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BACKGROUND So far, there was no search engine dedicated to Digital Health resources on the Internet, especially for French. OBJECTIVE The aim of this paper is to describe a Catalog and Index of Digital Health Teaching Resources on the Internet (CIDHR), a multilingual multiterminology semantic search engine using: (1) two different knowledge organization systems: (1a) a Medical Informatics Multilingual Ontology (MIMO), which contains 3,645 concepts in 33 languages, mainly European languages; (1b) a National (French) referential to describe 70 different competences on digital health, (2) two different sets of metadata: (2a) Learning Object Metadata (LOM) set and (2b) Dublin Core Metadata set. METHODS MIMO & the National (French) referential on digital health are integrated into HeTOP, which is a cross-lingual multi terminology server. Teaching resources are collected from different academic web sites and watched every week. RESULTS Each teaching resource is indexed with MIMO and the National Referential on digital health vocabularies and catalogued with LOM & Dublin Core metadata sets. A total of 334 resources have been catalogued and indexed in CIDHR so far and are available at https://doccismef.churouen.fr/dc/#env=CIDHR CONCLUSIONS Referencing and indexing teaching resources about Digital Health is a valuable tool for both teachers and students. Such task is possible thanks to adapted tools (specific terminologies and medata sets) and is freely available for the community on the Internet.

Antibiotic resistance of bacterial pathogens is considered by the World Health Organization as a major threat to global health aggravated by the misuse of antibiotics. In clinical practice results of bacterial cultures and antibiograms can take several days. In the meantime, prescribing an empirical antimicrobial treatment constitutes a challenge in which the practitioner has to strike a balance between antibiotics spectrum and expected susceptibility probability. In this contribution, we report the development and testing of a machine-learning-based system that early predicts the antimicrobial susceptibility probability and provides explanations of the contribution of the different cofactors at 4 different stages prior to the antibiogram (sampling, direct examination, culture, and species identification stages). A comparative analysis of different state of the art machine learning and probabilistic methods was carried out using 7 years of historical bacterial resistance data from the Hôpital Européen Marseille, France. Our results suggest that dense neural network-based models and Bayesian models are suitable to early predict antibiotics susceptibility (average AUC 0.91 at the species identification stage) even for the less frequent situations.

International audience; The main goal of dental education is to develop health professionals who will maintain and improve the oral health of patients. This requires the quantitative and qualitative assessment of dental student activity. The aim of this work is to describe the ECHO information system that was developed at Timone Hospital (France) for the monitoring and evaluation of dental student activity and to present the results of a qualitative evaluation of student perceptions of this system. According to the analysis of the UML model of care-related procedures and data, the pre-existing process of student evaluation was characterized by redundancy between administrative and educational data. ECHO was developed in PHP/MySQL and designed to centralize the two types of data in a unified computerized process. The qualitative evaluation of dental student perceptions of ECHO was performed using an anonymous online Google Form questionnaire. Among the respondents (102/254 students), 96% stated that ECHO is easy to use, 86% that it saves time, and 81% that it gives them a better overview of their activity. After several years of use, ECHO has solved many of the difficulties related to the use of internship paper booklets, while also providing a documentary database of the activities of our dental department. The student activity data stored in ECHO are directly accessible by faculty members and can be reused to facilitate departmental management and research and to improve patient follow-up.

