Individualised sensory intervention to improve quality of life in people with dementia and their companions (SENSE-Cog trial): study protocol for a randomised controlled trial

Background: Hearing and vision impairments are highly prevalent in people with dementia and may have a negative impact on quality of life and other dementia-related outcomes. Intervening to optimise sensory impairment and support sensory function may be a means of improving dementia-related outcomes. The SENSE-Cog trial will test whether a home-based multi-part sensory intervention is effective in improving quality of life and other key outcomes in people with dementia and hearing or vision problems (or both) and their companions. Methods: This is an European, multi-centre, observer-blind, pragmatic, randomised controlled trial. Three hundred fifty four people with dementia and hearing or vision impairment (or both) and their companions will be randomly assigned to receive either "care as usual" or a multi-component sensory intervention including assessment and correction of hearing or vision impairments (or both), home-based (maximum 10 visits over 18 weeks), therapist-delivered sensory support (that is, adherence to devices; improving the sensory environment (that is, lighting), communication training, and sign-posting to other support agencies). Change from baseline to intervention end (18 weeks) and post-intervention (36 weeks) will be compared between the two arms in the following outcomes: quality of life (primary endpoint), sensory and cognitive functional ability, relationships, mental well-being, health resource utilisation and cost-effectiveness. Discussion: This is one of two articles outlining the SENSE-Cog trial. Here, we describe the protocol for the effectiveness of the SENSE-Cog intervention. A parallel and complementary process evaluation will be described elsewhere. If the SENSE-Cog trial demonstrates that the sensory intervention improves outcomes in dementia, we will make a toolkit of training materials, resources and information available to health and social care providers to implement the intervention in routine practice. This will be a significant contribution to the therapeutic management of people with dementia and sensory impairment. Trial registration: ISRCTN (Trial ID: ISRCTN17056211) on 19 February 2018

Age-Related Expression of IFN-l1 Versus IFN-I and Beta-Defensins in the Nasopharynx of SARS-CoV-2-Infected Individuals

International audienceSARS-CoV-2 coronavirus infection induces heterogeneous symptoms, ranging from asymptomatic to lethal forms. Severe forms usually occur in the elderly and/or individuals with comorbidities. Children generally remain asymptomatic to primary infection, suggesting that they may have an effective local innate immune response. IFN-I and-III have non-redundant protective roles against SARS-CoV-2, although sometimes damaging the host. The expression and role of anti-viral peptides during SARS-CoV-2 infection have thus far been little studied. We aimed to identify the innate immune molecules present at the SARS-CoV-2 entry point. We analyzed the mRNA levels of type I (IFN-a and-b) and type III (IFN-l1-3) interferons and selected antiviral peptides (i.e., b-defensins 1-3, a-defensins [HNP1-3, HD5] pentraxin-3, surfactant protein D, the cathelicidin LL-37 and interleukin-26) in nasopharyngeal swabs from 226 individuals of various ages, either infected with SARS-CoV-2 (symptomatic or asymptomatic) or negative for the virus. We observed that infection induced selective upregulation of IFN-l1 expression in pediatric subjects (≤15 years), whereas IFN-a, IFN-b, IFN-l2/l3, and bdefensin 1-3 expression was unaffected. Conversely, infection triggered upregulation of IFN-a, IFN-b, IFN-l2/l3, and b-defensin 1-3 mRNA expression in adults (15-65 years) and the elderly (≥ 65 years), but without modulation of IFN-l1. The expression of these innate molecules was not associated with gender or symptoms. Expression of the interferon-stimulated genes IFITM1 and IFITM3 was upregulated in SARS-CoV-2positive subjects and reached similar levels in the three age groups. Finally, age-related differences in nasopharyngeal innate immunity were also observed in SARS-CoV-2negative subjects. This study shows that the expression patterns of IFN-I/-III and certain anti-viral molecules in the nasopharyngeal mucosa of SARS-CoV-2-infected subjects differ with age and suggests that susceptibility to SARS-CoV-2 may be related to intrinsic differences in the nature of mucosal anti-viral innate immunity

