Validation and bifactor structure of the French Adult ADHD Symptoms Rating Scale v1.1 (ASRS).

BACKGROUND: Three scoring methods for the widely available Adult ADHD Symptoms Rating Scale v1.1 (ASRS) have been proposed to screen for ADHD, but these three methods have rarely been compared against formal clinical diagnoses. We aimed to validate the French version of the ASRS against a clinical interview using DSM-IV and DSM-5 diagnostic algorithms. METHODS: One hundred five adults from a convenience sample were evaluated with the ASRS and the DIVA 2.0, using both DSM-IV and DSM-5 criteria. We used Confirmatory Factor Analysis to investigate the underlying structure of the ASRS. Sensitivity, specificity, and classification accuracy were compared between the rating algorithms of the ASRS. RESULTS: The full score method had worse predictive performance than the Screener and the 2-stage scoring method. All characteristics of the three scoring methods for the ASRS were worse when applying DSM-5 criteria. The best-fitting structure was a bi-factor model with a general ADHD factor and three specific factors. CONCLUSIONS: ADHD was best conceived as a one-dimensional construct. The 2-stage scoring method superseded the Screener with comparable sensitivity and specificity.

[3D printing in plastic surgery, an accessible tool: Technical note around a case of otopoiesis assisted by 3D model]. / L'impression 3D en chirurgie plastique, un outil accessible : note technique autour d'un cas d'otopoïèse assistée par modèle 3D.

3D printing has been used in the medical field since the beginning of the 21st century. Over the years, it has been democratized and has become an accessible tool at almost no cost, provided that a 3D printer is available. The surgeon can thus easily integrate it into his practice and techniques in the operating room, provided that he learns to use 3D image processing software. In order to illustrate the whole process, from the genesis and processing of the 3D image to its application in the operating room, we describe the case of a patient with a left auricle amputation, whose reconstruction was guided by a 3D model printed from his right ear.

Use of perfusion device for free flap salvage after ischemia in swine.

INTRODUCTION: In free flap reconstruction, improving flap tolerance to warm ischemia (WI) is fundamental. WI is the result of a venous or arterial thrombosis, which can only be addressed through surgical revision. No additional treatments have shown superior efficacy at salvaging free flaps after or during WI. Custom perfusion machines (PM), used to reduce the intensity of lesions of the flap stored in cold ischemia, have not been evaluated for WI flap salvage. This proof-of-concept study assessed whether the Lifeport® perfusion machine could improve the salvage procedure's success rates after one hour of venous WI. METHODS: Five different groups were evaluated with four porcine latissimus dorsi free flaps included in each group. Depending on the group, the flaps were subjected to one hour of WI followed by revascularization, static hypothermic submersion, or dynamic Lifeport® perfusion. Additionally, two flap perfusion liquids were evaluated: KPS-1® and IGL-1®. Biopsies were performed before in vivo warm ischemia of the flap, after in vivo warm ischemia of the flap, and after one and two hours of preservation. Interstitial edema, muscular cell size and muscular diffuse necrosis were quantified by histological assessment. RESULTS: Static submersion did not demonstrate any efficacy for venous flap salvage. Dynamic perfusion on Lifeport® machine showed a significant improvement in tissue parameters. Thrombi and fibrine, present during the WI period, were no longer visible inside vessels and the perfusion machine flow evacuated the inflammatory cells and their substrates from the flap. The flap weights did not increase during perfusion time, confirming the benefits of the Lifeport® perfusion machine. CONCLUSION: Evaluating Lifeport® advantages on human free flap salvage is necessary to confirm the benefits for the tissue and to increase post-operative results after congestive free flap revision surgery.

[Mental health, an ecosystem issue]. / La santé mentale, une question écosystémique.

The question of mental health can be approached using the three-dimensional model. In the light of the biological, environmental and circumstantial ingredients characterizing it, a critical analysis of both diagnosis and treatment can be proposed. The environment, like the individual, is both a factor and a player in psychological suffering. Treating one as well as the other is therefore the challenge of an ecosystemic approach.

[Budget impact of self-testing in the national cervical cancer screening program]. / Impact budgétaire de l'utilisation de l'autotest dans le cadre du programme national de dépistage du cancer du col de l'utérus.

