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We report the UV and IR photofragmentation spectroscopies of protonated synephrine in a cryogenically cooled Paul trap. Single (UV or IR) and double (UV-UV and IR-UV) resonance spectroscopies have been performed and compared to quantum chemistry calculations, allowing the assignment of the lowest-energy conformer with two rotamers depending on the orientation of the phenol hydroxyl (OH) group. The IR-UV hole burning spectrum exhibits the four expected vibrational modes in the 3 μm region, i.e., the phenol OH, Cβ-OH, and two NH2+ stretches. The striking difference is that, among these modes, only the free phenol OH mode is active through IRPD. The protonated amino group acts as a proton donor in the internal hydrogen bond and displays large frequency shifts upon isomerization expected during the multiphoton absorption process, leading to the so-called IRMPD transparency. More interestingly, while the Cβ-OH is a proton acceptor group with moderate frequency shift for the different conformations, this mode is still inactive through IRPD. [ABSTRACT FROM AUTHOR]

[Display omitted] • Structures of isolated kilodalton ligand-protected gold nanoclusters are studied. • By means of gas-phase InfraRed Multiple Photon Dissociation spectroscopy compared to quantum chemistry calculations. • Nanocluster complexes consist of ten or eleven gold atoms that are bound to glutathione or phosphine ligands. • Theoretical calculations are able to reproduce well the experimental IR spectra, although the size of such species makes difficult a precise assignment among the many possible molecular arrangements. This paper reports an attempt to structurally characterize isolated ligand-protected gold nanoclusters by means of gas-phase InfraRed Multiple Photon Dissociation (IRMPD) spectroscopy compared to quantum chemistry Density Functional Theory (DFT) calculations. The mass-selected kilodalton nanocluster complexes consist of ten or eleven gold atoms that are bound to glutathione or phosphine ligands and are produced by ElectroSpray Ionization (ESI) in the form of multiply charged anions or cations. This study allows us to build some methodology benchmarks for species that are large for IRMPD experiments and that are used for biochemistry applications. These gas-phase results on isolated ions are compared to condensed phase data from Fourier-Transform InfraRed (FTIR) spectroscopy and to theoretical IR spectra that are calculated with two different functional/basis sets, namely B3LYP/6-31G* and M06L/LanL2DZ, at the scaled static harmonic level. Although theoretical calculations are able to reproduce well the experimental IR spectra, the size of such species and the presence of many possible interactions between ligands make difficult a precise assignment among the many possible molecular arrangements. [ABSTRACT FROM AUTHOR]

Abstract: Microfluidic LC systems present undeniable advantages over classical LC in terms of sensitivity. Hepcidin, a peptide marker of clinical disorders linked to iron metabolism, was used as model to demonstrate peptide quantification potentialities of LC-chip coupled to a nanoelectrospray source ion trap mass spectrometer in an aqueous sample. First, stable isotope labelled hepcidin was chosen as internal standard and gradient as well as sample compositions were optimised using design of experiments as development tool. The method was then prevalidated using accuracy profiles in order to select the most appropriate response function and to confirm the ability of the technique to quantify low hepcidin concentration. A reliable and very sensitive quantitation method was finally obtained using this integrated microfluidic technology. Indeed, good results with respect to accuracy, trueness and precision were achieved, as well as a very low limit of quantitation (0.07ng/ml). Method suitability of nano-LC on chip tandem mass spectrometry for hepcidin quantitation was also demonstrated in complex media such as human plasma. [Copyright &y& Elsevier]

Abstract: Vesicular systems have shown their ability to increase dermal and transdermal drug delivery. Their mechanism of drug transport into and through the skin has been investigated but remains a much debated question. Several researchers have outlined that drug penetration can be influenced by modifying the surface charge of liposomes. In the present work we study the influence of particle surface charge on skin penetration. The final purpose is the development of a carrier system which is able to enhance the skin delivery of two model drugs, betamethasone and betamethasone dipropionate. Liposomes were characterised by their size, morphology, zeta potential, encapsulation efficiency and stability. Ex vivo diffusion studies using Franz diffusion cells were performed. Confocal microscopy was performed to visualise the penetration of fluorescently labelled liposomes into the skin. This study showed the potential of negatively charged liposomes to enhance the skin penetration of betamethasone and betamethasone dipropionate. [Copyright &y& Elsevier]