0305 : Heterogeneous conduction properties in the pig right ventricle

The right ventricular outflow tract (RVOT) has a distinct embryological origin and is a common anatomical source of arrhythmias in the healthy and diseased myocardium. We hypothesised that specific RVOT activation and conduction properties may underlie the preferential RVOT origin of arrhythmias. Pig right ventricular (RV) wedge preparations were perfused via the left anterior descending and right coronary arteries. Electrical activation and conduction properties were obtained by optical mapping of the epicardial surface (di-4- ANEPPS 10μM) upon electrical stimulation of the preparation. Transmural needles were inserted in the RV free wall and RVOT and unipolar electrograms (EGMs) were recorded. Fiber orientation was obtained by diffusion tensor MRI. Regional mRNA expression was determined by RT-PCR and fibrosis was assessed histologically. Longitudinal and transverse conduction velocities were significantly reduced in RVOT compared to RV free wall (P<0.01). A different direction of propagation was observed in the RVOT compared to the RV free wall and a line of slowed propagation was found at the interface between the 2 regions. This was consistent with a 135±2° change in fiber orientation observed between the 2 regions within a restricted distance (<6cm). The RVOT showed more sites with fractionated EGMs (P<0.01) and more deflections per electrode (P<0.001) than the RV free wall. In line with these findings, a decreased expression of Scna5 and Gja1 was found in the RVOT compared to the RV free wall (P<0.001). Moreover, the RVOT was characterized by an upregulation of type I collagen mRNA, a higher collagen content (P<0.05) and the presence of fat infiltrations which were absent in the free wall.Conduction is slower in the pig RVOT and is associated with fractionated unipolar electrograms. Conduction slowing was related to (i) reduced connexin and sodium channel expression and (ii) region-specific structural properties which may generate a substrate for RVOT arrhythmias

Individualised sensory intervention to improve quality of life in people with dementia and their companions (SENSE-Cog trial): study protocol for a randomised controlled trial

BackgroundHearing and vision impairments are highly prevalent in people with dementia and may have a negative impact on quality of life and other dementia-related outcomes. Intervening to optimise sensory impairment and support sensory function may be a means of improving dementia-related outcomes. The SENSE-Cog trial will test whether a home-based multi-part sensory intervention is effective in improving quality of life and other key outcomes in people with dementia and hearing or vision problems (or both) and their companions.MethodsThis is anEuropean, multi-centre, observer-blind, pragmatic, randomised controlled trial. Three hundred fifty four people with dementia and hearing or vision impairment (or both) and their companions will be randomly assigned to receive either care as usual or a multi-component sensory intervention including assessment and correction of hearing or vision impairments (or both), home-based (maximum 10 visits over 18weeks), therapist-delivered sensory support (that is, adherence to devices; improving the sensory environment (that is, lighting), communication training, and sign-posting to other support agencies). Change from baseline to intervention end (18weeks) and post-intervention (36weeks) will be compared between the two arms in the following outcomes: quality of life (primary endpoint), sensory and cognitive functional ability, relationships, mental well-being, health resource utilisation and cost-effectiveness.DiscussionThis is one of two articles outlining the SENSE-Cog trial. Here, we describe the protocol for the effectiveness of the SENSE-Cog intervention. A parallel and complementary process evaluation will be described elsewhere. If the SENSE-Cog trial demonstrates that the sensory intervention improves outcomes in dementia, we will make a toolkit of training materials, resources and information available to health and social care providers to implement the intervention in routine practice. This will be a significant contribution to the therapeutic management of people with dementia and sensory impairment.Trial registrationISRCTN (Trial ID: ISRCTN17056211) on 19 February 2018

BRAS DESSUS, BRAS DESSOUS ("Why") fox moderato / P. de ANGELIS et B. MARCUCCI. NOTRE CONCERTO : slow / U. BINDI. BANJO BOY : fox / NIESSEN. MA CHANSON EST POUR TOI : rocky-slow ("Beautiful obsession") / R. BERTHIER et E.A. FREEMAN. LE BLEU DE L'ETE : texan boléro du film "Alamo" / D. TIOMKIN. DITES A L'ORCHESTRE : valse lente du film "Les Mordus" / Sacha DISTEL. DE TOUT MON COEUR : boléro / Franck POURCEL et J. CANA. COU COUCHE PANIER : cha cha baïon / René DENONCIN. C'EST TOI QUI ("Gail's song") (moderato / Joe REISMAN. LA JOIE D'AIMER ("The Unforgiven") slow-rock du film "Le vent dans la plaine" / D. TIOMKIN. L'ABSENT : baïon moderato / Gilbert BECAUD. POUR UN GRAND AMOUR : valse lente / Hubert GIRAUD ; Franck POURCEL et son Grand Orchestre

