[The manager-IPA pair in mental health: experimenting with a new form of collaboration]. / Le binôme cadre-IPA en santé mentale : expérimenter une nouvelle collaboration.

In 2021, the first advanced practice nurses (APNs) specializing in psychiatry and mental health will have entered the vast field of practice of this discipline. Two years on, the missions entrusted to them within the establishments that have supported the development of their new skills are as varied as ever. While their scope of action remains to be defined in some places, the fact remains that collaboration between the APN and the local health executive is already proving to be a powerful lever for the successful completion of large-scale projects aimed at the continuous improvement of care in their shared field of practice. A look back at the deployment of a quality tool to improve care safety.

A novel quantitative real-time PCR with the GAPDH reference gene for peste des petits ruminants.

Peste des petits ruminants (PPR) is a serious acute, highly contagious disease caused by the peste des petits ruminants virus (PPRV). This study aims to establish a qRT-PCR assay with an internal amplification control for the rapid and accurate detection of PPRV. The primers and probes for PPRV N were based on the national standard of the diagnostic techniques for PPR of China, and a pair of primers and TaqMan probes for the internal reference gene of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was designed. Optimisation of the reaction conditions, specificity, sensitivity and reproducibility tests, and clinical sample detection were conducted. The results showed that the optimal primers and probe concentrations of PPRV were 0.4 µmol/l and 0.4 µmol/l, respectively, and were 0.4 µmol/l and 0.2 µmol/l for the reference gene GAPDH, respectively. The established method has no cross-reaction with other viruses. The minimum detection limit was 6.8 copies/µl for PPRV and 190 copies/µl for GAPDH. The coefficients of variation (CV%) of PPRV and GAPDH were both lower than 2%. The results suggest that the PPRV qRT-PCR method containing internal reference genes has strong specificity, high sensitivity, and good reproducibility. The addition of internal reference genes for the sample quality control improves the accuracy of the detection.

Molecular characterization of peste des petits ruminants virus and Mycoplasma capricolum subsp. capripneumoniae in small ruminants in northern Mauritania, 2023.

Global eradication of peste des petits ruminants (PPR) is planned for 2030 by international animal health organizations in collaboration with national partners. As the deadline approaches, it is fundamental that the PPR status in each country is determined. In addition, the identification of other pathogens of small ruminants that share common geographical locations and can produce similar clinical signs is also important for differential diagnosis. With this in mind, 37 samples collected from goats and sheep presenting respiratory symptoms in Mauritania in 2023 were screened for the presence of PPR virus, Capripoxvirus, Pasteurella multocida and Mycoplasma capricolum subspecies capripneumoniae (Mccp) using a one-step multiplex RT-qPCR assay. None of the samples were positive for Capripoxvirus or P. multocida. Nine of them were positive for PPRV and sequence analysis of a segment of the PPRV nucleoprotein revealed that they belonged to lineage IV and were similar to viruses recently identified in Côte D'Ivoire, Guinea, and Niger indicating transboundary movement. The full genome of one representative virus was also generated. Mccp was identified in eight samples and multi-locus sequence analysis (MLSA) identified them as belonging to MLSA Group 3 together with Mccps identified in China, Tajikistan, Turkey and the United Arab Emirates. This is the first time that such a study has been undertaken in Mauritania and the data generated should be of interest to those involved in the management of goat diseases in Mauritania and neighbouring countries.

A cascaded process to upgrade bleached bamboo pulp into dissolving pulp and arabinoxylan.

