Multivariate Analysis of Dietary Patterns in 939 Swiss Adults: Sociodemographic Parameters and Alcohol Consumption Profiles

A dietary survey of 939 Swiss adults, randomly selected from the population of Geneva and its surrounding communities, was performed according to the history method. A factor analysis, using average weekly intakes for 33 food variables, reveals three principal components of the diet: satiating capacity, healthfulness and culinary complexity. These characteristics, together with the energy content of the diet, were analysed for differences according to sex, age, relative weight index, birthplace, marital status and occupation. All of these sociodemographic variables influence some dimension of dietary habits. Alcohol consumption is positively associated with satiating, protein rich diets, but energy intake from foods does not significatively differ between various groups of abstainers and drinkers. Although the energy contribution of alcoholic beverages is globally additive, we suggest that cultural and societal norms may modulate the relationship of alcohol and die

Les plafonds de bois peints à Rome au XVIe siècle: le cas du palazzo del Vaso (Colonna) à Santi Apostoli

En 1482, lorsque la construction du palazzo del Vaso s’achève sous le cardinal Giuliano della Rovere (1443-1513), l’édification d’imposants palais au cœur de la ville de Rome consiste en une pratique que se réservent, presque exclusivement, les Princes de l’Église. Manifestation ostensible du pouvoir, les riches et puissantes familles de la capitale ne tardent pas, dès le tournant du XVIe siècle, à s’approprier à leur tour cette prérogative dans le but de légitimer leur statut social. Certes, l’architecture extérieure du palais demeure, pour ces familles, un moyen efficace d’y parvenir, mais à plus forte raison, le décor intérieur – mobilier, frises, plafonds de bois peints, etc. – devient un dispositif didactique de prédilection qui permet au commanditaire d’articuler ses visions politiques à l’intérieur de programmes iconographiques savamment élaborés. Suivant cette perspective, ce mémoire souhaite interroger une composante du décor rarement examinée par la discipline de l’histoire de l’art : le plafond de bois peint. À cet effet, celui commandité par Marcantonio II Colonna (1535-1584) pour le salone du palazzo del Vaso (Colonna) de Rome fait ici office de cas d’étude. En tant que l’une des plus anciennes familles baronniales romaines, alliée des impériaux espagnols, la famille Colonna est ponctuellement impliquée, au cours de son histoire, dans des conflits qui l’opposent à la papauté, notamment à partir de 1557, année où Marcantonio II Colonna devient le chef de la famille. Ainsi, il s’agira d’abord de recenser les variantes structurelles et les modalités d’ornementation des plafonds de bois de la Renaissance pour identifier celui du salone. Puis, nous procéderons à une première interprétation iconographique de son programme peint afin de montrer de quelle manière cette composante décorative véhicule un message politique, directement lié aux enjeux du clan Colonna.Under the order of Cardinal Giuliano della Rovere (1443-1513), the construction of Palazzo del Vaso was completed in 1482, a time when virtually all major palace constructions in the heart of Rome were restricted to the Princes of the Church. From the 16th century onwards, the leading wealthy families of the Italian capital appropriated this prerogative in order to legitimize their social status. The architecture of these palaces, as well as interior decoration such as furniture, friezes, painted wooden ceilings, etc., became symbols of status and power. Interior decoration also served as a didactic device that allowed the owner to articulate his political views within sophisticated iconographic programmes. From this perspective, the purpose of this thesis is to examine a décor component rarely addressed by art historians: the painted wooden ceiling. The ceiling commissioned by Marcantonio II Colonna (1535-1584) for the salone of the Palazzo del Vaso (Colonna) in Rome will serve as a case study. The Colonnas, traditionally pro-Spanish and one of the oldest Roman baronial families, were frequently involved in conflicts with the papacy, especially during the period when Marcantonio II Colonna was head of the household, from 1557. The structural variants and modalities of ornamentation specific to Renaissance wooden painted ceilings will be explored in order to form an in-depth analysis of the ceiling of the salone. Lastly, a first iconographic interpretation of its painted programme will be provided in order to demonstrate the conveyance of political messages directly linked to the stakes of the Colonna family

