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Clinical Research Informatics: Contributions from 2023
No full textInternational audienceSummary Objectives: To summarize key contributions to current research in the field of Clinical Research Informatics (CRI) and to select the best papers published in 2023. Methods: A bibliographic search using a combination of MeSH descriptors and free-text terms on CRI was performed using PubMed, followed by a double-blind review in order to select a list of candidate best papers to be then peer-reviewed by external reviewers. After peer-review ranking, a consensus meeting between the two section editors and the editorial team was organized to finally conclude on the selected three best papers. Results: Among the 1,119 papers returned by the search, published in 2023, that were in the scope of the various areas of CRI, the full review process selected three best papers. The first best paper describes the process undertaken in Germany, under the national Medical Informatics Initiative, to define and validate a provenance metadata framework to enable the interpretation including quality assessment of health data reused for research. The authors of the second-best paper present a methodology for the generation of computable phenotypes and the covariates associated with success rates in e-phenotype validation. The third-best presents a review of published and accessible tools that enable the assessment of health data quality through an automated process. This year's survey paper marks the tenth anniversary of the CRI section of the Yearbook by reviewing the dominant themes within CRI over the past decade and the major milestone innovations within this field. Conclusions: The literature relevant to CRI in 2023 has largely been populated by publications that assess and enhance the reusability of health data for clinical research, in particular data quality assessment and metadata management
La fonction publique civile et le statut général des militaires : une relation permanente ?
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Towards Accurate Gait Instability Assessment: Identifying a Fixed Pelvis Point that Best Matches the Whole-Body Center of Mass
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Morpho‐Histo‐Cytological Evaluation of Oral Tissues in Burning Mouth Syndrome: A Systematic Review
No full textInternational audienceBackground: Burning Mouth Syndrome (BMS) is an idiopathic condition characterised by chronic oral burning pain without clinically evident lesions. Despite its prevalence and impact on quality of life, the pathophysiology of BMS remains poorly understood, limiting diagnostic and therapeutic options.Objective: To systematically review histological, morphological and cytological changes in oral tissues of BMS patients, with a focus on epithelial cells and nerve fibres, to identify potential biomarkers and inform future research directions.Methods: A systematic search of electronic databases and grey literature was conducted through October 2024, identifying case–control studies assessing histological or cytological features of oral tissues in adults diagnosed with BMS according to validated criteria. Risk of bias was assessed using the Joanna Briggs Institute tool, and evidence quality was evaluated with GRADE.Results: Fourteen studies involving 214 BMS patients and 130 controls were included. Findings consistently reported reduced epithelial nerve fibre density and increased expression of nociceptive markers such as TRPV1, NGF and P2X3 in BMS tissues. Subepithelial alterations, including increased keratinisation and altered expression of cannabinoid receptors (CB1/CB2), were also observed. Methodological heterogeneity and risk of bias were notable, precluding meta-analysis. The overall quality of evidence was very low.Conclusion: Histological evidence supports neuropathic changes in BMS, involving both neuronal and non-neuronal cells. While these biomarkers hold promise for understanding BMS pathogenesis, standardisation of techniques and further research, including development of animal models, is needed to establish diagnostic and therapeutic utility
Health research protocols: a template for empirical bioethics and other investigations
No full textInternational audienceWe have formalized a protocol template suitable for all types of humanities and social sciences investigations in the domain of health, including empirical bioethics in particular. To achieve this, we revisited the protocol template proposed by O’Brien et al. in Academic Medicine in 2014, better known as the “Standards for Reporting Qualitative Research (SRQR)”. We reorganized, fused and/or renamed several of the sections, and partly or entirely rewrote several of the corresponding instructions. This made it possible to overcome the limitation of the initial protocol to qualitative approaches, and to render the resulting template equally suitable for quantitative and mixed approaches, and/or other approaches. This new protocol template should be seen as a highly adaptable base
