Non-pharmacological treatment of Attention Deficit Disorder with or without Hyperactivity (ADHD). Overview and report of the first international symposium on the non-pharmacological management of ADHD.

Attention Deficit Disorder with or without Hyperactivity (ADHD is a neurodevelopmental disorder which affects the day-to-day functioning of children and adults with this condition. Pharmacological treatment can reduce the symptoms associated with ADHD, but it has some limitations. The objective of this symposium is to determine the effects of non-pharmacological approaches on ADHD symptoms. Results indicate that the following intervention are promising approaches: cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), yoga, cognitive and metacognitive intervention, neurofeedback and parental training programs. Current research advocates multimodal approaches in conjunction with school or work accommodations integrating innovative technologies.

Oral health, a public health issue in 2023: Reflections and actions of the ASPBD / La santé orale, un enjeu de santé publique en 2023 ­ Réflexions et actions de l'ASPBD

The first Dental Public Health Day, in 2001, was not only the starting point for the creation of the Association des Acteurs de la Santé Publique Bucco-Dentaire (ASPBD), but also for the recognition of this specialty in France, even though it had already been recognized by the American Dental Association as early as 1950. Every year, the ASPBD organizes a national oral health day. The ASPBD brings together the vast majority of French odontologists and academic researchers in the field, as well as other French-speaking academics. Throughout the year, we work to bring together the dental and non-dental worlds, mainly the institutional and non-profit sectors with users, freelancers, and employees, the World Health Organization, and the French Public Health Society. This is in keeping with the partnership approach taken by the association for the past twenty-two years. Our aim is to bring together all the actors concerned to work toward integrating oral health into all health policies and health promotion and prevention schemes. We believe it is vital to provide oral health training for medical and paramedical staff, as well as for those working in education and outreach. Likewise, we are working to ensure that prevention is organized on a territorial level, involving local people as closely as possible and focusing on their needs. This is why we are actively involved in the fight against social and territorial inequalities in health, oral health being a strong indicator of these inequalities.

La première Journée de santé publique dentaire, en 2001, a été non seulement le point de départ de la création de l'association des Acteurs de la santé publique bucco-dentaire (ASPBD), mais aussi celui de l'identification en France de cette spécialité, alors qu'elle était déjà reconnue comme telle par l'Association dentaire américaine dès 1950. L'ASPBD organise, depuis annuellement une journée nationale de santé publique bucco-dentaire. L'ASPBD rassemble la grande majorité des odontologistes, enseignants-chercheurs hospitalo-universitaires français, mais aussi les autres hospitalo-universitaires francophones. Nous œuvrons tout au long de l'année à faire travailler ensemble le dentaire et le non-dentaire, principalement le monde institutionnel et associatif avec les usagers, les libéraux et les salariés, l'Organisation mondiale de la santé et la Société française de santé publique. À l'image du binôme qui préside chacune de nos journées depuis vingt-deux ans. Notre association a pour vocation de rassembler tous les acteurs concernés pour œuvrer à l'intégration de la santé orale dans toutes les politiques de santé et dispositifs de promotion de la santé et de prévention. Nous pensons qu'il est indispensable de former à la santé orale tant les personnels médicaux et paramédicaux que ceux de l'éducation et de l'animation. De même, nous agissons pour que la prévention s'organise à l'échelon territorial, au plus près des populations en fonction de leurs besoins. C'est le sens de notre participation active à la lutte contre les inégalités sociales et territoriales de santé, la santé orale étant un marqueur fort d'inégalités sociales de santé.

Determinants of the evolutions of behaviours, school adjustment and quality of life in autistic children in an adapted school setting: an exploratory study with the International Classification of Functioning, disability and health (ICF).