OBJECTIVES: A nationwide screening program for cervical cancer (CC) was organized in 2018 as part of the 2014-2019 French cancer plan, with the objective of reducing CC incidence and mortality in France by reaching an 80 % coverage rate. As an alternative to pap smear, vaginal self-sampling (VSS) aimed at identifying high-risk HPV carriage could help to achieve this goal. The objective of the present study is to compare the respective budgetary impacts of several self-sampling strategies. METHOD: A budget impact model was developed to compare non-use of self-sampling in CC screening to the 5-year costs of 5 VSS strategies viewed from an all-payer perspective. While the first strategy was based on mailing the VSS kit with a reminder to participate in the screening program, the second was based on accompanying the mailed kit with an invitation to participate. The third and fourth strategies were based on providing health professionals with the kit, and thereby offering self-sampling as an alternative to pap smears for women undergoing CC screening and having previously received the kits. Finally, the fifth strategy was based on self-sampling as the one and only CC screening modality. The parameters of the model were based on past screening participation data and experiments in France on organized screening and VSS use. The costs included those of procedures associated with screening and program organization. RESULTS: All in all, the costs associated with cervical cancer screening would represent approximately 1 billion euros over 5 years. All strategies would be associated with participation ranging from 81% to 84%, which would represent an increase of 4.7% to 5.2% of lesions diagnosed by screening and a cost reduction between €30M and €87M over 5 years, with the exception of the strategy based on sending the kit (with the reminder associated or not) to the health professionals offering this option (+€23M and +€6M). CONCLUSIONS: In conclusion, the use of self-sampling as an alternative to pap smears for non-participating women would increase participation, with only a moderate budgetary impact and could, in some cases, even induce savings.

Reproducible method for assessing the effects of blue light using in vitro human skin tissues.

INTRODUCTION: High-intensity visible light (HEV), also referred to as blue light, has a wavelength of 400-500 nm and accounts for approximately one-third of the visible light. Blue light is also emitted from electronic devices and artificial indoor lighting. Studies have shown that exposure of human skin cells to light emitted from electronic devices, even as short as 1 h, can cause an increase in reactive oxygen species (ROS), apoptosis and necrosis. Despite comprising a significant portion of the light spectrum, the effects of HEV light have not been studied as extensively. This is in part due to a lack of suitable in vitro testing methods. This work was conducted in order to develop a reproducible testing method for assessing the effects of blue light on the skin. METHODS: Testing was performed using a full thickness, 3D in vitro skin tissue model. Different exposure protocols were tested to (1) determine the biological effects of blue light on the skin and (2) to identify an appropriate exposure for routine testing of cosmetic materials that may protect the skin from blue light damage. Gene expression and protein biomarkers were measured using qPCR, ELISA and immunohistochemical (IHC) methods. RESULTS: Our work demonstrates that daily exposure to blue light produced dose-and-time-dependent changes in biomarkers associated with skin damage. Exposure to blue light for 6 h for 5 consecutive days (total intensity of 30 J/cm2 ) increased the expression of genes that regulate inflammation and oxidative stress pathways and decreased the expression of genes that maintain skin barrier and tissue integrity. Exposure to blue light significantly increased protein biomarkers associated with ageing, inflammation and tissue damage. IHC staining confirmed changes in collagen, filaggrin and NQO1 protein expression. Treatment with ascorbic acid inhibited the effects of blue light, demonstrating a role in protection from blue light. CONCLUSION: Our results showed that consistent blue light exposure produced skin damage via alterations in biological pathways that are associated with skin ageing. This work provides a new, reproducible in vitro testing method for assessing the effects of blue light on human skin using gene expression, protein ELISA and IHC staining.

