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Nous avons étudié la façon dont l’activité de résolution de problèmes mathématiques est abordée en classe du primaire (école élémentaire), particulièrement lorsque celle-ci est abordée par l’entremise d’une méthode de type « ce que je cherche, ce que je sais ». Nous avons documenté la façon dont cette méthode est utilisée par des élèves québécois de quatrième année (9-10 ans) qui choisissent librement d’y avoir recours, c’est-à-dire sans que cette méthode leur soit imposée. Les productions de 45 élèves ont été analysées afin d’étudier la cohérence interne de la démarche mise en œuvre.

Background: Cancer survivors are at an increased risk of cardiovascular disease (CVD) compared with the general population. We sought to evaluate the impact of mosaic chromosomal alterations (mCA) on death of CVD causes, coronary artery disease (CAD) causes, and of any cause in patients with a cancer diagnosis. Methods: The study was a prospective cohort analysis of 48,919 UK Biobank participants with a cancer diagnosis. mCAs were characterized using DNA genotyping array intensity data and long-range chromosomal phase inference. Multivariable Cox regression models were used to ascertain the associations of mCAs. Exploratory endpoints included various incident cardiovascular phenotypes. Results: Overall, 10,070 individuals (20.6%) carried ≥ 1 mCA clone. In adjusted analyses, mCA was associated with an increased risk of death of CAD causes [HR, 1.37; 95% confidence interval (CI), 1.09–1.71; P = 0.006]. In sub-analyses, we found that carriers of mCAs diagnosed with kidney cancer had an increased risk of death of CVD causes (HR, 2.03; 95% CI, 1.11–3.72; P = 0.022) and CAD causes (HR, 3.57; 95% CI, 1.44–8.84; P = 0.006). Women diagnosed with breast cancer who carried a mCA also had a higher risk of death of CAD causes (HR, 2.46; 95% CI, 1.23–4.92; P = 0.011). Conclusions: Among cancer survivors, carriers of any mCA are at an increased risk of CAD death compared with noncarriers. Mechanistic studies should be considered to better ascertain the biological mechanisms underneath the observed associations between mCAs and cardiovascular events for specific cancer types. Impact: There may be clinical relevance in considering mCAs in patients diagnosed with cancer and undergoing treatment.

Background: In breast cancer patients, neoadjuvant chemotherapy (NAC) allows to obtain pathological complete response (pCR). In case of initially involved node before NAC, pCR after NAC could make it possible to avoid axillary surgery. The aim of our study was to address parameters to build a tool able to accurately select patients at a high probability of axillary pCR after NAC. Method: GANEA 3 was a French prospective multi institutional cohorts of breast cancer patients with a proven axillary involved node treated with NAC (NCT03630913). Initially involved node was clipped before treatment. Each patient received, before and after NAC, a bilateral mammography, a Magnetic Resonance Imaging (MRI), an axillary sonography. After NAC breast, conservative or radical, and axillary surgery, were performed. Breast surgery allowed to measure breast tumor residual and to perform a Sataloff classification. Targeted axillary detection (TAD) was defined as the combination of the resection of the clipped node and SLN dissection. Axillary clipped node, sentinel lymph node (SLN) and axillary lymph node dissection (ALND) were always performed. ALND allowed to assess the false negative rate (FNR) of axillary clipped node and SLN dissection. A total of 500 included patients is planned to close this still ongoing trial. Results : From January 2019 to March 2022, 405 patients were included from 18 institutions. We present here the results of the 260 first patients, who experienced a complete treatment with NAC courses and post NAC breast and axillary surgery. Among these patients, SBR grade was III in 52%, OR and PR were positive in 59% and 46% respectively, HER2 was overexpressed in 40%, 26% were triple negative and pCR was present in 28%. FNR of the SLN detection was 21.1%, 9% for the clipped node alone and 6% for the TAD. Histopronostic grading, progesteron receptors, HER2 expression, MRI results and Sataloff grading of breast residual tumor were indepently linked with global pCR (breast and axilla) in multivariate analysis. The Area Under the Curve (AUC) model was 0.91 with 82% correctly patients classified. The false negative rate of no pCR classified patients was 14%. Conclusion : Intermediate results of Ganea 3 trial showed that operable breast cancer patients with an initially involved axillary node treated with NAC, showed that TAD allows to reduce the FNR of axillary surgery. Patients with histopronostic grade 3, negative progesteron receptors, HER2 overexpression, a normal MRI after NAC and a breast Sataloff A, have a low risk of axillary tumour residual burden and could be safely spare from any axillary surgery. Large prospective trials are needed to confirm the safety of this surgical de-escalation. Citation Format: Céline Renaudeau, Pierre Gimbergues, Eugénie Guillot, Marie-Pierre Chauvet, Marian Gutowski, Eva Jouve, Philippe Rauch, Monique Cohen, Christelle Faure, Marie-Martine Padeano, Vivien Ceccato, Catherine Uzan, Anne-Sophie Bats, Hélène Charitansky, Pierre-François Dupré, Augustin Reynard, Séverine Alran, Cécile Bendavid-Athias, Loïc Campion, Isabelle Doutriaux, Jean-Marc Classe. Axillary surgery de-escalation after neoadjuvant chemotherapy in breast cancer patients with initially involved node: the GANEA 3 trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT1-09-01.