Abstract: A sensitive and accurate LC/MS method was developed for the monitoring of glucosamine (GLcN) dog plasmatic concentration. In this scope, relatively low plasmatic concentrations of GLcN were expected, ranging from 50 to 1000ng/mL. Liquid chromatography coupled to simple quadrupole mass spectrometry detection (LC/MS) was selected bringing the selectivity and the sensitivity needed for this application. Additionally, a solid phase extraction (SPE) step was performed to reduce matrix and ion suppression effects. Due to the ionisable character of the compound of interest, a mixed-mode strong cation exchange (Plexa PCX) disposable extraction cartridge (DEC) was selected. The separation was carried out on a Zorbax SB-CN column (5μm, 4.6mm i.d.×250mm), considering hydrophilic interaction liquid chromatography (HILIC). Indeed, the mobile phase was made of methanol and 5mM ammonium hydrogen carbonate buffer at pH 7.5 (95/5, v/v). The detection was led at m/z ratios of 180.0 and 417.0, for GLcN and IS, respectively. Reliability of the results was demonstrated through the validation of the method using an approach based on the accuracy profile allowing managing the risk associated to the use of these methods in routine analysis: it is thus guaranteed that each future result will fall in the ±30% acceptance limits with a probability of at least 90%. Successful application of the method to a preliminary pharmacokinetic study illustrated the usefulness of the method for pre-clinical studies. [Copyright &y& Elsevier]

Abstract: A novel, multidimensional on-line SPE-LC method with electrochemical detection is described for the fully automated and direct analysis of the catecholamines norepinephrine, epinephrine and dopamine in urine. The integrated extractive clean-up of the raw biofluid is based on a SPE-column packed with restricted access material (RAM) which is modified with the affinity ligand nitrophenylboronic acid. The method was fully validated according to a recent approach based on an accuracy profile. The acceptance limits were set at ±15% of the nominal concentration values. The method was found accurate over a concentration range from 15 to 500μg/l for norepinephrine, from 5 to 500μg/l for epinephrine and from 50 to 500μg/l for dopamine. The relative risk for the use of the validated method in routine analysis was also assessed based on this validation strategy. It was found that at most 3.5% of future sample measurements will fall outside the acceptance limits. This demonstrates the high reliability of the analytical method described. Moreover, the measurements uncertainties were deduced from the validation experiments without any additional effort. [Copyright &y& Elsevier]

Summary: Background: Topical photodynamic therapy (PDT) using methyl aminolaevulinate is a noninvasive treatment option suitable to treat clinical and subclinical actinic keratosis (AK) over a large area (field cancerization). The most widely used, conventional protocol in Europe includes illumination with a red‐light lamp. This illumination commonly causes pain, and patients often cannot complete the treatment. Objectives: The aims of this paper are twofold. The first aim is to introduce a novel protocol, the Phosistos protocol (P‐PDT), which includes illumination with a fabric‐based biophotonic device. The second and major aim is to assess the noninferiority, in terms of efficacy for PDT of AK, of P‐PDT compared with the conventional protocol (C‐PDT). Methods: A randomized, controlled, multicentre, intraindividual clinical study was conducted. Forty‐six patients with grade I–II AK of the forehead and scalp were treated with P‐PDT on one area (280 AK lesions) and with C‐PDT on the contralateral area (280 AK lesions). The primary end point was the lesion complete response (CR) rate at 3 months, with an absolute noninferiority margin of −10%. Secondary end points included pain scores, incidence of adverse effects and cosmetic outcome. Results: Three months following treatment, the lesion CR rate of P‐PDT was noninferior to that of C‐PDT (79·3% vs. 80·7%, respectively; absolute difference −1·6%; one‐sided 95% confidence interval −4·5% to infinity). The noninferiority of P‐PDT to C‐PDT in terms of the lesion CR rate remained at the 6‐month follow‐up (94·2% vs. 94·9%, respectively; absolute difference −0·6%; one‐sided 95% confidence interval −2·7% to infinity). Moreover, the pain score at the end of illumination was significantly lower for P‐PDT than for C‐PDT (mean ± SD 0·3 ± 0·6 vs. 7·4 ± 2·3; P < 0·001). Conclusions: P‐PDT is noninferior to C‐PDT in terms of efficacy for treating AK of the forehead and scalp and resulted in much lower pain scores and fewer adverse effects. What's already known about this topic? Topical photodynamic therapy using methyl aminolaevulinate is effective for treating actinic keratosis.In Europe, the conventional protocol involves illumination with a red‐light lamp. Unfortunately, pain is often experienced by patients undergoing this protocol.An alternative protocol that uses daylight illumination has recently been shown to be as effective as the conventional protocol while being nearly painless. However, this alternative protocol can be conducted only in suitable weather conditions. What does this study add? The Phosistos protocol is demonstrated to be as effective as the conventional protocol, nearly as painless as the daylight protocols and suitable year round for treatment of actinic keratosis. Plain language summary available online Linked Comment: Gilaberte. Br J Dermatol 2020; 182:11–12. [ABSTRACT FROM AUTHOR]

