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Background: External ear canal exostoses are usually bilateral and broad-based, secondary to external ear canal chronic cold exposure, especially water. Objectives: The objectives were to analyze the influence of the surgeon's experience on the 3-year recurrence and on the complication. We also studied the influence of prolonged exposure to cold water on the incidence of recurrence. Material and Methods: This monocentric retrospective study included 98 ears operated for canalplasty between 2009 and 2016 by nine different operators including one senior, a junior, and seven beginner surgeons. Senior, Junior, and Beginner groups were compared. Results: 3-year recurrence rate was higher in the Beginner and Junior groups than in the Senior group (69% and 38% vs 18%, P =.001). Although there was a difference between the Beginner (69%) and Junior (38%) groups, it was not significant (P =.407). Among the recurrences, 48% had continued exposure to cold water while only 7% of the ears without recidivism were still exposed (P <.001, OR = 1.25 [4.4; 36.1]). The complication rates were similar between groups, concerning pain (8% vs 30% vs 12%), per procedure perforation (17% vs 10% vs 16%), scarring disorders (25% vs 20% vs 13%), and osteitis (8% vs 0% vs 1%). Hearing was unaffected. Conclusions: This is the first study evaluating the risk of recurrence of external ear canal exostoses after canalplasty based on the surgeon's experience. This risk of recurrence seems to decrease with the surgeon's experience. There was no difference in complication rates. [ABSTRACT FROM AUTHOR]

We investigated a new phenomenon that sheds light on age-related differences in strategy selection: the strategy repetition phenomenon (i.e., tendency to repeat the same strategy over consecutive items). Young and older adults had to provide the best estimates of multiplication problems like 47 × 86. They had to select the best of 2 rounding strategies on each problem, the rounding-down strategy (i.e., doing 40 × 80 = 3,200) or the rounding-up strategy (i.e., doing 50 × 90 = 4,500). Data showed that both young and older adults repeated the same strategy over consecutive problems more often than chance and repeated strategies more often in the 2-prime condition (i.e., after executing one strategy to solve the 2 immediately preceding problems) than in the 1-prime condition (i.e., after executing a strategy on one immediately preceding problem). Moreover, this strategy repetition phenomenon increased with age, especially in the most difficult condition (e.g., when participants solved rounding-up problems in the 2-prime condition). Our findings have important theoretical and empirical implications for computational models of strategy selection and for furthering our understanding of strategic development during adulthood.

Despite the acknowledged benefits of crop diversification, the transition towards more diversified cropping systems needs to be supported, mainly due to socio-technical lock-ins favoring major dominant crop species. This calls for the development of new approaches to support the design of locally tailored diversified cropping systems. This paper aims to present an original participatory and multi-actor design approach, developed to support the introduction of camelina (Camelina sativa) into the cropping systems of northern France and to provide some insights about the characteristics, the specificities, and the limits of this approach to support its use and adaptation to other contexts. For 3 years, and in connection with the development of an oilseed biorefinery, we gathered a variety of actors (farmers, advisors, engineers in agronomy, researchers, and industrialists) to locally support the introduction of camelina in the cropping systems. First, we illustrate the diversity of the modalities that have been collectively imagined to introduce and manage camelina in the local cropping systems. Then, we describe the originality and the diversity of the knowledge produced on camelina, especially during the assessment of some of these modalities within on-farm experiments. Finally, drawing on concepts and theories from design sciences, we show that (i) the pre-existence of networks of actors, (ii) the rationale involvement of the actors, (iii) the implementation of a situated design process fueled by action and distributed among actors, (iv) the sharing and the circulation of knowledge among a diversity of actors involved in the production and use of the new crop, and (v) the implementation of an effective network management contributed to foster the three key elements that we identified as crucial to support crop diversification, namely, the production of actionable knowledge, the exploration of new ideas/concepts, and the active participation of a diversity of actors of the agri-food system. [ABSTRACT FROM AUTHOR]

