Investigating associations between social determinants, self-efficacy measurement of sleep apnea and CPAP adherence: the SEMSA study

Study objectivesThe prospective Self-Efficacy Measure for Sleep Apnea study (SEMSAS) is investigating thresholds for health literacy, self-efficacy and precariousness at obstructive sleep apnea (OSA) diagnosis to predict CPAP adherence. This paper describes the study protocol and presents baseline data from the ongoing study.MethodsEligible individuals had confirmed OSA and were referred to a homecare provider for continuous positive airway pressure (CPAP) therapy initiation. Data on patient characteristics and comorbidities were collected, along with baseline evaluations of self-efficacy [15-item Self-Efficacy Measure for Sleep Apnea tool (SEMSA-15)], precariousness [Deprivation in Primary Care Questionnaire (DipCareQ)], and health literacy (Health Literacy Questionnaire). CPAP adherence over 12 months of follow-up will be determined using remote monitoring of CPAP device data. The primary objective is to define an optimal SEMSA-15 score threshold to predict CPAP adherence at 3- and 12-month follow-up.ResultsEnrollment of 302 participants (71% male, median age 55 years, median body mass index 31.6 kg/m2) is complete. Low self-efficacy (SEMSA-15 score ≤ 2.78) was found in 93/302 participants (31%), and 38 (12.6%) reported precariousness (DipCareQ score > 1); precariousness did not differ significantly between individuals with a SEMSA-15 score ≤ 2.78 versus >2.78. Health literacy was generally good, but was significantly lower in individuals with versus without precariousness, and with low versus high self-efficacy.ConclusionSEMSAS is the first study using multidimensional baseline assessment of self-efficacy, health literacy and precariousness, plus other characteristics, to determine future adherence to CPAP, including CPAP adherence trajectories. Collection of follow-up data is underway

Assessment of potential health risk for inhabitants living near a former lead smelter. Part 2 : site-specific human health risk assessment of Cd and Pb contamination in kitchen gardens

International audienceMetal contamination of urban soils and homegrown products has caused major concern. In Part 1, we investigated the long-term effects of a former smelter on the degree of kitchen garden-soil contamination and the quality of the homegrown vegetables from these gardens. The results showed that the soils retained a high level of contamination and that a large proportion of the vegetables produced did not comply with the legislation on the levels of metals allowed for human consumption. The present study aims to assess the associated potential health risk to local inhabitants through consumption of homegrown vegetables and ingestion of soil particles using a land use-based approach. For lead (Pb), the standard hazard quotient (HQ)-based risk assessment method was used to determine the HQ. For cadmium (Cd), the approach consisted of calculating the HQs and then deriving site-specific assessment criteria (SSAC) using the SNIFFER method. The results suggested that the exposure pathways considered should not engender any form of deleterious health effects for adults. For children, Pb was the main concern and induced a relatively high health risk through soil particle ingestion, and most total soil Cd concentrations exceeded the derived SSAC, in particular, through consumption of vegetables. The metal bioaccessibility in soils was incorporated into the methods to establish more realistic risk assessment measures. This study proposes an approach to integrate different human health risk assessment methods. Further investigations should complete the assessment to improve risk determination, e.g., the determination of metal bioaccessibility in vegetables

Performance Study of a Zirconia-Doped Fiber for Distributed Temperature Sensing by OFDR at 800 °C

Optical Frequency Domain Reflectometry (OFDR) is used to make temperature distributed sensing measurements along a fiber by exploiting Rayleigh backscattering. This technique presents high spatial and high temperature resolutions on temperature ranges of several hundred of degrees Celsius. With standard telecommunications fibers, measurement errors coming from the correlation between a high temperature Rayleigh trace and the one taken as a reference at room temperature could be present at extremely high temperatures. These correlation errors, due to low backscattering signal amplitude and unstable backscattering signal, induce temperature measurement errors. Thus, for high temperature measurement ranges and at extremely high temperatures (e.g., at 800 °C), a known solution is to use fibers with femtosecond laser inscribed nanograting. These fs-laser-insolated fibers have a high amplitude and thermally stable scattering signal, and they exhibit lower correlation errors. In this article, temperature sensing at 800 °C is reported by using an annealed zirconia-doped optical fiber with an initial 40.5-dB enhanced scattering signal. The zirconia-doped fiber presents initially OFDR losses of 2.8 dB/m and low OFDR signal drift at 800 °C. The ZrO2-doped fiber is an alternative to nanograting-inscribed fiber to make OFDR distributed fiber sensing on several meters with gauge lengths of 1 cm at high temperatures