The dissolving pulp preparation from bleached kraft pulp while realizing the high-value application of hemicellulose fraction is of great significance for improving the overall economics of the process. This work proposed a two-step cascaded process of deep eutectic solvent (DES) pretreatment combined with mechanical refining for the co-production of dissolving pulp and arabinoxylan (AX) from bleached bamboo pulp. Results showed that using alkaline DES composed of quaternary ammonium hydroxide and urea prepared high-quality dissolving pulp (α-cellulose content of 97.7 %) while selectively extracting high-quality AX. The mechanical refining rapidly opened up the cellulose structure to increase its Fock reactivity to over 70.0 %. When 100 g bleached bamboo pulp was subjected to this technology route, the high yields of dissolving pulp (63.8 g) and AX (13.0 g) were respectively obtained. It was proposed that the tailored DES with different alkalinity could specifically produce dissolving pulp or AX which were more favorable for downstream application through distinct action pathways. The swelling effects of DES on the cellulose surface facilitated the subsequent mechanical fibrillation, allowing a synergistic enhancement of the reactivity. Thus, the integrated process provided a sustainable alternative for dissolving pulp upgrading while adding attractiveness by co-producing AX product stream.

Polyol-assisted ternary deep eutectic solvent protective lignocellulose pretreatment for high-efficiency xylan utilization and ethanol production.

The traditional lignocellulose pretreatment by deep eutectic solvent (DES) was usually conducted under higher acidic, alkaline and high temperature conditions, which leads to the severe degradation of xylan, decreasing the subsequent reducing sugar concentration by enzymatic hydrolysis and further ethanol fermentation. It is essential to develop an effective DES that selectively removes lignin while preventing excessive xylan degradation during lignocellulose pretreatment. An effective ethylene glycol-assisted ternary DES was designed to treat corn straw (CS) at 100 °C for 6 h. 65.51 % lignin removal was achieved, over 93.46 % cellulose and 50.22 % xylan were retained in pretreated CS with excellent enzymatic digestibility (glucan conversion of 77.05 % and xylan conversion of 71.72 %), total sugar conversion could reach 75.93 %, implying the unique capacity to selectively remove lignin while preserving carbohydrate components. Furthermore, the universality of the selective removal of lignin and effective retention of xylan by ternary DES has been successfully proven by other polyols. The enzymatic hydrolysate of ternary DES-pretreated CS fermented over our genetically engineered yeast strain SFA1OE gave a high ethanol yield of 0.488 g/g total reducing sugar, demonstrating the effectiveness of the polyol-assisted ternary DES pretreatment in achieving high-efficiency cellulosic ethanol production.

[The world is changing, and so is the world of care]. / Le monde change, l'univers du soin aussi.

In the post-Covid context, which is unstable and changing, what is the role of the team when it is reduced to operating with a growing number of temporary staff? The medical desertification that is gradually taking hold in certain regions is a cause for concern, as is the growing disaffection of nurses throughout France. It is essential to draw up a map that incorporates survival oases, in order to meet the essential need to provide care anyway, while at the same time perpetuating the process of improving care. Advanced practice nursing faces many challenges.

[Supporting care teams as a lever for improving practices]. / L'accompagnement des équipes de soins comme levier à l'amélioration des pratiques.

Thanks to their guidance and coaching skills, advanced practice nurses (APNs) support teams on a daily basis in improving their practices and developing their reflexivity. Their leadership enables caregivers to question themselves, exchange ideas and think about care from a different angle. Situational analysis sessions provide a space for them to step back, debate and innovate. This meaningful support enabled a newly-qualified IPA to find her place among the teams. Here's a testimonial.

La pharmacothérapie en fonction des gènes chez les enfants et les adolescents qui prennent des médicaments psychoactifs.

