A MOOC About Bariatric Surgery Improves Knowledge and Promotes Patients' Soft Skills.

The ASMBS recommends that patients should be provided with educational materials to improve informed consent about bariatric surgery. Massive online open courses (MOOCs) are learning sources which are free, online, and available to people in remote situations. A French language MOOC regarding preparation for obesity surgery targets patients, as well as HCP, and people curious about this treatment. The patients' knowledge and skills after completion of the 5-week learning sessions (evaluated with semi-direct interviews) improved. Soft skills such as feeling empowered to ask questions to their HCP and explaining their plan to their relatives improved. This study suggests that MOOC can be a resource to improve knowledge and soft skills in patients for a better consent to surgery and follow-up.

Lymphogranuloma venereum in Quebec: Re-emergence among men who have sex with men.

BACKGROUND: Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis genotypes L1, L2 and L3. This LGV is associated with significant morbidity and increased risk of HIV transmission. While fewer than two cases per year were reported in Quebec before 2005, LGV emerged in 2005-2006 with 69 cases, followed by a period of low incidence (2007-2012), and subsequent re-emergence since 2013. OBJECTIVES: To describe the incidence of LGV in Quebec and the characteristics of the affected population, including demographics and risk factors, clinical manifestations, laboratory tests, treatments and reinfection rates. METHODS: Descriptive data were collected from the notifiable diseases records through the Institut national de santé publique du Québec (INSPQ) infocentre portal. Questionnaires were obtained through the enhanced surveillance system and transmitted anonymously to the Quebec Ministry of Health. In-depth analysis was performed on cases from 2013 to 2016. RESULTS: There were 338 cases of LGV over the four-year period in Quebec. All cases were male, excluding one transsexual. Mean age was 41 years. Most lived in Montréal (81%) and were men who have sex with men (MSM; 99%). The majority (83%) reported four sexual partners or more in the last year, met mostly through the Internet (77%) and in saunas (73%). Frequency of sexual intercourse with out-of-province residents decreased in 2013-2016 (27%) compared with 2005-2012 (38%). History of STIs was frequent: 83% were HIV-infected, 81% reported previous syphilis and 78% previous gonorrhea. Recreational drug use was frequent (57%), reaching 71% in 2016. Most cases were symptomatic, a proportion which decreased in 2016 (68%) compared with 2013-2015 (82%; p=0.006). Clinical presentations included proctitis (86%), lymphadenopathy (13%) and ulcer/papule (12%). Reinfections, mostly within two years of first infection, occurred in 35 individuals (10%).Conclusion: The re-emergence of LGV in Quebec involves an urban subpopulation composed almost exclusively of MSM with STIs, who have a high number of partners and often use drugs.

Efficacy and safety of golimumab in Crohn's disease: a French national retrospective study.

BACKGROUND: Anti-tumour necrosis factor (TNF) agents have improved the care of Crohn's disease (CD). After the first anti-TNF discontinuation, it is possible to switch to another anti-TNF. Three anti-TNF agents are available for ulcerative colitis (infliximab, adalimumab and golimumab), but only the first 2 have been approved for CD because golimumab has not been studied for this indication. AIM: To report the efficacy and safety of golimumab in CD. METHODS: Crohn's disease patients who received golimumab were identified in 12 French tertiary centres and were retrospectively analysed. The primary endpoint was the duration of golimumab treatment before escalation or discontinuation. The clinical response was defined as a decrease of more than 3 points in the Harvey-Bradshaw index or by global physician assessment. RESULTS: One hundred and fifteen patients were included. The golimumab treatment duration was 9.8 months (0.55-44), and 48.7% of the patients were still under treatment at the end of follow-up. Clinical response was observed in 55.8% of the patients after a mean duration of 3.8 months. The probability of remaining under treatment without escalation at 6, 12 and 24 months was 54.6%, 34.9% and 19.3% respectively. In multivariate analysis, discontinuation of the first anti-TNF agent due to intolerance (odds ratio, OR = 2.16; 95% CI, confidence interval [1.25-3.86]; P = .005) and co-immunosuppression for more than 6 months (OR = 3.98; 95% CI [2.3-7.1]; P < .0001) were predictive factors of efficacy. Six per cent of the patients discontinued treatment due to intolerance. CONCLUSION: After failure of infliximab or adalimumab for Crohn's disease, golimumab was safe and seemed beneficial in half of the patients.