The gas-phase conformation of the intact (parent) unprotected RGD- peptide anion has been investigated using a combination of anion photoelectron spectroscopy and quantum chemistry calculations of its low-energy stable structures. The experimentally observed RGD- species correspond to a conformation in which the guanidinium group is protonated, the C-terminus is neutral, the aspartic acid carboxyl is deprotonated, and the anion’s excess electron orbital is localized on the protonated guanidinium. This structure is reminiscent of the RGD loop, which is the peptide motif recognized by trans-membrane integrins. The parent RGD- radical anion was generated using a unique infrared desorption-photoemission-helium jet ion source, whose ability to produce radical anions of peptides may also have analytical mass spectrometric implications. [ABSTRACT FROM AUTHOR]

Summary: Background: Photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AK), particularly for patients with large areas of field cancerization. Among the approved protocols in Europe, the most widely used requires irradiation with the Aktilite CL 128 lamp. However, pain during irradiation and the suboptimal adaptability of the lamp relative to the treatment area are two limiting factors of this protocol. To overcome these limits, a new protocol (referred to as the Flexitheralight protocol) involving irradiation with a light‐emitting, fabric‐based device was developed. Objectives: This paper aims to assess the noninferiority, in terms of PDT efficacy for treating AK, of the Flexitheralight protocol compared with the conventional protocol, which requires irradiation with the Aktilite CL 128 lamp. Methods: A monocentric, randomized, controlled, phase II clinical study was performed. Twenty‐five patients with grade I–II AKs of the forehead and scalp were treated with methyl aminolaevulinate PDT in two symmetrical areas. One area was treated with the conventional protocol (n = 154 AKs), whereas the other area was treated with the Flexitheralight protocol (n = 156 AKs). The primary end‐point was the lesion complete response (CR) rate at 3 months (an absolute noninferiority margin of –10% was used). The secondary end‐points included patient‐reported pain at the end of the irradiation. Results: At 3 months, the lesion CR rate with the Flexitheralight protocol was noninferior to that obtained with the conventional protocol (66·0% vs. 59·1%, respectively; absolute difference, 6·9%; 95% confidence interval –0·6% to 14·5%). Patient‐reported pain was significantly lower with the Flexitheralight protocol than with the conventional protocol (mean ± SD: 0·4 ± 0·6 vs. 5·0 ± 2·6; P < 0·0001). Conclusions: The Flexitheralight protocol is noninferior in terms of efficacy and superior in terms of tolerability to the conventional protocol for treating AKs of the forehead and scalp. What's already known about this topic? Methyl aminolaevulinate photodynamic therapy (PDT) is an effective and noninvasive treatment for actinic keratosis (AK).Treatment‐associated pain is frequently experienced by patients treated with the conventional protocol, which requires irradiation with the Aktilite CL 128 lamp.PDT using daylight as the activating light source has been confirmed as equally effective and less painful than the conventional protocol, but it cannot be performed in all weather conditions. What does this study add? This study demonstrates that the Flexitheralight protocol, which can be performed in all weather conditions, is equally effective as the conventional PDT protocol for AK and is a less painful technique. Linked Comment:Morton. Br J Dermatol 2019; 180:703–704. Respond to this article Plain language summary available online [ABSTRACT FROM AUTHOR]