INTRODUCTION: La lumière visible à haute énergie (VHE), également appelée lumière bleue, a une longueur d'onde de 400 à 500 nm et représente environ un tiers de la lumière visible. La lumière bleue est également émise par les appareils électroniques et l'éclairage intérieur artificiel. Des études ont montré que l'exposition des cellules cutanées humaines à la lumière émise par les appareils électroniques, même pour une période de seulement 1 h, peut entraîner une augmentation des dérivés réactifs de l'oxygène (DRO), de l'apoptose et de la nécrose. Bien qu'ils représentent une partie importante du spectre lumineux, les effets de la lumière VHE n'ont pas été étudiés aussi largement. Cela est en partie dû à un manque de méthodes de test in vitro appropriées. Ces travaux ont été réalisé afin de développer une méthode de test reproductible pour évaluer les effets de la lumière bleue sur la peau. MÉTHODES: Les tests ont été réalisés à l'aide d'un modèle de tissu cutané 3D in vitro de pleine épaisseur. Différents protocoles d'exposition ont été testés pour (1) déterminer les effets biologiques de la lumière bleue sur la peau et (2) identifier une exposition appropriée pour les tests de routine des produits cosmétiques susceptibles de protéger la peau des dommages causés par la lumière bleue. L'expression génique et les biomarqueurs protéiques ont été mesurés à l'aide des méthodes de PCR quantitative, de dosage par la méthode immuno-enzymatique ELISA et immunohistochimiques (IHC). RÉSULTATS: Nos travaux démontrent que l'exposition quotidienne à la lumière bleue a produit des modifications dépendantes de la dose et du temps dans les biomarqueurs associés aux lésions cutanées. L'exposition à la lumière bleue pendant 6 h au cours de 5 jours consécutifs (intensité totale de 30 J/cm2) a augmenté l'expression des gènes qui régulent l'inflammation et les voies du stress oxydatif, et a diminué l'expression des gènes qui maintiennent la barrière cutanée et l'intégrité tissulaire. L'exposition à la lumière bleue a significativement augmenté les biomarqueurs protéiques associés au vieillissement, à l'inflammation et aux lésions tissulaires. La coloration par IHC a confirmé les modifications de l'expression du collagène, de la filaggrine et de la protéine NQO1. Le traitement par acide ascorbique a inhibé les effets de la lumière bleue, démontrant un rôle dans la protection contre la lumière bleue. CONCLUSION: Nos résultats ont montré qu'une exposition continue à la lumière bleue produisait des lésions cutanées par le biais d'altérations des voies biologiques associées au vieillissement de la peau. Ces travaux fournissent une nouvelle méthode de test in vitro reproductible pour évaluer les effets de la lumière bleue sur la peau humaine à l'aide de l'expression des gènes, du test ELISA de détection de protéines et de la coloration IHC.

Unintended Consequences of "Breast Is Best" Messaging on Mothers: An Autoethnography.

Purpose: To describe the breastfeeding experiences of a dietitian and mother so as to expose dominant discourses reinforcing expert-driven imperatives to breastfeed.Methods: Professional experiences and personal challenges related to breastfeeding promotion are described, analyzed, and interpreted using autoethnography. The social ecological model (SEM) is used as a sensitizing concept to guide the organization, presentation, and analysis of experiences.Results: Data were organized into two discussion themes: breastfeeding promotion practices and "failure" to breastfeed. Dominant discourses reinforcing expert-driven imperatives to breastfeed are revealed, including health as a duty, intensive motherhood, and mother blame. Discourses promoting or reinforcing breastfeeding simultaneously judge and denormalize formula-feeding.Conclusions: Contemporary breastfeeding promotion messages and strategies are quiet coercions used to influence infant-feeding decisions and do not support the principles of evidence-based practice, person-centred care, and informed choice.

DC: 0-5 system in clinical assessment with specialty pediatric populations.

Early childhood mental health (ECMH) programs provide an opportunity to provide specialized mental health services to vulnerable young children and connect them with necessary evidence-based early intervention. However, there is a paucity of descriptive and explorative studies of the clinic protocols in the literature. Even within published work, there is a lack of standardization in clinical models and diagnostic systems limiting comparison and extrapolation. This paper describes how the DC: 0-5 framework guides the development of the model for an ECMH clinic embedded in the context of academic pediatrics. It also highlights the opportunity the DC 0-5 presents for developing the standardized protocols and a mechanism for standardized data collection in clinical settings. The paper demonstrates the utility of using the DC 0-5 in protocol development, assessment and data collection the mental health assessments of 87 children ages 0-6 were reviewed to gather information on history, presenting problems, parent-child relationship, and mental health diagnoses. This paper and associated data underscore the utility and necessity of ECMH clinics while identifying challenges in the field.

Los programas de salud mental en la temprana niñez ofrecen una oportunidad para proveer servicios de salud mental especializados a niños pequeños vulnerables y ponerlos en contacto con la necesaria intervención temprana que se base en la evidencia. Sin embargo, hay escasez de estudios descriptivos y de exploración de los protocolos clínicos en la información impresa. Aun dentro de los trabajos publicados, se da una falta de estandarización en los modelos clínicos y sistemas de diagnóstico, lo cual limita la comparación y la extrapolación. Este ensayo describe cómo el marco de trabajo DC: 0-5 guía el desarrollo del modelo para una clínica de salud mental en la temprana niñez enmarcado dentro del contexto de la pediatría académica. También resalta la oportunidad que DC 0 a 5 presenta para desarrollar los protocolos estandarizados y un mecanismo para la recolección de datos estandarizados en escenarios clínicos. El ensayo demuestra la utilidad de usar el DC 0 a 5 en el desarrollo de protocolos, evaluación y recolección de datos. Se revisaron las evaluaciones de salud mental de 87 niños de edad 0-6 para obtener información acerca del historial, la presentación de problemas, la relación progenitor-niño y la diagnosis de salud mental. Este ensayo y la información asociada subraya la utilidad y necesidad de las clínicas de salud mental en la temprana niñez, al tiempo que identifica los retos en el campo.