Functionalization of Zr-based MOFs with alkyl and perfluoroalkyl groups: the effect on the water sorption behavior.

Stability and sorption of Metal-Organic Frameworks (MOFs) towards water are critical in many applications, and can a priori be modulated through the introduction of suitable organic functional groups on their backbone. We report here the preparation of a series of Zr(iv)-based MOFs functionalized with alkyl and perfluoroalkyl groups and their characterization by X-ray powder diffraction, multi-nuclei ((1)H, (13)C, (19)F) solid state nuclear magnetic resonance analyses, and nitrogen sorption measurements at 77 K. Their water sorption behavior was evaluated at 298 K and related to their physico-chemical features, highlighting both the effect of the confinement and the nature of the functional groups on the hydrophilic/hydrophobic balance.

A "green" strategy to construct non-covalent, stable and bioactive coatings on porous MOF nanoparticles.

Nanoparticles made of metal-organic frameworks (nanoMOFs) attract a growing interest in gas storage, separation, catalysis, sensing and more recently, biomedicine. Achieving stable, versatile coatings on highly porous nanoMOFs without altering their ability to adsorb molecules of interest represents today a major challenge. Here we bring the proof of concept that the outer surface of porous nanoMOFs can be specifically functionalized in a rapid, biofriendly and non-covalent manner, leading to stable and versatile coatings. Cyclodextrin molecules bearing strong iron complexing groups (phosphates) were firmly anchored to the nanoMOFs' surface, within only a few minutes, simply by incubation with aqueous nanoMOF suspensions. The coating procedure did not affect the nanoMOF porosity, crystallinity, adsorption and release abilities. The stable cyclodextrin-based coating was further functionalized with: i) targeting moieties to increase the nanoMOF interaction with specific receptors and ii) poly(ethylene glycol) chains to escape the immune system. These results pave the way towards the design of surface-engineered nanoMOFs of interest for applications in the field of targeted drug delivery, catalysis, separation and sensing.

Effects of short-chain fructooligosaccharides on growth performance of preruminant veal calves.

This study was conducted to evaluate the effects of 2 different daily doses of short-chain fructooligosaccharides (scFOS), a prebiotic ingredient, added to a calf milk replacer on growth performance, carcass characteristics, and fecal concentrations of short-chain fatty acids of preruminant veal calves. In total, 112 male Prim'Holstein calves, between 8 and 10d of age, were randomized in this study according to their body weight and were bred until the age of 168 d. They were fed a calf milk replacer containing 5% soluble wheat proteins as well as cereal-based pellets, the composition of which was adapted to cover the needs of the animals throughout the study. After 2 wk of adaptation, the calf milk replacer was supplemented or not supplemented with a daily dose of 3 or 6g of scFOS. Growth performance of calves, as measured by body weight, cold carcass weight, feed intake, average daily gain, and feed conversion ratio, was recorded and feces samples were taken to evaluate short-chain fatty acid concentrations. The inclusion of wheat proteins in milk replacer did not negatively affect the growth performance of calves in comparison with general standards. The addition of scFOS in the milk reduced the feed conversion ratio of veal calves in a dose-dependent manner and tended to increase the carcass weight. A general trend was observed for an increased production of total short-chain fatty acids in time, but scFOS decreased acetate proportion to the benefit of butyrate proportion. These data suggest that inclusion of scFOS in the calf milk replacer allowed the growth performance of preruminant calves to be enhanced, possibly via a modification of the activities of microbial fermentation.

Advances in structural analysis of fluoroaluminates using DFT calculations of 27Al electric field gradients.