Titre uniforme : [The unforgiven]Titre uniforme : [Bras dessus, bras dessous = Why]Collection : Amour, danse et violons ; 15BnF-Partenariats, Collection sonore - BelieveContient une table des matière

KARTING-PARTY

Titre uniforme : [Royal garden blues]Titre uniforme : [Muskrat ramble]Titre uniforme : [Verte campagne]Comprend : MUSKRAT RAMBLE : dixieland / Kid ORY ; Maxim SAURY - ROYAL GARDEN BLUES : dixieland / WILLIAMS ; Maxim SAURY - LA MONTAGNE : boléro / G. MOREAU et A. ALGUERO ; Arturo DIAZ - TOUT POUR TOUTOU : cha cha cha / JIL et JAN ; Arturo DIAZ - BANJO BOY : fox / NIESSEN ; SAX Succès avec Orchestre dir. G. LAFITTE - ROLY POLY : fox / S. LAKE - E. DORAN ; SAX Succès avec Orchestre dir. G. LAFITTE - A MEDIA LUZ : tango / LENZI et DONATO ; A. PINTO - YIRA, YIRA : tango / DISCEPOLO ; A. PINTO - VERTE CAMPAGNE : slow / GILKYSON - DEHR et MILLER ; SAX-SUCCES avec Orchestre dir. G. LAFITTE - TETE DE BOIS - moderato / Gilbert BECAUD ; Ted RICHARDS - LES PAPOUS - calypso / Noël ROUX ; Arturo DIAZ - ITSI BITSI, PETIT BIKINI : cha cha cha / VANCE et POCKRISS ; SAX-SUCCES avec Orchestre dir. G. LAFITTE - RENDEZ-VOUS : tango / E. CADICAMO ; Rafaël de MONCADA - PRIMAVERA CRIOLLA - tango / R. MONCADA et L. CONTI ; Rafaël de MONCADA - FAIS-MOI LE COUSCOUS, CHERIE : guaracha / A. CANFORA ; Arturo DIAZ - MARIAGE ANTILLAIS - mambo guaracha / G. MAGENTA ; Rafaël de MONCADABnF-Partenariats, Collection sonore - BelieveContient une table des matière

PETER MOORE DANCE-PARTY / Peter MOORE et son Ensemble

Comprend : BANJO BOY : fox / C. NIESSEN et J. BROUSSOLLE - SOUVENIRS, SOUVENIRS : cha-cha rock / C. COBEN et Fernand BONIFAY - LES CITRONS DE TEL-AVIV : fox / SPIERS et BONIFAY - PREMIER BAL : slow / Sidney BECHET et B. DIMEY - PARIS A LE COEUR TENDRE : valse du film "Os Bandeirantes" / Henri CROLLA et Marcel CAMUS - ALLEZ SAVOIR POURQUOI : calypso / J.P. CALVET et BROUSSOLLE - LES VOILIERS : boléro / A. PATE et S. CASTEL - VIENI VIENI SI : fox / C.A. ROSSI et Jean CONSTANTIN - TETES DE BOIS : fox / Gilbert BECAUD et Pierre DELANOE - NI CHAUD NI FROID : rock / SHERMAN - MANN et Pierre COUR - OLA, OLA, OLA OLA ! : fox / A. ALGUERO et Bob AZZAM - COMPLAINTE DE BERLIN : medium-fox / STERN et MARNAY - AMOUREUX DE MADRID" slow / CASCALES et ROLAND - TOI MON BEL AMOUR : rock / SALVADOR et PON - TOI C'EST AUTRE CHOSE ("Eres diferente") boléro-rock / ALGUERO et GUIJARRO - LA VIGNE BLEUE : fox / DECKER et PAPINBnF-Partenariats, Collection sonore - BelieveContient une table des matière