[What's new in dermatological research?] / Quoi de neuf en recherche dermatologique ?

This manuscript provides a selection of dermatological research manuscripts published from September 2016 to August 2017. It is not an exhaustive review but rather a selection of manuscripts susceptible to modify the dermatological practice or affording new pathophysiologic mechanisms and new therapeutic approaches. The following areas of interest are concerned: recognition of dermatological images by artificial intelligence, new concepts in atopic dermatitis, wound repair and hair growth cycle. New data concerning melanomagenesis, epidermolysis bullosa simplex and drug eruption are also highlighted.

Occupational Performance Coaching for Children With Neurodisability: A Randomized Controlled Trial Protocol.

Background. Occupational Performance Coaching (OPC) is a goal-oriented approach in which client agency takes precedence in goal selection, analysis, choice of action, and evaluation of success. The intended outcomes of OPC are improved occupational performance and participation in clients' life situations. Randomized clinical trials are needed to determine the effectiveness of OPC. Purpose. This study protocol outlines a randomized controlled trial (RCT) of OPC compared to usual care with caregivers of children with neurodisability in improving child, caregiver, and family occupational performance. Method. A single-blind, 2-arm parallel-group, cluster RCT of OPC compared to usual care is planned. Therapists delivering the intervention (N = 14) are randomized to "OPC training" or "usual care" groups. The primary outcome is occupational performance improvement in caregiver (N = 84) identified goals. Implications. Findings will provide translational evidence of the effectiveness of OPC and clarify intervention processes. Areas of future OPC research and development will be indicated.

Research Knowledge Translation in Sensory Integration-Based Therapy: Exploring Subjectivity of Clinical Expertise.

Background. Clinical expertise is the mechanism through which practitioners implement other components of evidence-based practice (EBP). Within occupational therapy practice, intervention approaches that are both closely and loosely aligned with Ayres' Theory of Sensory Integration are widespread, offering a unique opportunity to investigate the subjective nature of clinical expertise in EBP. Purpose. This qualitative study explored motivations to offer sensory integration-based interventions, and factors informing occupational therapists' clinical decision making in relation to an arguably contentious evidence base. Method. Six post-graduate sensory integration trained UK occupational therapists participated in individual semi-structured interviews. Interviews were transcribed, member-checked and analyzed using thematic coding analysis. Findings. Despite sound understanding of theory and continuous efforts to develop clinical knowledge, non-traditional hierarchies of evidence notably inform clinical decisions. The clinical expertise required for integration of patient preferences, clinical state and circumstances, and research evidence is informed by pragmatic responses to facilitators and barriers across contexts, combined with unique profession-specific identity factors. Implications. While empirical healthcare research is ideally undertaken under controlled conditions, realities of clinical practice are rarely so clear cut. Study findings highlight important subjective factors that are central to real-world research knowledge translation and further understanding of the clinical expertise component of EBP.

[Disruptors of thyroid hormones: Which consequences for human health and environment?] / Les perturbateurs des hormones thyroïdiennes : comment estimer leurs impacts sur la santé humaine et l'environnement ?

Endocrine disruptors (EDs) of chemical origin are the subject of numerous studies, some of which have led to measures aimed at limiting their use and their impact on the environment and human health. Dozens of hormones have been described and are common to all vertebrates (some chemically related messengers have also been identified in invertebrates), with variable roles that are not always known. The effects of endocrine disruptors therefore potentially concern all animal species via all endocrine axes. These effects are added to the other parameters of the exposome, leading to strong, multiple and complex adaptive pressures. The effects of EDs on reproductive and thyroid pathways have been among the most extensively studied over the last 30 years, in a large number of species. The study of the effects of EDs on thyroid pathways and brain development goes hand in hand with increasing knowledge of 1) the different roles of thyroid hormones at cellular or tissue level (particularly developing brain tissue) in many species, 2) other hormonal pathways and 3) epigenetic interactions. If we want to understand how EDs affect living organisms, we need to integrate results from complementary scientific fields within an integrated, multi-model approach (the so-called translational approach). In the present review article, we aim at reporting recent discoveries and discuss prospects for action in the fields of medicine and research. We also want to highlight the need for an integrated, multi-disciplinary approach to studying impacts and taking appropriate action.

