Showing papers by "Université Nantes Angers Le Mans published in 2017"

Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data

Abstract: BACKGROUND: Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. METHOD: We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol. RESULTS: We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47-2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04-1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81-1.32). CONCLUSIONS: Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.

Addition of Androgens Improves Survival in Elderly Patients With Acute Myeloid Leukemia: A GOELAMS Study

Abstract: Purpose Elderly patients with acute myeloid leukemia (AML) have a poor prognosis, and innovative maintenance therapy could improve their outcomes. Androgens, used in the treatment of aplastic anemia, have been reported to block proliferation of and initiate differentiation in AML cells. We report the results of a multicenter, phase III, randomized open-label trial exploring the benefit of adding androgens to maintenance therapy in patients 60 years of age or older. Patients and Methods A total of 330 patients with AML de novo or secondary to chemotherapy or radiotherapy were enrolled in the study. Induction therapy included idarubicin 8 mg/m 2 on days 1 to 5, cytarabine 100 mg/m 2 on days 1 to 7, and lomustine 200 mg/m 2 on day 1. Patients in complete remission or partial remission received six reinduction courses, alternating idarubicin 8 mg/m 2 on day 1, cytarabine 100 mg/m 2 on days 1 to 5, and a regimen of methotrexate and mercaptopurine. Patients were randomly assigned to receive norethandrolone 10 or 20 mg/day, according to body weight, or no norethandrolone for a 2-year maintenance therapy regimen. The primary end point was disease-free survival by intention to treat. Secondary end points were event-free survival, overall survival, and safety. This trial was registered at www.ClinicalTrials.gov identifier NCT00700544. Results Random assignment allotted 165 patients to each arm; arm A received norethandrolone, and arm B did not receive norethandrolone. Complete remission or partial remission was achieved in 247 patients (76%). The Schoenfeld time-dependent model showed that norethandrolone significantly improved survival for patients still in remission at 1 year after induction. In arms A and B, respectively, 5-year disease-free survival was 31.2% and 16.2%, event-free survival was 21.5% and 12.9%, and overall survival was 26.3% and 17.2%. Norethandrolone improved outcomes irrelevant to all prognosis factors. Only patients with baseline leukocytes. 30 3 10 9 /L did not benefit from norethandrolone. Conclusion This study demonstrates that maintenance therapy with norethandrolone significantly improves survival in elderly patients with AML without increasing toxicity.

Permeability prediction of soils including degree of compaction and microstructure.

Abstract: The present paper deals with the proposition of an original analytical permeability model of compacted soils. The model involves the microstructure of the material through the porosity and the pore-size distribution obtained by mercury intrusion porosimetry (MIP), as well as the degree of compaction. Their effects on the morphological parameters of the porous network (tortuosity and interconnection of pore network) are studied. The model was developed and tested on various types of soil: a loamy sand, a gravelous sand, a clay, and an alterite. Samples were compacted with various degrees of compaction: 85, 95, 100, and 105% of the optimum dry density as determined by a standard compaction method. The experimental results obtained for both loamy and gravelous sands and for clay were well reproduced by the model, except for the alterite. Such results might be explained by the high brittleness of the alterite, leading to a crumbling phenomenon rather than to its densification during the compaction pro...

Brain Activity during Mental Imagery of Gait Versus Gait-Like Plantar Stimulation: A Novel Combined Functional MRI Paradigm to Better Understand Cerebral Gait Control.

Abstract: Human locomotion is a complex sensorimotor behavior whose central control remains difficult to explore using neuroimaging method due to technical constraints, notably the impossibility to walk with a scanner on the head and/or to walk for real inside current scanners. The aim of this functional MRI (fMRI) study was to analyze interactions between two paradigms to investigate the brain gait control network: 1) mental imagery of gait, and 2) passive mechanical stimulation of the plantar surface of the foot with the Korvit boots. The Korvit stimulator was used through two different modes, namely an organized (“gait like”) sequence and a destructured (chaotic) pattern. Eighteen right-handed young healthy volunteers were recruited (mean age, 27±4.7 years). Mental imagery activated a broad neuronal network including the supplementary motor area-proper (SMA-proper), pre-SMA, the dorsal premotor cortex, ventrolateral prefrontal cortex, anterior insula, and precuneus/superior parietal areas. The mechanical plantar stimulation activated the primary sensorimotor cortex and secondary somatosensory cortex bilaterally. The paradigms generated statistically common areas of activity, notably bilateral SMA-proper and right pre-SMA, highlighting the potential key role of SMA in gait control. There was no difference between the organized and chaotic Korvit sequences, highlighting the difficulty of developing a walking-specific plantar stimulation paradigm. In conclusion, this combined-fMRI paradigm combining mental imagery and gait-like plantar stimulation provides complementary information regarding gait-related brain activity and appears useful for the assessment of high-level gait control.