Background The field of mobile health (mHealth) is constantly expanding. Integrating mHealth apps and devices in clinical practice is a major and complex challenge. General practitioners (GPs) are an essential link in a patient’s care pathway. As they are patients’ preferred health care intermediaries, GPs play an important role in supporting patients’ transition to mHealth. Objective This study aims to identify the factors associated with the willingness of French GPs to prescribe mHealth apps and devices to their patients. Methods This study was part of the ApiAppS project whose overall objective was to help remove barriers GPs face when prescribing mHealth apps and devices by developing a custom-built platform to aid them. The study included GPs recruited from the general practice department of several medical faculties in France (Lyon, Nice, and Rouen) and mailing lists of academic GPs, health care professional associations, and social and professional networks. Participants were asked to complete a web-based questionnaire that collected data on various sociodemographic variables, indicators of their involvement in continued education programs and the amount of time they dedicated to promoting healthy behaviors during patient consultations, and indicators characterizing their patient population. Data on their perceptions of mHealth apps and devices were also collected. Finally, the questionnaire included items to measure GPs’ acceptability of prescribing mHealth apps and devices for several health-related dimensions. Results Of the 174 GPs, 129 (74.1%) declared their willingness to prescribe mHealth apps and devices to their patients. In multivariate analysis, involvement in continued education programs (odds ratio [OR] 6.17, 95% CI 1.52-28.72), a better patient base command of the French language (OR 1.45, 95% CI 1.13-1.88), GP-perceived benefits of mHealth apps and devices for both patients and their medical practice and GP-perceived drivers for mHealth apps and device implementation in their medical practice (OR 1.04, 95% CI 1.01-1.07), and validation of mHealth apps and devices through randomized clinical trials (OR 1.02, 95% CI 1.00-1.04) were all associated with GPs’ willingness to prescribe mHealth apps and devices. In contrast, older GPs (OR 0.95, 95% CI 0.91-0.98), female GPs (OR 0.26, 95% CI 0.09-0.69), and those who perceived risks for the patient or their medical practice (OR 0.96, 95% CI 0.94-0.99) were less inclined to prescribe mHealth apps and devices. Conclusions mHealth apps and devices were generally seen by GPs as useful in general medicine and were, for the most part, favorable to prescribing them. Their full integration in general medicine will be conditioned by the need for conclusive certification, transparency (reliable and precise data concerning mHealth app and device methods of construction and clinical validation), software aids to assist GPs prescribe them, and dedicated training programs.

BACKGROUND Over the past 50 years, dental informatics has developed significantly in the field of health information systems. Accordingly, several studies have been conducted on standardized clinical coding systems, data capture, and clinical data reuse in dentistry. OBJECTIVE The primary objective of this systematic review was to summarize studies on standardized clinical coding systems and electronic dental record (EDR) data capture in dentistry. The secondary objective was to explore the practical implications of reusing EDR data in clinical decision support systems, quality measure development, and clinical research. METHODS Based on the definition of health information systems, we divided the literature search into 3 specific sub-searches: “standardized clinical coding systems,” “data capture,” and “reuse of routine patient care data.” PubMed and Web of Science were searched for peer-reviewed articles. The review was conducted following the PRISMA protocol. RESULTS A total of 43 articles were identified for inclusion in the review. Of these, 15 were related to “standardized clinical coding systems,” 15 to “data capture,” and 13 to “reuse of routine patient care data.” Articles related to standardized clinical coding systems focused on the design and/or development of proposed systems, on their evaluation and validation, on their adoption in academic settings, and on user perception. Articles related to data capture addressed the issue of data completeness, evaluated user interfaces and workflow integration, and proposed technical solutions. Finally, articles related to reuse of routine patient care data focused on clinical decision support systems centered on patient care, institutional or population-based health monitoring support systems, and clinical research. CONCLUSIONS While the development of health information systems, and especially standardized clinical coding systems, has led to significant progress in research and quality measures, the vast majority of reviewed articles were published in the US. Clinical decision support systems that reuse EDR data have been little studied. Likewise, few studies have examined the working environment of dental practitioners or the pedagogical value of using health information systems in dentistry.

