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Cerebral palsy, a common physical disability in childhood, often causes abnormal patterns of movement and posture. To better understand the pathology and improve rehabilitation of patients, a comprehensive bone shape analysis approach is proposed in this article. First, a group analysis is performed on a clinical MRI dataset using two state-of-the-art shape analysis methods: ShapeWorks and a voxel-based method relying on Advanced Normalization Tools (ANTs) registration. Second, an analysis of three bones of the ankle is done to provide a complete view of the ankle joint. Third, a bone shape analysis is carried out at subject level to highlight variability patterns for personnalized understanding of deformities.

We present the case of a female patient with a heterozygous somatic BLNK mutation, a T-cell LGL (large granular lymphocyte) leukemia, and multiple autoimmune diseases. Although this mutation seems uncommon especially in this kind of clinical observation, it could represent a new mechanism for autoimmune diseases associated with LGL leukemia. The patient developed several autoimmune diseases: pure red blood cell apalsia, thyroiditis, oophoritis, and alopecia areata. She also presented a T-cell LGL leukemia which required treatment with corticosteroids and cyclophosphamide, with good efficacy. Interestingly, she had no notable infectious history. The erythroblastopenia also resolved, the alopecia evolves by flare-ups, and the patient is still under hormonal supplementation for thyroiditis and oophoritis. We wanted to try to understand the unusual clinical picture presented by this patient. We therefore performed whole-genome sequencing, identifying a heterozygous somatic BLNK mutation. Her total gamma globulin level was slightly decreased. Regarding the lymphocyte subpopulations, she presented a B-cell deficiency with increased autoreactive B-cells and a CD4+ and Treg deficiency. This B-cell deficiency persisted after complete remission of erythroblastopenia and LGL leukemia. We propose that the persistent B-cell deficiency linked to the BLNK mutation can explain her clinical phenotype.

Radiculopathy in horses is often a diagnosis of exclusion because of the non-specific clinical signs related to neck pain and possible forelimb lameness. There are no reported treatment options in the equine veterinary literature. The purpose of the study was to describe an ultrasound-guided injection of the cervical nerve root C3 to C8, to evaluate accuracy, time and safety and to anticipate possible complications on clinical cases. Under general anesthesia and with ultrasound guidance, five horses were injected from C3 to C8 with 1.5mL mix of contrast and latex. Immediately after euthanasia, the necks were taken for CT examination and then dissection was performed 3 days later. Data regarding the accuracy of injection, the presence of injectate in the nerve root, vertebral vessel or vertebral canal were recorded from both CT and dissection. The time of injection and ability to visualize the nerve root prior to injection were also recorded. Out of 60 intended injections, 55 (CT images) and 57 (dissection) led to injectate deposited within the target zone with direct contact between contrast/latex and cervical nerve roots noted in 76.4% and 73.7%, respectively. Presence of contrast/latex injectate within nerves (≤11%), vertebral vessels (

ObjectiveDespite recent progress in caring for patients born with esophageal atresia (EA), undernutrition and stunting remain common. Our study objective was to assess nutritional status in the first year after birth with EA and to identify factors associated with growth failure.Study designWe conducted a population-based study of all infants born in France with EA between 2010 and 2016. Through the national EA register, we collected prenatal to 1 year follow-up data. We used body mass index and length-for-age ratio Z scores to define patients who were undernourished and stunted, respectively. Factors with P < 0.20 in univariate analyses were retained in a logistic regression model.ResultsAmong 1,154 patients born with EA, body mass index and length-for-age ratio Z scores at 1 year were available for about 61%. Among these, 15.2% were undernourished and 19% were stunted at the age of 1 year. There was no significant catch-up between ages 6 months and 1 year. Patients born preterm (41%), small for gestational age (17%), or with associated abnormalities (55%) were at higher risk of undernutrition and stunting at age 1 year (P < 0.05). Neither EA type nor surgical treatment was associated with growth failure.ConclusionUndernutrition and stunting are common during the first year after birth in patients born with EA. These outcomes are significantly influenced by early factors, regardless of EA type or surgical management. Identifying high-risk patient groups with EA (i.e., those born preterm, small for gestational age, and/or with associated abnormalities) may guide early nutritional support strategies.

