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Standing or Very Low-Intensity Cycling as Sedentary Breaks: Does Physical Activity Level Matter?
No full textInternational audienceBackground : Active breaks and very low- to low-intensity exercises such as walking or cycling at an active desk have been shown to significantly counteract the negative effect of prolonged sedentary behaviors. The objective was to investigate the effect of physical activity level (PAL) on changes in energy expenditure (EE), heart rate, and substrate oxidation from sit-to-stand and sit-to-light cycling. Methods : Fifty healthy young males and females (age: 23.9 [3.9] y, body mass index: 22.9 [2.3] kg/m 2 ) were submitted to a fixed 1 hour session of different posture allocations: 15-minute sitting, 15-minute standing, 15-minute sitting, and 15-minute very low-intensity cycling. EE, substrate oxidation rates, and heart rate were continuously assessed throughout the experimental visit. Data were then compared between participants according to their PAL in tertiles (low, medium, or high). The high-PAL group showed lower sedentary time ( P < .0001) and higher time spent in low ( P < .0001), moderate ( P < .0001), and vigorous physical activity ( P = .0034). Results : ANOVA’s analysis showed that EE significantly increased when standing (+11%) and cycling (+94%) relative to the seated position ( P < .05) without any differences between groups. There was also a significant increase in heart rate during standing and cycling compared with sitting ( P < .05) without any differences between groups. Relative EE (in kilocalories per minute per kilogram) was significantly higher when seated ( P < .05) independent of PAL but marginally higher in the high-PAL group when standing relative to the medium-PAL group ( P = .06). Conclusion : The findings of this study suggest that people’s PAL does not impact energetic and metabolic adaptations during sit-to-stand and sit-to-very-light-intensity cycling exercise
Adapting work at the hospital during the COVID-19 pandemic: A qualitative study of administrative staff's teleworking experience
No full textInternational audienceThe COVID-19 pandemic changed the organisation of hospital work with telework and the adaptation of resource management. It is essential to involve the workers themselves in the evaluation of telework, especially the administrative staff who are the most likely to telework. The aim of this study was to assess the feelings of hospital administrative staff in a university hospital in France towards telework, regardless of the period in which they had experienced it (before the COVID-19 crisis, during the first lockdown, or after the crisis). A descriptive exploratory study, using a qualitative approach through semi-structured interviews, was carried out to provide answers to the benefits of continuing telework. Of the hospital's 8815 employees, we included 23 workers (22 women) who were representative of the 400 administrative staff who had experienced teleworking. We showed that the hierarchical barriers to teleworking before the pandemic were overcome after the pandemic, and that some absenteeism was avoided. Teleworking is a good tool for managing public human resources in hospitals, reducing physical symptoms and improving work-life balance. These results should enable human resources departments in healthcare institutions to adapt telework posts and schedules to promote productivity at work and the physical and psychological well-being of employees.</div
Pregnancy and birth outcomes in women with multiple sclerosis: Comparison of the RESPONSE study to the general French population
No full textInternational audienceBackground: Retrospective studies did not show strong evidence of higher risk of adverse neonatal or pregnancy outcomes in women with multiple sclerosis (MS) compared to general population, but there are contradictory data on prematurity, cesarean section, and small birthweight for gestational age (SGA).Methods: We compared pregnancy and birth outcomes in MS women included in RESPONSE, a French prospective cohort, with a recent survey (Enquête Nationale Périnatale (ENP)) describing leading indicators in perinatal epidemiology in France.Results: On 7 April 2023, 476 pregnancies (461 MS women, 482 expected newborns) from RESPONSE were available. The ENP study reported 12,723 women and 12,939 expected newborns in March 2021. MS patients were older (mean age 32.6 ± 4.4 vs. 30.9 ± 5.3 years, p < 0.001), with similar rate of cesarean (23.8% vs. 21.4%, p = 0.115) and use of locoregional analgesia (86.6% vs. 85.1%, p = 0.51). Preterm birth was less frequent (4.0% vs. 7.0%, p = 0.001). Birthweight of children from MS mothers was similar to general population (3240 ± 477.2 vs. 3264.5 ± 552.9 g, p = 0.22), with slightly more children with SGA (13.4% vs. 9.8%, p = 0.04).Conclusion: This prospective and contemporary comparison of pregnancy in MS women and the French population provides reassuring results. In the future, we need to assess the impact of disease-modifying treatment exposure during conception
Diagnostic value of biological parameters in biopsy-confirmed thrombotic microangiopathy-MATRIX consortium group