Title: Les perturbateurs des hormones thyroïdiennes : comment estimer leurs impacts sur la santé humaine et l'environnement ? Abstract: Les perturbateurs endocriniens (PE) d'origine chimique font l'objet de nombreuses études, certaines ayant permis des mesures visant à limiter leur utilisation et leurs impacts sur l'environnement et la santé humaine. Des dizaines d'hormones ont été décrites et sont communes à l'ensemble des vertébrés (certains messagers chimiquement proches ont été également répertoriés chez les invertébrés) avec des rôles variables et pas toujours connus. Les effets des PE concernent donc potentiellement toutes les espèces animales via tous les axes endocriniens ; ils s'ajoutent aux autres paramètres de l'exposome qui induisent une pression d'adaptation forte, multiple, et difficile à appréhender. Les effets des PE sur les voies de la reproduction et les voies thyroïdiennes sont parmi les plus étudiés depuis ces trente dernières années et ce, sur un grand nombre d'espèces. L'étude des effets des PE sur les voies thyroïdiennes ainsi que sur le développement cérébral va de pair avec l'augmentation des connaissances sur 1) les différents rôles des hormones thyroïdiennes au niveau cellulaire ou tissulaire (notamment le tissu cérébral en développement) chez de nombreuses espèces, 2) les autres voies hormonales et 3) les interactions épigénétiques. De façon générale, si l'on veut appréhender comment agissent les PE sur les organismes vivants, il est nécessaire d'analyser dans une approche intégrée et multi-modèles (approche dite translationnelle) les résultats issus de domaines scientifiques complémentaires. Dans cette brève revue, nous dressons un état des lieux de découvertes récentes et discutons les perspectives d'action dans les champs de la médecine et de la recherche. Nous mettons en avant la nécessité d'une approche intégrée et multidisciplinaire pour étudier les impacts des PE et prendre des mesures appropriées.

[Clinical research in radiation oncology: how to move from the laboratory to the patient?] / Recherche clinique en oncologie radiothérapie : comment passer du laboratoire au patient ?

Translational research in radiation oncology is undergoing intense development. An increasingly rapid transfer is taking place from the laboratory to the patients, both in the selection of patients who can benefit from radiotherapy and in the development of innovative irradiation strategies or the development of combinations with drugs. Accelerating the passage of discoveries from the laboratory to the clinic represents the ideal of any translational research program but requires taking into account the multiple obstacles that can slow this progress. The ambition of the RadioTransNet network, a project to structure preclinical research in radiation oncology in France, is precisely to promote scientific and clinical interactions at the interface of radiotherapy and radiobiology, in its preclinical positioning, in order to identify priorities for strategic research dedicated to innovation in radiotherapy. The multidisciplinary radiotherapy teams with experts in biology, medicine, medical physics, mathematics and engineering sciences are able to meet these new challenges which will allow these advances to be made available to patients as quickly as possible.

[Goals, motivations, and difficulties of young oncology residents]. / Objectifs, motivations et difficultés des internes en phase socle en oncologie.

INTRODUCTION: The Association for education and research of interns in oncology (AERIO) conducted a national survey of the 2020-year oncology residents promotion in the "phase socle". The objective was to collect and analyze their motivations, as well as the objectives and limitations in the life and career of the residents during this first year of residency. METHODS: A questionnaire included 45 closed questions divided into 6 sections describing: the demographic characteristics of the population, the commitment of the students' and their clinical and academic expectations in the, their training, their life and career objectives, and their commitment in associative life. RESULTS: Seventy-eight of 119 residents participated (66%), of which 68 (87.2%) completed the questionnaire entirely. The population was predominantly women (60%) with a median age of 24 years. The choice between medical or radiation oncology was mostly undefined (87%) and 15% of the residents considered to change their medical specialty. The average hospital work time reported was predominantly between 45 and 65hours per week (83%). Sixty-nine percent were primarily interested in clinical research. One out of two residents (52%) did not have access to their half-day of training per week. DISCUSSION: This national survey made possible to analyze the perception of oncology young residents, as well as their career aspirations and their relationship to research.

[A GERCOR-AERIO national survey of oncology residents in France: Current setting and expectations regarding post-internship and research]. / État des lieux et attentes des internes d'oncologie français concernant le post-internat et la recherche : une enquête nationale GERCOR-AERIO.

INTRODUCTION: The demographics of oncology residents has changed since 2010 with the increase in the size of promotions. The evolution of the residents' aspirations towards research and their future exercise in parallel with these demographic changes has not been assessed. METHODS: A questionnaire was developed by a working group from GERCOR (cooperative group in oncology), involving clinicians, researchers, GERCOR members, and residents. It consisted of 62 questions divided into 7 sections: demographics, medical thesis, post-residency, mobility, publication activity, basic research, and clinical/translational research. The national survey was published online by the Association d'enseignement et de recherche des internes en oncologie (AERIO). RESULTS: In total, 143 residents participated, of which 116 (81.1%) completed the questionnaire entirely. The population was representative of the current demographics, with a majority of women (65.0%), a median age of 28 years, and 39.7% of residents from Paris region. The unsupervised analysis revealed four profiles of residents, including one group strongly committed to research (16.8%), one group with moderate involvement (41.3%) and one group that did not seem interested in research (14.7%). Uncertainty about future position and lack of time and interaction with researchers appeared to be the main barriers to involvement of residents in research. DISCUSSION: This national survey provided useful information about the residents' perspective to academic research. It may serve as a basis for proposing measures adapted to their expectations.