BACKGROUND: Previous studies about Quality of Life (QoL) in autistic children (ASD) have put forward the negative impact of factors such as Autism Spectrum Disorder (ASD) severity, psychiatric comorbidities and adaptive behaviour impairment. However, little is known about the relation of these factors to school adjustment, measured with the International Classification of Functions disability and health (ICF) framework (World Health Organization, 2001), and QoL evolutions. Thus, this study aimed at investigating the determinants of behaviours, school adjustment and QoL changes in 32 children in an ASD inclusion program over one academic year. METHODS: Using Bayesian methods, we studied the impact of ASD severity, psychiatric comorbidities, adaptive behaviour level and a diagnosis of Pathological Demand Avoidance (PDA) on evolutions of behaviour, school adjustment (measured with the ICF) and QoL. RESULTS: As predicted, adequate adaptive behaviour levels were associated with better progress of behaviours and school adjustment whereas psychiatric comorbidities were related to worse outcome of school adjustment. Contrary to our hypotheses, severe ASD was associated to better evolution of adjustment at school. PDA was not discriminant. We did not find any association between the studied factors and the evolution of QoL over the academic year. CONCLUSION: Our results show that the assessment of adaptive behaviour levels, psychiatric comorbidities and ASD severity level may be useful predictors to discriminate of school adjustment evolution (assessed by teachers within the ICF model) over a one-year period in autistic children. The assessment of this time course of school adjustment was sensitive to change and adapted to differentiate evolutions in an inclusive education framework. The investigation of quality of school life of autistic children as well as its determinants may therefore be relevant to improving academic adaptation. However, further research in larger groups, over longer periods and in different personalized school settings for autistic children is needed.

[City-hospital link, strengthening the safety of technical oncological care at home]. / Lien ville-hôpital, renforcer la sécurisation des soins techniques oncologiques à domicile.

The return back home of certain patients treated for cancer in the palliative phase requires efficient coordination of caregivers in order to guarantee the well-being of patients and the quality and safety of the care provided. Two hospital coordination nurses have developed a quality approach that aims to reinforce the security of technical care at home in a perfect coordination of all the city-hospital contributors.

[Competency-based pedagogical approach: illustration applied to the care relationship]. / Approche pédagogique par compétences : illustration appliquée à la relation de soins.

The reform of health studies and the inclusion in the Bachelor-Master-Doctorate curriculum implies a new way of teaching, with an inverted pedagogical relationship between student and teacher. The competency-based approach contributes to the development of the student's professional and interpersonal skills, in the same way as the support provided by the nurse in the care relationship, particularly in therapeutic education, in order to promote patient autonomy.

An acute presentation of pediatric mesenteric lymphangioma: a case report and literature overview.

INTRODUCTION: Lymphangioma accounts for 5% of benign pediatric tumors and less than 1% is located in the abdomen. While mesenteric lymphatic malformation or mesenteric lymphangioma (ML), mostly appears asymptomatic in adults, an acute clinical presentation is seen more often in children. Symptoms can mimic obstruction or peritonitis and diagnosis can therefore be challenging. Imaging studies are performed to exclude other causes of obstruction or peritonitis. Diagnosis of ML is always made by histology. Surgery is the treatment of choice and recurrence after complete resection is rare. CASE REPORT: We describe an acute abdomen in a four-year-old boy caused by a mesenteric lymphatic malformation. Imaging studies at the emergency department were inconclusive and final diagnosis was made by histological examination. Surgical intervention with resection of an ischemic ileal segment was necessary. Complete resection of the ML was not possible without compromising the functional digestive outcome due to diffusely spread lesions in the mesentery of the small bowel. Follow-up with ultrasound was performed. CONCLUSION: Mesenteric lymphangioma can cause an acute abdomen in children. Complete resection is recommended but might not be feasible without compromising the functional digestive outcome. Alternative treatments should be studied further to treat diffuse and complicated ML.

"Survival classes for a neurotypical world": What French autistic adults want and need after receiving an autism diagnosis.