Healthy individuals exhibit blood pressure variation over a 24-hour period with higher blood pressure during wakefulness and lower blood pressure during sleep. Loss or disruption of the blood pressure circadian rhythm has been linked to adverse health outcomes, for example, cardiovascular disease, dementia, and chronic kidney disease. However, the current diagnostic and therapeutic approaches lack sufficient attention to the circadian rhythmicity of blood pressure. Sleep patterns, hormone release, eating habits, digestion, body temperature, renal and cardiovascular function, and other important host functions as well as gut microbiota exhibit circadian rhythms, and influence circadian rhythms of blood pressure. Potential benefits of nonpharmacologic interventions such as meal timing, and pharmacologic chronotherapeutic interventions, such as the bedtime administration of antihypertensive medications, have recently been suggested in some studies. However, the mechanisms underlying circadian rhythm-mediated blood pressure regulation and the efficacy of chronotherapy in hypertension remain unclear. This review summarizes the results of the National Heart, Lung, and Blood Institute workshop convened on October 27 to 29, 2021 to assess knowledge gaps and research opportunities in the study of circadian rhythm of blood pressure and chronotherapy for hypertension.

The Mobile Motor Activity Research Consortium for Health (mMARCH) is a collaborative network of clinical and community studies that employ common digital mobile protocols and collect common clinical and biological measures across participating studies. At a high level, a key scientific goal which spans mMARCH studies is to develop a better understanding of the interrelationships between physical activity (PA), sleep (SL), and circadian rhythmicity (CR) and mental and physical health in children, adolescents, and adults. mMARCH studies employ wrist-worn accelerometry to obtain objective measures of PA/SL/CR. However, there is currently no consensus on a standard data processing pipeline for raw accelerometry data and few open-source tools which facilitate their development. The R package GGIR is the most prominent open-source software package for processing raw accelerometry data, offering great functionality and substantial user flexibility. However, even with GGIR, processing done in a harmonized and reproducible fashion across multiple analytical centers requires a nontrivial amount of expertise combined with a careful implementation. In addition, there are many statistical methods useful for analyzing PA/SL/CR patterns using accelerometry data which are implemented in non-GGIR R packages, including methods from multivariate statistics, functional data analysis, distributional data analysis, and time series analyses. To address the issues of multisite harmonization and additional feature creation, mMARCH developed a streamlined harmonized and reproducible pipeline for loading and cleaning raw accelerometry data via GGIR, merging GGIR, and non-GGIR features of PA/SL/CR together, implementing several additional data and feature quality checks, and performing multiple analyses including Joint and Individual Variation Explained, an unsupervised machine learning dimension reduction technique that identifies latent factors capturing joint across and individual to each of three domains of PA/SL/CR. The pipeline is easily modified to calculate additional features of interest, and allows for studies not affiliated with mMARCH to apply a pipeline which facilitates direct comparisons of scientific results in published work by mMARCH studies. This manuscript describes the pipeline and illustrates the use of combined GGIR and non-GGIR features by applying Joint and Individual Variation Explained to the accelerometry component of CoLaus|PsyCoLaus, one of mMARCH sites. The pipeline is publicly available via open-source R package mMARCH.AC.

The vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is a newly identified autoinflammatory disorder related to somatic UBA1 mutations. Up to 72% of patients may show lung involvement.What are the pleuropulmonary manifestations in VEXAS syndrome?One hundred fourteen patients were included in the French cohort of VEXAS syndrome between November 2020 and May 2021. Each patient included in the study who had an available chest CT scan was discussed in an adjudication multidisciplinary team and classified as showing potentially pleuropulmonary-specific involvement of VEXAS syndrome or others.Fifty-one patients had a CT scan available for review and 45 patients (39%) showed pleuropulmonary abnormalities on chest CT scan that were considered related to VEXAS syndrome after adjudication. Most patients were men (95%) with a median age 67.0 years at the onset of symptoms. Among these 45 patients, 44% reported dyspnea and 40% reported cough. All 45 patients showed lung opacities on chest CT scan (including ground-glass opacities [87%], consolidations [49%], reticulation [38%], and septal lines [51%]) and 53% of patients showed pleural effusion. Most patients showed improvement with prednisone, but usually required20 mg/d. The main clinical and biological features as well the median survival did not differ between the 45 patients with pleuropulmonary involvement and the rest of the cohort, suggesting that the prevalence of pleuropulmonary involvement might have been underdiagnosed in the rest of the cohort.Pulmonary manifestations are frequent in VEXAS syndrome, but rarely are at the forefront. The initial outcome is favorable with prednisone and does not seem to lead to pulmonary fibrosis.

International audience; Objectives: To assess the contribution of whole-body magnetic resonance imaging (WBMRI) and bone scintigraphy (BS) in addition to skeletal survey (SS) in detecting traumatic bone lesions and soft-tissue injuries in suspected child abuse.Methods: In this prospective, multicentre, diagnostic accuracy study, children less than 3 years of age with suspected physical abuse were recruited. Each child underwent SS, BS and WBMRI. A blinded first review was performed in consensus by five paediatric radiologists and three nuclear medicine physicians. A second review investigated discrepancies reported between the modalities using a consensus result of all modalities as the reference standard. We calculated the sensitivity, specificity and corresponding 95% confidence interval for each imaging modality (SS, WBMRI and BS) and for the combinations [SS + WBMRI] and [SS + BS].Results: One hundred seventy children were included of which sixty-four had at least one lesion. In total, 146 lesions were included. The sensitivity and specificity of each examination were, respectively, as follows: 88.4% [95% CI, 82.0-93.1] and 99.7% [95% CI, 99.5-99.8] for the SS, 69.9% [95% CI, 61.7-77.2] and 99.5% [95% CI, 99.2-99.7] for WBMRI and 54.8% [95% CI, 46.4-63.0] and 99.7% [95% CI, 99.5-99.9] for BS. Sensitivity and specificity were, respectively, 95.9% [95% CI, 91.3-98.5] and 99.2% [95% CI, 98.9-99.4] for the combination SS + WBMRI and 95.2% [95% CI, 90.4-98.1] and 99.4% [95% CI, 99.2-99.6] for the combination SS + BS, with no statistically significant difference between them.Conclusion: SS was the most sensitive independent imaging modality; however, the additional combination of either WBMRI or BS examinations offered an increased accuracy.Key points: • SS in suspected infant abuse was the most sensitive independent imaging modality in this study, especially for detecting metaphyseal and rib lesions, and remains essential for evaluation. • The combination of either SS + BS or SS + WBMRI provides greater accuracy in diagnosing occult and equivocal bone injuries in the difficult setting of child abuse. • WBMRI is a free-radiation technique that allows additional diagnosis of soft-tissue and visceral injuries.