Background: The end-tidal carbon dioxide (ETCO2) concentration during resuscitation (CPR) of an out-of-hospital cardiac arrest (OHCA) has an increasingly well-known prognostic value. Nevertheless, few studies have investigated its maximum value in different etiologies. Methods: It was a retrospective, observational, multicentre study from the French OHCA Registry. All adult OHCA with a known maximum value of ETCO2 during CPR were included. The primary end-point was to determine the area under the receiver operating characteristic curve (AUROC) of the maximum value of ETCO2 during resuscitation for the return of spontaneous circulation (ROSC). Results: Of the 53,048 eligible subjects from 2011 to 2018, ETCO2 was known in 32,249 subjects (61%). Among them, there were 9.2% of traumatic OHCA, 37.7% of suspected cardiac etiology and 16.4% of suspected respiratory etiology. The AUROC of maximum value of ETCO2 during CPR to achieve ROSC was 0.887 95CI [0.875–0.898] in traumatic OHCA, 0.772 95CI [0.765–0.780] in suspected cardiac etiology and 0.802 95CI [0.791–0.812] in suspected respiratory etiology. The threshold with no survivors at d-30 was <10 mmHg for traumatic etiologies and <6 mmHg for suspected cardiac and respiratory causes. The probability of ROSC increased with the value of ETCO2 in the 3 etiologies studied. Conclusions: The maximum value of ETCO2 during OHCA resuscitation was strongly associated with ROSC, especially in the case of a traumatic cause. This suggests that a single elevated ETCO2 value, regardless of time, could help to predict the outcome. [ABSTRACT FROM AUTHOR]

Background: The main objective of this study was to explore the relationships between inpatients' social differentiation and satisfaction with the medical information delivered by caregivers.Methods: In four departments of a teaching hospital, patients were enrolled as well as their attending physician and one of the nurses assigned to them. Structured survey questionnaires were administered face-to-face to patients and caregivers. Patients were asked to rate their satisfaction with the medical information received, the quality and duration of the interactions with the caregivers, and their experience regarding their involvement in medical decision-making. Caregivers were asked to rate their perception of the patients' social position and involvement in medical decision-making. Social deprivation was assessed using the EPICES score in particular. The statistical analysis was mainly descriptive and completed by a structural equation model.Results: A sample of 255 patients, 221 pairs of patient-physician and 235 pairs of patient-nurse were considered. One third of the patients (32.7%) were identified as socially deprived. They were significantly less satisfied with the information they received on their health status or their treatment; 56.7% of patients thought that they received sufficient explanations without having to ask. This proportion was significantly lower in socially deprived patients (42.3%) compared to not deprived patients (63.6%, p < 0.01). Patients' reported involvement in medical decision-making was significantly lower for socially deprived patients (75.0% vs 89.0%, p < 0.001). The structural equation model showed that the main determinant of patients' satisfaction regarding medical information was their perceived involvement in informed medical decision-making (CFI = 0.998, RMSEA = 0.022).Conclusions: These findings suggest that physicians and nurses need training on communication targeted towards vulnerable patients, in order to improve the accessibility of medical information, and thus to reduce health inequalities. [ABSTRACT FROM AUTHOR]

Copyright of Gériatrie et Psychologie Neuropsychiatrie du Vieillissement is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Langage & Societe is the property of Fondation Maison des Sciences de l'Homme and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

SUMMARY A crustal-scale N130°E strike-slip fault in the Ubaye-Argentera area, southwestern French-Italian Alps, was the locus of a seismic swarm in 2003-2004. Its reactivation is examined by a 2-D frictional fault analysis. The regional stress tensor in the vicinity of the fault is determined by inversion of focal mechanisms of the 38 events with largest magnitudes of the 2003-2004 swarm. Inversion shows that the axis of the maximum principal stress σ1 is oriented nearly horizontal and at 63° from the fault plane and that the intermediate principal stress σ2 is almost parallel to the fault plane. A 2-D analysis with a static coefficient of friction of 0.4 (consistent with the presence of phyllosilicate-rich gouges at depth) shows that the N130°E fault is unfavourably oriented and that its reactivation is possible only with pore fluid pressure excess in the hypocentral region (6-7 km below surface). A calculation based on a pore fluid factor-differential stress failure mode diagram shows that the required excess pressure is comprised between 7 and 26 MPa. The presence of thermal springs in the Argentera area indicates that the pore fluid is water. The pore water overpressure is likely achieved by fault zone compaction and hydraulic barriers. The hydraulic barriers can be provided by hydrothermal sealing of the fault damage zone and by the 1-2-km-thick sedimentary lid (marl-rich autochtonous sedimentary cover and Embrunais-Ubaye sedimentary nappes) whose permeability is lower than that of the underlying crystalline rocks. [ABSTRACT FROM AUTHOR]