Polycyclic aromatic hydrocarbons (PAHs) are persistent organic pollutants produced by anthropogenic activities that contaminate all environmental spheres, including soils. This study focused on PAHs measured in 2154 soils in France, covering the entire territory based on a regular sampling grid. The quantified concentrations in the Σ15 PAHs ranged from 5.1 to 31 200 µg kg−1, with a median value of 32.6 µg kg−1, and PAHs were detected in 70 % of the soil samples. The map of Σ15 PAH concentrations revealed strong spatial variations in soil contamination throughout France, with larger concentrations in soils of industrial regions and near major cities. PAH molecular diagnostic ratios support the historical origin of PAHs in the northern part of France being linked to the significant emissions of PAHs in Europe during the industrial period of 1850–1950, in particular with the contribution of coal and/or biomass combustion and iron–steel production. A health risk assessment conducted for the residential population resulted in a median value of 1.07 × 10−8 in total lifetime cancer risk, with only 20 sites above the limit of 10−6 and one above the limit of 10−5 adopted by the French government. These results reveal the need to conduct large-scale studies on soil contamination to determine the fate of PAHs and evaluate the risks induced by soil pollution at a country-level scale.

The dynamics of water molecules at interfaces controls natural and artificial processes, but experimental investigations have been challenging. Here the authors investigate water molecules on a graphene surface using helium spin-echo spectroscopy, and reveal a regime where freely mobile molecules undergo strong repulsive mutual interactions which inhibit ice nucleation.

Based on field surveys undertaken in two conservation areas, we report new distribution data of Hyalinobatrachium taylori (Goin, 1968) and H. tricolor Castroviejo-Fisher, Vilà, Ayarzagüena, Blanc & Ernst, 2011 from the state of Amapá, northern Brazil. We provide acoustic data from these new populations. These are the first records of H. taylori and H. tricolor from Amapá, extending the geographic distributions of these species by 317 km from Mitaraka and 320 km from Saut Grand Machicou, both in French Guiana, respectively.

Resumen: Introducción: La profesión médica se encuentra en un momento de transición debido a los avances científicos y tecnológicos así como a los cambios sociales que han impactado en la atención a la salud. Este nuevo contexto demanda una transformación de sus atributos para pasar de un modelo de total autonomía hacia un modelo centrado en el paciente, lo cual tiene implicaciones significativas para la educación médica. Método: El objetivo del presente estudio fue identificar la percepción de los estudiantes de medicina sobre estos cambios y explorar en qué medida reflejan el paradigma clásico «centrado en el médico» versus la nueva tendencia «centrada en el paciente». Se realizaron entrevistas semiestructuradas a 55 estudiantes de tres escuelas de medicina. Resultados: El análisis cualitativo demuestra que predomina una interpretación de estos cambios a partir del modelo tradicional con la autonomía y estatus de la profesión sobre el enfoque centrado en el paciente. Conclusión: Se discute el proceso de socialización y el currículo oculto para problematizar la forma en la que se sigue promoviendo este paradigma en oposición al discurso vigente. Abstract: Introduction: The medical profession is in a period of transition due to the improvements in the scientific, technological, and social advances that affecting health care. This new context requires the transformation from a model of total autonomy of the profession to a model centred on the patient, which has important implications for medical education. Method: The objective of the present study was to identify the perception of medical students towards these changes and explore to what extent they reflect the classic paradigm that would entail a «physician centred» perspective vs the new «patient centred» trend. Semi-structured interviews were conducted with 55 medical students of three different schools. Results: Qualitative analysis showed that an interpretation based on the classic model that focuses on the autonomy and status of the profession prevails over the patient centred approach. Conclusion: The process of socialisation and the hidden curriculum are brought up for discussion in order to explore the way in which such paradigm is promoted instead of the patient centred approach.