Rôle des cellules dendritiques SIRPα+ dans l’asthme expérimental

L’asthme est une maladie multifactorielle hétérogène qui engendre une inflammation pulmonaire associée à une variété de manifestations cliniques, dont des difficultés respiratoires graves. Globalement, l’asthme touche environ une personne sur 6 et présente actuellement un sérieux problème de santé publique. Bien que de nombreux traitements soient disponibles pour soulager les symptômes de la maladie, aucun traitement curatif n’est actuellement disponible. La compréhension des mécanismes qui régissent l’état inflammatoire au cours de la maladie est primordiale à la découverte de nouvelles cibles thérapeutiques efficaces. Les cellules dendritiques captent les allergènes dans les poumons et migrent vers les ganglions drainants pour les présenter aux cellules T et engendrer la réponse inflammatoire pathogénique chez les asthmatiques. Nous avons contribué à l’avancement des connaissances mécanistiques de l’asthme en identifiant chez la souris la sous-population de cellules dendritiques responsable de l’initiation et du maintien de la réponse inflammatoire locale et systémique associée à l’asthme. En effet, nous avons démontré que le SIRPα, récepteur extracellulaire impliqué dans la régulation de la réponse immune, est sélectivement exprimé à la surface des cellules dendritiques immunogéniques. L’interruption de la liaison entre le SIRPα et son ligand, le CD47, interfère avec la migration des cellules dendritiques SIRPα+ et renverse la réponse inflammatoire allergique. Ce mécanisme constitue une avenue thérapeutique prometteuse. D’ailleurs, les molécules de fusion CD47-Fc et SIRPα-Fc se sont avérées efficaces pour inhiber l’asthme allergique dans le modèle murin. Nous avons également démontré l’implication des cellules dendritiques SIRPα dans un modèle d’inflammation pulmonaire sévère. L’administration répétée de ces cellules, localement par la voie intra-trachéale et systémiquement par la voie intra-veineuse, mène au développement d’une réponse inflammatoire mixte, de type Th2-Th17, similaire à celle observée chez les patients atteints d’asthme sévère. La présence de cellules T exprimant à la fois l’IL-17, l’IL-4, l’IL-13 et le GATA3 a été mise en évidence pour la première fois in vitro et in vivo dans les poumons et les ganglions médiastinaux grâce à ce modèle. Nos expériences suggèrent que ces cellules Th2-Th17 exploitent la plasticité des cellules T et sont générées à partir de la conversion de cellules Th17 qui acquièrent un phénotype Th2, et non l’inverse. Ces résultats approfondissent la compréhension des mécanismes impliqués dans l’initiation et le maintien de l’asthme allergique et non allergique, en plus d’ouvrir la voie à l’élaboration d’un traitement spécifique pour les patients asthmatiques, particulièrement ceux pour qui aucun traitement efficace n’est actuellement disponible.Asthma is a heterogeneous multifactorial disease resulting in airway inflammation associated with a variety of clinical manifestations, which include severe breathing difficulties. Asthma affects approximately one out of six people and is currently a serious public health problem. As of now, many treatments are available to relieve the symptoms of the disease, but no definitive cure is available. Understanding the mechanisms that regulate the inflammatory condition during the disease is essential to the discovery of effective new therapeutic targets. Dendritic cells capture allergens in the lungs, migrate to the draining lymph nodes where they activate cognate T cells, which cause the pathogenic inflammatory response. My work help defined and deepened the mechanistic understanding of asthma by identifying the subpopulation of dendritic cells responsible for the initiation and maintenance of local and systemic inflammatory response. We demonstrated that SIRPα is selectively expressed on the surface of immunogenic dendritic cells. Indeed, the interruption of the ligation between SIRPα and its ligand, CD47, interferes with the migration of SIRPα+ dendritic cells and reverses the allergic inflammatory response. This mechanism is a promising new therapeutic avenue. Moreover, we showed that the soluble fusion molecules CD47-Fc and SIRPα-Fc are potent inhibitors of the allergic asthma in a mouse model. In addition, we demonstrated the involvement of SIRPα+ dendritic cells in a model of severe airway inflammation induced upon local and systemic repeated administration of those cells. Either treatment led to the development of a mixed Th2-Th17 inflammation, a phenotype recently described in patients with severe asthma. This model allowed us to show the presence of T cells expressing at once IL-17, IL-4, IL-13 and GATA3 in vitro and in vivo in the lungs and in the mediastinal lymph nodes. Our results suggest that these Th2-Th17 cells are generated from the conversion of Th17 cells acquiring a Th2 phenotype, and not the other way around, a hallmark of Th17 cells plasticity. These results deepen the understanding of the mechanisms involved in the initiation and maintenance of allergic and non-allergic asthma. Besides, we open a way to the development of a specific treatment for asthmatic patients, particularly those for whom no effective treatment is currently available