LAY ABSTRACT: Adults receiving an autism diagnosis might not react the same depending on their countries or cultures. We also know that autistic people are rarely asked what they think would be best for them following this diagnosis. In this study, we asked 12 French autistic adults about their experiences of receiving an autism diagnosis as well as what they thought might be useful afterwards. Overall, we found that some experiences were similar to experiences related by English or American participants, but some were specific to the French culture, suggesting that such research should expand into new territories and cultures, especially non-European ones. Our participants also had quite a few ideas as to what would be useful for people in the same situation. Some of the suggestions can be put into action by peers and professionals alike, while others are wishes relating to how our participants would like society to behave toward them and people like them, for example. This article allows for a better comprehension of how cultural differences can impact the experience of receiving an autism diagnosis as an adult and provides some insight into what these adults want and desire following such a diagnosis.

Sodium hypochlorite accident diagnosis and management: Analysis from the literature and the French pharmacovigilance database.

PURPOSE: Sodium hypochlorite (NaOCl) is considered as the reference irrigation solution in endodontics. However, NaOCl-related accidents may occur, and non-dentist health professionals might under-recognize this rare adverse effect although it is potentially severe, with possible medical and aesthetic sequelae. We performed a literature review to provide to non-dentist healthcare professionals a large picture of symptoms, management and potential consequences of NaOCl accidents. METHODS: We queried PubMed and the French Pharmacovigilance database and retrieved 76 cases for analysis (70 from 57 published articles, and six from the database). RESULTS: The analysis showed that patients were mostly women (79%), aged around of 42 years, undergoing upper jawbone (74%) endodontic procedure. NaOCl concentration ranged from 1% to 10%, with 0.5 to 30 mL injected. Most cases (86%) corresponded to an accidental extrusion beyond the root apex to the periapical tissues, followed by tissular injection by error (8%) and extrusion into the maxillary sinus (3%). Local symptoms always occurred within 24 h, mostly pain (99%), edema (89%) and/or ecchymosis (61%). Complications were mainly neurological (29%), necrotic (22%) and cutaneous (9%). Most of patients (76%) fully recovered after medical management but 18 (24%) required surgical management. CONCLUSION: Any healthcare professional should be aware of the classical symptomatic triad of NaOCl accident with sudden pain, haemorrhage/ecchymosis and swelling, to start or recommend adequate management. Patients should be reassured, but a close follow-up is necessary to avoid delayed complication.

Glossary of healthcare pathways: a methodological approach involving a transdisciplinary team in public health.

Introduction: The healthcare pathway is at the heart of public health organization concerns, but communication between the various players can be an obstacle. This work, produced by a French transdisciplinary team, offers a methodological approach based on formalized consensus to elaborate a glossary of healthcare pathways. A two-steps procedure was elaborated, including a double rounded Delphi method to formalize expert consensus, and two groups of experts: a workgroup and a review group. Methods: The workgroup provided a list of words or expressions that, in their opinion, described, evaluated or compared the healthcare pathways for patients, caregivers or regulators. The review group checked this list and added or deleted words or expressions. Then, definitions were added by the workgroup based into account three dimensions: official, academic and from the field. The review group validated the definitions and provided complementary proposals if needed. Results: After pooling the list of words proposed by each of the six members of the working group, 417 words/expressions were ranked. After the two rounds of evaluation, 294 words/expressions were rated "appropriate" and were analyzed by the review group. This group, after two rounds of evaluation, agreed on 263 words/expressions that were transmitted to the working group who defined them. These definitions were rated by the review group. The first round of evaluation established 195 definitions as being appropriated whereas 68 definitions were amended by the review group. Conclusion: This glossary supports transdisciplinary communication, reduces the extent of variations in practice and optimizes decision-making. International debate on all aspects might be strengthened by an improved understanding of the concept of health pathway.

French Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q).

