Insights of undergraduate health sciences students about a French interprofessional training initiative.

BACKGROUND: Incorporating interprofessional collaboration within healthcare is critical to delivery of patient-centered care. Interprofessional Education (IPE) programs are key to promoting such collaboration. The 'Public Health Service' (PHS) in France is a mandatory IPE initiative that embodies this collaborative spirit, bringing together students from varied health undergraduate training programs-nursing, physiotherapy, pharmacy, midwifery, and medicine- in a common training program focused on primary prevention. The aim of the study was to assess the experience and attitudes of students in the five health training programs regarding the interest of IPEs in the PHS. METHODS: A cross-sectional survey was administered to 823 students from the 2022-2023 cohort at a French university. The questionnaire was designed with 12 Likert-scale questions specifically created to evaluate the students' experiences, knowledge, and attitudes focused on IPE during the practical seminars, school interventions, and the overall PHS. Additionally, an open-ended question was utilized to gather qualitative data. Statistical analyses assessed satisfaction levels across undergraduate training programs, while thematic analysis was applied to the qualitative responses. RESULTS: Within the surveyed cohort, 344 students responded to the survey. The findings showed that students were satisfied with the interprofessional collaboration, both in practical teaching sessions (75% satisfaction) and in primary prevention projects conducted in schools (70% satisfaction), despite their having faced challenges with coordination. Pharmacy students, in particular, highlighted the need for adjustments in program scheduling. The qualitative feedback underscored the positive value of IPE, notwithstanding the organizational difficulties stemming from different academic timetables. CONCLUSION: The student feedback indicated a high level of satisfaction with the interprofessional work carried out in both the practical teaching and the primary prevention projects. To further enhance the educational impact and address the scheduling complexities, it is recommended that program refinements be made based on student feedback and pedagogical best practices.

Sensor Failure Detection in Ambient Assisted Living Using Association Rule Mining.

Ambient Assisted Living (AAL) is becoming crucial to help governments face the consequences of the emerging ageing population. It aims to motivate independent living of older adults at their place of residence by monitoring their activities in an unobtrusive way. However, challenges are still faced to develop a practical AAL system. One of those challenges is detecting failures in non-intrusive sensors in the presence of the non-deterministic human behaviour. This paper proposes sensor failure detection and isolation system in the AAL environments equipped with event-driven, ambient binary sensors. Association Rule mining is used to extract fault-free correlations between sensors during the nominal behaviour of the resident. Pruning is then applied to obtain a non-redundant set of rules that captures the strongest correlations between sensors. The pruned rules are then monitored in real-time to update the health status of each sensor according to the satisfaction and/or unsatisfaction of rules. A sensor is flagged as faulty when its health status falls below a certain threshold. The results show that detection and isolation of sensors using the proposed method could be achieved using unlabelled datasets and without prior knowledge of the sensors' topology.

A Systematic Survey on Sensor Failure Detection and Fault-Tolerance in Ambient Assisted Living.

Ambient Assisted Living (AAL) systems aim to enable the elderly people to stay active and live independently into older age by monitoring their behaviour, provide the needed assistance and detect early signs of health status deterioration. Non-intrusive sensors are preferred by the elderly to be used for the monitoring purposes. However, false positive or negative triggers of those sensors could lead to a misleading interpretation of the status of the elderlies. This paper presents a systematic literature review of the sensor failure detection and fault tolerance in AAL equipped with non-intrusive, event-driven, binary sensors. The existing works are discussed, and the limitations and research gaps are highlighted.

Rubella virus-associated uveitis: The essentiality of aqueous humor virological analysis.

AIMS / BACKGROUND: Rubella virus-associated uveitis (RVAU) classically presents with the clinical features of Fuchs uveitis syndrome (FUS). We report a series RVAU, and discuss the relevance of available diagnostic strategies, and how vaccination could potentially prevent disease. METHODS: We retrospectively included patients with RV-positive aqueous humor (AH) with RT-PCR and/or intraocular RV-IgG production, between January 2014 and December 2019. RV-IgG titers from AH and serum were compared with other virus-specific IgG titers (VZV and/or CMV and/or HSV-1), to determine the derived Goldmann-Witmer coefficient (GWC'). Clinical findings at presentation and during follow-up are reported, as well as the anti-RV vaccination status. RESULTS: All 13 included patients demonstrated intraocular synthesis of RV-IgG (median GWC': 9.5; 3.2-100). RV-RNA was detected in one patient while PCR results were negative for other HSV1, VZV and CMV. The mean delay in diagnosis was 13 ± 12.6 years, with an initial presentation of FUS in only 3 patients (23%). Only four patients had been vaccinated, but all after the recommended age. CONCLUSION: As RVAU is a pleiomorphic entity, virological analysis (RV RT-PCR and GWC') of aqueous humor is essential to improve the diagnosis and management of this entity. Improper vaccination against RV appears to be implicated in RVAU.

Clinical Characteristics and Multimodal Imaging Findings of Central Serous Chorioretinopathy in Women versus Men.

(1) The aim of this study was to compare the clinical characteristics and multimodal imaging findings of central serous chorioretinopathy (CSCR) between women and men. (2) Women and men with CSCR were compared in terms of their age and risk factors, the clinical form of their disease, multimodal imaging findings and the presence of macular neovascularization (MNV) on optical coherence tomography (OCT)-angiography. (3) Results: The data of 75 women and 75 men were compared. The women were significantly older than the men (52.2 years versus 45.7 years; p < 0.001). Corticosteroid intake was more frequent in the women (56% versus 40%; p = 0.05). The women had a single foveal subretinal detachment more often than the men (73.3% versus 46.9%; p < 0.001) and they often had fewer gravitational tracks (16.3% versus 29.6%; p = 0.03). On mid-phase indocyanine green angiography, hyperfluorescent plaques were detected less often in the women than in the men (48% versus 72.2%, p = 0.001). MNV was detected on OCT-angiography in 35.9% of the women and in 13.3% of the men (p = 0.004). (4) In the women, CSCR occurs at an older age, is more often unifocal foveolar, and is associated with a higher rate of MNV. The reasons for these gender-related differences remain to be determined.