Les médicaments psychoactifs sont de plus en plus utilisés pour traiter les enfants et les adolescents ayant des troubles de santé mentale, mais la variabilité des réponses individuelles fait ressortir l'importance d'une médecine personnalisée. Les tests pharmacogénétiques sont un volet important d'un tel type de médecine. Le nombre d'entreprises de tests pharmacogénétiques commerciaux qui font la promotion de tests de ce genre et promettent un traitement efficace et individualisé des troubles de santé mentale se multiplie depuis quelques années. Les preuves scientifiques en appui à l'utilisation de la pharmacogénétique sont limitées, particulièrement dans les populations pédiatriques. Le présent point de pratique souligne les étapes qui orientent le recours à ces tests pour la prise de médicaments psychoactifs en milieu clinique et présente des ressources de soutien importantes. Il existe des directives cliniques sur les variants des pharmacogènes qui encodent les enzymes de métabolisation du cytochrome P450 (p. ex., CYP2C19, CYP2D6, CYP2C9), lesquels sont l'un des déterminants des concentrations pharmacologiques dans le sang et peuvent appuyer à la fois le choix du médicament et la stratégie posologique de certains antipsychotiques, antidépresseurs et antiépileptiques. Les effets indésirables de certains médicaments antiépileptiques (p. ex., la carbamazépine et la phénytoïne) sont associés à certains types d'antigènes d'histocompatibilité humaine et à des variants de l'ADN polymérase gamma (POLG; acide valproïque). Les données probantes sont limitées à l'égard des variants génétiques des protéines qui ciblent les médicaments, et c'est pourquoi il est difficile de déterminer quels patients présenteraient une réponse altérée au traitement à une concentration sanguine thérapeutique.

Améliorer la sécurité à vélo chez les enfants et les adolescents.

Le vélo demeure une activité populaire pour les enfants et les adolescents du monde entier; elle combine le plaisir de se déplacer rapidement et de nombreux avantages pour la santé et la société. Cependant, le vélo est également associé à un risque de blessures graves et de décès. Depuis dix ans, les recherches démontrent de plus en plus que l'amélioration de la sécurité des cyclistes dépend en grande partie de l'environnement dans lequel ils se déplacent et de mesures de sécurité individuelles comme le port du casque. Pour de nombreux enfants et adolescents, la pandémie a accru les possibilités de faire du vélo et, et elle ramené l'attention du public vers des infrastructures cyclables sécuritaires, telles que des voies cyclables réservées. Le présent document de principes passe en revue les données probantes en appui à des infrastructures cyclables plus sécuritaires pour les enfants et les adolescents, de même que les bienfaits du vélo pour la santé physique et mentale. Les avantages du transport actif chez les jeunes et l'influence de l'environnement bâti sur la sécurité et l'adoption du vélo sont exposés. Un aperçu des mesures que chacun peut prendre pour améliorer la sécurité à vélo est suivi de recommandations pour les cliniciens, la communauté des cyclistes, les parents et les décideurs.

Comparative long-term efficacy and safety of two paclitaxel-coated balloons with different coating strategies for the treatment of drug-eluting coronary stent restenosis.

BACKGROUND: We previously showed non-inferiority of a low-dose paclitaxel-coated balloon (PCB) with citrate excipient (Agent PCB) as compared to normal-dose iopromide excipient (SeQuent Please PCB) in terms of angiographic and clinical endpoints at 12 months. The long-term clinical efficacy and safety of Agent PCB is not defined. METHODS: 262 patients (323 DES-ISR lesions) were enrolled in this study and treated with either Agent PCB (125 patients, 151 lesions) in the ISAR-DESIRE 3a trial or with SeQuent Please PCB (137 patients, 172 lesions) in the setting of the randomized ISAR-DESIRE 3 trial with similar in- and exclusion criteria serving as historical control arm. The follow-up period was extended to 7 years. The efficacy and safety endpoints of this analysis were target-lesion revascularization (TLR), death, myocardial infarction (MI) and target lesion thrombosis (TLT) at 7 years. RESULTS: At 7 years, 206 patients (78.6%) were alive. The risks of TLR (hazard ratio [HR]: 1.29, 95% confidence interval [CI]: 0.87-1.90; p = 0.205), death (HR: 1.38, 95% CI: 0.82-2.35; p = 0.227), MI (HR: 1.10, 95% CI: 0.39-3.15; p = 0.852) and TLT (HR: 2.18, 95% CI: 0.20-24.10; p = 0.523) were comparable between Agent PCB and SeQuent PCB. Multivariate analysis showed comparable risks of TLR, death and MI between both PCB devices. CONCLUSIONS: In patients treated for DES-ISR by angioplasty with Agent PCB and SeQuent Please PCB, there was no statistically significant difference in TLR at 7 years. Randomized trials with standardized lesion preparation and long-term follow-up are warranted to further evaluate comparative efficacy of both devices. (ClinicalTrials. gov Identifier: NCT02367495).