No full textInternational audienceIntroductionThe diagnosis of thrombotic microangiopathy (TMA) relies on common biological parameters which diagnostic value is unknown.MethodsThe presence of common biological parameters was assessed in 967 patients with TMA during the 2009-2023 period (ClinicalTrials.gov: NCT05991245).ResultsMedian age was 49 [36-64] and 53.2% were male. All TMA causes were represented (atypical hemolytic uremic syndrome (HUS): 41.6%; drugs: 24.9%; malignancy: 21.4%; auto-immune: 18.8%; infection: 7.6%, complement-mediated HUS (C-HUS): 6.8%, organ transplantation: 5.8%, pregnancy: 3.8%, bone marrow transplantation (BMT): 2.9%, shigatoxin (STEC-HUS): 0.6%, thrombotic thrombocytopenic purpura (TTP) (0.6%).The presence of TMA-related parameters concerned virtually all patients with TTP but varied widely for the other patients: anemia 81.7% (anemia (81.7%), high lactate deshydrogenase (LDH) (75.4%), low haptoglobin (53.7%), thrombocytopenia (40.3%). Their diagnostic performance was accurate only for TTP. Eleven distinct ways were used for schistocyte metrics and reporting. Relying on schistocytes presence as the single diagnostic criterion would lead to missed diagnosis in 23.8% (shigatoxin HUS) to 86.4% (bone marrow transplantation) of patients (for anemia: 8.2% to 22.3%; thrombocytopenia: 31.8% to 67.9%; high LDH: 10.0% to 40.7%, low haptoglobin: 0% to 70.4%, according to the causes of TMA). The overall risk of missed diagnosis using these parameters was ≥ 50% in all TMA, except in TTP.The best diagnostic performances were obtained when fibrinogen levels were <5 g/L, creatinine ≥300 μmol/L, prothrombin time (PT) <90% and when TMA causes were TTP, STEC-HUS, infection or complement-mediated HUS.ConclusionsCommon biological parameters miss the diagnosis in more than 50% of TMA except when fibrinogen is <5 g/L, creatinine ≥300 μmol/L and prothrombin time (PT) <90%. Schistocyte reporting is heterogenous, and its results are usually deceptive in TMA
Evaluation of serum NFL, T-tau, p-tau181, p-tau217, Aβ40 and Aβ42 for the diagnosis of neurodegenerative diseases.
No full textInternational audienceTo assess the variations and diagnostic performance of serum biomarkers of neurodegenerative diseases. Methods In this monocentric prospective study, neurofilament light (NFL), T-tau, p-tau181, p-tau217, Aβ40, and Aβ42 were measured in serum collected from orthopedic patients (control group, n=114) and patients in the neurology department (n=69) previously diagnosed with Alzheimer’s disease (AD, n=52), parkinsonian syndromes (n=10), and other etiologies of neurodegeneration (non-AD, n=7). Results In the control group, serum NFL, T-tau, p-tau181, p-tau217, and Aβ40 significantly increased with age, independently of sex. NFL (p=0.0078), p-tau217 (p<0.001) were significantly increased with neurodegeneration when compared to controls, with only p-tau217 significant in the multivariate analysis (p<0.001). Multivariate regression analysis accounting for age highlighted a significant increase of p-tau217 (p<0.001) in the AD subgroup. NFL was significantly increased in the non-AD patients (p<0.001), and in the parkinsonian syndromes subgroup (p=0.016) when compared to negative controls. Serum p-tau181 and p-tau217 were significantly correlated with CSF p-tau181 (Spearman’s coefficients of 0.43 and 0.48 respectively, n=40). Areas under the ROC curves for the identification of patients with neurodegenerative diseases were 0.62 (0.54–0.70) for NFL, 0.62 (0.54–0.71) for T-tau, 0.83 (0.76–0.89) for p-tau217, and 0.66 (0.58–0.74) for Aβ40. Conclusions Serum biomarkers can help identify patients with neurodegenerative disease and may be a valuable tool for care and orientation. Phosphorylated tau p-tau217 is a promising blood biomarker for AD and NFL for other etiologies
Features and outcomes of hypertrophic cardiomyopathy complicated by cardiogenic shock: an analysis of the FRENSHOCK multicenter prospective registry
No full textInternational audienceBackground: Cardiogenic shock (CS) in patients with left ventricular hypertrophy (LVH) due to hypertrophic cardiomyopathy (HCM) or hypertensive heart disease, is underreported in the literature. This study aimed to delineate the characteristics, management strategies and outcomes of patients experiencing CS with preexisting LVH and HCM.Methods: FRENSHOCK is a prospective multicenter registry including 772 unselected CS patients from 49 centers. Baseline characteristics, management and 1-year outcomes were analyzed according to the occurrence on preexisting LVH.Results: Within 772 CS patients included, CS occur on a preexisting LVH in 34 patients (4.4%, 1.4% with HCM). Clinical characteristics, medical history, and usual medications, as well as hemodynamic parameters upon inclusion, did not differ between patients with or without LVH. The LVEF in CS patients with LVH was 27.3 ± 14.5% indicating a non-obstructive cause of CS. In-hospital management according to LVH and non-LVH groups indicated no differences between the groups. The 1-month and 1-year mortality did not differ between CS patients with and without LVH (respectively 26.5% vs 26%, (adjusted HR [95% CI]: 0.87 [0.44-1.72]) and 55.9% vs 44.7%, (adjusted HR [95% CI]:0.88 [0.54-1.42]). Subgroup analyses comparing HCM (n =11) and hypertensive LVH (n=23) revealed similar clinical characteristics, in-hospital management, and one-year rehospitalization rates for these patients.Conclusion: In a large and unselected CS population, the prevalence of LVH patients is low (4.4%) with less than half having HCM (1.4%). The presentation, management, and outcomes of CS are similar to the broader CS population in our series. However, HCM-CS represents a distinct clinical entity necessitating tailored management approaches