• Camelina yield was positively correlated to nitrogen crop status at flowering. • Downy mildew significantly reduced camelina yield and oil content in 2018. • Oil and polyunsaturated fatty acids contents increased with grain filling duration. • High temperatures during grain filling reduced linolenic acid content. Camelina Camelina sativa (L.) Crantz] is an emerging oilseed crop combining both industrial and agronomic advantages. Camelina seed yield, oil and protein contents, and fatty-acid composition, vary across genotypes, environments, and agricultural practices. However, no studies have been conducted to identify and rank major limiting factors explaining yield and quality variations under on-farm conditions. Camelina performance was measured on 39 experimental strips corresponding to five camelina crop management routes (grown as an intercrop or sole crop), implemented in nine farmers' fields across northern France in 2017 and 2018. The ranking of candidate limiting factors, defined a priori from scientific literature, was carried out using a model mixing method based on the Akaike Information Criterion. Main limiting factors of camelina yield (ranging from 62 to 2585 kg ha−1) were nitrogen crop status at flowering stage and downy mildew. Camelina yield was indeed positively correlated with the Nitrogen Nutrition Index at flowering stage (R2 = 0.44, p = 0.007). Oil content varied from 36.6 to 46.5 % and was negatively correlated with protein content. Main indicators explaining oil content variations were grain filling duration and downy mildew. Both poly-unsaturated and linolenic acid contents were positively correlated to grain filling duration, and negatively correlated to temperature during grain filling period. Camelina nitrogen status at flowering stage was mainly explained by N uptake of the intercropped species (pea or barley), and the amount of available inorganic nitrogen in the soil between sowing and flowering. Downy mildew was influenced by both weather conditions and the amount of weed biomass. This study showed a large variability in camelina seed yield and quality under on-farm conditions. The identification of the major limiting factors made it possible to pinpoint ways of improving camelina performance namely choosing genotypes with high resistance to mildew, better managing nitrogen fertilization or delaying camelina sowing date. Finally we also identified major research topics to be addressed to support the adoption of this new crop by farmers as the elaboration of the critical nitrogen dilution curve. [ABSTRACT FROM AUTHOR]

• Herbicide-free camelina crop management routes were designed to compete with weeds. • Weed biomass was lower for each alternative than for the chemical weed control. • Increased camelina sowing rate reduced weed biomass and maintained camelina yield. • Camelina-barley intercrop significantly reduced weed biomass and camelina yield. • Camelina-pea intercrop highly reduced weed biomass without reducing camelina yield. Camelina (Camelina sativa L. Crantz) is a minor oilseed crop identified as a candidate crop for biorefinery in Europe. This crop should therefore meet specific quantitative, qualitative and environmental requirements. Weeds have been identified as a major problem for growing camelina. Weed competition may result in low camelina yields and poor seed oil quality. Herbicide application during the crop cycle is more over often not effective enough and does not match with a sustainable production. This study aimed at assessing the effect of four crop management routes (CMRs) on weed biomass and camelina yields across various environments in northern France. Three spring camelina CMRs without herbicide were specifically designed: one consisted in doubling camelina sowing rate (DD), and two others consisted in intercropping camelina with either barley (CB) or pea (CP). These CMRs were compared with a current chemical weeding-based crop management route (SD). These four CMRs were tested in nine on-farm trials covering two growing seasons and three soil types. Crop and weed biomass were measured at camelina flowering and maturity stages, and crop yields were estimated at harvest. Across the nine environments, crop biomass was significantly higher in both intercrops than in pure stand (SD and DD). Weed biomass varied across CMRs and environments, and was negatively correlated with total crop biomass, thus explaining the better weed control observed in the intercrops. Considering the nine environments, DD and CP did not significantly impact camelina yields in comparison to SD. However, camelina yields were reduced by 90% in CB due to strong competition from barley. In conclusion, both DD and CP seemed to be promising alternatives to reduce weed competition without using herbicides. In the future, multi-criteria assessment covering quality, environment, and economic performances would be useful to conclude on the implementation of these CMRs in on-farm conditions. [ABSTRACT FROM AUTHOR]