Emergency Department Boarding Time Is Associated with Functional Decline in Older Adults Six Months Post Discharge.

Functional decline following hospitalization remains an important problem in health care, especially for frail older adults. Modifiable factors related to reduction in harms of hospitalization are not well described. One particularly pervasive factor is emergency department (ED) boarding time; time waiting from decision to admit, until transfer to an in-patient medical unit. We sought to investigate how the functional status of frail older adults correlated with the length of time spent boarded in the ED. We found that patients who waited for 24 hours or more exhibited functional decline in both the Barthel Index and Hierarchical Assessment of Balance and Mobility and an increase in the Clinical Frailty Scale from discharge to 6 months post discharge. In conclusion, there is a need for additional investigation into ED focused interventions to reduce ED boarding time for this population or to improve access to specialized geriatric services within the ED.

[Prognostic factors: Degree of subserosal invasion, tumor-serosal distance and subserosal elastic boundary invasion in colonic adenocarcinoma]. / Facteurs pronostiques : degré d'invasion de la sous-séreuse, distance tumeur-séreuse et invasion de la limitante élastique de la sous-séreuse dans l'adénocarcinome colique.

The aim was to study the prognostic impact of tumor infiltration of the subserosa in colonic adenocarcinoma, by evaluating the degree of tumor infiltration in the subserosa (DISS), tumor-serosa distance (DTS), and invasion of the elastic boundary of the subserosa (ILE) after elastic fiber staining. MATERIAL AND METHODS: All patients operated on for colonic adenocarcinoma classified as pT3 without lymph node or visceral metastasis operated on at the CHU d'Amiens between 2004 and 2017 were included. All slides were reviewed by 2 pathologists. Bivariate and subgroup analyses were performed according to the presence of a DISS≤5mm or>5mm, a DTS≤1mm or>1mm and the presence or absence of an ILE. These statistical analyses were then correlated with the 5-year survival. RESULTS: One hundred and one patients were included in the study. We performed elastic fiber staining on an average of 2 tumor blocks per case and 39.6% of patients had invasion of the elastic boundary. However, bivariate and subgroup analyses showed no statistically significant association between DISS, DTS or ILE and 5-year survival. CONCLUSION: None of these three histopathological criteria proved to have prognostic value in our series, contrary to some results in the literature. However, as these data are subject to a number of confounding factors, we do not recommend that pathologists specify these different criteria in their reports.

Selective microextraction of erythrosine (E127) in foodstuffs using a new generation high-density type-V deep eutectic solvent.

A novel and selective (deep eutectic solvent) DES-based microextraction method was established for the first time, utilizing a synthesized new generation High-Density Type-V DES for monitoring the dye Erythrosine (E127) in various foodstuffs and drugs. Type-V DES was created from acetophenone and diphenylamine at 3:1 M ratio. The pH, DES amount, and vortex time were optimized using Box-Behnken Design (BBD) of Response Surface Methodology (RSM). The quadratic microextraction model with R2 = 0.9982 was obtained. The limit of detection, preconcentration factor and linear dynamic range were determined to be 12 µg/L, 50 and 41-4000 µg/L, respectively. Effects of matrix components were examined. The developed High-Density Type-V Deep Eutectic Solvent Microextraction (HD-V-DES-ME) method was applied to foodstuffs and drugs to monitor their E127 contents and subsequently validated by applying spiked tests to real samples, with recoveries ranging between 94 and 101 %. The indexes of environmental friendliness and practicality for the method were evaluated using the Analytical GREEnness metric approach tool (AGREE) and the Blue Applicability Grade Index tool (BAGI), respectively.

A Network Analytic Approach to Dissociation: New Insights from Clinical Data.

