluation is rather simple and non-invasive and includes a complete history, general and urogenital physical examination, urinalysis, total serum PSA measurement, urinary tract ultrasound, and uroflowmetry. If necessary, other explorations and testings will be carried out, such as CT scan, MRI, retrograde uretero-pyelography, uretero-renoscopy, cystoscopy, urethro-cystography or urodynamic examination. This article reviews the various pathologies involved, and sets out practical recommendations for explorations to be performed.

Les candidats à une transplantation rénale doivent faire l'objet d'une évaluation complète, y compris urologique. Ce bilan urologique permet, tout d'abord, d'exclure toute pathologie de l'arbre urinaire susceptible de contre-indiquer une greffe rénale ou susceptible de s'aggraver sous immunosuppression. Par ailleurs, ce bilan permet d'évaluer l'aptitude du bas appareil urinaire à recevoir un greffon. Il convient donc de dépister et, éventuellement, de traiter les cancers uro-génitaux, les uropathies bénignes des reins natifs ou les anomalies du bas appareil urinaire. L'évaluation de base est simple et non invasive et comprend une anamnèse complète, un examen clinique général et uro-génital, une analyse d'urine, un dosage de PSA sérique total, une échographie des voies urinaires, et une débitmétrie. Elle sera complétée par d'autres explorations si nécessaire, telles que le scanner, l'IRM, l'urétéro-pyélographie rétrograde, l'urétéro-rénoscopie, la cystoscopie, l'urétro-cystographie rétograde et permictionnelle, ou l'examen urodynamique. Cet article revoit les différentes pathologies urologiques concernées, et définit des recommandations pratiques concernant les explorations à envisager.

[ELECTRONIC LOGBOOK: LEARNING TOOL AND TEACHING AID FOR THE EVALUATION OF LEARNING ACTIVITIES]. / LogBook numérique: un carnet de bord réflexif comme outil d'apprentissage en contexte de stage.

A LogBook is a learning tool and teaching aid I where clinical settings lived during training courses are provided. A LogBook is basically a journal which evidences learning and skills. LogBook provides a means for monitoring student learning, both for the student and for the instructor. It provides a feedback loop for the evaluation of learning activities. This LogBook has been developed for the student's training in psychiatry but it may be extended to all medical disciplines. The authors have developed an electronic logbook to support learning and assessment. In the context of Europe, it has become necessary to set up a LogBook of uniform learning outcomes to assist medical students.

[TRAUMATIC RUPTURE OF THE AORTIC ISTHMUS: MODERN PERSPECTIVES]. / Rupture post-traumatique de l'isthme aortique: perspectives modernes de prise en charge.

Traumatic aortic rupture of the thoracic aorta (usually at the isthmus) is frequently associated with concomitant life-threatening injuries. Historically, the conventional care consisted of surgical repair of the lesion performed as soon as possible. However, in spite of constant technical improvements the morbi-mortality remains high because of these associated lesions. In addition, their management can have priority and delay aortic surgery. The endovascular approach has been shown to be a feasible and efficient technique and currently represents a valuable alternative to open surgery for patients with multiple traumas. We report a patient presenting with a traumatic aortic rupture of the aortic isthmus, which was successfully treated by delayed combined endovascular (thoracic aortic stentgrafting) and open approach (hemiaortic arch debranching).

Pushing NMR sensitivity limits using dynamic nuclear polarization with closed-loop cryogenic helium sample spinning.

We report a strategy to push the limits of solid-state NMR sensitivity far beyond its current state-of-the-art. The approach relies on the use of dynamic nuclear polarization and demonstrates unprecedented DNP enhancement factors for experiments performed at sample temperatures much lower than 100 K, and can translate into 6 orders of magnitude of experimental time-savings. This leap-forward was made possible thanks to the employment of cryogenic helium as the gas to power magic angle sample spinning (MAS) for dynamic nuclear polarization (DNP) enhanced NMR experiments. These experimental conditions far exceed what is currently possible and allows currently reaching sample temperatures down to 30 K while conducting experiments with improved resolution (thanks to faster spinning frequencies, up to 25 kHz) and highly polarized nuclear spins. The impressive associated gains were used to hyperpolarize the surface of an industrial catalyst as well as to hyperpolarize organic nano-assemblies (self-assembling peptides in our case), for whom structures cannot be solved using diffraction techniques. Sustainable cryogenic helium sample spinning significantly enlarges the realm and possibilities of the MAS-DNP technique and is the route to transform NMR into a versatile but also sensitive atomic-level characterization tool.

[Catamenial pneumothorax: easy to see, difficult to manage]. / Pneumothorax cataménial : facile à reconnaître, difficile à traiter.

INTRODUCTION: Catamenial pneumothorax (PNO) is a real clinical occurrence. Several cases are reported in the literature as a spontaneous PNO occurring during the catamenial period among women in their thirties. There is no consensus about management and the recurrence rate is very high whatever the initial treatment. PATIENTS AND METHODS: Among 310 cases of spontaneous PNO operated in our institution in 10 years, we identified five cases of catamenial PNO. A retrospective study of these cases was used to study the initial operating data, including the existence of intrathoracic lesions and the choice of technique of pleurodesis. Patient follow-up was clinically and radiologically. Adjuvant hormonal therapies, recurrence of PNO and treatment modalities have been studied. RESULTS: These five patients of average age 37.6 years (37,38) who had 2.6 (2.3) episodes of right catamenial PNO before hospitalization in surgery department. No patient was smoker. Two of them had a known thoracic or pelvic endometriosis. The initial surgery was video assisted thoracic surgery with a parietal pleurectomy and twice a mesh upon the diaphragm. There were no immediate postoperative complications, and the average length of stay was 6.6 days (5.9). Two patients had adjuvant hormonal therapy. All patients had at least one recurrence and three of them had redo surgery. CONCLUSION: The diagnosis of catamenial PNO must be mentioned in any woman who has a spontaneous pneumothorax right in catamenial period. Endometriosis should be systematically sought. A standardized therapeutic approach to establish the role of surgery and the most appropriate technique as well as the appropriateness and duration of peroperative hormonal therapy remains to be defined.