Abstract Background Cardiac surgery is known to induce acute endothelial dysfunction, which may be central to the pathophysiology of postoperative complications. Preoperative endothelial dysfunction could also be implicated in the pathophysiology of postoperative complications after cardiac surgery. However, the relationship between preoperative endothelial function and postoperative outcomes remains unknown. The primary objective was to describe the relationship between a preoperative microcirculatory dysfunction identified by iontophoresis of acetylcholine (ACh), and postoperative organ injury in patients scheduled for cardiac surgery using cardiopulmonary bypass (CPB). Methods Sixty patients undergoing elective cardiac surgery using CPB were included in the analysis of a prospective, observational, single-center cohort study conducted from January to April 2019. Preoperative microcirculation was assessed with reactivity tests on the forearm (iontophoresis of ACh and nitroprusside). Skin blood flow was measured by laser speckle contrast imaging. Postoperative organ injury, the primary outcome, was defined as a Sequential Organ Failure Assessment score (SOFA) 48 h after surgery greater than 3. Results Organ injury at 48 h occurred in 29 cases (48.3%). Patients with postoperative organ injury (SOFA score > 3 at 48 h) had a longer time to reach the peak of preoperative iontophoresis of acetylcholine (133 s [104–156] vs 98 s [76–139] than patients without, P = 0.016), whereas endothelium-independent vasodilation to nitroprusside was similar in both groups. Beyond the proposed threshold of 105 s for time to reach the peak of preoperative endothelium-dependent vasodilation, three times more patients presented organ dysfunction at 48 h (76% vs 24% below or equal 105 s). In multivariable model, the time to reach the peak during iontophoresis of acetylcholine was an independent predictor of postoperative organ injury (odds ratio = 4.81, 95% confidence interval [1.16–19.94]; P = 0.030). Conclusions Patients who postoperatively developed organ injury (SOFA score > 3 at 48 h) had preoperatively a longer time to reach the peak of endothelium-dependent vasodilation. Trial registration Clinical-Trials.gov, NCT03631797. Registered 15 August 2018, https://clinicaltrials.gov/ct2/show/NCT03631797

Summary: Targeting immune checkpoints, such as Programmed cell Death 1 (PD1), has improved survival in cancer patients by restoring antitumor immune responses. Most patients, however, relapse or are refractory to immune checkpoint blocking therapies. Neuropilin-1 (NRP1) is a transmembrane glycoprotein required for nervous system and angiogenesis embryonic development, also expressed in immune cells. We hypothesized that NRP1 could be an immune checkpoint co-receptor modulating CD8+ T cells activity in the context of the antitumor immune response. Here, we show that NRP1 is recruited in the cytolytic synapse of PD1+CD8+ T cells, cooperates and enhances PD-1 activity. In mice, CD8+ T cells specific deletion of Nrp1 improves anti-PD1 antibody antitumor immune responses. Likewise, in human metastatic melanoma, the expression of NRP1 in tumor infiltrating CD8+ T cells predicts poor outcome of patients treated with anti-PD1. NRP1 is a promising target to overcome resistance to anti-PD1 therapies.

We report on the structure and diffusion behaviour of the various constituent molecules in ionic liquid (IL) mixtures under confinement in nanoporous glasses. X-Ray diffraction measurements indicate that the ions adopt a lamellar arrangement under confinement. Furthermore, using selective deuteration in combination with high resolution neutron spectroscopy reveals how the dynamics and the activation energy of the IL is affected by different confinement conditions (pore sizes 50 Å and 135 Å) and different temperatures (265 and 318 K). With different deuteration schemes we could separate the different motions of acetate and water. The confinement leads to distortions of the domains, which gives more room for diffusion. In the smaller pores, the stronger distortion gives even more room such that the hydrogen bonds between acetate and water seem to be even stronger than in bulk and weaker confinement. The results are discussed in the context of previous measurements on dry samples.

OBJECTIVE: This study aimed to estimate the proportion and number of incident upper-extremity musculoskeletal disorders (UEMSD) cases attributable to occupational risk factors in a working population. METHODS: Between 2002−2005, occupational physicians randomly selected 3710 workers, aged 20–59, from the Pays de la Loire (PdL) region. All participants underwent a standardized clinical examination. Between 2007−2010, 1611 workers were re-examined. This study included 1246 workers who were free of six main clinically diagnosed UEMSD at baseline but were diagnosed with at least one of these UEMSD at follow-up [59% of men, mean age: 38 (standard deviation 8.6) years]. Relative risks and population-attributable fractions (PAF) were calculated using Cox multivariable models with equal follow-up time and robust variance. The total number of incident UEMSD in the PdL region was estimated after adjustment of the sample weights using 2007 census data. The estimated number of potentially avoidable UEMSD was calculated by multiplying PAF by the total number of incident UEMSD in PdL. RESULTS: At follow-up, 139 new cases of UEMSD (11% of the study sample) were diagnosed. This represented an estimated 129 320 incident cases in the PdL in 2007. Following adjustment for personal factors, 26 381 (20.4% of all incident UEMSD) were attributable to high physical exertion, 16 682 (12.9%) to low social support, and 8535 (6.6%) to working with arms above shoulder level. CONCLUSIONS: A large number and important proportion of incident UEMSD may be preventable by reducing work exposures to physical exertion and working with arms above shoulder level as well as improving social support from co-workers/supervisors.