Comparaison des flux de travail hybride et numérique pour la réalisation d’une couronne unitaire implantaire – Étude clinique pilote menée au service d’odontologie du CHU de Clermont-Ferrand
No full textInternational audienc
Associations Between Stress Level, Environment, and Emotional and Behavioral Characteristics in Service Sector Employees: Associations between stress, context, positive and negative emotions, physical activity and food intake
No full textInternational audienceBackground: The prevalence of stress-related health issues is becoming increasingly significant. This study aimed to examine the relationships between work stress, home stress, overall stress, and individual behavioral and perceptual characteristics among middle-aged employees in the service sector. Methods: Physical activity, diet, and perceptions were assessed using the WellBeNet application (2.10.2, INRAE, Clermont-Ferrand, France) while perceived stress levels were evaluated through an online questionnaire during a one-week period. The associations between stress levels and individual and behavioral characteristics were examined using multiple linear regressions and analyses of variance. Results: General stress was significantly influenced by both work and home stress. Home stress was positively correlated with the perception of one’s silhouette in red, the increasing consumption of dairy products, and the decreasing consumption of vegetables. Work stress was inversely correlated with age and positively correlated with body shape. Conclusions: Our study identified various context markers of stress—including age, body shape, food intake, and color of the silhouette. These markers could be used in subsequent intervention studies to demonstrate causal links.La prévalence des problèmes de santé liés au stress devient de plus en plus importante. Cette étude visait à examiner les relations entre le stress au travail, le stress à la maison, le stress global et les caractéristiques comportementales et perceptives individuelles chez les employés d'âge moyen du secteur des services. Méthodes : L'activité physique, l'alimentation et les perceptions ont été évaluées à l'aide de l'application WellBeNet (2.10.2, INRAE, Clermont-Ferrand, France), tandis que les niveaux de stress perçus ont été évalués à l'aide d'un questionnaire en ligne pendant une période d'une semaine. Les associations entre les niveaux de stress et les caractéristiques individuelles et comportementales ont été examinées à l'aide de régressions linéaires multiples et d'analyses de variance. Résultats : Le stress général était significativement influencé par le stress au travail et à la maison. Le stress à la maison était positivement corrélé à la perception de sa silhouette en rouge, à l'augmentation de la consommation de produits laitiers et à la diminution de la consommation de légumes. Le stress au travail était inversement corrélé à l'âge et positivement corrélé à la corpulence de la silhouette. Conclusions : Notre étude a identifié divers marqueurs contextuels du stress, notamment l'âge, la corpulence de la silhouette, l'apport alimentaire et la couleur de la silhouette. Ces marqueurs pourraient être utilisés dans des études d'intervention ultérieures afin de démontrer des liens de causalité
STAGING OF SUICIDALITY IN BIPOLAR DISORDER: FINDINGS FROM THE FACE-BD COHORT (FondaMental Advanced centre of Expertise for Bipolar Disorders)
No full textInternational audienceIntroduction: Suicidal behaviors (SB) in bipolar disorder (BD) are major adverse outcomes that may influence disease progression. While staging models exist for psychiatric disorders, none include suicide. This study aims to stratify suicidal risk in BD, propose a staging model for SB, and assess its clinical utility.Methods: Participants from the FondaMental Advanced Center of Expertise for Bipolar Disorder (FACE-BD) cohort were categorised into five stages (St) based on SB: St0 (no suicidal ideation [SI]), St1 (SI but no suicide attempt [SA]), St2a (non-severe/violent SA), St2b (severe /violent SA), and St3 (multiple SAs). Stages were analysed based on demographic, clinical, cognitive, and biological characteristics using logistic regression.Results: Key differences emerged between stages. St1 showed longer untreated illness and higher lability and lower functioning than St0. St2a was linked to anxiety, substance use disorders, and longer disorder duration, while male gender and lithium bitherapy were protective. St2b exhibited shorter untreated illness and higher childhood trauma (CTQ) scores, with male gender and alcohol use as risk factors. St3 was associated with BD-II, alcohol use, longer disorder duration, and more depressive episodes, but less anxiety. No biochemical or cognitive differences were found across stages. The model was significantly associated with SA occurrence (LRT = 28.74, p < 0.0001).Conclusion: This staging model for suicidality in BD provides a multifaceted approach to risk stratification and predictive insights, although further refinement is needed