Les programmes de santé mentale de la petite enfance offrent une chance d'offrir des services spécialisés de santé mentale à des jeunes enfants vulnérables et de les connecter à une intervention précoce ayant des preuves à l'appui. Cependant, dans les recherches, il existe très peu d'études descriptives et exploratoires des protocoles cliniques. Même au sein du travail qui est publié, nous observons un manque de standardisation dans les modèles cliniques et dans les systèmes diagnostiques, limitant la comparaison et l'extrapolation. Cet article décrit comment la structure DC: 0-5 guide le développement du modèle pour une clinique de santé mentale de la petite enfance ancrée dans le contexte de la pédiatrie académique. L'article met également en lumière l'opportunité que présente la DC 0 à 5 pour le développement de protocoles standardisés et un mécanisme pour une collecte de données standardisée dans des contextes cliniques. Nous démontrons l'utilité de l'utilisation de la DC 0 à 5 dans le développement du protocole, l'évaluation et la collecte de données. Les évaluations de santé mentale de 87 enfants âgés de 0-6 ont été passées en revue afin de récolter des données sur l'histoire, ce qui présente des problèmes, la relation parent-enfant, et les diagnostics de santé mentale. Cet article et les données qui y sont liées soulignent l'utilité et la nécessité des cliniques de santé mentale de la petite enfance tout en identifiant les défis qui se présentent dans ce domaine.

Synthesis and Biological Evaluation of Flavonoid-Cinnamic Acid Amide Hybrids with Distinct Activity against Neurodegeneration in Vitro and in Vivo.

Flavonoids are polyphenolic natural products and have shown significant potential as disease-modifying agents against neurodegenerative disorders like Alzheimer's disease (AD), with activities even in vivo. Hybridization of the natural products taxifolin and silibinin with cinnamic acid led to an overadditive effect of these compounds in several phenotypic screening assays related to neurodegeneration and AD. Therefore, we have exchanged the flavonoid part of the hybrids with different flavonoids, which show higher efficacy than taxifolin or silibinin, to improve the activity of the respective hybrids. Chemical connection between the flavonoid and cinnamic acid was realized by an amide instead of a labile ester bond to improve stability towards hydrolysis. To investigate the influence of a double bond at the C-ring of the flavonoid, the dehydro analogues of the respective hybrids were also synthesized. All compounds obtained show neuroprotection against oxytosis, ferroptosis and ATP-depletion, respectively, in the murine hippocampal cell line HT22. Interestingly, the taxifolin and the quercetin derivatives are the most active compounds, whereby the quercetin derivate shows even more pronounced activity than the taxifolin one in all assays applied. As aimed for, no hydrolysis product was found in cellular uptake experiments after 4 h whereas different metabolites were detected. Furthermore, the quercetin-cinnamic acid amide showed pronounced activity in an in vivo AD mouse model at a remarkably low dose of 0.3 mg/kg.

Zebrafish optineurin: genomic organization and transcription regulation.

Optineurin (OPTN) is involved in a variety of mechanisms, such as autophagy, vesicle trafficking, and nuclear factor kappa-B (NF-κB) signaling. Mutations in the OPTN gene have been associated with different pathologies, including glaucoma, amyotrophic lateral sclerosis, and Paget's disease of bone. Since the relationship between fish and mammalian OPTN is not well understood, the objective of the present work was to characterize the zebrafish optn gene and protein structure and to investigate its transcriptional regulation. Through a comparative in silico analysis, we observed that zebrafish optn presents genomic features similar to those of its human counterpart, including its neighboring genes and structure. A comparison of OPTN protein from different species revealed a high degree of conservation in its functional domains and three-dimensional structure. Furthermore, our in vitro transient-reporter analysis identified a functional promoter in the upstream region of the zebrafish optn gene, along with a region important for its transcription regulation. Site-directed mutagenesis revealed that the NF-κB motif is responsible for the activation of this region. In conclusion, with this study, we characterize zebrafish optn and our results indicate that zebrafish can be considered as an alternative model to study OPTN's biological role in bone-related diseases.

Generation of prolactin-inducible protein (Pip) knockout mice by CRISPR/Cas9-mediated gene engineering.