The aim of this study was to develop a transcultural adaptation of the Diagnostic Adaptive Behavior Scale (DABS) in French and to perform a field evaluation of the adapted version of the tool (DABS-F). Eight experts in intellectual and developmental disabilities (IDD) and two professional translators formed two committees to translate the instrument. Thirty-four independent experts in IDD rated the clarity and relevance of the DABS-F. Results indicated complete agreement between the two translation committees and also demonstrated very satisfactory levels of clarity and relevance for the DABS-F. The latter result can be considered as evidence of the content validity of the adapted tool. Adjustments for the few items that presented less satisfactory results are discussed.

Dissecting the liquid water organization in contact with hydrophobic and hydrophilic surfaces is essential for understanding the chemical and physical properties of aqueous interfaces. Recently developed descriptors for microscopic hydrophobicity/hydrophilicity based either on molecular dynamics (MD) simulations or on surface-sensitive nonlinear optical techniques, such as sum frequency generation (SFG) spectroscopy, manage to capture and quantify the change in local molecular hydrophobicity at heterogeneous surfaces. However, the connections between the theoretical/structural descriptors and spectroscopic fingerprints have not been established yet. Here, we combine density functional theory-based MD simulations (DFT-MD) and both theoretical and experimental SFG spectroscopy to explore how the interfacial water responds in contact with self-assembled monolayers (SAM) of tunable hydrophilicity. We introduce a microscopic metric to track the transition from hydrophobic to hydrophilic interfaces, which combines a structural descriptor based on the preferential orientation within the water network in the topmost binding interfacial layer (BIL) and spectroscopic fingerprints of H-bonded and dangling OH groups of water pointing towards the surface carried by BIL-resolved SFG spectra. This metric builds a bridge between molecular descriptors of hydrophilicity/hydrophobicity and spectroscopically measured quantities, and provides a recipe to quantitatively or qualitatively interpret experimental SFG signals.

Digital technology offers several opportunities to improve access to professional expertise in primary care, and the offer of various “virtual” services has exploded in the past few years. The aim of this study was to evaluate the implementation of a direct-to-consumer on-line pharmacy consultation service (Ask Your Pharmacist - AYP) to a universal phone consultation service led by the universal public health system in Quebec (811 Info-Santé), through a direct bridge. Semi-structured interviews were conducted with clinician users of the service, and stakeholders involved in this pilot project funded by the Ministry of Economy (n = 22); documents were also analyzed, and content of the question was asked through the AYP service. Adoption of the service was low, and it suggests a poor alignment between the need and the service as implemented. Further research should investigate the mechanisms for an appropriate integration of digital services for primary care universal consultation services.

Im Zuge der rasanten Entwicklung der Computertechnik ist künstliche Intelligenz heute zu einem wesentlichen Bestandteil des täglichen Lebens geworden. Auch die Bereiche Medizin und Lungengesundheit stellen in diesem Zusammenhang keine Ausnahme dar. Wissenschaftliche Forschung auf der Grundlage von Big Data durchzuführen, bedeutet nicht, einfach eine große Menge an Daten zu sammeln und dann den Maschinen die Arbeit zu überlassen. Wissenschaftler müssen vielmehr Probleme identifizieren, deren Lösung sich positiv auf die Versorgung der Patienten auswirken würde. In dieser Übersichtsarbeit wird die Rolle der künstlichen Intelligenz sowohl aus physiologischer als auch aus anatomischer Sicht erörtert. Ausgehend von der automatischen quantitativen Bewertung anatomischer Strukturen mithilfe der Bildgebung der Lunge betrachten wir die Themenbereiche der Erkennung von Krankheiten und der Einschätzung der Prognose auf der Grundlage von maschinellem Lernen. Die Bewertung der aktuellen Stärken und Einschränkungen wird es uns ermöglichen, einen breiteren Blick auf zukünftige Entwicklungen zu werfen.

