Education thérapeutique à l'insulinothérapie fonctionnelle au CHU d'Angers au sein d'une cohorte de 124 diabétiques de type 1 (évaluation de l'impact sur les paramètres clinico-biologiques et sur la qualité de vie à 6 mois)

L'insulinothérapie fonctionnelle (IF) est un modèle d'éducation thérapeutique qui a pour objectif d'améliorer l'équilibre glycémique et de restaurer une bonne qualité de vie, en offrant au patient une plus grande souplesse dans le maniement de son traitement. L IF a considérablement amélioré la prise en charge thérapeutique des diabétiques de type 1. Matériel et méthodes : Depuis 2008, un programme d'éducation à l'IF est proposé au CHU d'Angers et a conduit à l'élaboration d'une cohorte de 124 diabétiques de type 1 éduqués à l'IF. Notre travail a consisté à étudier l'évolution de l'équilibre métabolique et de la qualité de vie au sein de cette cohorte. L'hémoglobine glyquée, la fréquence des hypoglycémies sévères et non sévères et le poids ont été analysés. Les questionnaires utilisés pour apprécier la qualité de vie sont l'ADDQoL et le DTSQ. Résultats : Les patients les plus déséquilibrés réduisent leur hémoglobine glyquée de plus de 0,5 %. De plus, les patients dont l'objectif personnalisé est de rééquilibrer leur diabète améliorent également leur HbA1C. Nous ne retrouvons pas de différence significative concernant les hypoglycémies, le poids ou la qualité de vie. Conclusion : Notre étude démontre que l'IF permet d'améliorer l'HbA1C des patients très déséquilibrés. Les patients ayant pour objectif personnalisé de rééquilibrer leur diabète améliorent également leur HbA1C. Ces résultats soulignent l'importance du diagnostic éducatif au sein d'un programme d'ETP, car il permet de susciter la motivation du patient et d'atteindre ainsi les objectifs définis avec l'équipe médicale.Functional intensified insulin therapy (FIT) is a model of structured education program, which objective is to improve glycemic control and to restaure a good quality of life. Giving the patient an easier way to manage his treatment, FIT has improved therapeutic management of type 1 diabetic persons. Material & methods : A structured education program to FIT is proposed in the diabetology unit of the Hospital of Angers since 2008. We followed a cohort of 124 type 1 diabetic patients trained to IIT during 6 months. Our aim is to assess the changes in glycemic control, biomedical outcomes and quality of life of these patients. The questionnaires used to assess quality of life are ADDQoL and DTSQ. Results : Patients with poor glycemic control improve their HbA1C, better than 0,5 % (main outcome). Moreover, patients whose personal objective was improving their metabolic control reach a significant value of HbA1C decrease. There is no difference regarding hypoglycemias, weight or quality of life. Conclusion : Our study show a better improvement of HbA1C among patients with poorer glycemic control, and in patients who attempt to improve their HbA1C. These results highlight the importance of the "shared educational assessment" within structured education programs, which define patients' needs and allow him to achieve this goal, by exploring his motivation to change.ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

Extensive Lensing Survey of Optical and Near-infrared Dark Objects (El Sonido): HST H-faint Galaxies behind 101 Lensing Clusters