PURPOSE: Autistic camouflaging is a collection of strategies used to hide autistic characteristics. It can have serious consequences on autistic people's mental health and needs to be addressed and measured in clinical practice. The purpose of this study is to evaluate the psychometric properties of the French adaptation of the Camouflaging Autistic Traits Questionnaire. METHODS: 1227 participants (744 autistic, 483 non-autistic) answered the French version of the CAT-Q in an online survey or on paper. Confirmatory factor analysis, measurement invariance testing, internal consistency analysis (McDonald's ω), and convergent validity with the DASS-21 depression subscale were conducted. Test-rest reliability was assessed on a sample of 22 autistic volunteers using intraclass correlation coefficient. RESULTS: A good fit was found for the original three-factor structure as well as a good internal consistency, excellent test-retest reliability and highly significant convergent validity. Measurement invariance testing indicates however that the meaning behind items is different for autistic vs. non-autistic people. CONCLUSION: The French version of the CAT-Q can be used in clinical settings to assess camouflaging behaviors and intent to camouflage. Further research is needed to clarify the camouflage construct and whether reported measurement noninvariance are due to cultural differences or a true difference in what camouflaging might mean for non-autistic people.

Efficacy of Sonic-Powered and Manual Toothbrushes on Plaque-Induced Gingivitis in Pregnant Women: A Randomized Controlled Trial.

Hormonal changes and physiological alterations in pregnancy increase the susceptibility of the woman to oral diseases such as plaque-induced gingivitis. In individual oral prophylaxis, effective tooth brushing can reduce gingival inflammation. Therefore, it is necessary to update the scientific evidence to identify which type of toothbrush, manual or sonic-powered, is most effective in reducing the incidence of gingivitis in pregnant women. The aim of this clinical trial is to compare the biofilm control effectiveness of two manual and two sonic toothbrushes in pregnant women. This study is designed as a four-arm, parallel, randomized controlled trial with an allocation ratio of 1:1:1:1. The pregnant woman will be included at 15-18 weeks of amenorrhea and followed for 3 months. The primary outcome will be the change in the incidence of gingival bleeding from a baseline and various follow-up periods of the study. Secondary outcomes measures will be to compare clinical effects of the toothbrushes tested on (i) gingival inflammation, (ii) dental plaque, (iii) gingival attachment and (iv) periodontal pocket; and to assess toothbrush acceptability. Thus, identifying the best device for effective tooth brushing in pregnancy could be helpful in reducing and improving the incidence of gingival inflammation.

Diagnostic performance of two teledentistry tools in elderly care facilities: the ONE-1 protocol for a pilot prospective diagnostic study.

INTRODUCTION: Elderly people living in care facilities suffer from difficulties in accessing preventive and curative dental care. This leads to poor oral health, which is an increased risk of systemic diseases, in a fragile and dependent population. All this contributes to a progressive loss of autonomy and a decreased quality of life. The use of information and communication technologies through oral telemedicine could help to overcome these barriers. We described the protocol for evaluating the diagnostic performance of two intraoral cameras against a gold standard clinical examination. METHODS AND ANALYSIS: We conduct a pilot multicentric and prospective diagnostic study (a minimal-risk, minimal-burden interventional research called ONE-1 (for Oral graNd Est step 1)) on two intraoral diagnostic tools (Soprocare camera and consumer camera) compared with a reference intraoral examination. Patients in four elderly care facilities will be included, with randomisation of participant selection and randomisation of the order of the three intraoral examinations performed by a dental surgeon. We will evaluate the diagnostic performance of each device with the asynchronous analysis of videos by two independent dental surgeons against the clinical gold standard examination performed by a single, third dental examiner. The primary outcome is the presence of at least one tooth decay in the dentition of each study participant. Second, we will evaluate the presence of other dental or oral diseases, and the time required to perform each examination. Finally, we will evaluate the organisation of patient follow-up. ETHICS AND DISSEMINATION: The protocol has been approved by the French ethics committee (Protection to Persons Committee, Nord-Ouest IV on 9 June 2021 and on 28 November 2022). Results will be disseminated through conferences' presentations and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT05089214.

