Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: The evaluation of geographical healthcare accessibility in residential areas provides crucial information to public policy. Traditional methods - such as Physician Population Ratios (PPR) or shortest travel time - offer only a one-dimensional view of accessibility. This paper developed an improved indicator: the Index of Spatial Accessibility (ISA) to measure geographical healthcare accessibility at the smallest available infra-urban level, that is, the Ilot Regroupe pour des Indicateurs Statistiques. Methods: This study was carried out in the department of Nord, France. Healthcare professionals are geolocalized using postal addresses available on the French state health insurance website. ISA is derived from an Enhanced Two-Step Floating Catchment Area (E2FCA). We have constructed a catchment for each healthcare provider, by taking into account residential building centroids, car travel time as calculated by Google Maps and the edge effect. Principal Component Analyses (PCA) were used to build a composite ISA to describe the global accessibility of different kinds of health professionals. Results: We applied our method to studying geographical healthcare accessibility for pregnant women, by selecting three types of healthcare provider: general practitioners, gynecologists and midwives. A total of 3587 healthcare providers are potentially able to provide care for inhabitants of the department of Nord. On average there are 92 general practitioners, 22 midwives and 21 gynecologists per 100,000 residents. The composite ISA for the three types of healthcare provider is 39 per 100,000 residents. A comparative analysis between ISA and physician-population ratios indicates that ISA represents a more even distribution whereas the physician-population ratios show an 'all-or-nothing' approach. Conclusion: ISA is a multidimensional and improved measure, which combines the volume of services relative to population size with the proximity of services relative to the population's location, available at the smallest feasible geographical scale. It could guide policy makers towards highlighting critical areas in need of more healthcare providers, and these areas should be earmarked for further knowledge-based policy making.
ISSN: 1475-9276

hal-01359567
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01359567
DOI : 10.1186/s12939-016-0411-z
PUBMED : 27485740

Éditeur(s) : HAL CCSD
Résumé : International audience
[No abstract available]
Journal of Gynecology Obstetrics and Human Reproduction

hal-01580501
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01580501
DOI : 10.1016/j.jogoh.2017.04.011
PUBMED : 28483643

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Evidence of the impact of exposure to lowlevels of lead on children's health is increasing. Residential floor dust is the assumed origin of lead exposure by young children. In this study, we estimate the contribution of different lead sources to household interior floor dust contamination. We also estimate the within-home variability of interior floor dust lead loadings. A multilevel model was developed based on data collected in a French survey in 2008-2009 (484 housing units, 1834 rooms). Missing data were handled by multiple imputation using chained equations. The intra-home correlation between interior floor Log dust lead loadings was approximately 0.6. Dust lead from the landing of an apartment, mostly originating outside the building, was the major contributor to interior floor dust lead. Secondary contributors included the lead-based paint on exterior railings, track-in of the exterior soil of the children's play area into the dwelling, smoking inside the home, demolition of nearby old buildings and sites of pollution in the vicinity. Interior lead-based paint contaminated interior floor dust only in old and non-renovated dwellings. To reduce interior floor dust lead levels in the general population of dwellings, common areas should be maintained, and track-in from the outside should be limited as much as possible.
Science of the Total Environment

hal-00997780
https://hal.archives-ouvertes.fr/hal-00997780
DOI : 10.1016/j.scitotenv.2013.10.028