Prolactin-inducible protein (PIP) is a multifunctional glycoprotein that is highly expressed and found in the secretions of apocrine glands such as salivary, lacrimal, and sweat glands including the mammary glands. PIP has been implicated in various diseases, including breast cancer, gross cystic disease of the breast, keratoconus of the eye, and the autoimmune Sjögren's syndrome. Here we have generated a Pip knockout (KO) mouse using the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/CRSPR-associated (Cas)9 system. The Cas9 protein and two single guide RNAs targeting specific regions for both exons 1 and 2 of the Pip gene were microinjected into mouse embryos. The deletions and insertions promoted by CRISPR/Cas9 system on the Pip gene successfully disrupted Pip protein coding, as confirmed by PCR genotyping, sequencing, and ultimately Western blot analysis. This mouse model was generated in the inbred C57Bl/6J mouse, which exhibits lower genetic variation. This novel CRISPR Pip KO mouse model will not only be useful for future studies to interrogate the multifunctional role of PIP in physiological processes but will facilitate a broader understanding of the function of PIP in vivo while providing unprecedented insight into its role in a spectrum of diseases attributed to the deregulation of the PIP gene.

Maternal caregiving representations of the infant in the first year of life: Associations with prenatal and concurrent reflective functioning.

Few studies have examined whether maternal caregiving representations are associated with maternal reflective functioning (MRF), especially when MRF is evaluated longitudinally beginning in pregnancy. This study addresses this gap by evaluating whether prenatal and postnatal MRF are associated with mothers' caregiving representations assessed at 7 months postpartum, and by exploring theoretically unexpected MRF scores in each of the representational categories. Forty-seven mothers were recruited during their last trimester of pregnancy from an obstetrics clinic at a university hospital located in a large mid-western city in the United States. During pregnancy, mothers completed the Pregnancy Interview, and at 7 months postpartum they completed the Parent Development Interview (PDI) and the Working Model of the Child Interview. Results indicate that higher prenatal and postnatal MRF increased the odds of being classified as balanced versus disengaged. At 7 months, MRF also increased the odds of being balanced vs. distorted. Ten mothers who were classified as balanced or distorted had unexpected prenatal MRF scores, and six mothers had unexpected MRF scores when representations were assessed concurrently. Mothers classified as balanced with low MRF scores tended to have a low level of education, whereas mothers classified as distorted with high MRF scores had responses that were hostile, helpless, and role-reversed.

Pocos estudios han examinado el hecho de si las representaciones maternas acerca del cuidado están asociadas con el funcionamiento reflexivo materno (MRF), especialmente cuando MRF se evalúa longitudinalmente comenzando en el embarazo. Este estudio aborda este vacío por medio de evaluar si el MRF prenatal y postnatal está asociado con las representaciones que las madres tienen de prestar el cuidado evaluadas a los 7 meses después del parto, y por medio de explorar teoréticamente los puntajes no esperados de MRF en cada categoría representativa. Se reclutaron cuarenta y siete madres durante su último trimestre de embarazo del hospital de una universidad localizado en una ciudad del medio oeste de los Estados Unidos. Durante el embarazo, las madres completaron la Entrevista de Embarazo y a los 7 meses después del parto ellas completaron la Entrevista del Desarrollo del Progenitor y el Modelo de Trabajo de la Entrevista del Niño. Los resultados indican que el más alto MRF prenatal y postnatal también aumentó las posibilidades de ser clasificada como equilibrada vs. indiferente. A los 7 meses, el MRF también aumentó las posibilidades de ser equilibrada vs. distorsionada. Diez madres a quienes se les clasificó como equilibradas o distorsionadas tuvieron puntajes de MRF prenatales no esperados, y seis madres tuvieron no esperados puntajes de MRF cuando las representaciones fueron evaluadas al mismo tiempo. Las madres a quienes se les clasificó como equilibradas con bajos puntajes de MRF tendían a tener un nivel bajo de educación, mientras que las madres a quienes se les clasificó como distorsionadas con puntajes altos de MRF tuvieron respuestas que eran hostiles, indefensas y de inversión de papeles.