High-grade HER2-positive mucoepidermoid carcinoma of the breast: a case report and review of the literature.

BACKGROUND: Mucoepidermoid carcinoma of the breast is a rare special type of salivary gland-like tumor of the breast, usually displaying triple-negative phenotype. To date, only 64 cases have been reported in the English literature. Herein, we report the first case of mucoepidermoid carcinoma of the breast with human epidermal growth factor receptor 2 gene amplification. CASE PRESENTATION: A 58-year-old Caucasian woman treated with breast-conserving surgery, radiotherapy, and chemotherapy for an invasive breast carcinoma of no special type, relapsed 20 years later in the ipsilateral left breast. Histological examination of the core needle biopsy of the relapse deferred to the surgical specimen for the definitive diagnosis, because of the broad differential diagnosis. On the resected specimen we observed the presence of a poorly differentiated carcinoma with mucoepidermoid carcinoma of the breast typical features consisting of epidermoid, intermediate and mucinous cells lacking true keratinization, in keeping with the latest World Health Organization diagnostic criteria. The mucoepidermoid carcinoma of the breast was weakly estrogen receptor and androgen receptor positive and progesterone receptor negative, but exceptionally showed human epidermal growth factor receptor 2 gene amplification. Mastermind-like transcriptional coactivator 2 gene translocations were not detected by fluorescent in situ hybridization. The patient received adjuvant chemotherapy with anti-human epidermal growth factor receptor 2 therapy but no endocrine therapy. After 61 months of follow-up, no signs of local or distant recurrence were observed. CONCLUSIONS: Mucoepidermoid carcinoma of the breast is a very rare entity. Despite being most frequently triple negative, the standard evaluation of receptor status is mandatory, as well as strict application of World Health Organization diagnostic criteria for correct patient management.

Supporting health education policies: translation, cross-cultural adaptation and validation of a health literacy instrument, in French.

Background: Oral health is a fundamental human right and is inseparable and indivisible from overall health and well-being. Oral Health Literacy (OHL) has been proved to be fundamental to promoting oral health and reducing oral health inequalities. To our knowledge, no OHL instrument to evaluate OHL level is currently validated in French language despite the fact it is the fifth most widely spoken languages on the planet. The Oral health literacy Instrument (OHLI) appears to be the most interesting OHL instrument to adapt into French because it is already available in English, Spanish, Russian, Malaysian, and it contains both reading comprehension and numeracy sections. Its psychometric properties have been rated as adequate. Objective: The aim of this study was to translate and adapt cross-culturally the OHLI into French, to evaluate its psychometric properties and to compare its results to oral health knowledge. Method: This study followed and applied well-established processes of translation, cross-cultural adaptation and validation, based on the recommendations of the World Health Organization guidelines and on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) study design checklist for patient-reported outcomes. Two psychometric assessments were planned, the comparison of OHLI-F scores according to education level and frequency of dental visits, and the test-retest reliability of the OHLI-F. Results: A total of 284 participants answered the OHLI-F. The OHLI-F scores were significantly different between participants with different levels of education and frequency of dental visits (p < 0.001). Participants with an education level lower than the baccalaureate, and those who never visit the dentist or only in case of pain, had significantly lower OHLI-F scores. Internal consistency was excellent (Cronbach's alpha = 0.881-0.914). Test-retest reliability was very high (intraclass correlation = 0.985 to 0.996). Conclusion: The OHLI-F has demonstrated adequate psychometric properties and can therefore be used to measure oral health literacy in French-speaking populations.

Metabolomic differentiation of maca (Lepidium meyenii) accessions cultivated under different conditions using NMR and chemometric analysis.