Evaluation of crack status in a meter-size concrete structure using the ultrasonic nonlinear coda wave interferometry

Abstract: The field of civil engineering is in need of new methods of non-destructive testing, especially in order to prevent and monitor the serious deterioration of concrete structures. In this work, experimental results are reported on fault detection and characterization in a meter-scale concrete structure using an ultrasonic nonlinear coda wave interferometry (NCWI) method. This method entails the nonlinear mixing of strong pump waves with multiple scattered probe (coda) waves, along with analysis of the net effect using coda wave interferometry. A controlled damage protocol is implemented on a post-tensioned, meter-scale concrete structure in order to generate cracking within a specific area being monitored by NCWI. The nonlinear acoustic response due to the high amplitude of acoustic modulation yields information on the elastic nonlinearities of concrete, as evaluated by two specific nonlinear observables. The increase in nonlinearity level corresponds to the creation of a crack with a network of microcracks localized at its base. In addition, once the crack closes as a result of post-tensioning, the residual nonlinearities confirm the presence of the closed crack. Last, the benefits and applicability of this NCWI method to the characterization and monitoring of large structures are discussed.

Proposal of a new classification of postoperative ileus based on its clinical impact—results of a global survey and preliminary evaluation in colorectal surgery

Abstract: PURPOSE: There is no consensual definition of postoperative ileus (POI), which leads to a lack of reproducibility. The aims of this study were (i) to propose and evaluate a classification of postoperative ileus based on its consequences and (ii) to assess the reproducibility of the classification. METHODS: A national global survey was carried out according to the DELPHI method in order to create a classification of primary POI. The classification was subsequently tested on a cohort of patients who underwent colorectal surgery. Finally, a reproducibility test was performed in five teaching hospitals with junior and senior surgeons. RESULTS: A five-stage classification was proposed: grade A (least) to grade E (worst). For better differentiation, subcategories (D1/D2) were included. Overall, 173 patients were included who underwent colorectal surgery. Forty of them experienced primary postoperative ileus (23.1%). Grade A occurred in 10 cases, grade B in 10 cases, grade C in 14 cases, grade D1 in 2 cases, and grade D2 in 2 cases. POI-related death (grade E) occurred in 2 cases. Patients with grade A POI recovered their gastrointestinal function significantly faster than those with higher grades (p = 0.01), and were more likely to undergo laparoscopic surgery (p = 0.04). The Intraclass Correlation Coefficient (ICC) was 0.83 in the overall population, and 0.83 and 0.82 respectively in the junior and senior surgeon populations. CONCLUSION: This classification is easy to both use and reproduce. It will improve the reproducibility, evaluation, and assessment of POI. These preliminary results should be confirmed in a multi-centric international study.

Bovine and murine models highlight novel roles for SLC25A46 in mitochondrial dynamics and metabolism, with implications for human and animal health.

Abstract: Neuropathies are neurodegenerative diseases affecting humans and other mammals. Many genetic causes have been identified so far, including mutations of genes encoding proteins involved in mitochondrial dynamics. Recently, the "Turning calves syndrome", a novel sensorimotor polyneuropathy was described in the French Rouge-des-Pres cattle breed. In the present study, we determined that this hereditary disease resulted from a single nucleotide substitution in SLC25A46, a gene encoding a protein of the mitochondrial carrier family. This mutation caused an apparent damaging amino-acid substitution. To better understand the function of this protein, we knocked out the Slc25a46 gene in a mouse model. This alteration affected not only the nervous system but also altered general metabolism, resulting in premature mortality. Based on optic microscopy examination, electron microscopy and on biochemical, metabolic and proteomic analyses, we showed that the Slc25a46 disruption caused a fusion/fission imbalance and an abnormal mitochondrial architecture that disturbed mitochondrial metabolism. These data extended the range of phenotypes associated with Slc25a46 dysfunction. Moreover, this Slc25a46 knock-out mouse model should be useful to further elucidate the role of SLC25A46 in mitochondrial dynamics.