Peu d'études ont examiné si les représentations du soin maternel sont liées au fonctionnement réflectif maternel (abrégé ici selon l'anglais maternal reflective functioning, soit MRF), surtout lorsque le MRF est évalué de manière longitudinale à commencer par la grossesse. Cette étude porte sur cet écart en évaluant si le MRF prénatal et postnatal est lié aux représentations du soin des mères évalué à 7 mois postpartum, et en explorant des scores MRF théoriquement inattendus dans chacune des catégories représentationnelles. Quarante-sept mères ont été recrutées durant leur dernier trimestre de grossesse dans un CHU situé dans une grande ville du centre des Etats-Unis. Durant la grossesse les mères ont passé l'Entretien de Grossesse et à 7 mois postpartum elles ont passé l'Entretien du Développement du Parent et le Modèle de Travail de l'Entretien de l'Enfant. Les résultats indiquent qu'un MRF prénatal et postnatal élevé augmentait les chances d'être classé comme équilibrée par rapport à désengagée. A 7 mois, le MRF augmentait aussi les chances d'être équilibrée par rapport à faussée. Dix mères qui ont été classées comme étant équilibrées ou faussées avaient des scores de MRF prénatal inattendus et six mères avaient des scores de MRF inattendu quand les représentations étaient évaluées en même temps. Les mères classées comme équilibrées avec des scores de MRF bas tendaient à avoir un niveau d'éducation plus bas, alors que les mères classées comme faussées avec des scores de MRF élevés ont fait preuve de réactions qui étaient hostiles, désemparées et de rôle inversé.

[Is personality assessment with the French Big Five Inventory (BFI-Fr) invariant according to gender and activity of the respondents?] / La mesure de la personnalité à l'aide du Big Five Inventory français (BFI-Fr) est-elle invariante selon le genre et l'activité des répondants ?

OBJECTIVES: The BFI-Fr is an effective tool to assess the five dimensions of the five-factor model of personality. The psychometric qualities are excellent in several validation studies. However, because the inconsistency of certain items may be due to a lack of invariance between groups, we examined this invariance according to the gender and activity of the respondents. METHODS: The sample consists of 1904 participants (1232 women and 672 men; 1159 students and 745 professionals). Recruitment was done by "snowball" from different studies conducted over four years. Respondents completed the BFI-Fr. The 45 items were corrected for the acquiescence bias. The Item Response Theory methodology was used to test the invariance using the differential item functioning (DIF) test. The T scores were subject to ANCOVA and correlations to compare the differences between subgroups. RESULTS: Whatever the subsample, we found the same five-factor structure (similarities were especially high for C). The cumulative explained variances are comparable for all groups. The functioning of eight items varied between men and women; and six between activity groups, however, all but one DIF values were low. No item in domain A varied in its measure. ANCOVA results showed that women have higher A and N scores than men and that professionals have higher C and lower N scores than students. There is no interaction effect between gender and activity. When we removed the non-invariant items, the effect of gender became significant in favor of women on dimension C even if the difference remained minimal. The difference by activity on N became non-significant. There was a very strong link between activity and age and between gender and activity: in the sample, women were more often students and vice versa. CONCLUSIONS: Overall and once again, the structure and internal consistency of the Big Five as measured by the BFI-Fr was replicated in new samples. There was a differential functioning of 12 items out of 45 (about a quarter). These differences were small since only one was of moderate magnitude. The deletion of these items did not strongly change the mean comparisons between groups. Therefore, our results do not call into question the usefulness of the BFI-Fr but invite to control the extent of this differential functioning. In all cases (with or without the non-invariant items) the analyses showed significant gender differences for A and N, differences which are typically found in many studies. Students and professionals differ in their levels of C and E. Certain inconsistencies are probably due to the translation from American to French, since the BFI-Fr is based on the lexical approach (in this context, item content was somewhat dependent of languages peculiarities). Thus, the BFI-Fr allows a robust evaluation of the five dimensions but requires a prior control of the invariance of item functioning in order to ensure that the intergroup differences in E-A-C-N-O mean scores do not reflect a psychometric artifact but genuine personality differences.

Topical finasteride dose evaluation for treatment of androgenetic alopecia using computer simulations.

OBJECTIVE: Our objective was to evaluate the absorption of finasteride administered by oral and topical routes for treatment of androgenetic alopecia, by means of computer simulations using the GastroPlus ® software. MATERIAL AND METHODS: In vivo plasma concentration profile of oral administration of finasteride 1 mg tablets from the literature was used in the software to build a compartmental pharmacokinetic model that was extrapolated to simulate topical administration of finasteride 0.25% solution in the scalp. Results were compared to literature and other drug concentrations (0.1% and 1%) were also predicted. RESULTS: Compared to literature data, predictive plasma curve from oral administration of finasteride 1 mg showed good correlation, R2=0.992, and Cmax=4.6769 ng/mL. Simulations of topical administration in the scalp for finasteride 0.25% solution showed good correlation, R2=0.908, and Cmax=0.04325 ng/mL when compared to literature data. Topical administration was also simulated at concentrations 0.1% and 1%, both with low plasma concentrations. CONCLUSION: The results obtained in this study suggest that topical finasteride is a potential treatment for androgenetic alopecia in the concentrations analyzed using computer simulations in GastroPlus ®.