To gain insights on the effects of color type, cultivation history, and growing site on the composition alterations of maca (Lepidium meyenii Walpers) hypocotyls, NMR profiling combined with chemometric analysis was applied to investigate the metabolite variability in different maca accessions. Maca hypocotyls with different colors (yellow, pink, violet, and lead-colored) cultivated at different geographic sites and different areas were examined for differences in metabolite expression. Differentiations of the maca accessions grown under the different cultivation conditions were determined by principle component analyses (PCAs) which were performed on the datasets derived from their ¹H NMR spectra. A total of 16 metabolites were identified by NMR analysis, and the changes in metabolite levels in relation to the color types and growing conditions of maca hypocotyls were evaluated using univariate statistical analysis. In addition, the changes of the correlation pattern among the metabolites identified in the maca accessions planted at the two different sites were examined. The results from both multivariate and univariate analysis indicated that the planting site was the major determining factor with regards to metabolite variations in maca hypocotyls, while the color of maca accession seems to be of minor importance in this respect.

"Without Them, I Would Never Have Been Able to Carry on" Levers for the Sustained Employment of Patients with Chronic Inflammatory Arthritis: A French Qualitative Study.

BACKGROUND: Chronic inflammatory arthritis (IA) is known to be involved in declining work outcomes and increased risk of experiencing unemployment. The aim of this study is to qualitatively identify the levers for the employment of patients with IA and AI-like conditions. METHODS: To accomplish this task, a multi-centered, exploratory qualitative design involving one-on-one semi-directed interviews and a focus group was performed among 18 IA French patients to deepen our understanding of what enables patients to maintain employment despite the limiting, chronic, and expanding nature of their symptoms. RESULTS: Analysis revealed five clusters of levers for the employment of chronic IA patients: The first cluster of levers was based on a set of verbatim records mentioning an overall improvement in the management of the disease. The second cluster of levers was based on a set of verbatim records mentioning the perceived added value of one's occupation at a personal, familial, or societal scale. The third cluster of levers was based on a set of verbatim records mentioning the perceived interpersonal supportiveness of the professional sphere. The fourth cluster of levers was based on a set of verbatim records mentioning the micro-, meso-, and macro-characteristics of the working environment. The fifth cluster of levers was based on a set of verbatim records mentioning intrapersonal attributes. CONCLUSIONS: This study deepens and updates the current knowledge on what empowers patients dealing with chronic AI. These results provide valuable insights for stakeholders involved in designing or deploying employment initiatives for patients with AI.

Recurrent oral granuloma gravidarum during two pregnancies of a patient with orthodontic treatment: A case report.

The aim of this article was to present the medical management and follow-up of a recurrent oral granuloma gravidarum (OGG). OGG is a common benign tumour that can occur during pregnancy in response to poor oral hygiene and hormonal factors. Its identification and management by primary health care professionals is necessary, including an orientation to a dentist, if needed. Indeed, this lesion may induce troubles such as gingival bleeding, oral hygiene difficulties, and sometimes pain or eating difficulties, but also presents a high risk of relapse. An early twenties woman consulted several times during two pregnancies for an OGG presented in the same proximal maxillary gingival area. The patient reported dental hygiene difficulties because of orthodontic treatment and developed this recurrent tumour four times in two years, despite surgical excisions. Oral hygiene, and information continuously provided by healthcare professionals are required to prevent gingival inflammation and recurrence of OGG. This tumour usually regresses spontaneously post-partum, except in the presence of aggravating factors such as orthodontics treatment and mouth breathing. Surgery of OGG is required when it interferes with normal oral functions.

Oral Hygiene Practices and Knowledge among Adolescents Aged between 15 and 17 Years Old during Fixed Orthodontic Treatment: Multicentre Study Conducted in France.