Background: The Nursing Home Survey on Patient Safety Culture (NHSOPS) questionnaire was developed by the Agency for Healthcare Research and Quality (AHRQ), particularly as an intervention to raise staff awareness about patient safety issues. The main objective of the present study was to provide a validated French-language measure of the safety culture (SC) in nursing homes. Thus the aim was i) to carry out a transcultural adaptation into French of the NHSOPS questionnaire, ii) to assess its psychometric properties in a sample of professionals working in French EHPAD facilities and iii) to develop our own tool.Methods: The study was carried out on volunteering professionals from 61 nursing homes (from January to March 2016). Two phases were conducted: an initial phase involving the translation and cultural adaptation of the questionnaire, and a second phase in which the psychometric properties of the questionnaire were assessed. A Structural Equation Model (SEM) with a maximum likelihood estimation method was used to evaluate the construct validity of the questionnaire. As the fit of the structure was not sufficient, an exploratory factor analysis using a principal axis factoring with an oblique rotation was then performed. Internal consistency was evaluated and we examined test-retest reliability using Intra-class Correlation Coefficients (ICC).Results: During the initial phase, all items were retained and minor adjustments were made. The participation rate by professionals was 58.4%. The exploratory analysis led to the identification of seven dimensions: Teamwork, Staffing, Compliance with procedures, Handoffs, Feedback and communication about incidents, Supervisor expectations and actions promoting resident safety, Overall perceptions of resident safety and Organizational learning. The SEM confirmed the existence of the seven latent dimensions (CFI = 0.946; TLI = 0.933; SRMR = 0.059; RMSEA = 0.061); internal consistency was acceptable. ICC per item ranged from 0.19 to 0.88.Conclusions: The results from this study were robust on seven dimensions. This French version is the first on Patient SC to have been applied to the medical-social sector caring for dependent elderly people in France. The NHSOPS questionnaire provides the opportunity to broach this subject. A national evaluation campaign should provide the opportunity to confirm or improve this measure.Trial Registration: NCT02908373 (September 21, 2016) «Retrospectively registered». [ABSTRACT FROM AUTHOR]

Background: Implementing a patient safety curriculum for medical students requires to identify their needs and current awareness of the topic. Several tools have been developed to measure patient safety culture, but none of them have been developed in the French context. Our objective was to adapt and refine the psychometric properties of the MSSAPS, developed by Liao et al, to use it among general practice (GP) residents. Methods: 1-We conducted a translation and transcultural adaptation of the MSSAPS questionnaire (28 items, 5 dimensions: safety culture, teamwork culture, experiences with professionalism, error disclosure culture and comfort expressing professional concerns) in accordance with the international recommendations. 2-We studied the new questionnaire' psychometric properties on a sample of GP residency students in 2016. This validation comprised 2 steps: a confirmatory factor analysis (CFA) for each dimension of the MSAPPS to explore the adequacy of the structure of the questionnaire; an exploratory factor analysis to refine the instrument, using a principal component analysis and Cronbach's α-coefficients calculation. A final CFA examined the structure validity of the refined questionnaire. 3-We described the items and the safety cultural scores in our sample of residents. Results: Among 391 eligible students, 213 responded (54%). The initial structure was not confirmed by CFAs, showing a poor fit for 3 of the 5 dimensions: safety culture, teamwork culture and professionalism. Exploratory PCA led to 3 dimensions: Safety culture (PVE: 18.5% and 7 of 8 initial items), Experiences with professionalism (PVE: 17.8% and 5 of 7 initial items) and Error disclosure culture (PVE: 13.6% and 3 of 4 original items). Cronbach's α-coefficients were 0.74, 0.78 and 0.76 respectively. The final CFA confirmed the existence of the 3 latent dimensions with a good fit to the and highly significant structural coefficients (P < 0.001). Mean scores were equal to 65.4 [63.6; 67.6] for the safety culture, 66.9 [63.8; 70.1] for the experience with professionalism, and 54.4 [51.6; 57.2] for the error disclosure culture. Conclusion: This study reports satisfactory psychometrics properties of the French version of the MSAPPS and provides evidence of important training needs for GP residents in the field of patient safety culture. [ABSTRACT FROM AUTHOR]

Background: Cladophialophora bantiana is one of the most virulent phaeohyphomycetes, typically causes non-angiogenic single (or sometimes multiple) cystic brain lesions, and has resulted in a mortality rate of up to 70%. Most C bantiana cases are described either in a series of isolated reports or in very small cohorts. The aim of this retrospective nation-based study was to share the data on C bantiana phaeohyphomycosis cases reported in France and French overseas territories over the past two decades to improve understanding of this disease., Methods: Patients with C bantiana infection were processed through the active surveillance programme of invasive fungal infections launched by the National Reference Center for Mycoses and Antifungals, Institut Pasteur (Paris, France), and the French Surveillance Network of Invasive Fungal Infections, which involved 29 hospitals from mainland France and overseas French territories. Only proven and probable cases of infection, according to the revised and updated consensus definitions from the European Organization for Research and Treatment of Cancer and Mycoses Study Group, were included in the study. Patients were diagnosed or confirmed, or both, using a polyphasic approach at the Institut Pasteur between 2002 and 2022. Patients were separated into two groups: those with CNS involvement and those with no CNS involvement. The primary outcome was the survival rate., Findings: A total of 23 patients with a C bantiana invasive infection were included during the study period (Jan 1, 2002, to Dec 31, 2022). The median age was 56 years in the CNS involvement group and 65 years in the non-CNS involvement group. Until 2021, the annual number of cases varied between zero and two, with six cases observed in 2022, the warmest year recorded in France since 1900. CNS involvement was observed in 15 (65%) patients, including three disseminated cases; skin and soft tissue involvement in seven (30%) patients and an isolated lung infection in one case. Diabetes was observed in five patients, and any immunodepression factor was observed in 14 (61%) of 23 patients. When considering only patients with CNS involvement, 9-month survival appeared higher in patients who underwent exeresis or large drainage (three [75%] of four patients vs three [27%] of 11 patients; p=0·24) and significantly higher in those treated for 2 or more weeks with triple antifungal therapy (liposomal amphotericin B plus posaconazole and flucytosine; seven [78%] of nine patients vs one [17%] of six patients; p=0·040). Two patients were treated with excision surgery alone (one patient with success, and the other patient lost to follow-up)., Interpretation: This study shows that the clinical presentations and underlying medical conditions of C bantiana infections are more diverse than previously described. It also emphasises a significant difference in mortality rate between those with and without CNS involvement. The prognosis improved when surgery was performed and triple antifungal therapy was administered. Such rare and devastating invasive fungal infections should be managed by a multidisciplinary team., Funding: Santé Publique France., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