BACKGROUND The field of mobile health (mHealth) is constantly expanding. Integrating mHealth apps and devices in clinical practice is a major and complex challenge. General practitioners (GPs) are an essential link in a patient’s care pathway. As they are patients’ preferred health care intermediaries, GPs play an important role in supporting patients’ transition to mHealth. OBJECTIVE This study aims to identify the factors associated with the willingness of French GPs to prescribe mHealth apps and devices to their patients. METHODS This study was part of the ApiAppS project whose overall objective was to help remove barriers GPs face when prescribing mHealth apps and devices by developing a custom-built platform to aid them. The study included GPs recruited from the general practice department of several medical faculties in France (Lyon, Nice, and Rouen) and mailing lists of academic GPs, health care professional associations, and social and professional networks. Participants were asked to complete a web-based questionnaire that collected data on various sociodemographic variables, indicators of their involvement in continued education programs and the amount of time they dedicated to promoting healthy behaviors during patient consultations, and indicators characterizing their patient population. Data on their perceptions of mHealth apps and devices were also collected. Finally, the questionnaire included items to measure GPs’ acceptability of prescribing mHealth apps and devices for several health-related dimensions. RESULTS Of the 174 GPs, 129 (74.1%) declared their willingness to prescribe mHealth apps and devices to their patients. In multivariate analysis, involvement in continued education programs (odds ratio [OR] 6.17, 95% CI 1.52-28.72), a better patient base command of the French language (OR 1.45, 95% CI 1.13-1.88), GP-perceived benefits of mHealth apps and devices for both patients and their medical practice and GP-perceived drivers for mHealth apps and device implementation in their medical practice (OR 1.04, 95% CI 1.01-1.07), and validation of mHealth apps and devices through randomized clinical trials (OR 1.02, 95% CI 1.00-1.04) were all associated with GPs’ willingness to prescribe mHealth apps and devices. In contrast, older GPs (OR 0.95, 95% CI 0.91-0.98), female GPs (OR 0.26, 95% CI 0.09-0.69), and those who perceived risks for the patient or their medical practice (OR 0.96, 95% CI 0.94-0.99) were less inclined to prescribe mHealth apps and devices. CONCLUSIONS mHealth apps and devices were generally seen by GPs as useful in general medicine and were, for the most part, favorable to prescribing them. Their full integration in general medicine will be conditioned by the need for conclusive certification, transparency (reliable and precise data concerning mHealth app and device methods of construction and clinical validation), software aids to assist GPs prescribe them, and dedicated training programs.

BACKGROUND Mobile and wireless technology utilization is expected to change the landscape of healthcare service delivery, especially given that there are more than 7 billion mobile telephone subscriptions around the world OBJECTIVE This systematic review aims to showcase existing mobile health (m-health) applications (apps) for cancer recovering populations, with a special focus on studies that have produced clinically proven results. METHODS We search the bibliographic database Pubmed (Medline) to identify studies that use mobile applications for cancer recovering patients. The search was limited to articles written in English published in the last 5 years. A search of the App Store for iOS devices and Google Play for Android devices was performed as well to find the apps identified in the included research articles. RESULTS In total 30 articles meting the inclusion criteria where identified. From them,/. n= 8 studies produced clinically proven results, with different health outcomes namely weight loss, physical activity promotion, symptoms management and reporting, pain management and physical recovery, and mindfulness and mental distress management. CONCLUSIONS There is a positive correlation between mobile health usage and an improvement of a variety of health outcomes including physical activity promotion and pain management among others. Thus, m-health apps serve as a means to bridge health services and access between physicians and their patients. However, most of the analyzed studies use apps designed for the general public and they are not adapted to be prescribed by a general practitioner. Therefore creating apps with cancer patients in mind would allow to tailor m-health solutions to being disease appropriate and to better suits this population.

BackgroundAdverse events are serious and frequent complications most often linked to the quality of nursing care.PurposeWe evaluated the compliance to traceability of nursing care at bedside using the Patient Smart Reader®, a personal digital assistant with a barcode.MethodsWe compared paper record forms, specific computer software in the hospital information system and the Patient Smart Reader®.ResultsThe Patient Smart Reader enhanced the recording of 90% of nursing care surveyed. Regarding the insertion of blood catheters, compliance rates increased from 44.19 % to 100%, and blood catheter monitoring has risen from 29.64% to 80.74%. Urinary catheter monitoring and insertion recording increased from 10.23% to 55.43% and from 16.67% to 100 % respectively.ConclusionsProviding to caregivers a nursing record system using barcoded implements at the point of care in real time significantly improved traceability of the nursing care.

