The TexiSense « Smart Sock » - a device for a daily prevention of pressure ulcers in the diabetic foot

International audienceGoals.– The term « diabetic foot » refers to a set of foot pathologies essentially stemming from the neuropathy and arteriopathy of the lower limb associated with diabetes mellitus. Chronic ischemia weakens the healing potential and favors the development of wounds on a more vulnerable foot. Friction or repeated micro-traumas can lead to an ulceration (which in turn can end up in an amputation) that will remain unnoticed because of the somato-sensory deficiency. The current prevention techniques largely relying on visual inspection of the foot and enhancement of the foot/insole interface are not fully satisfying as the prevalence of plantar ulcers remains very high.Patients and methods.– A device for the prevention of plantar ulcers–called “Smart Sock” is described. It consists of:– a sock made of a 100% textile pressure sensing fabric developed by the TexiSense company;– a microcontroller running a biomechanical model of the soft tissues of the foot of the diabetic person;– a vibrating watch (and eventually a smartphone) used to warn the bearer if a pressure pattern threatens the soft tissues integrity.Results.– Internal overpressures within the soft tissues, especially nearby bony prominences are likely to develop into deep foot ulcerations. The biomechanical model gives an estimation of their magnitude based on the external pressures measured by the sock/sensor. This modeling relies on a faithful representation of the morphology of the diabetic subject. The device sends a vibro-tactile alert in case of occasional overpressure or excessive stress dose accumulated during daytime activities.Discussion.– The continuous use of the device, compatible with daytime activities of the diabetic person, helps compensate for the lack of attention in the prevention of pressure ulcer formation. The TexiSense “Smart Sock” can be designed so that when worn, pressure sensors fall onto sensitive anatomical areas such as the dorsal side of the toes or the posterior side of the heel, which makes it also possible to monitor regions located outside the sole of the foot

Reducing Influenza Virus Transmission: The Potential Value of Antiviral Treatment

Prompt antiviral treatment has the potential to reduce influenza virus transmission to close contacts, but rigorous data on the magnitude of treatment effects on transmission are limited. Animal model data indicate that rapid reductions in viral replication after antiviral treatment reduce the risk of transmission. Observational and clinical trial data with oseltamivir and other neuraminidase inhibitors indicate that prompt treatment of household index patients seems to reduce the risk of illness in contacts, although the magnitude of the reported effects has varied widely across studies. In addition, the potential risk of transmitting drug-resistant variants exists with all approved classes of influenza antivirals. A controlled trial examining baloxavir treatment efficacy to reduce transmission, including the risk of transmitting virus with reduced baloxavir susceptibility, is currently in progress. If reduced transmission risk is confirmed, modeling studies indicate that early treatment could have major epidemiologic benefits in seasonal and pandemic influenza.This work was supported by F. Hoffmann-La Roche Ltd. (funding for medical writing support and journal fee) and by a seed fund for basic research for new staff from the University of Hong Kong (202009185062 to Z. D.).Integrative Biolog

Evidence of the contribution of the X chromosome to systemic sclerosis susceptibility: Association with the functional IRAK1 196Phe/532Ser haplotype

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Relationship between ozone and temperature during the 2003 heat wave in France: consequences for health data analysis

BACKGROUND: PAPRICA is a research program designed to estimate the impact on the health of patients with chronic respiratory insufficiency of a prevention strategy based on notification of ozone pollution. The first year of this study was conducted during the 2003 heat wave, and high temperatures were therefore considered as a confounding factor in the data analysis. The aim of the present study was to assess the relationship between ozone and temperature in order to propose a methodology to distinguish between the effects of ozone and temperature on the impact of a prevention strategy with regard to ozone pollution. METHODS: Multivariate analyses were used to identify associated climate and ozone pollution profiles. This descriptive method is of great value to highlight the complexity of interactions between these parameters. RESULTS: Ozone concentration and temperature were strongly correlated, but the health impact of ozone pollution alone will be evaluated by focusing on situations characterized by ozone concentrations above 110 μg/m(3)/8h (air quality guidelines to protect human health defined by the French legislation) and temperatures lower than 26°C, below the discomfort threshold. CONCLUSION: The precise relationship between ambient ozone concentration and temperature identified during the PAPRICA 2003 study period will be used in analysing the PAPRICA health data