Background: Cognitive aids improve the technical performance of individuals and teams dealing with high-stakes crises. Hand-held electronic cognitive aids have rarely been investigated. A randomized controlled trial was conducted to investigate the effects of a smartphone application, named MAX (for Medical Assistance eXpert), on the technical and non-technical performance of anaesthesia residents dealing with simulated crises.Methods: This single-centre randomized, controlled, unblinded trial was conducted in the simulation centre at Lyon, France. Participants were anaesthesia residents with >1 yr of clinical experience. Each participant had to deal with two different simulated crises with and without the help of a digital cognitive aid. The primary outcome was technical performance, evaluated as adherence to guidelines. Two independent observers remotely assessed performance on video recordings.Results: Fifty-two residents were included between July 2015 and February 2016. Six participants were excluded for technical issues; 46 participants were confronted with a total of 92 high-fidelity simulation scenarios (46 with MAX and 46 without). Mean (sd) age was 27 (1.8) yr and clinical experience 3.2 (1.0) yr. Inter-rater agreement was 0.89 (95% confidence interval 0.85-0.92). Mean technical scores were higher when residents used MAX [82 (11.9) vs 59 (10.8)%; P<0.001].Conclusion: The use of a hand-held cognitive aid was associated with better technical performance of residents dealing with simulated crises. These findings could help digital cognitive aids to find their way into daily medical practice and improve the quality of health care when dealing with high-stakes crises.Clinical Trial Registration: NCT02678819. [ABSTRACT FROM AUTHOR]

Abstract: The HPLC separation of six alkaloids extracted from Strychnos usambarensis leaves has been developed and optimized by means of a powerful methodology for modelling chromatographic responses, based on three steps, i.e. design of experiments (DoE), independent component analysis (ICA) and design space (DS). This study was the first application of a new optimization strategy to a complex natural matrix. The compounds separated are the isomers isostrychnopentamine and strychnopentamine, 10-hydroxyusambarine and 11-hydroxyusambarine, also strychnophylline and strychnofoline. Three LC parameters have been optimized using a multifactorial design comprising 29 experiments that includes 2 center point replicates. The parameters were the percentage of organic modifiers used at the beginning of a gradient profile which consisted in different proportions of methanol (MeOH) and acetonitrile (MeCN), the gradient time to reach 70% of organic modifiers starting from the initial percentage and the percentage of MeCN found in the mobile phase. Subsequent to the experimental design application, predictive multilinear models were developed and used in order to provide optimal analytical conditions. The optimum assay conditions were: methanol/acetonitrile-sodium pentane sulfonate (pH 2.2; 7.5mM) (33.4:66.6, v/v) at a mobile phase flow rate of 1ml/min during a 40.6min gradient time. The initial organic phase contained 3.7% MeCN and 96.3% MeOH. The method showed good agreement between the experimental data and predictive value throughout the studied parameters space. Improvement of the analysis time and optimized separation for the compounds of interest was possible due to the original and powerful tools applied. Finally, this study permitted the acquisition of isomers profiles allowing the identification of the optimal collecting period of S. usambarensis. [Copyright &y& Elsevier]

Abstract: An innovative methodology based on design of experiments (DoE), independent component analysis (ICA) and design space (DS) was developed in previous works and was tested out with a mixture of 19 antimalarial drugs. This global LC method development methodology (i.e. DoE–ICA–DS) was used to optimize the separation of 19 antimalarial drugs to obtain a screening method. DoE–ICA–DS methodology is fully compliant with the current trend of quality by design. DoE was used to define the set of experiments to model the retention times at the beginning, the apex and the end of each peak. Furthermore, ICA was used to numerically separate coeluting peaks and estimate their unbiased retention times. Gradient time, temperature and pH were selected as the factors of a full factorial design. These retention times were modelled by stepwise multiple linear regressions. A recently introduced critical quality attribute, namely the separation criterion (S), was also used to assess the quality of separations rather than using the resolution. Furthermore, the resulting mathematical models were also studied from a chromatographic point of view to understand and investigate the chromatographic behaviour of each compound. Good adequacies were found between the mathematical models and the expected chromatographic behaviours predicted by chromatographic theory. Finally, focusing at quality risk management, the DS was computed as the multidimensional subspace where the probability for the separation criterion to lie in acceptance limits was higher than a defined quality level. The DS was computed propagating the prediction error from the modelled responses to the quality criterion using Monte Carlo simulations. DoE–ICA–DS allowed encountering optimal operating conditions to obtain a robust screening method for the 19 considered antimalarial drugs in the framework of the fight against counterfeit medicines. Moreover and only on the basis of the same data set, a dedicated method for the determination of three antimalarial compounds in a pharmaceutical formulation was optimized to demonstrate both the efficiency and flexibility of the methodology proposed in the present study. [Copyright &y& Elsevier]