Introduction Au cours des 12 mois suivant un accident vasculaire cerebral (AVC), 62 % des patients aphasiques developpent une depression (Kauhanen et al., 2000). La depression est un facteur important de la qualite de vie des patients aphasiques (Hilari, Needle et Harrison, 2012). La prise en compte de ce trouble secondaire par les orthophonistes est essentielle, mais il existe encore peu d’informations a ce sujet. Notre etude s’inscrit dans une volonte d’amelioration de la prise en charge des patients aphasiques souffrant de depression. L’objectif de cette etude est de faire un etat des lieux de cette prise en charge afin de degager certains besoins des orthophonistes. Methode A l’aide d’un questionnaire en ligne, nous avons interroge les orthophonistes sur leurs connaissances, les consequences de la depression sur leurs pratiques et sur les aspects relationnels de la reeducation. Resultats et analyse Les 201 reponses collectees ont permis de mettre en evidence un besoin principal d’information sur la depression des patients aphasiques. Les orthophonistes sont peu nombreux a declarer etre bien informes a ce sujet (Bassi et al., 2019). Ils ont des connaissances parcellaires sur les signes de la depression post-AVC, sur ses consequences ainsi que sur certaines notions emergentes. Nous avons pu egalement degager un profil de pratiques en fonction du niveau de connaissances des orthophonistes appelant ensuite a de futures recherches afin de reveler l’impact de ces pratiques. Plus les orthophonistes ont declare avoir des connaissances et plus ils modifient frequemment les aspects temporels, certains aspects relationnels de la reeducation et certains moyens de reeducation. Discussion Les consequences psychologiques et relationnelles de la depression sur la reeducation restent a approfondir. Les orthophonistes ont valide l’utilite d’une plaquette d’information sur la depression pour eux-memes ainsi que pour les patients aphasiques et leur entourage.

International audience; IntroductionLes technologies de l’information et de la communication ont permis la naissance du web 2.0, caractérisé par la mise en place et l’utilisation de nouveaux outils collaboratifs de communication tels que les blogs, les wikis, les fils RSS et les réseaux sociaux. En s’appropriant ces outils, une médecine participative basée sur le partage d’informations et d’expériences entre professionnels, patients et tout acteur de la santé s’est développée. Depuis juin 2012, une communauté médicale échange sur Twitter avec le hashtag #DocTocToc et contribue à la naissance de la e-santé sur ce réseau social. L’objectif de cette étude est d’analyser les principales thématiques des demandes effectuées via le hashtag #DocTocToc par les médecins généralistes entre juin 2012 et mars 2017.MéthodesUne collecte de données par une méthode de « web scraping » a permis de constituer un corpus de tweets dont les auteurs ont été identifiés manuellement afin de procéder à un échantillonnage, de façon à ne conserver que les tweets émis par les médecins généralistes. Une étape de prétraitement a permis de transformer les formes potentiellement non reconnues par les logiciels de traitement du langage naturel. Le corpus a été appréhendé à l’aide de deux approches : une approche lexicale via le logiciel Iramuteq® et une indexation terminologique par l’extracteur de concepts multi-terminologiques (ECMT) du Catalogue et index des sites médicaux francophones (CISMeF).RésultatsSur les 12 716 tweets recueillis, 7366 étaient rédigés par des médecins généralistes et ont été analysés. L’approche lexicale détermine deux grands mondes lexicaux représentés sous forme de dendrogramme, l’un en lien avec les demandes médico administratives relatives à la gestion du cabinet et à la prise en charge sociale du patient, l’autre en lien avec les demandes d’ordre purement médicales. La méthode d’indexation terminologique met en évidence les spécialités médicales pourvoyeuses de demandes de télé-expertise : gynécologie, neurologie, infectiologie, pédiatrie, cardiologie, dermatologie ; et permet de les croiser avec l’objectif de la demande : diagnostic, thérapeutique.ConclusionSur Twitter®, le hashtag #DocTocToc est utilisé par les médecins généralistes comme un espace de partage informel d’informations en matière de santé mais aussi de gestion de problèmes administratifs et sociaux. Le DocsTocToc se présente comme un groupe d’échange de pratique à grande échelle ou le médecin compte sur l’avis de ses pairs.(Fig. 1)