The aims of this study were to assess oral health knowledge, attitudes, and practices among orthodontic patients between the ages of 15 and 17 years old compared to adolescents without orthodontic treatment. This cross-sectional study included 392 adolescents drawn from various French teaching hospitals. A closed-ended questionnaire was used to collect data. Adolescents undergoing orthodontic treatment had a higher knowledge of oral health than adolescents without orthodontic treatment. The majority of adolescents for both groups (69%) claimed to brush their teeth twice a day. Regarding complimentary dental material, 81.9% of adolescents without orthodontic treatment never used an interdental brush and 78.8% never used dental floss. For those undergoing orthodontic treatment, 48.5% never used an interdental brush. Only 4% of adolescents without and 3% of adolescents with orthodontic treatment never consumed fizzy drinks, 4.9% and 3% never consumed sweets, and 4% and 8.4% never ate fast-food. Adolescents without treatment consumed more sodas (p = 0.048) and more fast food (p = 0.029). Adolescents had insufficient knowledge of oral health. Health education programmes should be implemented to improve adolescents' knowledge and individual oral prophylaxis with interdental brushes.

Selinexor, Bortezomib and Dexamethasone: An Effective Salvage Regimen for Heavily Pretreated Myeloma Patients.

Purpose: Multiple myeloma (MM) patients with triple- and penta-refractory disease have a poor survival and limited treatment options. Selinexor, in combination with bortezomib and dexamethasone, demonstrated clinical activity in the STOMP study as well as in the BOSTON study in previously treated patients with disease refractory to a proteasome inhibitor (PI). Patients and Methods: Here, we report a real-world case series of 7 heavily pretreated MM patients who had been extensively pretreated with bortezomib and had disease refractory to PIs, including carfilzomib; who were administered a starting dose of 100 mg of selinexor, 20-40 mg dexamethasone and 1.3 mg/m2 of bortezomib, each once weekly. The majority of these patients (6 patients, 86.0%) had penta-refractory disease, with 5 patients (71.4%) having disease refractory to bortezomib and carfilzomib, and all 7 patients having pomalidomide refractory disease. The median number of prior lines of therapy was 8 (range 4-12). Results: The seven patients in this case series received selinexor for a median of 5 cycles (range 1-10). Four patients (57.1%) had a dose reduction of selinexor. Five patients (71.4%) had a response, of which 2 (29.0%) had a very good partial response (VGPR) and 3 (43.0%) had a partial response (PR). One patient (14.3%) had stable disease (SD) and 1 (14.3%) had progressive disease (PD). There were no new safety signals. Conclusion: The selinexor, bortezomib, and dexamethasone triplet combination demonstrates activity in PI-resistant MM and patients with heavily pretreated MM with refractory disease and after multiple lines of therapy.

Oral-Hygiene-Related Mobile Apps in the French App Stores: Assessment of Functionality and Quality.

Mobile health apps can contribute to increased quality of individual oral hygiene behaviors. This study provides an overview and an evaluation of quality of oral-hygiene-related mobile apps currently available in Google Play Store and the French Apple App. A shortlist of nine apps was assessed by 10 oral health professionals using the Mobile App Rating Scale. Intraclass correlation was used to evaluate interrater agreement. Best quality scores were obtained by Oral-B (3.4 ± 0.97), Colgate Connect (3.20 ± 0.63), and Preventeeth (3.10 ± 1.1) and worst ones by Mimizaur se brosse les dents (1.80 ± 0.79) and Kolibree (2.30 ± 0.82). The subjective quality scores ranged from 2.62 ± 0.61 (Oral-B) to 1.5 ± 0.61 (MSD). Specificity of the content ranged from 3.46 ± 0.84 (Preventeeth) to 1.78 ± 0.47 (Mimizaur se brosse les dents). Thus, even if oral health professionals positively evaluated the quality of oral-hygiene-related mobile apps, they are less assertive concerning their impact on the user's knowledge, attitudes, and intentions to change, as well as the likelihood of actual change in the oral hygiene behavior. Further investigations are needed to assess whether information from these apps is consistent with oral hygiene recommendations and to determine the long-term impacts of these apps.