Inter-Destination Multimedia Synchronization; Schemes, Use Cases and Standardization

Traditionally, the media consumption model has been a passive and isolated activity. However, the advent of media streaming technologies, interactive social applications, and synchronous communications, as well as the convergence between these three developments, point to an evolution towards dynamic shared media experiences. In this new model, geographically distributed groups of consumers, independently of their location and the nature of their end-devices, can be immersed in a common virtual networked environment in which they can share multimedia services, interact and collaborate in real-time within the context of simultaneous media content consumption. In most of these multimedia services and applications, apart from the well-known intra and inter-stream synchronization techniques that are important inside the consumers playout devices, also the synchronization of the playout processes between several distributed receivers, known as multipoint, group or Inter-destination multimedia synchronization (IDMS), becomes essential. Due to the increasing popularity of social networking, this type of multimedia synchronization has gained in popularity in recent years. Although Social TV is perhaps the most prominent use case in which IDMS is useful, in this paper we present up to 19 use cases for IDMS, each one having its own synchronization requirements. Different approaches used in the (recent) past by researchers to achieve IDMS are described and compared. As further proof of the significance of IDMS nowadays, relevant organizations (such as ETSI TISPAN and IETF AVTCORE Group) efforts on IDMS standardization (in which authors have been and are participating actively), defining architectures and protocols, are summarized.This work has been financed, partially, by Universitat Politecnica de Valencia (UPV), under its R&D Support Program in PAID-05-11-002-331 Project and in PAID-01-10, and by TNO, under its Future Internet Use Research & Innovation Program. The authors also want to thank Kevin Gross for providing some of the use cases included in Sect. 1.2.Montagud, M.; Boronat Segui, F.; Stokking, H.; Van Brandenburg, R. (2012). Inter-Destination Multimedia Synchronization; Schemes, Use Cases and Standardization. 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S.11.1 Influence of digital ulcer healing on disability and daily activity limitations in SSc

Objective. We previously showed that DU significantly increased global and hand disability with a significant impact on activities of daily living (ADLs) and work disability. This study aims to evaluate the impact of digital ulcer (DU) healing on disability and daily activity limitations in SSc. Methods. From January 2008 and June 2009, we prospectively evaluated 189 SSc patients for DU history, disability, employment and occupational status during meetings of the French SSc Patient Association (n = 86, 45.5%) or during hospitalization (n = 103, 54.5%)1. Among the 60 patients with at least one active DU at baseline (M0), 40 patients were followed longitudinally over 6 (3) months. These patients were evaluated for DU history, global and hand disability, health-related quality of life (HRQoL), daily activity limitation and employment status. Results. The median (IQR) age was 57.5 (43.5-68) years and the median (IQR) disease duration was 8.3 (3-16.5) years. Twenty-two (55%) patients had diffuse SSc and 34 (85%) were females. At baseline, a mean of 2.9 (2.8) DU per patient was reported. Thirty-three (82.5%) patients had ischaemic DU, 7 (17.5%) patients had >1 DU associated with calcinosis and 13 (32.5%) patients had mechanical DU. Thirteen (32.5%) patients had >4 DU at baseline. Among the 40 patients, 16 (40%) patients showed complete ulcer healing. In these patients with DU, the presence of calcinosis was associated with a lower probability of healing (P = 0.03). Comparison between healed and no-healed DU patients showed an improvement of hand disability provided by an improvement of the Cochin Hand Function score (P = 0.05)) and a trend towards HAQ domain dressing and grooming (P = 0.06) between M0 and M6 (3) visit in healed patients but not in no-healed patients. Concerning HRQoL, there were no difference for Mental and Physical component Scores of SF-36 but significant improvement of Bodily Pain score (P = 0.04) and Physical Role score (P = 0.05) between M0 and M6 (3) visit in patients with healed DU. The absence of healing was associated with significantly decreased work productivity (P = 0.05), whereas the performance in ADL was not significantly decreased (P = 0.15). Patients who were on sick-leave and who received some help for household tasks at the time of active DU were more likely to heal. Conclusion. For the first time, we provide prospective data with evidence that DU healing is associated with an improvement in hand function. Sick leave was associated with better healing of D