Abstract: The transfer of analytical methods from a sending laboratory to a receiving one requires to guarantee that this last laboratory will obtain accurate results. Undeniably method transfer is the ultimate step before routine implementation of the method at the receiving site. The conventional statistical approaches generally used in this domain which analyze separately the trueness and precision characteristics of the receiver do not achieve this. Therefore, this paper aims first at demonstrating the applicability of two recent statistical approaches using total error-based criterion and taking into account the uncertainty of the true value estimate of the sending laboratory, to the transfer of bioanalytical methods. To achieve this, they were successfully applied to the transfer of two fully automated liquid chromatographic method coupled on-line to solid-phase extraction. The first one was dedicated to the determination of three catecholamines in human urine using electrochemical detection, and the second one to the quantitation of N-methyl-laudanosine in plasma using fluorescence detection. Secondly, a risk-based evaluation is made in order to understand why classical statistical approaches are not sufficient to provide the guarantees that the analytical method will give most of the time accurate results during its routine use. Finally, some recommendations for the transfer studies are proposed. [Copyright &y& Elsevier]

Summary: 光化性角化症 (AK) 是指主要在身体曝光部位(尤其是前臂、手背、面部、耳部、光头头皮和小腿)发现的晒伤皮肤区域。若未经治疗,AK 可能进展成为一种名为鳞状细胞癌的皮肤癌,但这一变化的风险较低。 治疗 AK 的一种方法称为光动力疗法 (PDT)。使用 PDT 治疗 AK 的常用或常规方案称为 C‐PDT。它需要在皮肤上涂抹感光的乳膏,该乳膏随后约 2.5 小时会被高强度红光激活。这会在皮肤上引发严重的炎症, 但只会破坏异常(而非正常)的皮肤组织。 C‐PDT 的主要缺陷是患者在治疗期间会经历疼痛。由于这种疼痛, 许多患者无法完成治疗。这项研究的作者来自法国和德国, 他们拟定了一项新 AK PDT 治疗方案, 称为 P‐PDT。 P‐PDT 涉及改良后的红光激活: 光强度已显著降低, 而且在分子(乳膏)涂抹后仅 30 分钟即开始激活。预计此改良将增加患者的耐受性。这项研究的主要目的在于评估 P‐PDT 在消除 AK 方面是否至少与 C‐PDT 一样有效。次要目的之一是比较 P‐PDT 与 C‐PDT 的疼痛程度。 包括 46 例头部 AK 患者。这些患者在头部一侧接受 P‐PDT 治疗, 另一侧接受 C‐PDT 治疗。研究发现 P‐PDT 至少与 C‐PDT 一样有效, 前者在治疗后 6 个月 94.2% AK 消失, 后者消失率为 94.9%。此外, 根据患者对每个研究方案报告的疼痛程度, 与 C‐PDT 相比, P‐PDT 的疼痛少得多, 甚或无痛。 This summary relates to the study: 光化性角化症光动力疗法的常规方案与基于织物的生物光子器械光照方案(Phosistos 方案):一项随机、对照、非劣效性临床研究 Linked Article: Mordon et al. Br J Dermatol 2020; 182:76–84 [ABSTRACT FROM AUTHOR]

Summary: An actinic keratosis (AK) is an area (lesion) of sun‐damaged skin, mainly found on sun‐exposed parts of the body, particularly the forearms, backs of the hands, face, ears, bald scalp and the lower legs. Left untreated, there is a small risk that an AK could progress into a form of skin cancer called squamous cell carcinoma. One way of treating AK is called photodynamic therapy (PDT). The usual, or conventional, protocol for using PDT to treat AK is called C‐PDT. It involves applying a light‐sensitising cream to the skin which is activated by a high‐intensity red light about 2.5 hours later. This causes intense inflammation in the skin which destroys abnormal, but not normal, skin tissue. The main drawback of C‐PDT is the pain experienced by patients during the treatment. Due to this pain, many patients cannot complete the treatment. The authors of this study, based in France and Germany, proposed a new protocol for PDT of AK, called P‐PDT. P‐PDT involves a revised red light activation: the light intensity has been considerably reduced and the activation begins only 30 minutes after the molecule (cream) application. This revision was expected to increase the patient's tolerance. The primary aim of the study was to assess whether P‐PDT is at least as effective as C‐PDT in destroying AK. One of the secondary aims was to compare pain levels between P‐PDT and C‐PDT. Forty‐six patients with AKs of the head were included. These patients were treated with P‐PDT on one side of the head and with C‐PDT on the other side. With 94.2% disappearance of AKs six months after the treatment, P‐PDT was found to be at least as effective as C‐PDT, which had a disappearance rate of 94.9%. Moreover, from the pain levels reported by the patients for each protocol, P‐PDT is much less painful, or even painless, compared to C‐PDT. This summary relates to the study: The conventional protocol vs. a protocol including illumination with a fabric‐based biophotonic device (the Phosistos protocol) in photodynamic therapy for actinic keratosis: a randomized, controlled, noninferiority clinical study Linked Article: Mordon et al. Br J Dermatol 2020; 182:76–84 [ABSTRACT FROM AUTHOR]