Surgical treatment of cardiovascular complications in patients with Marfan syndrome: a report of two cases and literature review.

Cardiovascular disease is the main cause of morbidity and mortality in patients with Marfan syndrome. The most life threatening complication is aortic root aneurysms leading to aortic dissection or rupture. It can be prevented by regular aortic follow-up and prophylactic aortic surgery. Modern aortic surgery has led to a substantial increase in the life expectancy of these patients. We report two cases of Marfan syndrome with cardiovascular complications. Their management is discussed according to the most recent literature.

Detection of hazardous weight-loss substances in adulterated slimming formulations using ultra-high-pressure liquid chromatography with diode-array detection.

The presence on the market of illegal products for slimming purposes or the treatment of overweight is a public health issue. These products may contain illicit chemicals in order to improve their effectiveness. Some of these weight-loss compounds are responsible for adverse events, including fatal outcomes. A general strategy for the analysis of any suspect formulation begins with a large screening for the general search of a wide range of compounds. A methodology for the qualitative and quantitative determination of 34 compounds in slimming preparations (such as dietary supplements or medicinal products) was used for the control of slimming formulations from the market, including over the Internet. The fast liquid chromatography system (ultra-high-pressure liquid chromatography) used a gradient of solvent (phosphate buffer and acetonitrile), a C18 endcapped column and a diode array detector. This system allows dual identification based on retention time and UV spectra. The analytical method is simple, fast and selective since 34 weight-loss compounds can be detected in a 15-min run time. Thus, 32 commercial slimming formulations were analysed using this method, allowing the detection and quantification of hazardous active substances: caffeine, clenbuterol, nicotinamide, phenolphthalein, rimonabant, sibutramine, didesmethylsibutramine, synephrine and yohimbine.

Epidemiological aspects and financial impact of lumpy skin disease in Ethiopia.

The financial cost of clinical Lumpy Skin Disease (LSD) and the financial benefit of its control through vaccination were studied based on questionnaire survey in Oromia region of Ethiopia from the perspective of livestock farmers. Production loss impacts for local zebu cattle were compared with those of Holstein Friesian (HF)/crossbred cattle in the study area. Annual cumulative incidence of LSD infection in HF/crossbred and local zebu cattle were 33.93% (95% CI: 30.92-36.94) and 13.41% (95% CI: 12.6-14.25) respectively and significantly different (p<0.05). Annual mortality was also significantly higher in HF/crossbred 7.43% (95% CI: 5.76-9.10) than in local zebu cattle 1.25% (95% CI: 0.98-1.52). The annual financial cost was calculated as the sum of the average production losses due to morbidity and mortality arising from milk loss, beef loss, traction power loss, and treatment and vaccination costs at the herd level. The financial cost in infected herds was estimated to be USD 6.43 (5.12-8) per head for local zebu and USD 58 (42-73) per head for HF/crossbred cattle. A partial budget analysis was used to estimate the financial benefit of an annual vaccination program in both the local zebu and HF/crossbred cattle farming systems. The marginal rate of return (MRR) gained from this control intervention was estimated to be 34 (3400%) and the net benefit per head was USD 1 for local zebu and USD 19 for HF/crossbred cattle. Vaccination thus enabled financial costs due to LSD to be reduced by 17% per head in local zebu herds and 31% per head in HF/crossbred herds. These results could provide guidance to producers and the government in their endeavors to control the disease.

[The management of blunt chest trauma]. / Prise en charge des traumatismes fermés du thorax.

INTRODUCTION: Blunt chest trauma is a frequent injury and it can be difficult to evaluate its seriousness. The risk of acute decompensation because of an occult thoracic lesion is a significant and justified cause for concern. STATE OF ART: As is common in the case of trauma to the torso, few studies are available to guide the development of structured recommendations about the diagnosis and management of such injuries. PERSPECTIVES: The authors review the anatomical and physiological knowledge relevant to this kind of injury. They propose a standardized management for the diagnosis and emergency management of blunt chest trauma. CONCLUSIONS: The management of blunt chest trauma should include a very systematic first evaluation to avoid diagnostic pitfalls and decrease the risk of subsequent respiratory failure.

[Thoracic drainage technique for emergencies]. / Drainage thoracique en situation précaire.

The purpose of this report is to describe a simple, reproducible technique for pleural drainage. This technique that requires scant resources should be used only in life-threatening situations calling for pleural drainage. It is not intended to replace conventional techniques.

Effect of curvature on C-F bonding in fluorinated carbons: from fullerene and derivatives to graphite.

The effect of the curvature of the carbon lattice is discussed taking into account NMR data on various fluorinated carbons including C(60) fullerenes, single, double and multiwall carbon nanotubes. Graphite fluorides and highly fluorinated fullerenes are used as limit model compounds for planar and spherical geometries, respectively. The curvature results in a weakening of the C-F bonding covalence. First of all, various highly fluorinated fullerenes with increasing F/C molar ratio were prepared by treatment with pure gaseous fluorine. A preliminary study using XRD, EPR and IR spectroscopy confirms that the highest fluorination level can be reached either at 133 or at 300 degrees C. In order to extract the correlation between fluorine and carbon atoms and the C-F bond length, specific sequences such as solid echo, two-dimensional (19)F -->(13)C cross polarization wide-line separation and inverse (19)F -->(13)C cross polarization were also used for fluorinated C(60).