17 research outputs found
Internal podalic version of second twin: Improving feet identification using a simulation model.
No full textPodalic version and breech extraction require high obstetrical expertise. Identifying fetal extremities is the first crucial step for trainees. When this skill is not polished enough, it increases the inter-twin delivery interval and can even jeopardize the whole manoeuver.
We present a model for simulating and training this specific skill, with obstetrical mannequin, and 3D printed hands and feet. Five feet and five hands (five rights and five lefts of each one) were printed in 3D after initial ultrasound acquisition of a near term fetus. Each foot and hand, was individually set in a condom filled with 100 cc of water and closed with a knot. A Sophie's Mum Birth Simulator Version 4.0 de MODEL-med was placed on the edge of the table. Each hand and foot was inserted into the pelvic mannequin. An evaluation of the students' skills using this model was performed. A significant reduction of the global mean to extract the first foot and all the feet was noticed at three month of interval.
This model is an option to train and assess a crucial skill for version and breech extraction
AI in obstetrics: Evaluating residents' capabilities and interaction strategies with ChatGPT: Correspondence.
No full textReporting Clauses as Quilt Metaphors in Margaret Atwood’s Alias Grace: The Visible Stitches of a Split Character
No full textThis paper investigates the use of reported speech (RS) and reporting clauses (RC) in the novel Alias Grace by Margaret Atwood (1996) from a linguistic and stylistic perspective in the context of discourse analysis. Alias Grace is a multiple viewpoint novel. The author uses the technique of dual (“split”) narrative: first-person and third-person narrators alternate chapters to construct the story of Grace Marks, a young Irish immigrant convicted of murder, and her interactions with Simon Jordan, a doctor interested in mental illnesses. The proportion of final, medial and front RCs varies significantly from one chapter to another and sometimes even within a single chapter. These variations create a “quilt pattern” reminiscent of the patchwork quilts that Grace sews throughout the novel. The paper focuses on first-person chapters, where the narrator is Grace herself. She gives precise and unlikely detail of past conversations but the frontiers between different types of RS can nevertheless be blurred in the absence of quotation marks, hence the extensive use of RCs.RCs of DS in final and medial positions—within or after the quote—are mostly found in written communication and can be used, in the context of fiction, as a means of creating the illusion of oral speech in writing (Salvan 2005). Paradoxically, oral “real life” conversations typically require that reported speakers be mentioned first, with a higher frequency of reporting clauses in front position (she said, “I will”) or of indirect speech (She said that she would). In the novel’s first-person chapters, reporting clauses in medial, final and front positions as well as direct and in indirect speech alternate in a way that reveals Grace’s split personality even before it starts showing in what she actually recounts, RCs being the visible stitches of her split character.Cet article se propose d’étudier l’utilisation du discours rapporté (DR), des incises et des énoncés introducteurs dans le roman de Margaret Atwood, Alias Grace paru en 1996. Alias Grace multiplie les points de vue. Adoptant une narration qui alterne entre première et troisième personne, l’auteur met en scène l’histoire de Grace Marks, jeune immigrante irlandaise au Canada reconnue coupable d’un double meurtre et de ses entretiens avec le docteur Simon Jordan, médecin qui se passionne pour les maladies mentales. Les énoncés rapportants, selon leur position, ne sont pas représentés de manière égale et leur proportion varie d’un chapitre à l’autre. Ces variations entre les différents types de discours créent un ou plusieurs « motif(s) » rappelant les courtepointes cousues par Grace tout au long du roman. Ce travail s’intéresse plus particulièrement aux chapitres de première personne, où Grace est le narrateur-personnage. Elle livre des détails d’une invraisemblable précision sur ses conversations passées, mais les frontières entre les différents discours se brouillent parfois, notamment en raison de l’absence de guillemets, d’où une multiplication des énoncés rapportants. Les incises médianes et finales se retrouvent surtout à l’écrit mais en contexte de fiction, elles peuvent également servir à créer « l’illusion de l’oral dans l’écrit » (Salvan 2005). Paradoxalement, les conversations orales du quotidien ont plutôt tendance à exiger que les énonciateurs rapportés soient mentionnés d’abord, ce qui explique une fréquence plus grande de ce type d’énoncé à l’oral au discours direct (elle a dit : « je m’en occupe ») ou au discours indirect (Elle a dit qu’elle s’en occuperait). Au fil des chapitres de première personne, les énoncés rapportants alternent quelle que soit leur position, de même que DS et DI. Cette alternance permet de donner un aperçu de la double personnalité de Grace avant même qu’elle commence à apparaître dans ses propos. Les énoncés rapportants, dans ce cas, peuvent être interprétés comme les coutures visibles d’un personnage aux multiples facettes
FANCD2 Maintains Fork Stability in BRCA1/2-Deficient Tumors and Promotes Alternative End-Joining DNA Repair
No full textSummaryBRCA1/2 proteins function in homologous recombination (HR)-mediated DNA repair and cooperate with Fanconi anemia (FA) proteins to maintain genomic integrity through replication fork stabilization. Loss of BRCA1/2 proteins results in DNA repair deficiency and replicative stress, leading to genomic instability and enhanced sensitivity to DNA-damaging agents. Recent studies have shown that BRCA1/2-deficient tumors upregulate Polθ-mediated alternative end-joining (alt-EJ) repair as a survival mechanism. Whether other mechanisms maintain genomic integrity upon loss of BRCA1/2 proteins is currently unknown. Here we show that BRCA1/2-deficient tumors also upregulate FANCD2 activity. FANCD2 is required for fork protection and fork restart in BRCA1/2-deficient tumors. Moreover, FANCD2 promotes Polθ recruitment at sites of damage and alt-EJ repair. Finally, loss of FANCD2 in BRCA1/2-deficient tumors enhances cell death. These results reveal a synthetic lethal relationship between FANCD2 and BRCA1/2, and they identify FANCD2 as a central player orchestrating DNA repair pathway choice at the replication fork