Summary: Actinic keratoses (AKs) are areas of sun‐damaged skin found mainly on sun‐exposed parts of the body, particularly the backs of the hands and forearms, the face and ears, and the scalp in balding men. They are usually harmless although they can be unsightly or inconvenient, and there is a very small risk of some actinic keratoses progressing to a form of skin cancer called squamous cell carcinoma. There are several possible treatments, including photodynamic therapy (PDT), in which a special light activates a cream called a photosensitiser, which has been applied to the affected area of skin. This treatment kills the abnormal cells in the skin. The photosensitisers approved in Europe for PDT of AKs require either activation by red light three hours after application of the photosensitiser (referred to as C‐PDT) or activation by daylight within 30 minutes following application of the photosensitiser (referred to as D‐PDT). The major drawback of C‐PDT is pain during treatment, whereas D‐PDT is nearly pain‐free due to the short time between photosensitiser application and daylight activation. Unfortunately, D‐PDT requires favourable weather conditions. The authors of this study, who belong to the ONCO‐THAI research unit based in France, therefore tested a way to activate the photosensitiser 30 minutes after application, by red light using a flexible, light‐emitting, fabric‐based device (hereinafter referred to as FLEXI‐PDT). This study aimed to assess whether FLEXI‐PDT is at least as effective as C‐PDT in destroying AK. The authors were also interested in whether pain scores differ between FLEXI‐PDT and C‐PDT. For these purposes, 35 patients with AKs on the scalp were treated with FLEXI‐PDT on one side of the scalp and with C‐PDT on the other side. Patients rated their pain during FLEXI‐PDT and during C‐PDT separately. The response of each AK (complete or incomplete disappearance) was assessed by a dermatologist at three months after treatment. From the analyses of the data collected, the authors showed that FLEXI‐PDT, which can be performed in all weather conditions, is at least as effective as and less painful than C‐PDT in destroying AK. Linked Article: Vicentini et al. Br J Dermatol 2019; 180:765–773 [ABSTRACT FROM AUTHOR]

Linked Article: Vicentini et al. Br J Dermatol 2019; 180:765–773 [ABSTRACT FROM AUTHOR]

Introduction La SHFI est une méthode pédagogique efficace pour l’entraînement en équipe [1] , et permet une approche des interactions entre diverses professions au sein d’une équipe constituée. Nous avons expérimenté lors d’expériences précédentes que cette diversité pouvait être cause de difficultés à l’implication de tous dans un scénario, en particulier de l’équipe chirurgicale. D’où des objectifs individuels difficiles à atteindre et une satisfaction parfois insuffisante. Le but de ce travail est d’explorer des moyens de pallier à ces limites et d’évaluer les effets sur les apprenants. Matériel et méthodes Deux sessions de simulation ont eu lieu, avec des apprenants similaires, et selon les recommandations de la Haute Autorité de Santé. La première a été réalisée en centre de simulation. Pour augmenter la fidélité psychologique, la deuxième journée s’est tenue au bloc opératoire, in situ, avec des scénarios très spécifiques des questions locales. De plus une hybridation entre le mannequin haute fidélité et des simulateurs procéduraux chirurgicaux simples permettait un usage réel des instruments et drapages chirurgicaux. Résultats Les caractéristiques et résultats comparés des deux journées figurent dans le Tableau 1 . Les taux d’atteinte des objectifs individuels et de satisfaction sont meilleurs après la 2 e journée. Le nombre de commentaires concernant les points d’amélioration (manque de réalisme et d’implication chirurgical) est aussi meilleur (4/14 commentaires contre 0/13). Le surcoût des nouvelles modalités de simulation a été de 643 Euros pour les modules chirurgicaux et de 250 Euros de dépenses liées au in situ (sont uniquement considérées les dépenses liées à la salle d’opération et matériel chirurgical). Discussion Des moyens simples et assez peu coûteux permettent de mieux intégrer les chirurgiens et IBODE dans la SHFI. La simulation in situ, l’utilisation de matériels familiers, des scénarios « sur mesure » et la simulation hybride engendrent une fidélité psychologique accrue, permettant aux apprenants y compris chirurgicaux une meilleure immersion. L’état cognitif des apprenants (en particulier chirurgiens et IBODE), moins passifs dans ces circonstances et moins soumis à l’hypervigilance, se rapprocherait plus de celui de leur quotidien, ce qui rendrait plus pertinente l’analyse des facteurs humains au débriefing. L’impact sur le transfert d’apprentissage reste à déterminer. [ABSTRACT FROM AUTHOR]