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Because earthworms sustain soil functioning and fertility, there is a need to advance the knowledge of their adaptation potential to chemicals in anthropogenic landscapes. Our hypothesis is that there is acclimation to organic chemicals (pesticides) in earthworms that durably persist under conventional farming in anthropogenic landscapes. The adaptation capability of two populations of earthworms (Aporectodea caliginosa) having a different chemical exposure history, - one originating from 20 years of organic farming (naïve population) and another from 20 years of conventional farming (pre-exposed population) - to cope with soil organic pollutant (Opus®, epoxiconazole a worldwide used fungicide) were investigated. Several complementary metabolic and energetic endpoints were followed, and cast production was assessed as a behavioural biomarker related to earthworms ecological role for the soil. Basal metabolism reflected by respiration rate was increased in both fungicide-exposed worms compared to controls. Glycogen resources were decreased in the same proportion in the two populations but more rapidly for the naïve (7 days) than for the pre-exposed population (28 days). Soluble protein and most amino-acids contents increased in the pre-exposed population only, suggesting a detoxification mechanism. Metabolomic profiles showed a cut-off between fungicide-exposed and control groups in the pre-exposed earthworms only, with an increase in most of the metabolites. Exposure to a low dose of epoxiconazole increased cast production of pre-exposed earthworms, and this resulted in an increase in pesticide disappearance. As far as we know, this is the first study which evidenced there is an acclimation to an agricultural chemical in earthworms derived from conventional farming that also relates to a change in their burrowing behaviour, and for which larger consequences for the soil ecosystem need to be addressed. This original finding is of major interest in the frame of ecosystem resilience to global changes. Whether this physiological adaptation is a general pattern of response against fungicides or other pesticides would need to be confirmed with other molecules and agricultural contexts.
Soil Biology and Biochemistry

hal-01005821
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01005821
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01005821/document
DOI : 10.1016/j.soilbio.2014.01.032

Éditeur(s) : HAL CCSD Météo et Climat
Résumé : International audience
Les risques hydrométéorologiques sont au coeur du programme de recherche HyMeX sur le cycle de l'eau en Méditerranée. HyMeX a pour ambition d'améliorer leur prévision, de mieux connaître leur variabilité à l'échelle pluriannuelle et de renseigner sur leur évolution, dans le contexte du changement climatique. À cette fin, deux campagnes de mesures dédiées à ces événements extrêmes (SOP1 : pluies intenses et crues rapides ; SOP2 : vents forts et formation d'eaux denses) sont organisées en Méditerranée nord-occidentale, entre septembre 2012 et mars 2013.
ISSN: 0026-1181

hal-00829760
https://hal.archives-ouvertes.fr/hal-00829760
DOI : 10.4267/2042/48793

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Patients with sickle cell anemia (SCA) have usually lower diastolic, systolic and mean blood pressure (BP) than the general population. However, BP values ≥120/70 mmHg considerably increase the risk for acute and chronic complications in SCA. The aim of this study was to identify biological factors associated with relative hypertension in adults with SCA. We compared the hematological, lipid and hemolytic profiles, as well as blood viscosity, between SCA patients with normal BP (<120/70 mmHg, n = 54) and those with relative hypertension (BP≥120/70 mmHg, n = 43). Our results demonstrated that male gender (OR: 3.49; 95%CI 1.20 to 10.16, p<0.05), triglycerides (OR: 9.19; 95% CI 2.29 to 36.95, p<0.01), blood viscosity (OR: 1.35; 95% CI 1.01 to 1.81, p<0.05) and body mass index (OR: 1.37; 95% CI 1.14 to 1.64, p<0.01) were independent risks factors for relative hypertension in SCA. No association was found between the BP status and the positive history of painful vaso-occlusive crisis or acute chest syndrome. An association between triglycerides level and the occurrence of these two major acute complications was detected. Our study suggests that male gender, increased triglycerides level, BMI and blood viscosity could increase the risk for developing relative hypertension in SCA. In addition, our results support a role of moderately elevated triglycerides in the pathophysiology of vaso-occlusive events.
ISSN: 1932-6203

inserm-00838991
http://www.hal.inserm.fr/inserm-00838991
http://www.hal.inserm.fr/inserm-00838991/document
http://www.hal.inserm.fr/inserm-00838991/file/Lamarre_et_al._2013_PloS_ONE_.pdf
DOI : 10.1371/journal.pone.0066004