Investigating associations between social determinants, self-efficacy measurement of sleep apnea and CPAP adherence: the SEMSA study

Study objectives: The prospective Self-Efficacy Measure for Sleep Apnea study (SEMSAS) is investigating thresholds for health literacy, self-efficacy and precariousness at obstructive sleep apnea (OSA) diagnosis to predict CPAP adherence. This paper describes the study protocol and presents baseline data from the ongoing study. Methods: Eligible individuals had confirmed OSA and were referred to a homecare provider for continuous positive airway pressure (CPAP) therapy initiation. Data on patient characteristics and comorbidities were collected, along with baseline evaluations of self-efficacy [15-item Self-Efficacy Measure for Sleep Apnea tool (SEMSA-15)], precariousness [Deprivation in Primary Care Questionnaire (DipCareQ)], and health literacy (Health Literacy Questionnaire). CPAP adherence over 12 months of follow-up will be determined using remote monitoring of CPAP device data. The primary objective is to define an optimal SEMSA-15 score threshold to predict CPAP adherence at 3-and 12-month follow-up. Results: Enrollment of 302 participants (71% male, median age 55 years, median body mass index 31.6 kg/m 2) is complete. Low self-efficacy (SEMSA-15 score ≤ 2.78) was found in 93/302 participants (31%), and 38 (12.6%) reported precariousness (DipCareQ score > 1); precariousness did not differ significantly between individuals with a SEMSA-15 score ≤ 2.78 versus >2.78. Health literacy was generally good, but was significantly lower in individuals with versus without precariousness, and with low versus high self-efficacy. Conclusion: SEMSAS is the first study using multidimensional baseline assessment of self-efficacy, health literacy and precariousness, plus other characteristics, to determine future adherence to CPAP, including CPAP adherence trajectories. Collection of follow-up data is underway

Distinct hematopoietic support by two human stromal cell lines

International audienceObjective. The hematopoietic microenvironment is complex, and the role of myofibroblast in its function is crucial. In order to obtain a stable model reflecting this particular cell type, we have previously established human bone marrow cell lines from primary myofibroblastic Stro1 ϩ population (pStro1 ϩ). We placed HPV16 E6 and E7 expression under the control of different promoters. Here, we have characterized and studied the hematopoietic support for two cell lines corresponding to the promoters ␣-SM (␣ SM-56 line) and SV40 (SV40-56 line). Materials and Methods. The expression profile was analyzed at the RNA level by gene array and at the protein level by Western blot, flow cytometry, and ELISA. Hematopoietic support determined using colony-forming unit (CFU) and stroma-adherent colony-forming cell (SA-CFC) assays. Results. The phenotype of cell lines was not significantly modified compared with primary myofibroblastic cells. They secreted a broad spectrum of hematopoietic cytokines and nonspecific mediators. The two lines allowed the growth of hematopoietic precursors and had different support capabilities. Conclusions. We have extensively characterized two novel human bone marrow stromal cell lines. They retained a myofibroblastic phenotype and have substantial but different hematopoietic support capabilities. These lines provided a basis for determining stromal factors involved in stem-cell regulation

Maîtriser les adventices dans le blé par un couvert permanent de légumineuse dans un système en semis direct sous couvert végétal géré sans glyphosate : quelques enseignements du Casdar Engaged

