Digital Representation of Patients as Medical Digital Twins: Data-Centric Viewpoint.

Precision medicine involves a paradigm shift toward personalized data-driven clinical decisions. The concept of a medical "digital twin" has recently become popular to designate digital representations of patients as a support for a wide range of data science applications. However, the concept is ambiguous when it comes to practical implementations.

Intersectoral professionals' understanding of the prevention of sexual violence against children, their role and that of the GP: A study using semi-structured interviews: Prevention of sexual violence against children.

Background: In 2020, the WHO reported a European prevalence of 9.6 % of sexual abuse among children, and called on every country to improve prevention of such violence.

Objective: To explore the understanding of an intersectional sample of professionals of their role and that of the general practitioner (GP) in the primary and secondary prevention of sexual violence against children (SVAC).

Double-Barreled Vascularized Fibula Free Flap in Pediatric Tibial Bone Defect Reconstruction: A 20-Year Monocentric Experience.

Introduction: Reconstructing large bone defects for lower limb salvage in the pediatric population remains challenging due to complex oncological or septic issues, limited surgical options, and lengthy procedures prone to complications. The vascularized double-barreled fibula free flap is pivotal for reconstructing large bones. In this article, we report our experience with this technique in the surgical management of pediatric tibial bone defects.

Epidemiology and Management of Actinic Keratosis in France: A General Population Survey (REAKT).

The objective of this retrospective observational study was to estimate the prevalence of actinic keratosis (AK) in individuals aged ≥ 40 years in France, to describe the characteristics of affected patients, and to describe treatments. A representative panel of 20,000 households with ≥ 1 member aged ≥ 40 years were invited to participate. Participants who reported AK lesions diagnosed by a physician were eligible.

Risk score stratification of cutaneous melanoma patients based on whole slide images analysis by deep learning.

Background: There is a need to improve risk stratification of primary cutaneous melanomas to better guide adjuvant therapy. Taking into account that haematoxylin and eosin (HE)-stained tumour tissue contains a huge amount of clinically unexploited morphological informations, we developed a weakly-supervised deep-learning approach, SmartProg-MEL, to predict survival outcomes in stages I to III melanoma patients from HE-stained whole slide image (WSI).

Methods: We designed a deep neural network that extracts morphological features from WSI to predict 5-y overall survival (OS), and assign a survival risk score to each patient.

Development and Evaluation of a New Gastroenteritis Clinical Severity Score for Children Aged Under 5.

Aim: To develop and internally validate a new severity score to more accurately assess the clinical severity forms of acute gastroenteritis (AGE) in children from birth to age 5 years.

Methods: We included children consulting for AGE in the emergency department of the University Hospital of Nantes (March 2017-June 2019). We developed and evaluated a new predictive score (GASTROVIM score) using the classification and regression trees.

Blood immunophenotyping of multiple sclerosis patients at diagnosis identifies a classical monocyte subset associated to disease evolution.

Introduction: Myeloid cells trafficking from the periphery to the central nervous system are key players in multiple sclerosis (MS) through antigen presentation, cytokine secretion and repair processes.

Methods: Combination of mass cytometry on blood cells from 60 MS patients at diagnosis and 29 healthy controls, along with single cell RNA sequencing on paired blood and cerebrospinal fluid (CSF) samples from 5 MS patients were used for myeloid cells detailing.

Results: Myeloid compartment study demonstrated an enrichment of a peculiar classical monocyte population in 22% of MS patients at the time of diagnosis.

Safety and effectiveness in an uncontrolled setting of glucagon-like-peptide-1 receptor agonists in patients with familial partial lipodystrophy: Real-life experience from a national reference network.

Aim: To describe the effects of Glucagon-like peptide-1 receptor agonists (GLP-1RA) in patients with familial partial lipodystrophy (FPLD) assessed in a real-life setting in a national reference network.

Patients And Methods: We retrospectively collected clinical and metabolic parameters in patients with FPLD in the French lipodystrophy reference network, who initiated GLP-1RA. Data were recorded before, at one-year (12 ± 6 months) and at the latest follow-up on GLP-1RA therapy (≥18 months).

GUT, VAGINAL AND URINARY MICROBIOTA AS POTENTIAL BIOMARKERS OF SENSITIZATION IN WOMEN WITH CHRONIC PELVIC PAIN.

Background: A subgroup of patients with chronic pelvic pain (CPP) exhibit organ sensitization, whose origin and mechanism remains largely unknown. Changes in microbiota composition in pelvic organs have been found to be associated with various pelvic pathological conditions. Therefore, a comprehensive analysis of the gut and genito-urinary microbiota composition and interactions in women with CPP may be key to understanding their involvement in the sensitization processes.

Influence of Anticoagulants on Platelet Counts: A Study and Recommendations From the French Speaking Cellular Hematology Group (GFHC).

Introduction: For complete blood count, ethylenediaminetetraacetic acid (EDTA) is universally used and has been recognized as the most robust anticoagulant. However, it may lead to pseudothrombocytopenia (PTCT), due to the formation of platelet clumps, which is currently followed by resampling on sodium citrate. Other possible anticoagulants are citrate theophylline adenosine dipyridamole (CTAD) and MgSO.

Chapter 5: The roles of genetics in primary hyperparathyroidism.