International audience; Breastfeeding is a major determinant of human health. Breast milk is not sterile and ecological large-scale sequencing methods have revealed an unsuspected microbial diversity that plays an important role. However, microbiological analysis at the species level has been neglected while it is a prerequisite before understanding which microbe is associated with symbiosis or dysbiosis, and health or disease. We review the currently known bacterial repertoire from the human breast and milk microbiota using a semiauto-mated strategy. Total 242 articles from 38 countries, 11,124 women and 15,489 samples were included. Total 820 species were identified mainly composed of Proteobacteria and Firmicutes. We report variations according to the analytical method (culture or molecular method), the anatomical site (breast, colostrum or milk) and the infectious status (healthy control, mastitis, breast abscess, neonatal infection). In addition , we compared it with the other human repertoires. Finally, we discuss its putative origin and role in health and disease. Breastfeeding has been associated with the health of the child and the mother, regardless of geography and socioeconomic level [1], child's growth and cognitive development [1,2]. Human studies suggest a protective effect against diarrhea, necrotizing enterocolitis, otitis media and respiratory infections in the short term and against leukemia, malocclusion, inflammatory bowel disease, malnutrition including kwashiorkor, obesity and diabetes in the long term [1,3,4]. Up to half of deaths caused by infections in children aged 6-23 months may be associated with the absence of adequate breastfeeding [1]. Breastfeeding has also been associated with a protective effect for mothers against breast cancer and possibly against ovarian cancer and diabetes [1]. In addition to nutrients, bioactive molecules such as human milk oligosaccharides, human maternal cells but also extracellular vesicles [5-8], milk contains many microbes and is therefore not sterile. The importance of the microbial diversity of human milk for the health of the offspring has been largely neglected to date. More recently, an increasing number of studies have reported an unsuspected diversity, including many health-promoting bacteria (probiotics) in the breast, colostrum or milk [9-11] but also bacteria usually considered pathogenic and frequently found in healthy controls [12]. The milk microbiota likely plays a critical role in the colonization of the child's digestive tract and in the development of its immunity [13-16]. Prolonged exclusive breastfeeding is associated with reduced diarrhea-related gut microbiota dysbiosis and microbiota differences that persist for life [8]. The disruption of this ecosystem has also been associated with maternal diseases, such as lactational mastitis and breast cancer [17-20]. Breast bacteria could also play a role in maintaining healthy breast tissue, including stimulating host immunity [17]. Many questions remain unanswered regarding the microbiome, such as the fact that microbes considered pathogenic are frequently found in controls, the mechanism by which the microbiota impacts immune development and how dysbiosis leads to gut inflammation [8]. Researchers suggested that future studies should employ metagenomics, metatranscriptomics and metabolomics approaches to understand the complete taxonomical, func

International audience; The aim of this article is to review the human repertoire of bacteria in urine already described by culture and metagenomic techniques and published in the literature. Our study led us to compare this repertoire with other available human repertoires. We followed automatic and manual bibliographical methods and found 562 bacterial species reported in the literature as part of the human urinary microbiota. Of the 562 species, 322 were described only by culture, 101 by both culture and metagenomics, and 139 only by metagenomics. A total of 352 species (62.6%) have been associated with at least one case report of human infection, of which 225 (40.0%) have been described as causative agents of urinary tract infection. The urinary tract bacterial repertoire contains 21.4% of the known prokaryotic diversity associated with human beings (464 species in common), and it shares 23.6% species with the human gut microbiota (350 species in common, 62.3% of the urine species). The urinary repertoire shares a significant difference in aerointolerant species compared with those of the gut microbiota (100/562 [17.8%] and 505/1,484 [34.0%], respectively; P < 0.001; odds ratio [OR] = 9.0 [7.0 to 11.4]). Studies using high-throughput sequencing show a higher proportion of aerointolerant bacteria in urine (74/240 [30.8%]) than studies using culture techniques (40/423 [9.5%]). Most pathogenic bacteria are part of the commensal human urinary tract bacteria, and their pathogenicity may occur following any imbalance of this microbiota. The restoration of urinary tract health can occur following a fecal transplantation. The potential gut origin of the human bacterial microbiota has to be explored.