Differentiating Merkel cell carcinoma of lymph nodes without a detectable primary skin tumor from other metastatic neuroendocrine carcinomas: The ELECTHIP criteria

Abstract: Background Merkel cell carcinoma (MCC) can present as a cutaneous tumor or a lymph node metastasis without a primary tumor. MCC presenting without a primary tumor (MCCWOPT) can be misinterpreted on histologic examination as lymph node metastasis (LNM) from another neuroendocrine carcinoma (LNMNEC). However, this distinction is crucial for therapeutic management. Objective To determine the discriminative criteria for the differential diagnosis of MCCWOPT, LNM from cutaneous MCC, and LNMNECs. Methods Clinical, morphologic, and immunohistochemical data (expression of cytokeratins AE1, AE3, 7, 19, and 20; chromogranin A, synaptophysin, thyroid transcription factor-1 [TTF-1]), as well as the presence of Merkel cell polyomavirus (by immunohistochemistry and PCR) were compared in patients with MCCWOPT (n = 17), LNM from a cutaneous MCC (n = 11), and LNMNEC (n = 20; 8 lung, 7 thyroid, 3 digestive tract, 2 other). Results MCC (including MCCWOPT and LNM from a cutaneous MCC) differed from LNMNEC by 7 discriminative criteria: 1) elderly age, 2) location of the tumor, 3) extent of the disease, 4) cytokeratin expression, 5) TTF-1 expression, 6) histologic type, and 7) Merkel cell polyomavirus detection, summarized under the acronym ELECTHIP. All MCC patients had ≥5 of the ELECTHIP criteria, whereas all patients with LNMNEC (except 1) had Limitations The discriminant ability of the ELECTHIP criteria should be validated in a second independent set. Conclusion MCCWOPT can be distinguished from other LNMNEC by the ELECTHIP criteria.

Nature and Specificity of Gestural Disorder in Children with Developmental Coordination Disorder: A Multiple Case Study.

Abstract: Aim: Praxis assessment in children with developmental coordination disorder (DCD) is usually based on tests of adult apraxia, by comparing across types of gestures and input modalities. However, the cognitive models of adult praxis processing are rarely used in a comprehensive and critical interpretation. These models generally involve two systems: a conceptual system and a production system. Heterogeneity of deficits is consistently reported in DCD, involving other cognitive skills such as executive or visual-perceptual and visuospatial functions. Surprisingly, few researches examined the impact of these functions in gestural production. Our study aimed at discussing the nature and specificity of the gestural deficit in DCD using a multiple case study approach. Method: Tasks were selected and adapted from protocols proposed in adult apraxia, in order to enable a comprehensive assessment of gestures. This included conceptual tasks (knowledge about tool functions and actions; recognition of gestures), representational (transitive, intransitive), and non-representational gestures (imitation of meaningless postures). We realised an additional assessment of constructional abilities and other cognitive domains (executive functions, visual-perceptual and visuospatial functions). Data from 27 patients diagnosed with DCD were collected. Neuropsychological profiles were classified using an inferential clinical analysis based on the modified t-test, by comparison with 100 typically developing children divided into five age groups (from 7 to 13 years old). Results: Among the 27 DCD patients, we first classified profiles that are characterised by impairment in tasks assessing perceptual visual or visuospatial skills (n = 8). Patients with a weakness in executive functions (n = 6) were then identified, followed by those with an impaired performance in conceptual knowledge tasks (n = 4). Among the 9 remaining patients, 6 could be classified as having a visual spatial/visual constructional dyspraxia. Gestural production deficits were variable between and within profiles. Discussion: This study confirmed the heterogeneity of gestural production deficit among children with a diagnosis of DCD, at both intra- and inter-individual levels. The contribution of other cognitive deficits in most of the profiles allows discussing the specificity of gestural difficulties. This argues in favour of the necessity to distinguish gestural problems with other deficits made apparent through gesture.