Purpose: The purpose of this study was to assess cryopreserved amniotic membrane (C-AM) versus chorion-free freeze-dried amniotic membrane (FD-AM) overlay transplantation for corneal ulcers in a French tertiary ophthalmology hospital., Methods: Between March and July 2020, when C-AMs were not available because of the COVID-19 pandemic, 28 corneal ulcers underwent FD-AM overlay transplantation and were retrospectively compared with 22 corneal ulcers treated with C-AM during the same period in 2018. All patients had at least 3 months of follow-up, and those who underwent combined surgeries were excluded. Ulcers were assessed at baseline and then at 72 hours, 1 month, and 3 months. Population demographics, follow-up time, ulcer etiologies, epithelial defect size, ulcer depth, and complications were also recorded., Results: Baseline characteristics and clinical features of both groups were comparable. There was no statistically significant difference in the number of overlay AM transplantations (P = 0.52) or early detachments (P = 0.57). At 3 months, the corneal healing rate was almost the same in both groups (89% and 91% for FD-AM and C-AM, respectively; P = 0.87). Complications were equally uncommon (11% and 9%, respectively; P = 0.92). In logistic regression, the type of the membrane did not influence corneal healing at 1 month (P = 0.42) or 3 months (P = 0.99), regardless of the depth of the ulcer. However, whatever the type of AM used, the deeper the ulcer was, the less likely it was to heal at 3 months (P = 0.02)., Conclusions: This is the first study that provides positive insight into the effectiveness of FD-AM compared with C-AM when used as overlay transplantation for treating corneal ulcers., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Staphylococcus aureus induces severe infective endocarditis (IE) where embolic complications are a major cause of death. Risk factors for embolism have been reported such as a younger age or larger IE vegetations, while methicillin resistance conferred by the mecA gene appeared as a protective factor. It is unclear, however, whether embolism is influenced by other S. aureus characteristics such as clonal complex (CC) or virulence pattern. We examined clinical and microbiological predictors of embolism in a prospective multicentric cohort of 98 French patients with monomicrobial S. aureus IE. The genomic contents of causative isolates were characterized using DNA array. To preserve statistical power, genotypic predictors were restricted to CC, secreted virulence factors and virulence regulators. Multivariate regularized logistic regression identified three independent predictors of embolism. Patients at higher risk were younger than the cohort median age of 62.5 y (adjusted odds ratio [OR] 0.14; 95% confidence interval [CI] 0.05-0.36). S. aureus characteristics predicting embolism were a CC30 genetic background (adjusted OR 9.734; 95% CI 1.53-192.8) and the absence of pIB485-like plasmid-borne enterotoxin-encoding genes sed, sej , and ser ( sedjr ; adjusted OR 0.07; 95% CI 0.004-0.457). CC30 S. aureus has been repeatedly reported to exhibit enhanced fitness in bloodstream infections, which might impact its ability to cause embolism. sedjr -encoded enterotoxins, whose superantigenic activity is unlikely to protect against embolism, possibly acted as a proxy to others genes of the pIB485-like plasmid found in genetically unrelated isolates from mostly embolism-free patients. mecA did not independently predict embolism but was strongly associated with sedjr . This mecA - sedjr association might have driven previous reports of a negative association of mecA and embolism. Collectively, our results suggest that the influence of S. aureus genotypic features on the risk of embolism may be stronger than previously suspected and independent of clinical risk factors.