Abstract Background Upper extremity musculoskeletal disorders (UEMSD) are one of the most common and costly occupational health problems. We aimed to assess the population-attributable fraction (PAF) of personal and occupational risk factors associated with incident UEMSD in a working population. Methods From 2002 to 2005, a random sample of 3710 workers from the Pays de la Loire region in France, aged 20–59 were included by occupational physicians (OPs). Between 2007 and 2010, 1611 workers were re-examined by their OPs. Subjects free from UEMSD at baseline were included in this study (1275 workers, mean age: 38.2 years). Cox regression models with equal follow-up time and robust variance estimates were used to estimate age-adjusted and multivariable-adjusted relative risks (RRs) and their 95% confidence intervals (CIs). Based on multivariable models, PAF associated with each factor included in the models was estimated. Results During the follow-up period, 143 (11%) cases of UEMSD were diagnosed. PAFs for factors associated with the incident UEMSD risk were 30% (7 to 51) for high physical exertion (RPE Borg scale ≥12), 12% (− 0.2 to 24) for low social support, 7% (− 3 to 17) for working with arms above shoulder level (≥2 h/day), 20% (12 to 28) for age group ≥45, 13% (3 to 22) for the age group 35–44, and 12% (0.3 to 24) for female gender. Conclusions Our study suggests that an important fraction of UEMSD can be attributed to occupational exposures after the contributions of personal and other work-related factors are considered. In terms of public health, our findings are in agreement with the ergonomic literature postulating that a high proportion of UEMSD are preventable through modifying workplace risk factors. Such information is useful to help public health practitioners and policy makers implement programs of prevention of UEMSD in the working population.

Abstract Background This study aims to compare the effects of storage solutions commonly used in coronary artery bypass grafting on the vascular reactivity in vein graft interposed in arterial position in syngeneic rats. Methods Twenty-seven male Lewis rats were sacrified to sample a vein graft implanted 6 weeks ago into abdominal aorta position. The vein grafts were inferior venae cavae initially pretreated with heparinized saline solution (HS) or autologous heparinized blood (AHB) or our referent solution, GALA. The endothelial functionality, the in situ Reactive Oxygen Species (ROS) levels and the histological characteristics were conducted from segments of arterialized vein graft. Results At 6 weeks, graft thrombosis occurred respectively in 22% of AHB group, 62.5% in the HS group and 82.5% in the GALA group. In each group, significative intimal hyperplasia was observed. After 6 weeks, an endothelium-remodeling layer associated with an increase of wall thickness was observed in each group. Endothelium-dependent tone was reduced in the vein graft regardless of the group. No difference was observed concerning the ROS in vein graft between the different groups. In distal aortic sections, ROS levels were increased in HS and GALA groups. Conclusions Storage solutions used in this experimental model of vein graft implanted in arterial position cause graft injury and a complete disappearance of vascular reactivity. GALA solution did not reduce intimal risk hyperplasia when the vein graft was exposed to arterial flow in a rat model.

Jacques Perriault was a pioneer in computer science at a time it scarcely existed. A major theme that runs throughout his work is the interaction between technology and society. His thesis The logic of use. Essay on communicating machines shows the different ways in which users follow or twist the prophetic proposals of inventors. Looking at pupils as well as e-learning adults using NTIC devices, he insisted on the consequences on cognition and the risk of social fracture. He embedded his analysis of the Technology Imprint on Société in a long term history (Memories of Shadow and Sound. An Archeology of Audiovisual Devices). From this historical perspective, a forward looking vision had him involved in the creation of international standards to be negotiated and built with respect to the end users, so as to be considered as public goods. His wide- reaching intellectual curiosity and his endless transgressions of disciplinary boundaries explain his atypical career. Many researchers are grateful to him for his generosity in suggesting new perspectives while endlessly opening up new and unexpected avenues of research.