DIZZYNET 2020: basic and clinical vestibular research united

Objective!#!To investigate diagnostic accuracy of a nerve ultrasound (US) protocol that is individualized to a patient's clinical deficits for the differentiation of amyotrophic lateral sclerosis with predominant lower motoneuron disease (ALS/LMND) and multifocal motor neuropathy (MMN).!##!Methods!#!Single-center, prospective, examiner-blinded, diagnostic study in two cohorts. Cohort I (model development): Convenience sample of subjects with ALS/LMND or MMN according to revised El-Escorial or EFNS guidelines. Cohort II (model validation): Consecutively recruited treatment-naïve subjects with suspected diagnosis of ALS/LMND or MMN. Cutoffs for 28 different US values were determined by Receiver Operating Curve (ROC) in cohort I. Area Under The Curve (AUC) of US was compared to nerve conduction studies (NCS). Diagnostic accuracy of US protocols, individualized according to clinical deficits, was compared to former rigid non-individualized protocols and to random examination site selection in cohort II.!##!Results!#!48 patients were recruited. In cohort I (28 patients), US had higher ROC AUCs than NCS, US 0.82 (0.12) (mean (standard deviation)), NCS (compound muscle action potential (CMAP) 0.60 (0.09), p < .001; two-sided t-test). US models based on the nerve innervating the clinically most affected muscles had higher correct classification rates (CCRs, 93%) in cohort II than former rigid protocols (85% and 80%), or models with random measurement site selection (66% and 80%).!##!Conclusions!#!Clinically guided US protocols for differentiation of ALS/LMND from MMN increase diagnostic accuracy when compared to clinically unguided protocols. They also require less measurements sites to achieve this accuracy

The paradoxes of communication and collaboration in maternity care:A video-reflexivity study with professionals and parents

Background: Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, we examined their interactions in the clinic, looking for “good practice”. Methods: We used the video-reflexive ethnographic method in 9 midwifery practices and 2 obstetric units. Findings: We conducted 16 meetings where participants reflected on video recordings of their clinical interactions. We found that informal strategies facilitate communication and collaboration: “talk work” – small talk and humour – and “work beyond words” – familiarity, use of sight, touch, sound, and non-verbal gestures. When using these strategies, participants noted that it is important to be sensitive to context, to the values and feelings of others, and to the timing of care. Our analysis of their ways of being sensitive shows that good communication and collaboration involves “paradoxical care”, e.g., concurrent acts of “regulated spontaneity” and “informal formalities”. Discussion: Acknowledging and reinforcing paradoxical care skills will help caregivers develop the competencies needed to address the changing demands of health care. The video-reflexive ethnographic method offers an innovative approach to studying everyday work, focusing on informal and implicit aspects of practice and providing a bottom up approach, integrating researchers, professionals and parents. Conclusion: Good communication and collaboration in maternity care involves “paradoxical care” requiring social sensitivity and self-reflection, skills that should be included as part of professional training

Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock

Background: Inflammatory response is an important feature of acute coronary syndromes and myocardial infarction (MI). The prognostic value of proinflammatory cytokines in patients with acute MI complicated by cardiogenic shock is unknown. Methods and results: In 41 patients admitted with acute MI (age 60 ± 11 years, six females, 19 Killip class IV) serial plasma concentration of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and interleukin 1 receptor antagonist (IL-1Ra) were measured. Seven patients with cardiogenic shock (CS) developed a systemic inflammatory response syndrome (SIRS). Patients with CS—particularly those who developed SIRS—showed significantly higher cytokine levels than patients with uncomplicated MI. In patients with CS and SIRS peak levels of IL-1Ra were 223,973 pg/ml, IL-6 252.8 pg/ml and TNF-α 7.0 pg/ml. In CS without SIRS IL-1Ra levels were 19,988 pg/ml, IL-6 109.3 pg/ml and TNF-α 3.8 pg/ml. In uncomplicated MI peak IL-1Ra levels were 1,088 pg/ml, IL-6 34.1 pg/ml and TNF-α 2.6 pg/ml. Conclusions: The inflammation-associated cytokines TNF-α, IL-6 and IL-1Ra are significantly elevated in patients with MI complicated by CS when compared to patients with uncomplicated MI. Among shock-patients IL-1Ra levels are promising diagnostic markers for early identification of patients developing SIRS, heralding a poor outcom