National audienceParmi les systèmes en agriculture de conservation, le semis direct sous couvert végétal a pourobjectif de maintenir, tout au long de la rotation, un couvert permanent de légumineuses danslaquelle l’agriculteur viendra semer en direct ses cultures. Parmi les objectifs visés, ce couvert doitnotamment permettre de gérer les adventices. Pour cela, il est nécessaire qu’il soit suffisammentdéveloppé pour avoir un effet compétitif vis-à-vis des adventices. Toutefois, trop développé, il peutégalement rentrer en compétition avec la culture principale et impacter le rendement. Dans lecadre du projet ENGAGED, deux leviers pour atténuer l’effet de compétition sur le blé ont étéidentifiés : l’augmentation de la densité de semis du blé et une régulation chimique raisonnée auprintemps. Les deux années d’expérimentation menés sur des parcelles d’agriculteurs ont montréqu’une forte augmentation de la densité de semis de blé permet un contrôle des adventicescomparable au glyphosate en sortie hiver, à rendement de blé assez proches. Il sembleégalement possible de réduire la dose utilisée lors de la régulation du couvert au printempsmais des études complémentaires sont nécessaires. Ces résultats ont été jugés encourageantspar les agriculteurs expérimentateurs mais pas suffisants pour envisager une généralisation decette pratique sur l’ensemble de leurs parcelles, compte tenu du risque de non maîtrised’adventices à moyen terme. D’autres pistes restent à explorer comme par exemple la régulationmécanique du couvert permanent

Table_1_Investigating associations between social determinants, self-efficacy measurement of sleep apnea and CPAP adherence: the SEMSA study.DOCX

Study objectivesThe prospective Self-Efficacy Measure for Sleep Apnea study (SEMSAS) is investigating thresholds for health literacy, self-efficacy and precariousness at obstructive sleep apnea (OSA) diagnosis to predict CPAP adherence. This paper describes the study protocol and presents baseline data from the ongoing study.MethodsEligible individuals had confirmed OSA and were referred to a homecare provider for continuous positive airway pressure (CPAP) therapy initiation. Data on patient characteristics and comorbidities were collected, along with baseline evaluations of self-efficacy [15-item Self-Efficacy Measure for Sleep Apnea tool (SEMSA-15)], precariousness [Deprivation in Primary Care Questionnaire (DipCareQ)], and health literacy (Health Literacy Questionnaire). CPAP adherence over 12 months of follow-up will be determined using remote monitoring of CPAP device data. The primary objective is to define an optimal SEMSA-15 score threshold to predict CPAP adherence at 3- and 12-month follow-up.ResultsEnrollment of 302 participants (71% male, median age 55 years, median body mass index 31.6 kg/m2) is complete. Low self-efficacy (SEMSA-15 score ≤ 2.78) was found in 93/302 participants (31%), and 38 (12.6%) reported precariousness (DipCareQ score > 1); precariousness did not differ significantly between individuals with a SEMSA-15 score ≤ 2.78 versus >2.78. Health literacy was generally good, but was significantly lower in individuals with versus without precariousness, and with low versus high self-efficacy.ConclusionSEMSAS is the first study using multidimensional baseline assessment of self-efficacy, health literacy and precariousness, plus other characteristics, to determine future adherence to CPAP, including CPAP adherence trajectories. Collection of follow-up data is underway.</p

New onset of myasthenia gravis after treatment of systemic sclerosis by autologous hematopoietic stem cell transplantation : sustained autoimmunity or inadequate reset of tolerance?

Autologous hematopoietic stem-cell transplantation (HSCT) showed promising results for the treatment of primary severe autoimmune diseases (ADs). In this context, development of secondary AD after HSCT has exceptionally been observed, further questioning the roles of patient propensity for AD and of the HSCT procedure. Herein, we report new onset of myasthenia gravis 3 years after successful HSCT in a patient with severe systemic sclerosis, while in complete remission from her first AD. The de novo occurrence of secondary AD (myasthenia gravis) after HSCT was accompanied by the appearance of clonal T-cell expansions measured by the "immunoscope" technique in the context of an ongoing T-cell immune reconstitution. Secondary ADs are increasingly recognized after HSCT for AD. In our case, development of myasthenia followed clonal T-cell expansion. Detailed T-cell repertoire analysis may shed light on autoreactivity mechanisms after HSCT and may help to identify patients at risk