Due to the superior physical properties of Wide bandgap (WBG) based power switching devices, silicon carbide (SiC) and gallium nitride (GaN) are believed to be promising candidates to replace Silicon in power electronics converters for EV/HEV applications. That is for this reason that the reliability of these switching devices is an important parameter which conditions their insertion in industrial applications. It is in this context that the subject of this paper falls, aiming at studying the reliability of these new generations of transistors by implementing an in-situ monitoring system in a 48 V/12 V DC/DC converter in order to monitor the evolution of the Rdson. Therefore, we propose a study focusing in the monitoring of Rdson considered as one of more important degradation indicator of a GaN transistor. After an introduction presenting the context of the study, the principle of PHM is described in this paper. The GaN transistor and its use in DC/DC converters are described. The method for monitoring Rdson, a sensitive parameter of the transistor, is developed. The simulations highlight the interest of such a monitoring method to predict the ageing of the transistor, while emphasising the practical difficulties of implementation.

Summary: Background: Erythrocytosis is a hematological disorder usually related to hematopoietic stem cell somatic mutations. However, unexplained erythrocytosis remains frequent. In this study, we evaluated the involvement of IgA1, a regulator of erythropoiesis also implicated in IgA nephropathy (IgAN) pathophysiology, in unexplained polycythemia/erythrocytosis (PE) of IgAN patients. Methods: IgAN-PE patients’ serum was collected, analyzed and used to study IgA1 effect on proliferation and differentiation of erythroid progenitors. Hematological parameters of transgenic mice for human alpha1 heavy chain were studied. Multicentric observational cohorts of chronic kidney disease (CKD) patients, including both native kidney diseases and renal transplants, were studied to analyze patient hemoglobin levels. Findings: We retrospectively identified 6 patients with IgAN and unexplained PE. In large CKD cohorts, IgAN was associated with PE in 3.5% of patients (p

Abstract Atractus badius has a long and controversial nomenclatural history due to both its antiquity and the brevity of its original description. This species was described based on two syntypes from Java. Later, a lectotype was designated and the distribution range restricted to the Guiana Shield. Although this species has been repeatedly recorded throughout Amazonia and the Andes, these records have been erroneously assigned to A. badius because of a considerable level of confusion in the literature. We found 13 additional specimens of this poorly known snake, expanding our knowledge on its morphological variability, phylogenetic relationships and distribution. In this paper, we report new localities and data on meristic, morphometric, coloration, scales micro-ornamentation, osteology and hemipenial morphology to A. badius. We also determine the phylogenetic position of A. badius as nested in a composite Guiana Shield clade. In addition, we discuss recent advances on the systematics of Atractus and comment on some ‘new arrangements’ with respect to previously recognized species groups and available morphological evidence. Finally, we highlight the importance of accurate voucher identification before promoting taxonomic changes or implementing nomenclatural acts derived from new phylogenetic hypotheses, and notably propose the synonymy of the recently described A. pyroni with A. roulei.

The human brain develops from a smooth cortical surface in early stages of fetal life to a convoluted one postnatally, creating an organized ensemble of folds. Abnormal folding patterns are linked to neurodevelopmental disorders. However, the complex multi-scale interactions involved in cortical folding are not fully known yet. Computational models of brain development have contributed to better understand the process of cortical folding, but still leave several questions unanswered. A major limitation of the existing models is that they have basically been applied to synthetic examples or simplified brain anatomies. However, the integration of patient-specific longitudinal imaging data is key for improving the realism of simulations. In this work we present a complete computational pipeline to build and validate patient-specific mechanical models of brain development. Starting from the processing of fetal brain magnetic resonance images (MRI), personalised finite-element 3D meshes were generated, in which biomechanical models were run to simulate brain development. Several metrics were then employed to compare simulation results with neonatal images from the same subjects, on a common reference space. We applied the computational pipeline to a cohort of 29 subjects where fetal and neonatal MRI were available, including controls and ventriculomegaly cases. The neonatal brain simulations had several sulcal patterns similar to the ones observed in neonatal MRI data. However, the pipeline also revealed some limitations of the evaluated mechanical model and the importance of including patient-specific cortical thickness as well as regional and anisotropic growth to obtain more realistic and personalised brain development models. Statement of Significance: Computational modelling has emerged as a powerful tool to study the complex process of brain development during gestation. However, most of the studies performed so far have been carried out in synthetic or two-dimensional geometries due to the difficulties involved in processing real fetal data. Moreover, as there is no correspondence between meshes, comparing them or assessing whether they are realistic or not is not a trivial task. In this work we present a complete computational pipeline to build and validate patient-specific mechanical models of brain development, mainly based on open-source tools.