Mid-Phase Hyperfluorescent Plaques Seen on Indocyanine Green Angiography in Patients with Central Serous Chorioretinopathy.

(1) Indocyanine green angiography (ICG-A) shows the presence of mid-phase hyperfluorescent area in central serous chorioretinopathy (CSCR). However, their exact meaning remains uncertain. (2) The clinical and multimodal imaging findings of 100 patients (133 eyes) with CSCR, including the enhanced-depth-imaging OCT (EDI-OCT), blue-light fundus autofluorescence (BAF), fluorescein and indocyanine green angiography (FA and ICG-A) findings were reviewed. Mid-phase hyperfluorescent plaques (MPHP) were defined as fairly well circumscribed hyperfluorescent regions during the midphase of the ICG-A. The association between MPHP and other clinical/imaging parameters was assessed using a multiple logistic regression analysis. (3) MPHP were detected in 59.4% of eyes with CSCR. The chronic form of the disease, the presence of irregular pigment epithelium detachments (PED) and the retinal pigment epithelium (RPE) changes seen on FA were associated with the presence of MPHP in the multivariate analysis (p = 0.015; p = 0.018 and p = 0.002; respectively). OCT showed RPE bulges or PED in 98.7% of areas with MPHP and BAF showed changes in 57.3% of areas with MPHP. (4) MPHP were associated with a chronic form of CSCR and colocated with PED or RPE bulges. MPHP should be recognized as a sign of early RPE dysfunction before it is detected with BAF.

Glenoidplasty With Posterior Labral Reattachment for Posterosuperior Glenoid Impingement.

BACKGROUND: Posterosuperior glenoid impingement (PSGI), also known as shoulder internal impingement, is a cause of shoulder pain in athletes involved in overhead-throwing sports. PSGI is a condition mostly treated by rehabilitation. Surgery is indicated after unsatisfactory nonoperative management. However, with most of the surgical techniques proposed, the shoulder remains persistently painful during sport activity. HYPOTHESIS: We aimed to evaluate the efficiency of adding posterior labral reattachment to glenoidplasty as a surgical treatment for PSGI. Our hypothesis was that posterior labral reattachment would have a positive effect on shoulder pain. To our knowledge, this combined procedure has not been previously described. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We retrospectively reviewed 11 male patients with PSGI treated with glenoidplasty and posterior labral reattachment at a single institution during a 7-year period and with a minimum 30-month follow-up after surgery. Most patients were recreational athletes, with 5 of them practicing at the national level and 1 being a professional athlete. Patients completed an online questionnaire consisting of the Simple Shoulder Test (SST), the Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire, and a specific PSGI survey. Pre- and postoperative shoulder pain were analyzed using the paired t test, with significance set at P < .05. RESULTS: All 11 patients investigated sought surgery because of persistent shoulder pain while practicing their sport. The patients underwent glenoidplasty and posterior labral fixation, and data for 9 patients were available for analysis (mean age, 29 years; range, 24-42 years). At a minimum 30-month follow-up, most patients (77.8%) showed decreased pain, and 8 patients were able to return to their previous sports activities, with 7 returning at the same or higher level. There was 1 patient who had to change sports because of a lack of force, while a second patient temporarily changed sport and then returned to his sport but at an inferior level. Pre- and postoperative pain differed significantly (P < .05). Surgery did not impair daily life in all patients. CONCLUSION: Glenoidplasty associated with posterior labral reattachment significantly diminished shoulder pain in athletes involved in throwing sports. Most patients were able to return to their previous sport at the same or higher level. Posterior labral fixation may improve the benefit of glenoidplasty by decreasing pain.

Influence of graft thickness and regularity on vision recovery after endothelial keratoplasty.

AIM: To assess the influence of graft thickness and regularity on visual recovery and postoperative wavefront aberrations after endothelial keratoplasty (EK). METHODS: 150 EKs performed in eyes with corneal endothelial disorders and no other ocular comorbidities, preoperative and postoperative assessment with spectral domain optical coherence tomography and postoperative assessment with whole eye wavefront aberrometry were retrospectively analysed. Eyes were classified into five groups: Descemet Membrane Endothelial Keratoplasty (DMEK), nanothin Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) (15-49 µm), ultrathin DSAEK (50-99 µm), thin DSAEK (100-149 µm) and conventional DSAEK (150-250 µm). RESULTS: The preoperative diagnosis was Fuchs dystrophy in 139 eyes (92.7%). The graft thickness measured after graft deswelling was in average 74 µm with a mean coefficient of variation of 17%. The average follow-up time was 32 months. The mean spectacle-corrected logarithm of minimum angle of resolution visual acuity improved from 0.76 (20/116) before surgery to 0.14 (20/27) at last follow-up visit. No significant differences in final visual acuity were found between the five groups. The time to reach 20/40 vision was significantly shorter in the DMEK and nanothin DSAEK groups compared with the remaining three DSAEK groups. No significant differences in postoperative aberrometry measurements were found between the five groups. Shorter time to reach 20/40 visual acuity was associated with better preoperative visual acuity and thinner graft. Higher final vision improvement was associated with poorer preoperative visual acuity. Higher postoperative high-order aberrations were associated with poorer preoperative visual acuity. CONCLUSION: The main advantage of DMEK and nanothin DSAEK over thicker DSAEKs was the rapidity of visual recovery. Final quality of vision was not influenced by graft thickness and regularity.