Background: Simulation-based education in healthcare encompasses a wide array of modalities aimed at providing realistic clinical experiences supported by meticulously designed scenarios. The French-speaking Society for Simulation in Healthcare (SoFraSimS) has developed guidelines to assist educators in the design of scenarios for manikin- or simulated participant- based immersive simulation and procedural simulation, the three mainly used modalities., Methods: After establishing a French-speaking group of experts within the SoFraSimS network, we performed an extensive literature review with theory-informed practices and personal experiences. We used this approach identify the essential criteria for practice-based scenario design within the three simulation modalities., Results: We present three comprehensive templates for creating innovative scenarios and simulation sessions, each tailored to the specific characteristics of a simulation modality. The SoFraSimS templates include five sections distributed between the three modalities. The first section contextualizes the scenario by describing the practicalities of the setting, the instructors and learners, and its connection to the educational program. The second section outlines the learning objectives. The third lists all the elements necessary during the preparation phase, describing the educational method used for procedural simulation (such as demonstration, discovery, mastery learning, and deliberate practice). The fourth section addresses the simulation phase, detailing the behaviors the instructor aims to analyze, the embedded triggers, and the anticipated impact on simulation proceedings (natural feedback). This ensures maximum control over the learning experience. Finally, the fifth section compiles elements for post-simulation modifications to enhance future iterations., Conclusion: We trust that these guidelines will prove valuable to educators seeking to implement simulation-based education and contribute to the standardization of scenarios for healthcare students and professionals. This standardization aims to facilitate communication, comparison of practices and collaboration across different learning and healthcare institutions.

Belgian community pharmacists play a pivotal role in both primary and tertiary preventive health activities. Their involvement extends beyond the pharmaceutical care associated with dispensing to include innovative services such as medication review. Additionally, they offer therapeutic education sessions to patients as part of the «Good Use of Medicines» programme. The recent pandemic has precipitated significant changes in pharmacists' responsibilities: they have been temporarily granted authority to prescribe and administer vaccines for COVID-19 and influenza, as well as to perform nasopharyngeal screenings for SARS-CoV-2. As frontline healthcare providers, pharmacists have the potential to expand their role in secondary prevention, particularly in screening and providing diagnostic guidance using in vitro diagnostic medical assays. The skills developed in the vaccination domain could be leveraged to enhance vaccination coverage for other diseases, emulating models used in other countries. Furthermore, the challenges posed by climate change present opportunities for pharmacists to contribute meaningfully to public health.

Introduction: Spinal cord stimulation is a common treatment option for neuropathic pain conditions. Despite its extensive use and multiple technological evolutions, long term efficacy of spinal cord stimulation is debated. Most studies on spinal cord stimulation include a rather limited number of patients and/or follow-ups over a limited period. Therefore, there is an urgent need for real-world, long-term data., Methods: In 2018, the Belgian government initiated a nationwide secure platform for the follow-up of all new and existing spinal cord stimulation therapies. This is a unique approach used worldwide. Four years after the start of centralized recording, the first global extraction of data was performed., Results: Herein, we present the findings, detailing the different steps in the centralized procedure, as well as the observed patient and treatment characteristics. Furthermore, we identified dropouts during the screening process, the reasons behind discontinuation, and the evolution of key indicators during the trial period. In addition, we obtained the first insights into the evolution of the clinical impact of permanent implants on the overall functioning and quality of life of patients in the long-term., Discussion: Although these findings are the results of the first data extraction, some interesting conclusions can be drawn. The long-term outcomes of neuromodulation are complex and subject to many variables. Future data extraction will allow us to identify these confounding factors and the early predictors of success. In addition, we will propose further optimization of the current process., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Bernaerts, Roelant, Lecomte, Moens, Van Buyten, Billet, Bryon, Puylaert, Turgay, Malone, Theys, Van Zundert, Berquin, Crombez, De Coster, Vangeneugden, Ly, Louagie and Hans.)