Characterization of the behavior of carotenoids from pitanga (Eugenia uniflora) and buriti (Mauritia flexuosa) during microemulsion production and in a dynamic gastrointestinal system

Uncommon tropical fruits are emerging as raw-material for new food products with health benefits. This work aimed at formulating and processing microemulsions from pitanga (Eugenia uniflora) and buriti (Mauritia flexuosa) fruits, since they are very rich in carotenoids (particularly lycopene and -carotene), in order to encapsulate and increase carotenoids bioaccessibility. Pitanga and buriti microemulsions were produced by applying a direct processing (high-speed homogenization at 15,000 rpm and ultrasound with 20 kHz probe at 40% amplitude) of the whole pulp together with surfactant (Tween 80 or Whey Protein Isolate at 2%) and corn oil (5%). All treatments (HSHUS for 04, 40, 44, 48 minmin) applied were able to increase the amount of carotenoid released. However, the processing also decreased the total amount of carotenoids in the whole pulp of studied fruits. The impact of processing during microemulsion production was not severe. The overall data suggest that the presence of surfactant and oil during processing may protect the carotenoids in fruits and microemulsions. Final recovery of total carotenoids, after passing the samples through a dynamic gastrointestinal system that simulates the human digestion, was higher for microemulsions than for whole pulps. High losses of total carotenoids in buriti and -carotene and lycopene in pitanga occurred during jejunum and ileum phases. The present work confirms that it is possible to increase -carotene and lycopene bioaccessibility from fruits by directly processing microemulsions (p<0.01).This work was supported by the São Paulo Research Foundation—FAPESP through research funding [Grant #2015/15507-9] and Ph.D. scholarship for Paulo Berni [Grant #2014/15119-6] and a Research Internships Abroad (BEPE) support [Grant #2016/13355-0]. The author Ana C. Pinheiro is recipient of a fellowship from the Portuguese Foundation for Science and Technology (FCT) [Grant SFRH/BPD/101181/2014]info:eu-repo/semantics/publishedVersio

Clearance of technetium-99m-DTPA and HRCT findings in the evaluation of patients with Idiopathic Pulmonary Fibrosis

BACKGROUND: Clearance of inhaled technetium-labeled diethylenetriamine pentaacetate ((99m)Tc-DTPA) is a marker of epithelial damage and an index of lung epithelial permeability. The aim of this study was to investigate the role of (99m)Tc-DTPA scan in patients with Idiopathic Pulmonary Fibrosis (IPF). Our hypothesis is that the rate of pulmonary (99m)Tc-DTPA clearance could be associated with extent of High Resolution Computed Tomography (HRCT) abnormalities, cell differential of bronchoalveolar lavage fluid (BALF) and pulmonary function tests (PFTs) in patients with IPF. METHODS: We studied prospectively 18 patients (14 male, 4 female) of median age 67yr (range 55–81) with histologically proven IPF. HRCT scoring included the mean values of extent of disease. Mean values of these percentages represented the Total Interstitial Disease Score (TID). DTPA clearance was analyzed according to a dynamic study using a Venticis II radioaerosol delivery system. RESULTS: The mean (SD) TID score was 36 ± 12%, 3 patients had mild, 11 moderate and 4 severe TID. Abnormal DTPA clearance half-time (t(1/2)<40 min) was found in 17/18 (94.5%) [mean (SD) 29.1 ± 8.6 min]. TID was weakly correlated with the DTPA clearance (r = -0.47, p = 0.048) and with % eosinophils (r = 0.475, p = 0.05). No correlation was found between TID score or DTPA and PFTs in IPF patients. CONCLUSION: Our data suggest that (99m)Tc-DTPA lung scan is not well associated with HRCT abnormalities, PFTs, and BALF cellularity in patients with IPF. Further studies in large scale of patients are needed to define the role of this technique in pulmonary fibrosis