Fungal genus Septoria causes diseases in a wide range of plants. Here, we report the first genome sequences of two strains of Septoria linicola, the causal agent of the pasmo disease of flax ( Linum usitatissimum). The genome of the first strain, SE15195, was fully assembled in 16 chromosomes, while 35 unitigs were obtained for a second strain, SE14017. Structural annotations predicted 13,096 and 13,085 protein-encoding genes and transposable elements content of 19.0 and 18.1% of the genome for SE15195 and SE14017, respectively. The four smaller chromosomes 13 to 16 show genomics features of potential accessory chromosomes. The assembly of these two genomes is a new resource for studying S. linicola and improving management of pasmo. [Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .

Introduction We examined whether factors identified as associated with cannabis use at age 14 to 16 years are also associated with ever use at age 12. Methods Participants in the AdoQuest study (n = 1852) were recruited in 2005 from among Grade 5 students in 29 French-language elementary schools in Montréal, Canada. Self-report data were collected from participants in Grade 5 (spring 2005) and 6 (fall 2005 and spring 2006) and from parents/guardians in 2006/07. Inclusion in the analytic sample (n = 1076; mean age [SD] = 10.7 [0.5]) required data from participant and parental questionnaires and data on cannabis use in Grade 6 (mean age [SD] = 11.7 [0.4]). We estimated associations between ever use at age 12 with 33 potential correlates, separately in unadjusted and adjusted logistic regression models. Results Fifty-three participants (4.9%) reported ever use at age 12. Factors associated with higher odds of ever use included older age, identifying as male, lower household income, more weekly spending money, ever tried cigarettes or other tobacco products, ever drank alcohol or binge drank, ever gambled, friends or siblings smoke cigarettes, greater nicotine dependence, higher depressive symptoms and greater impulsivity. Protective factors included higher levels of parental/guardian monitoring and greater self-esteem and school connectedness. Conclusion Factors associated with cannabis use at later ages are also associated with ever use at age 12. Our findings suggest that surveillance for and interventions to prevent cannabis use are warranted before age 12.

Introduction Nous avons vérifié si les facteurs connus pour être associés à la consommation de cannabis entre 14 et 16 ans sont aussi associés au fait d’avoir déjà consommé du cannabis à l’âge de 12 ans. Méthodologie Les participants à l’étude AdoQuest (n = 1 852) ont été recrutés en 2005 parmi les élèves de 5e année de 29 écoles primaires francophones à Montréal (Canada). Des données autodéclarées ont été recueillies auprès des participants en 5e année (printemps 2005) et en 6e année (automne 2005 et printemps 2006) ainsi qu’auprès de leurs parents ou personnes responsables en 2006-2007. Pour que les participants soient inclus dans l’échantillon d’analyse (n = 1 076; âge médian = 10,7 ans [écart-type : 0,5]), il fallait avoir accès aux données des questionnaires remplis par les participants et par leurs parents de même qu’aux données sur leur consommation de cannabis en 6e année (âge médian = 11,7 ans [écart-type : 0,4]). Nous avons estimé les associations possibles entre le fait d’avoir déjà consommé du cannabis à 12 ans et 33 facteurs de corrélation évalués séparément dans des modèles de régression logistique ajustés et non ajustés. Résultats Cinquante-trois participants (4,9 %) ont déclaré avoir déjà consommé du cannabis à l’âge de 12 ans. Les facteurs associés à une consommation étaient un âge plus élevé, s’identifier comme garçon, un faible revenu du ménage, une allocation hebdomadaire élevée, le fait d’avoir déjà consommé des cigarettes ou d’autres produits du tabac, le fait d’avoir déjà bu de l’alcool, le fait d’avoir déjà eu une consommation excessive d’alcool, le fait d’avoir déjà joué à des jeux de hasard, le tabagisme chez les amis ou les frères et soeurs, une dépendance accrue à la nicotine, des symptômes de dépression importants et une forte impulsivité. Les facteurs de protection étaient un niveau élevé de surveillance par les parents ou les personnes responsables des jeunes, une bonne estime de soi et un sentiment d’appartenance à l’école. Conclusion Les facteurs associés à la consommation de cannabis à des âges plus élevés sont aussi associés au fait d’avoir déjà consommé du cannabis à l’âge de 12 ans. D’après nos résultats, une surveillance et des interventions visant à prévenir la consommation de cannabis sont nécessaires chez les jeunes de moins de 12 ans.