The transdiagnostic construct of dissociation, characterized by a disintegration of specific psychological functions such as consciousness, memory, identity, perception, body representation, and behavior, remains elusive to a unified conceptualization. Specifically, its dimensionality is a matter of ongoing controversy. Empirical approaches applying factor analyses to the Dissociative Experiences Scale (DES) have yielded inconsistent findings. This study adopts a novel methodological approach, utilizing Exploratory Graph Analysis (EGA) to address this issue. In a sample of 668 day-hospital patients undergoing psychotherapy for a variety of mental disorders, a Gaussian graphical model was estimated for the 28 items of the DES. Additionally, the stability of the results was ensured by bootstrap procedures. While both the original EGA and the bootstrap EGA suggested four dimensions, the structural consistency of this solution was low due to an instability of 12 items. After excluding 10 of these unstable items, re-analyses again revealed a four-factor structure, but boot EGA indicated that one factor had unsatisfactory structural consistency due to the multidimensionality of its two items. Upon removing these, our final network consisted of 16 items mapping onto 3 dimensions. Our study, using data from a diagnostically heterogeneous sample, replicates and extends previous findings on the dimensionality of dissociation as captured by the DES. The three dimensions identified correspond to segregated processes, derealization/depersonalization, and absorption. This solution aligns with a bipartite model of dissociation with two broader categories referring to either altered states of consciousness (often named detachment) or to non-integrated mental modules (labeled as compartmentalization).

Space-time cluster analysis and maximum entropy modeling of Peste des petits ruminants (PPR) in Türkiye.

Peste des petits ruminants (PPR) is an economically important highly serious transboundary disease that mainly occurs in small ruminants such as sheep and goats. The aim of this study was to identify the probability of risk and and space-time clusters of Peste des Petits Ruminants (PPR) in Türkiye. The occurrence of PPR in Türkiye from 2017 to 2019 was investigated in this study using spatial analysis based on geographic information system (GIS). Between these dates, it was determined that 337 outbreaks and 18,467 cases. The highest number of outbreaks were detected in the Central Anatolia region. It was determined that PPR is seen more intensely in sheep compared to goats in Türkiye. In this study, 34 environmental variables (19 bioclimatic, 12 precipitation, altitude and small livestock density variables) were used to explore the environmental influences on PPR outbreak by maximum entropy modeling (Maxent). The clusters of PPR in Türkiye were identified using the retrospective space-time scan data that were computed using the space-time permutation model. A PPR prediction model was created using data on PPR outbreaks combination with environmental variables. Nineteen significant (p < 0.001) space-time clusters were determined. It was discovered that the variables altitude, sheep density, precipitation in june, and average temperature in the warmest season made important contributions to the model and the PPR outbreak may be strongly related with these variables. In this study, PPR in Türkiye has been characterized significantly spatio-temporal and enviromental factors. In this context, the disease pattern and obtained these findings will contribute to policymakers in the prevention and control of the disease.

Environmentally stable, adhesive, self-healing, stretchable and transparent gelatin based eutectogels for self-powered humidity sensors.

Intrinsic environmental and stability limitations of hydrogels have inhibited their practical applications as a flexible wearable device due to water evaporation or freezing in complex environments such as low temperatures and arid environments. In this work, a multifunctional gelatin based ionic conductive eutectogel with double network structure is designed via ternary deep eutectic solvent (DES) (acrylic acid (AA), choline chloride (ChCl) and ethylene glycol (EG)). In this system, the introduction of ethylene glycol (EG) can be used to dissolve gelatin. The resulting DESG eutectogel exhibited excellent adhesion, mechanical robustness, anti-freeze, anti-drying, and self-healing. Interestingly, the DESG gels showed high humidity sensitivity in a wide humidity detection range (11 %-83 %), which can be assembled as a self-powdered humidity sensor to monitor human mouth and nose breathing. This work is expected to bring new prospect to construct high performance humidity sensors using gelatin based humidity-responsive materials for a wide range of potential applications in respiratory diagnostics, sleep monitoring, electronic skin and wearable electronics.

