No association between fear of hypoglycemia and blood glucose variability in type 1 diabetes: The cross-sectional VARDIA study

AIMS: In type 1 diabetes (T1D), treatment efficacy is limited by the unpredictability of blood glucose results and glycemic variability (GV). Fear of Hypoglycemia (FOH) remains a major brake for insulin treatment optimization. We aimed to assess the association of GV with FOH in participants with T1D in an observational cross-sectional study performed in 9 French Diabetes Centres (NCT02790060). METHODS: Participants were T1D for ≥5 years, aged 18-75 years, on stable insulin therapy for ≥3 months. The coefficient of variation (CV) of blood glucose and mean amplitude of glycemic excursions (MAGE) were used to assess GV from 7-point self-monitoring of blood glucose (SMBG). FOH was assessed using the validated French version of the Hypoglycemia Fear Survey-II (HFS-II) questionnaire. RESULTS: Among a total of 570 recruited participants, 298 were suitable for analysis: 46% women, 58% on continuous subcutaneous insulin infusion [CSII], mean age 49 ± 16 years, HbA1c 7.5 ± 0.9%, HFS-II score 67 ± 18 and 12% with recent history of severe hypoglycemia during the previous 6 months, mean CV 39.8 ± 9.7% and MAGE 119 ± 42 mg/dL. CV and MAGE did not significantly correlate with HFS-II score (R = -0.05;P = 0.457 and R = 0.08;P = 0.170). Participants with severe hypoglycemia in the previous 6 months had higher HFS scores. Participants with higher HFS scores presented more hypoglycemias during follow-up. CONCLUSIONS: FOH as determined using the HFS-II questionnaire was not associated with 7-point SMBG variability in participants with T1D, but was associated with a positive history of severe hypoglycemia. Higher FOH was associated with higher frequency of hypoglycemia during follow-up

Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE

Network analysis and inter-ecosystem comparison of two intertidal mudflat food webs (Brouage Mudflat and Aiguillon Cove, SW France)

Network analysis was used to analyse steady-state models of the food webs of two intertidal mudflat ecosystems: Aiguillon Cove and Brouage Mudflat, on the South-Western Atlantic Coast of France. The aim was to highlight emergent properties of food-web functioning in these two ecosystems and to compare these properties with other coastal ecosystems. Both ecosystems imported detritus in parallel to a high benthic primary production. They were characterised by a high diversity of resources. Both also exported living material, leading to a high quality production, quantified as export of Exergy. This export was mainly composed of cultivated bivalves during the cold season for Brouage Mudflat, and of the migration of grazing fish in Aiguillon Cove during the warm season. Their internal organization was characterised by short pathways, high recycling, high redundancy and low net ecosystem production, compared to the other systems selected. These characteristics, encountered in many estuaries, presented less extreme values. © 2007 Elsevier Ltd. All rights reserved

Lanthanide complexes as redox and ROS/RNS probes: A new paradigm that makes use of redox-reactive and redox non-innocent ligands

International audienc

Modeling the impact of oyster culture on a mudflat food web in Marennes-Oléron Bay (France)

International audienceWe used a carbon-based food web model to investigate the effects of oyster cultivation on the ecosystem of an intertidal mudflat. A previously published food web model of a mudflat in Marennes-Oléron Bay, France, was updated with revised parameters, and a realistic surface area and density of existing oyster cultures on the mudflat. We developed 2 hypothetical scenarios to estimate the impact of oyster cultivation on the food web structure of the ecosystem: one with no oysters, the other with a doubled area devoted to cultivated oysters in the bay. Oysters are direct trophic competitors of other filter feeders, and their presence modifies benthic-pelagic coupling by forcing a shift from pelagic consumers to benthic consumers. Increasing the surface area of cultivated oysters caused secondary production to increase, providing food for top predators (in particular juvenile nekton), reinforcing the nursery role of the mudflat in the ecosystem, and altering the species composition available to the top predators