We present a Spitzer/IRAC survey of H-faint (H160 ≳ 26.4, < 5σ) sources in 101 lensing cluster fields. Across a CANDELS/Wide-like survey area of ∼648 arcmin2 (effectively ∼221 arcmin2 in the source plane), we have securely discovered 53 sources in the IRAC Channel-2 band (CH2, 4.5 μm; median CH2 = 22.46 ± 0.11 AB mag) that lack robust HST/WFC3-IR F160W counterparts. The most remarkable source in our sample, namely ES-009 in the field of Abell 2813, is the brightest H-faint galaxy at 4.5 μm known so far (CH2 = 20.48 ± 0.03 AB mag). We show that the H-faint sources in our sample are massive (median Mstar = 1010.3±0.3 M⊙), star-forming (median star formation rate $={100}_{-40}^{+60}$ M⊙ yr−1), and dust-obscured (AV = 2.6 ± 0.3) galaxies around a median photometric redshift of z = 3.9 ± 0.4. The stellar continua of 14 H-faint galaxies can be resolved in the CH2 band, suggesting a median circularized effective radius (Re,circ; lensing corrected) of 1.9 ± 0.2 kpc and <1.5 kpc for the resolved and whole samples, respectively. This is consistent with the sizes of massive unobscured galaxies at z ∼ 4, indicating that H-faint galaxies represent the dusty tail of the distribution of a wider galaxy population. Comparing with the ALMA dust continuum sizes of similar galaxies reported previously, we conclude that the heavy dust obscuration in H-faint galaxies is related to the compactness of both stellar and dust continua (Re,circ ∼ 1 kpc). These H-faint galaxies make up ${16}_{-7}^{+13}$% of the galaxies in the stellar-mass range of 1010 − 1011.2 M⊙ at z = 3 ∼ 5, contributing to ${8}_{-4}^{+8}$% of the cosmic star formation rate density in this epoch and likely tracing the early phase of massive galaxy formatio

High temperature VUV cross-section measurements for the study of hot exoplanets' atmospheres: new line list and temperature dependance of A1Π-X1Σ+ CO transition, 3 ≤v' ≤ 10 and v" = 0, 1

International audienc

High temperature VUV cross section measurements of acetylene for hot exoplanets study

International audienc

Global molecular analysis and APOE mutations in a cohort of autosomal dominant hypercholesterolemia patients in France

International audienceAutosomal dominant hypercholesterolemia (ADH) is a human disorder characterized phenotypically by isolated high-cholesterol levels. Mutations in the low density lipoprotein receptor (LDLR), APOB, and proprotein convertase subtilisin/kexin type 9 (PCSK9) genes are well known to be associated with the disease. To characterize the genetic background associated with ADH in France, the three ADH-associated genes were sequenced in a cohort of 120 children and 109 adult patients. Fifty-one percent of the cohort had a possible deleterious variant in LDLR, 3.1% in APOB, and 1.7% in PCSK9. We identified 18 new variants in LDLR and 2 in PCSK9. Three LDLR variants, including two newly identified, were studied by minigene reporter assay confirming the predicted effects on splicing. Additionally, as recently an in-frame deletion in the APOE gene was found to be linked to ADH, the sequencing of this latter gene was performed in patients without a deleterious variant in the three former genes. An APOE variant was identified in three patients with isolated severe hypercholesterolemia giving a frequency of 1.3% in the cohort. Therefore, even though LDLR mutations are the major cause of ADH with a large mutation spectrum, APOE variants were found to be significantly associated with the disease. Furthermore, using structural analysis and modeling, the identified APOE sequence changes were predicted to impact protein function

Tma108, a putative M1 aminopeptidase, is a specific nascent chain-associated protein in Saccharomyces cerevisiae

International audienceThe discovery of novel specific ribosome-associated factors challenges the assumption that translation relies on standardized molecular machinery. In this work, we demonstrate that Tma108, an uncharac-terized translation machinery-associated factor in yeast, defines a subpopulation of cellular ribosomes specifically involved in the translation of less than 200 mRNAs encoding proteins with ATP or Zinc binding domains. Using ribonucleoparticle dissoci-ation experiments we established that Tma108 directly interacts with the nascent protein chain. Additionally , we have shown that translation of the first 35 amino acids of Asn1, one of the Tma108 targets, is necessary and sufficient to recruit Tma108, suggesting that it is loaded early during translation. Comparative genomic analyses, molecular model-ing and directed mutagenesis point to Tma108 as an original M1 metallopeptidase, which uses its pu-tative catalytic peptide-binding pocket to bind the N-terminus of its targets. The involvement of Tma108 in co-translational regulation is attested by a drastic change in the subcellular localization of ATP2 mRNA upon Tma108 inactivation. Tma108 is a unique example of a nascent chain-associated factor with high selectivity and its study illustrates the existence of other specific translation-associated factors besides RNA binding proteins