Mental health impact of autism on families of children with intellectual and developmental disabilities of genetic origin

BACKGROUND: Many children with an intellectual or developmental disability (IDD) have associated autism spectrum disorders (ASD), as well as an increased risk of mental health difficulties. In a cohort with IDD of genetic aetiology, we tested the hypothesis that excess risk attached to those with ASD + IDD, in terms of both children's mental health and parental psychological distress. METHODS: Participants with a copy number variant or single nucleotide variant (5–19 years) were recruited via UK National Health Service. 1904 caregivers competed an online assessment of child mental health and reported on their own psychological wellbeing. We used regression to examine the association between IDD with and without co-occurring ASD, and co-occurring mental health difficulties, as well as with parental psychological distress. We adjusted for children's sex, developmental level, physical health, and socio-economic deprivation. RESULTS: Of the 1904 participants with IDD, 701 (36.8%) had co-occurring ASD. Children with both IDD and ASD were at higher risk of associated disorders than those with IDD alone (ADHD: OR = 1.84, 95% confidence interval [CI] 1.46–2.32, p < 0.0001; emotional disorders: OR = 1.85, 95%CI 1.36–2.5, p < 0.0001; disruptive behaviour disorders: OR = 1.79, 95%CI 1.36–2.37, p < 0.0001). The severity of associated symptoms was also greater in those with ASD (hyperactivity: B = 0.25, 95%CI 0.07–0.34, p = 0.006; emotional difficulties: B = 0.91, 95%CI 0.67 to 1.14, p < 0.0001; conduct problems: B = 0.25, 95%CI 0.05 to 0.46, p = 0.013). Parents of children with IDD and ASD also reported greater psychological distress than those with IDD alone (β = 0.1, 95% CI 0.85 to 2.21, p < 0.0001). Specifically, in those with ASD, symptoms of hyperactivity (β = 0.13, 95% CI 0.29–0.63, p < 0.0001), emotional difficulties (β = 0.15, 95% CI 0.26–0.51, p < 0.0001) and conduct difficulties (β = 0.07, 95% CI 0.07–0.37, p < 0.004) all significantly contributed to parental psychological distress. CONCLUSIONS: Among children with IDD of genetic aetiology, one third have co-occurring ASD. Not only do those with co-occurring ASD present with a wider range of associated mental health disorders and more severe mental health difficulties than those with IDD alone, but their parents also experience more psychological distress. Our findings suggest that the additional mental health and behavioural symptoms in those with ASD contributed to the degree of parental psychological distress

Optimization of microwave-assisted alkaline pre-treatment method for the cellulolytic fermentation of abaca stripping waste into glucose

Abaca fiber remains a vital export product that contributes primarily to the continuous economic growth of the Philippines. However, the voluminous amount of byproducts generated has consistently caused setbacks which often result to major losses to the growing abaca industry in the country. In an attempt to provide a practical solution to the emerging problem, we investigate the utilization of abaca stripping waste (ASW) as a precursor material to produce bioethanol. We test the extent of conversion of the hemicellulose-rich by product to glucose. A box-behnken experimental design was used to obtain the optimal conditions in the conversion process. Alkaline concentration (%), microwave power (W), and microwave time (min) were found to have significant influence on the glucose yield. Actual values of these independent variables were chosen on the basis of preliminary experimental results. Optimum conditions using ridge analysis were found to be: alkaline concentration 2.55%, microwave power 124.0 W, and microwave time at 1.0 min. Conversion to glucose was also performed at optimum conditions. In conclusion, a high glucose yield obtained which is suitable for bioethanol fermentation presents evidence encouraging the utilization of abaca stripping waste to produce high value products