[Medico-economic evaluation of the impact of measures to adapt to the switch to surgery robot-assisted in urology]. / Évaluation médico-economique de l'impact de mesures d'adaptation au virage de la chirurgie robot-assistée en urologie.

INTRODUCTION: The development of robot-assisted urological surgery is held back by the lack of robust medico-economic analyses and their heterogeneity. We conducted a medico-economic study to evaluate the implementation of measures to optimize the transition to robotic surgery. METHOD: We carried out a single-center, controlled study from the point of view of the public healthcare establishment for 4 years. Economic data collection was based on a micro-costing method and revenues from stay-related groups. Clinical data corresponded to mean lengths of stay, operating duration, complications and stays in intensive care. The measures to optimize the transition to robotic, implemented mid-study period, enabled before/after comparison. RESULTS: Altogether, 668 patients undergoing robotic surgery were included. Robotic activity increased significantly from periods 1 to 2 to 256% (P=<0.001) as did the overall proportion of robotic by 45% to 85% (P=<0.001). The mean lengths of stay fell significantly, 6.8 d vs. 5.1 d (P<0.001). Costs and revenues increased significantly, resulting in a persistent deficit for the activity €226K vs. €382K (P=<0.001). With increased volume of activity, the deficit per operation and the cost per minute of robotic operating room fell significantly, €3,284 vs. €1,474/procedure (P=<0.001) and €27 vs €24/min (P=<0.029), tending towards a break-even point (=zero deficit) at 430 operations per year. CONCLUSIONS: Robotic-assisted surgery can be significantly optimized by implementing measures for the robotic turn to reach a break-even point at 430 operations per year. A better multidisciplinary case mix could lower the break-even volume of activity in short term. LEVEL OF EVIDENCE: 3.

[Acceptance, mourning of delusions and recovery]. / Acceptation, deuil des idées délirantes et rétablissement.

Recovering from a mental disorder is a process by which the affected person will develop a new life project, based on the optimal use of personal and environmental resources. This involves adapting and managing certain symptoms better, in order to be able to rebuild oneself psychologically. This may be the case for delusions, which need to be distanced and accepted in order to develop this new life stage in. In this perspective, the notions of mourning for the self and mourning for delusional beliefs seem to be necessary steps in the reconstruction of a self that is favourable to recovery.

[The nurse at the heart of the assistance system for outpatients in the post-cancer period]. / L'infirmière au cœur du dispositif d'assistance des malades ambulatoires dans l'après-cancer.

An innovative approach to post-treatment follow-up of lymphoma, Ambulatory Cancer Assistance (ACA) is a model of care shared between a general practitioner, a hematologist and a nurse coordinator. The role of the nurse coordinator is preponderant in this type of follow-up, which appears to be more effective in detecting medical, psychological and social events than standard follow-up. The AMA-AC helps patients return to their pre-cancer life.

[French validation of a scale evaluating Internet Gaming Disorder: the Internet Gaming Disorder-20]. / Validation française d'une échelle de mesure de l'utilisation problématique des jeux vidéo en ligne : l'Internet Gaming Disorder-20.

BACKGROUND: The study aims to validate an online video game problematic use (Internet Gaming Disorder or IGD) scale in French language: the IGD-20. IGD-20 has been elaborated considering the discussion about the etiology of the IGD, which was included in the section III of the DSM-5. The IGD-20 is composed of 20 items split in six components based on the six components model of addiction from Griffiths. METHODS: A total of 166 online video game players were recruited on specialized forums, playing 21.9 hours per week. The French version of the IGD-20 was validated through a confirmatory factor analysis via structural equation modeling (SEM). RESULT: The French version of the IGD-20 showed a good validity and a six-factor structure (salience, mood modification, tolerance, withdrawal symptoms, conflict and relapse) (RMSEA = 0.063 [0.049; 0,077], CFI = 0.912, TLI = 0.909). CONCLUSION: The validation of a French scale such as the IGD-20 shows some interest for the French-speaking population, including therapists who could use this scale to investigate the IGD-20 more precisely and for people with IGD-20 who could benefit from a more refined support.