Friction stir welding is a recommended green process that can replace other assembly techniques.FSW process reveals good mechanical properties, good corrosion resistance and good economic value. For thepurpose to evaluate combinations of operating parameters and estimating the welded joint quality, mathematicalrelationships were carried out using a design of experiment on three levels of rotational speed, feed rate and tooltilt angle. The models allow micro-hardness prediction in the different FSW joint zones of AA3003 aluminumalloy. The interaction of the factors shows that a decrease in rotational speed, angle of inclination and anincrease in feed rate leads to a decrease in temperature and good microhardness. A ‘W’ shape profile ofmicrohardness was shown cross the section, indicating an efficiency equal to 88% and 79% in the nugget andthe heat-affected zone successively, compared to the base metal. Contrary any deviation of welding intervalmay cause various defect such as tunnel voids, ‘kissing-bond’ defects and crack-like root flaws.

According to expert guidelines, lymph node surgical excision is the standard of care for lymphoma diagnosis. However, core needle biopsy (CNB) has become widely accepted as part of the lymphoma diagnostic workup over the past decades. The aim of this study was to present the largest multicenter inventory of lymph nodes sampled either by CNB or surgical excision in patients with suspected lymphoma and to compare their diagnostic performance in routine pathologic practice. We reviewed 32 285 cases registered in the French Lymphopath network, which provides a systematic expert review of all lymphoma diagnoses in France, and evaluated the percentage of CNB and surgical excision cases accurately diagnosed according to the World Health Organization classification. Although CNB provided a definitive diagnosis in 92.3% and seemed to be a reliable method of investigation for most patients with suspected lymphoma, it remained less conclusive than surgical excision, which provided a definitive diagnosis in 98.1%. Discordance rates between referral and expert diagnoses were higher on CNB (23.1%) than on surgical excision (21.2%; P = .004), and referral pathologists provided more cases with unclassified lymphoma or equivocal lesion through CNB. In such cases, expert review improved the diagnostic workup by classifying ∼90% of cases, with higher efficacy on surgical excision (93.3%) than CNB (81.4%; P < 10−6). Moreover, diagnostic concordance for reactive lesions was higher on surgical excision than CNB (P = .009). Overall, although CNB accurately diagnoses lymphoma in most instances, it increases the risk of erroneous or nondefinitive conclusions. This large-scale survey also emphasizes the need for systematic expert review in cases of lymphoma suspicion, especially in those sampled by using CNB.

Cet article met en lumière les intrications entre le design d’innovations pédagogiques propres à la recherche design en éducation et l’expérience sensible de l’ordre de l’artistique comme méthode de recherche, caractéristique de la recherche-création. En présentant la réalisation d’une étude pilote en éducation artistique, l’autrice démontre comment la recherche design en éducation bénéficie du processus de création artistique et des orientations épistémologiques de la recherche-création pour la conception et l’implantation d’un design éducatif. Cette intrication du processus de création au cœur de la production du design peut ainsi contribuer à la génération de nouveaux savoirs, spécifiquement reliés au champ de l’éducation artistique.