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Introduction In order to study social health inequalities, contextual (or ecologic) data may constitute an appropriate alternative to individual socioeconomic characteristics. Indices can be used to summarize the multiple dimensions of the neighborhood socioeconomic status. This work proposes a statistical procedure to create a neighborhood socioeconomic index. Methods The study setting is composed of three French urban areas. Socioeconomic data at the census block scale come from the 1999 census. Successive principal components analyses are used to select variables and create the index. Both metropolitan area-specific and global indices are tested and compared. Socioeconomic categories are drawn with hierarchical clustering as a reference to determine "optimal" thresholds able to create categories along a one-dimensional index. Results Among the twenty variables finally selected in the index, 15 are common to the three metropolitan areas. The index explains at least 57% of the variance of these variables in each metropolitan area, with a contribution of more than 80% of the 15 common variables. Conclusions The proposed procedure is statistically justified and robust. It can be applied to multiple geographical areas or socioeconomic variables and provides meaningful information to public health bodies. We highlight the importance of the classification method. We propose an R package in order to use this procedure.
International Journal for Equity in Health

hal-00854028
https://hal.archives-ouvertes.fr/hal-00854028
https://hal.archives-ouvertes.fr/hal-00854028/document
DOI : 10.1186/1475-9276-12-21

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
An important objective on diagnosis of patients with Langerhans cell histiocytosis (LCH) is to determine the extent of disease. However, whether systematic extrathoracic investigation is needed in adult patients with clinically isolated pulmonary LCH (PLCH) has not been evaluated
ISSN: 1750-1172

hal-01269910
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01269910
DOI : 10.1186/s13023-016-0387-1
PUBMED : 26833097

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
BACKGROUND/AIM: Although it has been hypothesized that muscle metabolism and fatigability could be impaired in sickle cell patients, no study has addressed this issue. METHODS: We compared muscle metabolism and function (muscle microvascular oxygenation, microvascular blood flow, muscle oxygen consumption and muscle microvascular oxygenation variability, which reflects vasomotion activity, maximal muscle force and local muscle fatigability) and the hemorheological profile at rest between 16 healthy subjects (AA), 20 sickle cell-hemoglobin C disease (SC) patients and 16 sickle cell anemia (SS) patients. RESULTS: Muscle microvascular oxygenation was reduced in SS patients compared to the SC and AA groups and this reduction was not related to hemorhelogical abnormalities. No difference was observed between the three groups for oxygen consumption and vasomotion activity. Muscle microvascular blood flow was higher in SS patients compared to the AA group, and tended to be higher compared to the SC group. Multivariate analysis revealed that muscle oxygen consumption was independently associated with muscle microvascular blood flow in the two sickle cell groups (SC and SS). Finally, despite reduced muscle force in sickle cell patients, their local muscle fatigability was similar to that of the healthy subjects. CONCLUSIONS: Sickle cell patients have normal resting muscle oxygen consumption and fatigability despite hemorheological alterations and, for SS patients only, reduced muscle microvascular oxygenation and increased microvascular blood flow. Two alternative mechanisms can be proposed for SS patients: 1) the increased muscle microvascular blood flow is a way to compensate for the lower muscle microvascular oxygenation to maintain muscle oxygen consumption to normal values or 2) the reduced microvascular oxygenation coupled with a normal resting muscle oxygen consumption could indicate that there is slight hypoxia within the muscle which is not sufficient to limit mitochondrial respiration but increases muscle microvascular blood flow.
ISSN: 1932-6203

inserm-00849035
http://www.hal.inserm.fr/inserm-00849035
http://www.hal.inserm.fr/inserm-00849035/document
http://www.hal.inserm.fr/inserm-00849035/file/2013_Waltz_-_Normal_muscle_oxygen_consumption_and_fatigability_in_sickle_cell_patients.pdf
DOI : 10.1371/journal.pone.0052471