A novel AES-DES with improved Cheetah optimisation algorithm for secured medical data transmission in cloud environment.

In recent years, transmitting medical data has been a regular process. Although strong, safe, and dependable encryption techniques are necessary for medical data, cryptography is largely a computational process. The research presents a selective encryption approach for the transfer of sensitive data. This study proposes a novel technique for selecting the optimal keys to offer more security to medical data. Initially, the medical data is encrypted using the hybrid AES-DES technique. To make an efficient encryption method, the most optimal keys are selected utilising an improved Cheetah optimisation algorithm (ICO). Finally, the keys are optimised, and the input medical data is safely kept in the cloud system according to the established model. As a result, the proposed approach utilises the Python tool to evaluate the results. The simulation results show that the proposed method outperforms others in terms of encryption time 96 s, decryption time 92 s, memory usage (16), and latency (0.006).

Epidemiological and pathomorphologic investigation of peste des petits ruminants in Western Algeria: A comprehensive study of clinical and histopathological findings.

Background: This study delves into the epidemiology and pathomorphologic characteristics of peste des petits ruminants (PPR) in western Algeria, a viral disease that constantly threatens small animals in Africa, the Middle East, and Asia. Aim: The purpose of this investigation was to evaluate the epidemiology of PPR in western Algeria and to understand the pathomorphological lesions in naturally infected small ruminants. Methods: An online survey conducted via google forms and shared with veterinarians in the wilaya of Tiaret, provided insights into the prevalence and clinical manifestations of PPR.A comprehensive examination of organs was conducted and representative tissue samples from the lungs, trachea, thymus, spleen, liver, kidney, heart, tongue, stomach, different parts of the small and large intestine, and mesenteric lymph nodes were collected and the specimen was fixed in a 10% neutral buffer formalin solution. Results: Among 2,200 small ruminants managed by expert veterinarians, 192 small ruminants exhibited clinical signs compatible with PPR, and 79 dead animals. Among the 31 sick young small ruminants, eight were confirmed to be infected with the PPR virus. Necropsies of affected animals revealed significant gross lesions in organs such as the lungs, intestines, spleen, and lymph nodes. Histopathological analysis further illuminated the severity of lesions, including interstitial pneumonia, syncytial cell formation, and severe gastroenteritis. Conclusion: The study's comprehensive approach, encompassing epidemiological data, necropsy findings, and histopathological insights, contributes valuable knowledge for understanding and managing PPR outbreaks.The pathological lesions observed in this study exhibited consistency with those previously documented in experimental studies, thereby providing support for the diagnosis based on clinical signs and disease history.

Robust, transparent, self-healable, recyclable all-starch-based gel with thermoelectric capability for wearable sensor.

Conventional all-starch-based (ASB) gels are weak and lack ductility. The preparation of a robust ASB gel with multi-functionalities e.g., self-healing, anti-freezing, conductivity, and so forth, is highly desirable but challenging. Herein, a new kind of ASB gel was prepared by gelatinizing starch in urea and choline chloride solution (UC) with the aid of water. Its tensile strength was up to 1.08 MPa with a tensile strain of 313 %, and this value hardly changed after 10 days ageing. A high healing efficiency of 98 % can be achieved after 1 h of healing at room temperature, and the healed tensile strength reaches up to ca. 1.06 MPa, which is almost the highest value for ASB gel. The resultant ASB gel can surfer from bending and twisting at -80 °C. Moreover, ASB gel also exhibits excellent biocompatibility and biodegradability. In addition, UC endowed the ASB gel with ion conductivity, allowing it to be used as a flexible strain sensor to monitor human movement. The ion-conductive ASB gel also exhibited thermoelectric ability with a Seebeck coefficient of 2.5 mV K-1, which can be further improved to 5 mV K-1 with a maximum output voltage of 252 mV by introducing a gradient of ionic concentration.