Modeling the impact of oyster culture on a mudflat food web in Marennes-Oléron Bay (France)

International audienceWe used a carbon-based food web model to investigate the effects of oyster cultivation on the ecosystem of an intertidal mudflat. A previously published food web model of a mudflat in Marennes-Oléron Bay, France, was updated with revised parameters, and a realistic surface area and density of existing oyster cultures on the mudflat. We developed 2 hypothetical scenarios to estimate the impact of oyster cultivation on the food web structure of the ecosystem: one with no oysters, the other with a doubled area devoted to cultivated oysters in the bay. Oysters are direct trophic competitors of other filter feeders, and their presence modifies benthic-pelagic coupling by forcing a shift from pelagic consumers to benthic consumers. Increasing the surface area of cultivated oysters caused secondary production to increase, providing food for top predators (in particular juvenile nekton), reinforcing the nursery role of the mudflat in the ecosystem, and altering the species composition available to the top predators

Structural and spectroscopic investigations of nine-coordinate redox active lanthanide complexes with a pincer O,N,O ligand

International audienceThe lanthanide complexesEuL(3),GdL3,YbL(3)andLuL(3)of theN,N '-bis(2-hydroxy-di-3,5-tert-butylphenyl)amine were prepared. The X-Ray crystal structures ofGdL(3)andLuL(3)demonstrated a nine-coordinate sphere with three ligand molecules under their anionic diamagnetic form (Cat-N-BQ)(-). The complexes showed three oxidation events (Eox11/2 = 0.15-0.16 V,E-1/2(2)= 0.51-55 V, andE(1/2)(3)= 0.75-0.78 Vvs.Fc(+)/Fc)viacyclic voltammetry, corresponding to the successive oxidation of the aminophenolate moeities to iminosemiquinone species. The complexesGdL(3)andYbL(3)were characterized by EPR spectroscopy, allowing for the determination of the zero field splitting (ZFS) parameters in the first case. The monocations(LnL(3))(+)and monoanions(LnL(3))(-)were electrochemically generated (Ln = Eu, Gd, Yb, Lu), as well as the dicationsYbL(3)(2+)andLuL(3)(2+). The spins are antiferromagnetically exchange coupled in the diradical speciesLuL(3)(2+)(|D| = 260 MHz,E= 0). All the complexes (incl. neutral) possess a strong absorption band in the NIR region (730-840 nm,epsilon> 19 mM(-1)cm(-1)) corresponding to ligand-based transitions

Practical management of diabetes patients before, during and after surgery: A joint French diabetology and anaesthesiology position statement

International audienc

Lanthanide complexes of DOTA–nitroxide conjugatesfor redox imaging: spectroelectrochemistry, CEST,relaxivity, and cytotoxicity

International audienceThe lanthanide(iii) complexes (Gd, Eu, Dy, and Yb) of DOTA tris(amide) and bis(amide) derivatives (L-1 and L-2) featuring one redox active TEMPO arm were prepared. Ligand L-2 harbours an alkyne fragment for further functionalization. The X-ray crystal structure of ligand L-2 in complexation with Na+ was solved. The complexes showed in their CV one oxidation wave (0.26-0. 34 V vs. Fc(+)/Fc) due to an oxoammonium/nitroxide redox couple and a broad reduction corresponding to the nitroxide/hydroxylamine system. The Eu complexes demonstrated the presence of one water molecule in their coordination sphere. The nitroxide complexes were characterized by EPR spectroscopy, showing the typical 3-line pattern in the high temperature regime, which is quenched upon the addition of ascorbate (reduction into hydroxylamine). In their nitroxide form, the complexes show essentially no CEST peak. Conversely, the reduced complexes demonstrate a 12% CEST peak at 51 ppm, corresponding to the metal bound water molecule. Fast exchange precluded the CEST activity for the amide protons. All the complexes proved to be essentially non-toxic for M21 cells at concentrations up to 50 mu M