International audience; Halophilic prokaryotes are described as microorganisms living in hypersaline environments. Here, we list the halotolerant and halophilic bacteria which have been isolated in humans. Of the 52 halophilic prokaryotes, 32 (61.54%) were moderately halophilic, 17 (32.69%) were slightly halophilic and three (5.76%) were extremely halophilic prokaryotes. At the phylum level, 29 (54.72%) belong to Firmicutes, 15 (28.84%) to Proteobacteria, four (7.69%) to Actinobacteria, three (5.78%) to Euryarchaeota and one (1.92%) belongs to Bacteroidetes. Halophilic prokaryotes are rarely pathogenic: of these 52 halophilic prokaryotes only two (3.92%) species were classified in Risk Group 2 (Vibrio cholerae, Vibrio parahaemolyticus) and one (1.96%), species in Risk Group 3 (Bacillus anthracis).

Introduction Le rapport hebdomadaire de surveillance epidemiologique du Burkina Faso agrege les donnees de 11 maladies transmissibles, ainsi que les donnees de deces maternels et neonataux. Initialement papier, il a ete informatise sous forme d’un formulaire electronique mobile capable d’alimenter directement l’entrepot de donnees national (ENDOS-BF). Ce projet denomme « initiative de Baskuy » a ete experimente dans le district sanitaire de Baskuy en 2013 et a ete etendu en 2015 a deux autres districts sanitaires du pays (Kongoussi et Gourcy). L’organisation pyramidale basee sur les missions et les entites a ete transformee en une organisation plus en reseau, axee sur le processus de partage de donnees. Nous avons realise une etude d’evaluation de cette configuration avec toutes les parties prenantes. Methode Nous avons evalue ce dispositif aupres : – des infirmiers chefs de postes de toutes les 87 structures sanitaires (SS) publiques des trois districts sanitaires (DS) ; – des medecins-chefs et des gestionnaires de donnees de ces trois districts ; – des trois gestionnaires de donnees des directions regionales de la sante (DRS) de ces DS ; – et dans trois directions centrales (DC) du ministere de la sante (MS) qui sont les utilisatrices de la plateforme. L’enquete a ete realisee de fevrier a avril 2016. L’ensemble des questions portaient sur l’utilisation du dispositif tout au long de l’annee 2015. Nous avons adopte le modele de l’outil « Tool for Assessing Level of Information » (TALI) developpe par « Health Information Systems Project » d’Afrique du Sud. Cet outil est structure en trois paliers : le fonctionnement du systeme d’information, l’analyse de l’information, et l’utilisation de l’information. Nous avons adopte les etapes d’evaluation des systemes d’information medicale utilisees par Ann Fruhling et Stacie Petter. Une echelle de Likert a sept options de choix a ete utilisee pour la majorite des items du questionnaire. Une question ouverte de satisfaction cloturait les items de chaque palier. Resultats Pour le fonctionnement correct du dispositif, il y avait « rarement » ou « jamais » : une transmission des donnees en dehors des delais ; un defaut de couverture du reseau ; une transmission incomplete des donnees ; ou une absence de transmission de donnees dans une semaine. Dans 73,6 % des structures sanitaires, il y avait une absence de feedback. L’information etait souvent analysee et discutee au niveau des DS. Les courbes de tendances des tableaux de bord dont tous les acteurs avaient acces ont permis aux trois DRS et aux trois DC d’identifier les alertes epidemiologies de meningites et de rougeole. Les indicateurs etaient « toujours » utilises pour l’elaboration des plans d’actions au niveau des DS, mais « jamais » utilises au niveau des DRS et des trois DC. La majorite (54 %) des SS avaient souhaite un acces aux informations des autres SS a travers l’application mobile. Des formations continues avaient ete demandees par 37 % des structures. Certains agents des SS (14 %) avaient exprime un besoin d’une plus grande implication des DS, des DRS et du MS. Conclusion Les resultats de cette etude ont montre que le dispositif de surveillance par la telephonie mobile au Burkina a permis d’identifier des alertes epidemiologiques. L’insuffisance d’implication des premiers acteurs constitue un frein pour ameliorer la transmission des donnees dans les delais et le suivi du fonctionnement correct des dispositifs mobiles.