To better understand the processes of digitalisation, dematerialisation and decarbonisation, this paper examines the relationship between energy and information for the global economy since 1850. It presents the long run trends in energy intensity and communication intensity, as a proxy for total information intensity. The evidence suggests that, relative to GDP, global economic production has been reducing energy and increasing information use since 1913. The analysis indicates that it initially required little information to replace energy in production and that the ability to substitute away from energy and towards information has been declining. The result implies that the global economy is now reducing energy and increasing information at a substitution rate of 0.2 kB per kWh of conserved energy or 0.8 GB per tonne of carbon dioxide mitigated. As the price ratio of energy to information is currently higher than this marginal rate of substitution, there are incentives to further substitute information for energy. However, one conclusion is that (without the long run escalation of carbon prices) substitution away from energy and towards information is likely to cease within the next few decades and, beyond that, digitalisation will play a declining role in the decarbonisation process.

Les petites et moyennes entreprises (PME) représentent la très grande majorité du tissu économique québécois. Des études récentes soulignent l’importance d’assurer la succession de ces PME dans les années à venir. L’option collective de la conversion en coopérative rend possible la continuité de ces entreprises et permet de sauver les emplois qu’elles offrent. Cette option de reprise implique le transfert des actifs et des activités de l’entreprise à ses employés ou à des membres de la communauté regroupés sous la formule juridique coopérative. Malheureusement, on a généralement négligé cette option, ce qui constitue une occasion manquée pour les communautés. Depuis 1980, pourtant, 106 coo- pératives ont repris une entreprise au Québec afin d’assurer sa pérennité sous ce nouveau statut. Les données montrent que, au 1 juillet 2021, 96% des coopératives ayant subi de telles prises de contrôle existent encore. Cette durabilité, y compris la préservation d’emplois et de l’activité économique locale qui s’y rattachent, est une bonne raison d’explorer l’utilité du modèle coopératif pour la reprise d’entreprises.

En el siglo XXI, la problemática del cambio climático se presenta como uno de los retos más desafiantes para la comunidad internacional. Por una parte, una de sus mayores causas es el gran incremento de la concentración de gases de efecto invernadero (GEIs) producto de emisiones generadas por los países más desarrollados y las potencias emergentes. Por otro lado, sus principales manifestaciones se han observado en consecuencias devastadoras en el ambiente durante el último tiempo. En India, el abordaje de esta temática fue evolucionando de acuerdo a las condiciones del contexto político interno, el cual en los años posteriores a la independencia estuvo caracterizado por el tratamiento de cuestiones estructurales en lo que hicieron a la conformación de Estado-nación, no permitiendo una gran profundización del debate respecto de las cuestiones ambientales. No obstante, la llegada al gobierno de Manmohan Singh en el año 2004, marcó el inicio de un punto de inflexión en el tratamiento, proceso que fue retomado posteriormente con la asunción de Narendra Modi en 2014, líder del Bharatiya Janata Party. En este sentido, el presente artículo se propone abordar la consolidación de la política de cambio climático de la República de India contrastando las propuestas realizadas en la materia por el país asiático tanto a nivel interno como externo desde 2004 a 2018.

Objectives Computerised physician order entry (CPOE) systems facilitate the review of medication orders by pharmacists. Reports have emerged that show conception flaws or the misuse of CPOE systems generate prescribing errors. We aimed to characterise pharmacist interventions (PIs) triggered by prescribing errors identified as system-related errors (PISREs) in French hospitals.Design This was a cross-sectional observational study based on PIs prospectively documented in the Act-IP observatory database from January 2014 to December 2018.Setting PISREs from 319 French computerised healthcare facilities were analysed.Participants Among the 319 French hospitals, 232 (72.7%) performed SRE interventions, involving 652 (51%) pharmacists.Results Among the 331 678 PIs recorded, 27 058 were qualified as due to SREs (8.2%). The main drug-related problems associated with PISREs were supratherapeutic (27.5%) and subtherapeutic dosage (17.2%), non-conformity with guidelines/contraindications (22.4%) and improper administration (17.9%). The PI prescriber acceptation rate was 78.9% for SREs vs 67.6% for other types of errors. The PISRE ratio was estimated relative to the total number of PIs. Concerning the certification status of CPOE systems, the PISRE ratio was 9.4% for non-certified systems vs 5.5% for certified systems (p