Dispositif et procédé pour réaliser une émulsion en continu de deux liquides immiscibles

Abstract: La presente invention a pour objet un dispositif (1) pour realiser une emulsion en continu de deux fluides immiscibles, muni d'un premier microsysteme (2) comprenant au moins deux micro-canaux (23, 24) d'admission de chaque fluide sections respectives S1 et S2 differentes, se faisant face le long d'un axe central A d'admission et presentant un ex-centrage, au moins deux micro-canaux (25, 26) de sortie dudit dispositif (1) de l'emulsion une fois formee, et une zone de croisement (27) des micro-canaux d'admission et de sortie, apte a generer une interface entre les fluides et constituer une pre-emulsion circulant dans les micro-canaux de sortie jusqu'a l'achevement de l'emulsion. Selon l'invention, le dispositif (1) comprend en outre au moins une singularite (31, 32, 33, 34, 35, 36) apte a destabiliser les interfaces entre les fluides dans la pre-emulsion. La presente invention a egalement pour objet un procede pour realiser une emulsion en continu de deux liquides immiscibles mettant en œuvre le dispositif (1) selon l'invention.

Étude de la reproductibilité du procédé de stérilisation et proposition d’un protocole de requalification des stérilisateurs

Abstract: Unlike EN 554, and since the publication of ISO 17665-1 standard, the user of autoclaves may use methods other than those indicated in the guidelines. Outsourcing the requalification of sterilizers by an external service provider and after observing from the previous requalification reports that the thermometric data seemed reproducible, we decided to propose and validate a validation method for the reproducibility of the sterilization process. This is to exempt from the study of the repeatability of the EN 554 standard in future requalifications. Reproducibility was studied with the sensors of the sterilization service and from the production cycles. This study was carried out in three parts. First, we checked whether our sensors were reliable. Then we evaluated the sterilization process fidelity of each sterilizer. Finally, we compared our measurements performed by the service sensors with the measurements performed by the service provider during the requalifications of the previous years. This work leads us to describe a new protocol of requalification of our sterilizers.

Efficient waterlines cleaning protocols in post-weaning rooms: a new way to reduce antibiotic consumption?

Abstract: In this study, we have chosen a sensitive period, the weaning period, to evaluate in pig farms the effects of different mechanical and chemical waterlines cleaning protocols similar to those used in poultry farms. The experiment has been set up during the down period in two post-weaning rooms with two different protocols. They combined the mechanical action of draining, one detergent (either alkaline or enzymatic), another draining state, and finally one acid used at an antibacterial concentration. To follow the bacteriological quality of water during protocols, we have counted the total flora at 22°C and 37°C in water. Before and after the experiment, cotton swabs were applied into the pipes to evaluate the biofilm. Bacterial concentration in water increased along the pipelines: total flora was higher at watering place than at the entry of the building. Both protocols combining mechanical and chemical procedures reduced total flora, improved water quality and cleanliness of pipes. Our results show that waterlines cleaning protocols used in poultry farms can be transferred in post-weaning rooms. By reducing water’s total flora and the formation of biofilms, they could be part of the health prevention measures for troubles which are linked to a poor water quality.

Caprine arthritis encephalitis: an example of risk assessment for embryo trading

Abstract: The risk of transmission of caprine arthritis encephalitis virus (CAEV) during embryo transfer has been demonstrated in vivo through the detection of CAEV proviral DNA in: (1) flushing media for embryo collection; (2) cells of the cumulus oophorus surrounding the oocytes, ovarian follicle, oviduct and uterine tissues; and (3) testis, epididymis, vas deferens and vesicular glands. Experimentally infected embryos without a zona pellucida (ZP), washed 10 times with Minimum Essential Media (MEM) and 5% Fetal Calf Serum (FCS) solution, were capable of transmitting CAEV. In vitro we demonstrated that granulosa, oviductal, epididymal and embryo cells are fully susceptible to CAEV infection and allow active replication. However, AI with in vitro-infected semen can result in the production, after ten washing, of CAEV-free embryos, and ten washing in vitro- or in vivo-infected embryos with an intact ZP, or ten washing oocytes with an intact ZP, resulted in the production of virus-free female gametes or embryos that can be used for IVF or embryo transfer. Therefore, we have demonstrated that: (1) that CAEV-free embryos can be produced by IVF using spermatozoa infected in vitro by CAEV; and (2) embryo transfer can be used under field conditions to produce CAEV-free kids from CAEV-infected biological mothers.