Conception d’un modèle de simulateur de pose de trocarts de coelioscopie à partir de données « in vivo » de patiente au bloc opératoire et de modélisation du chirurgien : le bon geste au bon endroit
No full textInternational audienc
AI in obstetrics: Evaluating residents’ capabilities and interaction strategies with ChatGPT
No full textInternational audienceIn line with the digital transformation trend in medical training, students may resort to artificial intelligence (AI) for learning. This study assessed the interaction between obstetrics residents and ChatGPT during clinically oriented summative evaluations related to acute hepatic steatosis of pregnancy, and their self-reported competencies in information technology (IT) and AI. The participants in this semi-qualitative observational study were 14 obstetrics residents from two university hospitals. Students' queries were categorized into three distinct types: third-party enquiries; search-engine-style queries; and GPT-centric prompts. Responses were compared against a standardized answer produced by ChatGPT with a Delphi-developed expert prompt. Data analysis employed descriptive statistics and correlation analysis to explore the relationship between AI/IT skills and response accuracy. The study participants showed moderate IT proficiency but low AI proficiency. Interaction with ChatGPT regarding clinical signs of acute hepatic steatosis gravidarum revealed a preference for third-party questioning, resulting in only 21% accurate responses due to misinterpretation of medical acronyms. No correlation was found between AI response accuracy and the residents' self-assessed IT or AI skills, with most expressing dissatisfaction with their AI training. This study underlines the discrepancy between perceived and actual AI proficiency, highlighted by clinically inaccurate yet plausible AI responses - a manifestation of the 'stochastic parrot' phenomenon. These findings advocate for the inclusion of structured AI literacy programmes in medical education, focusing on prompt engineering. These academic skills are essential to exploit AI's potential in obstetrics and gynaecology. The ultimate aim is to optimize patient care in AI-augmented health care, and prevent misleading and unsafe knowledge acquisition
Training for breech deliveries with the mother in an upright position: An innovative adaptation of a simulation model
No full textInternational audienc
The Playful Potential of Digital Commensality: Learning from Spontaneous Playful Remote Dining Practices
No full textWith one-person households being increasingly common and Covid-19 lockdown policies forcing people to stay home, remote dining has become common practice for many, who take it as an opportunity to connect with others in times of loneliness. Sharing meals online, also known as digital commensality, is a rich form of interaction, where people leverage technology to achieve a sense of connectedness and belonging while eating. In this paper, we look at digital commensality and we explore its inherent playful potential with the aim to inspire the design of engaging technologies that can support, enhance and augment this form of interaction. For this, we used a situated play design approach to document and analyze the behavior of 36 people (including pairs of friends and strangers) sharing meals online. Our analysis surfaced a set of play potentials of remote dining -- i.e., playful things people already do and enjoy spontaneously while sharing meals online. We present those play potentials as inspirational material: they can motivate and enrich the design of future digital commensality technologies by responding to people's desire for playful and social interaction with, through, and around food
Comparative pregnancy rate after colorectal resection versus other surgical procedures for deep infiltrating rectal endometriosis: a systematic review and meta-analysis
No full textAbstract The debate around colorectal surgery for endometriosis has been ongoing, but to date no meta-analysis has investigated the impact of the different surgical approaches on the pregnancy rate. The aim of this meta-analysis study was to determine in women with deep infiltrating rectal endometriosis, how does colorectal resection surgery compare to other surgical techniques (e.g., rectal shaving, disc excision) in terms of pregnancy rates. We searched PubMed, Web of Science, Cochrane library and Clinical Trials for relevant studies published from inception to December 2024. We performed a systematic review and meta-analysis of all English language full-text articles addressing colorectal resection compared with other management of deep infiltrating rectal endometriosis and presenting pregnancy outcomes. We included a study when it (i) provided data on surgical management (shaving, disc excision, and/or colorectal resection) and (ii) detailed the pregnancy outcomes in each subgroup. Four authors independently performed the initial search to evaluate the eligibility criteria. Four authors extracted the data and a fifth author checked this extraction. Of the 113 full-text articles assessed for eligibility, we included 13 in the meta-analysis. These studies represented a total of 3,248 patients. Pregnancy information was available for 2,131 patients: 1073 colorectal resection, 502 shaving, 172 disc excisions, and 384 other practices (expectant management). Colorectal resection was associated with a lower pregnancy rate compared with the other techniques (N = 2,131, odds ratio [OR] = 0.64 [95% confidence interval 0.52–0.79], p < 0.001, I2 = 35%). There were similar results when comparing colorectal resection with rectal shaving (N = 952, OR = 0.51 [95% confidence interval 0.36–0.73], p < 0.001, I2 = 0%), but not when comparing colorectal resection with disc excision (N = 432, OR = 0.65 [95% confidence interval 0.37–1.13], p = 0.13). Conclusions Rectal resection for endometriosis is associated with a lower pregnancy rate compared with other type of surgery, such as shaving. Trial registration: PROSPERO registration number CRD42024512328