INTRODUCTION: L'objectif de cette étude est de valider en langue française une échelle de mesure de l'usage problématique des jeux vidéo en ligne (Internet Gaming Disorder ou IGD): l'Internet Gaming Disorder-20. L'échelle IGD-20 s'inscrit dans le débat sur les déterminants et les facteurs de maintien de l'IGD, trouble introduit dans la section III du DSM-5 et récemment référencé à la classification statistique internationale des maladies et des problèmes connexes sous l'intitulé de « trouble du jeu vidéo ¼. L'échelle se compose de 20 items séparés en six composantes reposant sur le modèle de l'addiction de Griffiths. MÉTHODE: L'étude a porté sur 166 joueurs de jeux vidéo francophones, recrutés sur des forums spécialisés, jouant en moyenne 21,9 heures par semaine. La version française de l'IGD-20 a été soumise à une analyse factorielle confirmatoire par le biais d'une modélisation en équations structurelles (SEM) afin de retrouver les six facteurs de l'échelle originale (saillance, modification de l'humeur, tolérance, manque, conflits et rechute). RÉSULTAT:S: L'analyse factorielle confirmatoire par modélisation en équations structurelles montre un ajustement satisfaisant du modèle (RMSEA = 0,063 [0,049; 0,077], CFI = 0,912, TLI = 0,909). DISCUSSION: Une validation en langue française d'un outil tel que l'IGD-20 a un intérêt pour les populations francophones, notamment pour les thérapeutes qui pourront investiguer de façon plus précise le trouble et pour les personnes atteintes qui bénéficieront d'un accompagnement affiné.

Recombinant R2-pyocin cream is effective in treating Pseudomonas aeruginosa-infected wounds.

Pseudomonas aeruginosa, a gram-negative opportunistic pathogen, is one of the major species isolated from infected chronic wounds. The multidrug resistance exhibited by P. aeruginosa and its ability to form biofilms that are difficult to eradicate, along with the rising cost of producing new antibiotics, has necessitated the search for alternatives to standard antibiotics. Pyocins are antimicrobial compounds produced by P. aeruginosa that protect themselves from their competitors. We synthesized and purified recombinant P. aeruginosa R2 pyocin and used it in an aqueous solution (rR2P) or formulated in polyethylene glycol (rR2PC) to treat P. aeruginosa-infected wounds. Clinical strains of P. aeruginosa were found to be sensitive (completely), partially sensitive, or resistant to rR2P. In the in vitro biofilm model, rR2P inhibited biofilm development by rR2P-sensitive isolates, while rR2PC eliminated partial biofilms formed by these strains in an in vitro wound biofilm model. In the murine model of excision wounds, and at 24 h post-infection, rR2PC application significantly reduced the bioburden of the clinical isolate BPI86. Application of rR2PC containing two glycoside hydrolase antibiofilm agents eliminated BPI86 from infected wounds. These results suggest that the topical application of rR2PC is an effective therapy for treating wounds infected with R2P-senstive P. aeruginosa strains.

[Interest of a geostatistical approach to analyze the geographical disparities in human papillomavirus vaccine coverage in France]. / Intérêt d'une approche géostatistique pour analyser les disparités géographiques de la couverture vaccinale contre les papillomavirus humains en France.

BACKGROUND: The use of geostatistical methods remains rare in health studies. In order to assess the usefulness of the geostatistical approach in epidemiology, we chose to apply these methods to the vaccination coverage rate (VCR) against human papillomavirus (HPV) in France. Indeed, HPV vaccine coverage remains low in France and geographical disparities are sizable. The objective of this study was to identify the socioecological factors that may explain these geographical variations. METHODS: Sociological, economic and behavioral data for 2016 have been gathered (demographics and public health database, web and social networks) and were correlated with the HPV VCR vaccine coverage over the French territory. Homogeneous geographical areas defined by strong correlations for groups of variables were selected. In each homogeneous area, principal component analysis was performed and a geostatistical approach provided an estimate predicting vaccine coverage at a given scale. RESULTS: HPV VCR spatial variations in France cannot be fully explained by a single model. In urban areas, a low rate of HPV VCR is preferentially associated with unfavorable socioeconomic factors (poverty, unemployment, immigration). In rural areas, HPV VCR is preferentially associated with sociocultural factors (socio-professional categories, education level, interest in alternative medicines the anti-vaccine movement). Two secondary geographical areas were defined: the Île-de-France region and 12 departments in northeastern France. In the Île-de-France region, the association with the economic factors one again appears as in urban areas in general. The northeasteran departments represent a particular case insofar as HPV VCR is relatively high, notwithstanding economic poverty indicators. CONCLUSION: Geostatistical modeling successfully identifies new potential explanations for HPV VCR geographical disparities in France. These results could help to adapt or develop future vaccination programs in specific areas by taking into account the sociological, economic and behavioral characteristics of their populations.