The role of early MRI in assessing the risk of local tumor progression following irreversible electroporation for hepatocellular carcinoma treatment
No full textInternational audienceBackground: Irreversible electroporation (IRE) in hepatocellular carcinoma (HCC) triggers apoptosis instead of thermal coagulation, resulting in specific modifications within ablation zones. Aim of this study is to evaluate the diagnostic value of MRI performed three days post-IRE (D3MRI). Methods: This single-institution retrospective study examined patients with HCC treated by IRE from 2012-2017. Criteria included no prior HCC treatment, available D3MRI and one-month MRI (M1MRI) without residual tumor and at least one follow-up MRI after 3 months. We measured the peripheral hyperemia (IREPZ) and central necrotic zone (IRECZ) in the ablation area along with the minimum thickness of IREPZ (min.Th/IREPZ) on both D3MRI and M1MRI. The duration of follow-up and instances of local tumor progression (LTP) were recorded. Results: Forty-eight patients (median age: 68 years) with 65 treated nodules (median diameter: 19 mm) were included. The median follow-up was 37 months. D3MRI median dimensions were 67 mm for IREPZ, 19 mm for IRECZ, and 5 mm for min.Th/IREPZ. LTP occurred in 25 nodules after 18 months. 52% had LTP at min.Th/IREPZ. A min.Th/IREPZ ≤ 5 mm on D3MRI indicated a 24-fold higher risk of LTP (95% CI [2.25-255.95], p < .01), conversely, the min.Th/IREPZ on M1MRI had no predictive value. Conclusion: D3MRI appears to be a valuable tool for assessing the true ablation margins in HCC nodules treated with IRE and for identifying potential sites of local recurrence. It may, therefore, be considered for integration into the follow-up protocol for patients undergoing IRE treatment for HCC. KEYPOINTIncluding an early MRI evaluation following electroporation of HCC nodules is beneficial for accurately measuring the size of the ablation zone and for anticipating potential sites of local recurrence.</div
Entretien avec Margaux Herman sur le manuel universitaire - History of women in Ethiopia, Addis-Abeba, AdéBooks, 2024
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The relative contribution of discs and vertebral bodies to thoracic kyphosis in healthy volunteers
No full textInternational audienceIntroduction : Understanding the normal anatomy of thoracic kyphosis (TK) in healthy subjects is essential for evaluating sagittal malalignment and planning the surgery accordingly. The aim of this study was to identify the proportion of thoracic kyphosis originating from disc versus vertebral body shape and to describe its variation according to age and thoracic kyphosis magnitude.Methods : This study was a retrospective review of a prospective multicenter database of healthy volunteers aged 18 years or older. Vertebral body and disc sagittal Cobb angles were measured at each level and summed within each of the 3 TK regions (Upper, Middle and Lower TK). Relative contributions of discs and vertebral bodies to Upper, Middle, Lower, and total TK were assessed in the whole cohort, and according to age and TK groups, after stratification. Finally, a multivariate analysis including age and TK magnitude was conducted.Results : Among these 645 subjects, the mean age was 37.6 ± 16.3 years with 51% of females. Intervertebral discs were kyphotic in Upper and Middle TK with respective discs contribution to total TK of 4.2% and 9.6%, for a total of 13.8% of total kyphosis. Lower TK discs were lordotic, with a participation of -13.2% of total TK, leading to an overall discs contribution to TK of 0.6%. Vertebral bodies were all kyphotic with a contribution of 99.4% of total kyphosis. Vertebral bodies kyphosis increased across age groups for Middle TK (p = 0.004), Lower TK (p < 0.001), and Total TK (p < 0.001). Discs contributions to total TK increased significantly with increasing TK (-13.8% for Low TK, -1.5% for Average-Low TK, 5.7% for Average-High TK and 9.1% for High TK), (p < 0.001). Finally, discs contribution was significantly greater in males than in females, with respective values of 2.6% and -1.8% (p = 0.01).Conclusion : This study highlights the predominant role of vertebral bodies contribution to thoracic kyphosis, 99.4% on average. The contribution of disc to thoracic kyphosis (values ranging from -13.8% to 9.1%) increases significantly with increasing thoracic kyphosis magnitude. The association of age with thoracic kyphosis was greater for vertebral bodies than discs, particularly in Middle and Lower TK