Around 10% of cases of primary hyperparathyroidism are thought to be genetic in origin, some of which are part of a syndromic form such as multiple endocrine neoplasia types 1, 2A or 4 or hyperparathyroidism-jaw tumor syndrome, while the remainder are cases of isolated familial primary hyperparathyroidism. Recognition of these genetic forms is important to ensure appropriate management according to the gene and type of variant involved, but screening for a genetic cause is not justified in all patients presenting primary hyperparathyroidism. The indications for genetic analysis have made it possible to propose a decision tree that takes into account whether the presentation is familial or sporadic, syndromic or isolated, patient age, and histopathological type of parathyroid lesion.

Chapter 0: Introduction to the Consensus on Primary Hyperparathyroidism from the French Society of Endocrinology, French Association of Endocrine Surgery and French Society of Nuclear Medicine.

This consensus on primary hyperparathyroidism, drawn up under the aegises of the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN), provides an update on positive, etiological and differential diagnosis and treatment in primary hyperparathyroidism. These recommendations take account of recent increase in the prevalence of primary hyperparathyroidism, due to 1. more systematic routine measurement of blood calcium and improved quality of parathyroid hormone assays, 2.

Chapter 3: IMPACT OF PRIMARY HYPERPARATHYROIDISM.

At present, primary hyperparathyroidism is most often discovered in an asymptomatic patient, but can sometimes be revealed by a renal or bone complications. In all cases, a full work-up is recommended, with assessment of renal function (glomerular filtration rate), 24-hour calciuria, screening for risk factors for lithiasis, and renal and urinary tract imaging (ultrasound or CT scan) to look for stones or nephrocalcinosis. Bone densitometry, with measurements of the spine, femur and radius, is the recommended reference test for demineralization.

Energy availability and macronutrient intake over a 7-day training period in adolescent rugby players.

Background: Understanding the dietary intake of elite adolescent athletes and its adequacy with sport nutrition recommendation is a key issue for health and player development, as well as performance and recovery. Energy availability needs to be considered to ensure optimal health and performance in young athletes. The present study aimed to quantify energy availability, energy expenditure and macronutrient intake in young male rugby union players competing at national level.

Outcomes and challenges in adolescents living with HIV in France: a nationwide cohort study over 35 years (1985-2020).

Objective: Most data published on adolescents living with HIV (ALH) have been collected before the large diffusion of second-generation integrase strand transfer inhibitors (INSTI) among the pediatric population. We analyzed the nationwide ANRS-MIE CO10 Pediatric cohort to assess the changes over time in health and social outcomes of French ALH.

Design: The cohort enrolled children born in France since 1985 and, from 2005, children diagnosed with HIV at ≤13 years, including those born abroad if antiretroviral-naive at first medical care in France.

Early systemic insults following severe sepsis-associated encephalopathy of critically ill patients: association with mortality and awakening-an analysis of the OUTCOMEREA database.

Background: Sepsis-associated encephalopathy (SAE) may be worsened by early systemic insults. We aimed to investigate the association of early systemic insults with outcomes of critically ill patients with severe SAE.

Methods: We performed a retrospective analysis using data from the French OUTCOMEREA prospective multicenter database.

Achilles Tendon Mechanical But Not Morphological Properties Change with Rehabilitation in Patients with Chronic Midportion Achilles Tendinopathy.

Purpose: Achilles tendinopathy (AT) is associated with altered tendon's morphological and mechanical properties, yet it is unclear whether these properties are reversed upon mechanical loading to promote tendon healing. This study aims to determine the extent to which pathological tendon's morphological and mechanical properties adapt throughout a 12-week eccentric rehabilitation protocol.

Methods: Forty participants with midportion AT were recruited and participated in a 12-week eccentric rehabilitation program.

Exploration of interprofessional collaboration for the diagnosis of infections and antibiotic prescription in nursing homes using multiple case study observational research.

Background: Antibiotic resistance in nursing homes (NHs) is inconsistently tackled by antimicrobial stewardship programmes. The literature on individual determinants of antibiotic prescriptions (APs) in NHs is extensive. However, less is known about the structural determinants of AP in NHs.

Hospital outbreak of NDM-producing Klebsiella pneumoniae in a surgical intensive care unit: sink traps as the causing source of epidemic strain resurgence.

We report the management of a New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae outbreak in a surgical intensive care unit over 1 year. NDM-producing Enterobacterales were isolated from sink traps. The installation of new sink traps closed the outbreak.

Coherent Excitation of the CH Stretching Vibrations in CH : The Role of the Derivative Coupling Studied by the Quantum Ehrenfest Method.

We report nonadiabatic dynamics computations on CH initiated on a coherent superposition of the five lowest cationic states, employing the Quantum Ehrenfest method. In addition to the totally symmetric carbon-carbon double bond stretch and carbon-hydrogen stretches, we see that the three non-totally symmetric modes become stimulated; torsion and three different CH stretching patterns. Thus, a coherent superposition of states, of the type involved in an attochemistry experiment, leads to the stimulation of specific non-totally symmetric motions.

Implementation of a program to strengthen oral hygiene in patient with cleft deformities: a prospective randomized controlled clinical trial.

Background: Cleft lip and/or palate is the most common congenital orofacial deformity, affecting 1/800 births. A thorough review of the literature has shown that children with cleft have poorer oral hygiene and dental health than other children, with higher levels of caries in both temporary and permanent teeth and poorer periodontal health. Cleft patients are treated by a multidisciplinary team that aims to provide comprehensive care from pre- or post-natal diagnosis to early adulthood and the end of growth.