Background: Simulation-based training is gaining increasing prominence in neonatology training. The Less Invasive Surfactant Administration (LISA) method is starting to be taught in simulation. The aim of this educational study was to develop and validate a rating scale for teaching the LISA method in simulation., Methods: The Downing framework was used to create this performance-rating scale. A first version of the scale was submitted to 12 French and Belgian experts to obtain their opinions. Consensus was reached using a modified Delphi method. The performance of 40 pediatricians was then evaluated with this scale on a preterm neonate manikin simulating a neonatal respiratory distress syndrome. Each run was evaluated using the scale by two independent observers based on video recordings., Results: The Cronbach alpha score of the rating scale was 0.72. The intraclass correlation coefficient (ICC) was 0.91 and the scores between raters were not significantly different. Finally, this rating scale correctly distinguished the experienced from the inexperienced learners (p < 0.01)., Conclusions: This rating scale is one of the first rating scales for the evaluation and teaching of the LISA method in simulation. This tool has ample potential for use in clinical practice to evaluate the performance of surfactant administration in preterm neonates., (© 2024. The Author(s).)

Molten salts are used in various waste treatments, such as recycling, recovery or making inert. Here, we present a study of the degradation mechanisms of organic compounds in molten hydroxide salts. Molten salt oxidation (MSO) using carbonates, hydroxides and chlorides is known for the treatment of hazardous waste, organic material or metal recovery. This process is described as an oxidation reaction due to the consumption of O 2 and formation of H 2 O and CO 2 . We have treated various organic products, carboxylic acids, polyethylene and neoprene with molten hydroxides at 400 °C. However, the reaction products obtained in these salts, especially carbon graphite and H 2 without CO 2 emission, challenges the previous mechanisms described for the MSO process. Combining several analyses of the solid residues and the gas produced during the reaction of organic compounds in molten hydroxides (NaOH-KOH), we demonstrate that these mechanisms are radical-based instead of oxidative. We also show that the obtained end products are highly recoverable graphite and H 2 , which opens a new way of recycling plastic residues., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: Healthcare curricula need summative assessments relevant to and representative of clinical situations to best select and train learners. Simulation provides multiple benefits with a growing literature base proving its utility for training in a formative context. Advancing to the next step, "the use of simulation for summative assessment" requires rigorous and evidence-based development because any summative assessment is high stakes for participants, trainers, and programs. The first step of this process is to identify the baseline from which we can start., Methods: First, using a modified nominal group technique, a task force of 34 panelists defined topics to clarify the why, how, what, when, and who for using simulation-based summative assessment (SBSA). Second, each topic was explored by a group of panelists based on state-of-the-art literature reviews technique with a snowball method to identify further references. Our goal was to identify current knowledge and potential recommendations for future directions. Results were cross-checked among groups and reviewed by an independent expert committee., Results: Seven topics were selected by the task force: "What can be assessed in simulation?", "Assessment tools for SBSA", "Consequences of undergoing the SBSA process", "Scenarios for SBSA", "Debriefing, video, and research for SBSA", "Trainers for SBSA", and "Implementation of SBSA in healthcare". Together, these seven explorations provide an overview of what is known and can be done with relative certainty, and what is unknown and probably needs further investigation. Based on this work, we highlighted the trustworthiness of different summative assessment-related conclusions, the remaining important problems and questions, and their consequences for participants and institutions of how SBSA is conducted., Conclusion: Our results identified among the seven topics one area with robust evidence in the literature ("What can be assessed in simulation?"), three areas with evidence that require guidance by expert opinion ("Assessment tools for SBSA", "Scenarios for SBSA", "Implementation of SBSA in healthcare"), and three areas with weak or emerging evidence ("Consequences of undergoing the SBSA process", "Debriefing for SBSA", "Trainers for SBSA"). Using SBSA holds much promise, with increasing demand for this application. Due to the important stakes involved, it must be rigorously conducted and supervised. Guidelines for good practice should be formalized to help with conduct and implementation. We believe this baseline can direct future investigation and the development of guidelines., (© 2022. The Author(s).)