Based on the analysis of 23 aluminum sites from 16 fluoroaluminates, the present work demonstrates the strong potential of combining accurate NMR quadrupolar parameter measurements, density functional theory (DFT)-based calculations of electric field gradients (EFG), and structure optimizations as implemented in the WIEN2k package for the structural and electronic characterizations of crystalline inorganic materials. Structure optimizations are essential for compounds whose structure was refined from usually less accurate powder diffraction data and provide a reliable assignment of the 27Al quadrupolar parameters to the aluminum sites in the studied compounds. The correlation between experimental and calculated EFG tensor elements leads to the proposition of a new value of the 27Al nuclear quadrupole moment Q(27Al) = 1.616 (+/-0.024) x 10(-29) m2. The DFT calculations provide the orientation of the 27Al EFG tensors in the crystal frame. Electron density maps support that the magnitude and orientation of the 27Al EFG tensors in fluoroaluminates mainly result from the asymmetric distribution of the Al 3p orbital valence electrons. In most cases, the definition of relevant radial and angular distortion indices, relying on EFG orientation, allows correlations between these distortions and magnitude and sign of the Vii.

19F high magnetic field NMR study of beta-ZrF4 and CeF4: from spectra reconstruction to correlation between fluorine sites and 19F isotropic chemical shifts.

High magnetic field and high spinning frequency one- and two-dimensional one-pulse MAS 19F NMR spectra of beta-ZrF4 and CeF4 were recorded and reconstructed allowing the accurate determination of the 19F chemical shift tensor parameters for the seven different crystallographic fluorine sites of each compound. The attributions of the NMR resonances are performed using the superposition model for 19F isotropic chemical shift calculation initially proposed by Bureau et al. (Bureau, B.; Silly, G.; Emery, J.; Buzaré, J.-Y. Chem. Phys. 1999, 249, 85-104). A satisfactory reliability is reached with a root-mean-square (rms) deviation between calculated and measured isotropic chemical shift values equal to 1.5 and 3.5 ppm for beta-ZrF4 and CeF4, respectively.

Multinuclear high-resolution NMR study of compounds from the ternary system NaF-CaF2-AlF3: from determination to modeling of NMR parameters.

27Al and 23Na NMR satellite transition spectroscopy and 3Q magic-angle-spinning spectra are recorded for three compounds from the ternary NaF-CaF2-AlF3 system. The quadrupolar frequency nuQ, asymmetry parameter etaQ, and isotropic chemical shift deltaiso are extracted from the spectrum reconstructions for five aluminum and four sodium sites. The quadrupolar parameters are calculated using the LAPW-based ab initio code WIEN2k. It is necessary to perform a structure optimization of all compounds to ensure a fine agreement between experimental and calculated parameters. By a comparison of experimental and calculated values, an attribution of all of the 27Al and 23Na NMR lines to the crystallographic sites is achieved. High-speed 19F NMR MAS spectra are recorded and reconstructed for the same compounds, leading to the determination of 18 isotropic chemical shifts. The superposition model developed by Bureau et al. is used, allowing a bijective assignment of the 19F NMR lines to the crystallographic sites.

Fear-avoidance beliefs about back pain in patients with subacute low back pain.

The fear-avoidance beliefs of patients with subacute low back pain (LBP) considered at risk for chronic disabling LBP are not well known. The objectives of this cross-sectional descriptive survey, conducted in secondary care practice, were to assess fear-avoidance beliefs about back pain in patients with subacute LBP and to seek an association between physician or patient characteristics and level of fear-avoidance beliefs. A total of 286 rheumatologists completed a self-administered questionnaire assessing physicians' demographic, professional data, personal history of back pain, and back pain fear-avoidance beliefs (on the Fear-Avoidance Belief Questionnaire [FABQ]) and 443 patients with sLBP completed one on pain, perceived handicap and disability (Quebec Back Pain Disability Scale), anxiety and depression (Hospital Anxiety Depression questionnaire), and back pain beliefs (FABQ). Mean FABQ scores for rheumatologists for physical activities (FABQ Phys) and occupational activities (FABQ Work) were 9.2+/-4.4 (range 0-21) and 16.7+/-6.9 (range 2-37), respectively, and patient scores were 16.7+/-5.2 and 19.3+/-12.4, respectively. A total of 68% of patients and 10% of physicians had a high rating on the FABQ Phys (>14). Patients' fear-avoidance beliefs about physical activity were associated with low level of education (odds ratio [OR] 4.19; 95% confidence interval [CI] 1.83-9.57), patients' perceived disability (OR 1.05; CI 1.03-1.07), and physicians' high FABQ Phys score (OR 5.92; CI 1.31-26.32). Here we show that fear-avoidance beliefs about back pain were high in patients with subacute LBP and their rheumatologists.

Outcome of subacute low back pain: influence of patients' and rheumatologists' characteristics.

OBJECTIVES: To assess the outcome of subacute low back pain, to identify the characteristics of patients and physicians which were related to outcome and to evaluate the influence of rheumatologists' beliefs about back pain on their following the guidelines for physical and occupational activity. DESIGN: a longitudinal descriptive survey. SETTING: a secondary care practice in France. PARTICIPANTS: 266 rheumatologists; 440 patients with subacute low back pain. OUTCOME MEASURES: the main outcome measure was persistence of back pain 3 months after baseline evaluation. A self-administered questionnaire for physicians assessed attitudes and beliefs about back pain [Fear-Avoidance Beliefs Questionnaire (FABQ)], and one for patients assessed pain, perceived handicap and disability (Quebec Scale), anxiety and depression (Hospital Anxiety Depression Questionnaire), and beliefs about back pain (FABQ). RESULTS: Forty per cent of patients had persistent low back pain at 3 months; 5.5% of these had sciatica. A total of 10% of rheumatologists and 68% of patients at baseline had a high FABQ physical score (phys; >14). Determinants of outcomes were work-related back pain [odds ratio (OR) = 3.37; 95% confidence interval (CI) 1.08-5.17], anxiety (OR = 2.41; 95% CI 1.44-4.09), sex (female OR = 2.03; 95% CI 1.30-3.18) and patients' beliefs about back pain at work (OR = 1.02; 95% CI 1.00-1.05). Physicians with high FABQ physical scores were less likely to follow guidelines on prescribing rest and occupational activity for back pain. CONCLUSION: Back pain commonly persists 3 months later in patients with subacute low back pain. Patients and rheumatologists still have negative beliefs about back pain. Rheumatologists' beliefs influence their following guidelines on physical and occupational activities. National education programmes about low back pain are needed in France.

A comparison of conventional microscopy, immunofluorescence microscopy and flow cytometry in the detection of Giardia lamblia cysts in beaver fecal samples.

A variety of domestic and wild animals are considered to be potential sources of giardiasis in humans. As a result, numerous studies have been reported on the prevalence of Giardia lamblia infection in animals. The majority of these surveys have involved various floatation techniques followed by conventional microscopy in order to detect cysts in fecal samples. Immunofluorescence microscopy has become popular in recent years for the detection of G. lamblia cysts in both clinical and environmental samples. This technique can be automated by combining it with flow cytometry. The present study represents a direct comparison of conventional microscopy, immunofluorescence microscopy, and flow cytometry in terms of their relative efficiency in the detection of G. lamblia cysts in beaver fecal samples. As a result of viewer fatigue, or low cyst concentrations, false negatives were common with conventional microscopy, leading to low prevalence estimates. By specifically targeting the cysts, immunofluorescence microscopy provided more reliable results in a shorter time than conventional methods. When flow cytometry was used in combination with immunofluorescence, a larger number of samples could be examined in a relatively short period of time. The results obtained indicated that this technique allowed for more consistent recognition than either conventional or immunofluorescence microscopy of positive samples containing smaller numbers of cysts.