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Sickle cell anemia (SS) is characterized by a reduced cerebral microvascular oxygen saturation (cerebral TOI), which is not associated with hemoglobin concentration. Cerebral TOI has never been studied in sickle cell-hemoglobin C disease (SC). We focused on the relationships between hemorheological alterations and cerebral TOI in sickle cell patients with no cerebral vasculopathy and on the usefulness of TOI variability to assess the cerebral vasomotion activity. The blood rheological profile, the level of cerebral TOI (spatial resolved spectroscopy) and the cerebral TOI variability, which reflects vasomotion activity, were compared between 20 healthy subjects (AA), 21 SC patients, and 21 SS patients. Cerebral TOI exhibited the following order: AA > SC > SS. The low cerebral TOI in SS patients was related to red blood cell aggregation and deformability properties. The cerebral TOI variability of SS and SC patients was increased above healthy values and vasomotion activity was negatively associated with the reduced cerebral TOI in SS patients. We demonstrated that (1) blood rheology could be involved in the reduced cerebral TOI in SS patients but not in SC patients; (2) vasomotion activity is increased in SS and SC patients to compensate for the reduced cerebral TOI.
ISSN: 0361-8609

inserm-00838966
http://www.hal.inserm.fr/inserm-00838966
http://www.hal.inserm.fr/inserm-00838966/document
http://www.hal.inserm.fr/inserm-00838966/file/2013_Waltz_American_Journalsur Hematology.pdf
DOI : 10.1002/ajh.23318

Éditeur(s) : HAL CCSD
Résumé : LPSC14037
Scientific data collected with modern sensors or dedicated detectors exceed very often the perimeter of the initial scientific design. These data are obtained more and more frequently with large material and human efforts. A large class of scientific experiments are in fact unique because of their large scale, with very small chances to be repeated and to superseded by new experiments in the same domain: for instance high energy physics and astrophysics experiments involve multi-annual developments and a simple duplication of efforts in order to reproduce old data is simply not affordable. Other scientific experiments are in fact unique by nature: earth science, medical sciences etc. since the collected data is "time-stamped" and thereby non-reproducible by new experiments or observations. In addition, scientific data collection increased dramatically in the recent years, participating to the so-called "data deluge" and inviting for common reflection in the context of "big data" investigations. The new knowledge obtained using these data should be preserved long term such that the access and the re-use are made possible and lead to an enhancement of the initial investment. Data observatories, based on open access policies and coupled with multi-disciplinary techniques for indexing and mining may lead to truly new paradigms in science. It is therefore of outmost importance to pursue a coherent and vigorous approach to preserve the scientific data at long term. The preservation remains nevertheless a challenge due to the complexity of the data structure, the fragility of the custom-made software environments as well as the lack of rigorous approaches in workflows and algorithms. To address this challenge, the PREDON project has been initiated in France in 2012 within the MASTODONS program: a Big Data scientific challenge, initiated and supported by the Interdisciplinary Mission of the National Centre for Scientific Research (CNRS). PREDON is a study group formed by researchers from different disciplines and institutes. Several meetings and workshops lead to a rich exchange in ideas, paradigms and methods. The present document includes contributions of the participants to the PREDON Study Group, as well as invited papers, related to the scientific case, methodology and technology. This document should be read as a "facts finding" resource pointing to a concrete and significant scientific interest for long term research data preservation, as well as to cutting edge methods and technologies to achieve this goal. A sustained, coherent and long term action in the area of scientific data preservation would be highly beneficial.
http://hal.in2p3.fr/in2p3-00959072

in2p3-00959072
http://hal.in2p3.fr/in2p3-00959072
http://hal.in2p3.fr/in2p3-00959072/document
http://hal.in2p3.fr/in2p3-00959072/file/PREDON_Scientific_Data_Preservation_2014.pdf

Éditeur(s) : HAL CCSD Nature Publishing Group
Résumé : International audience
Everyone is subject to environmental exposures from various sources, with negative health impacts (air, water and soil contamination, noise, etc.or with positive effects (e.g. green space). Studies considering such complex environmental settings in a global manner are rare. We propose to use statistical factor and cluster analyses to create a composite exposure index with a data-driven approach, in view to assess the environmental burden experienced by populations. We illustrate this approach in a large French metropolitan area. The study was carried out in the Great Lyon area (France, 1.2 M inhabitants) at the census Block Group (BG) scale. We used as environmental indicators ambient air NO2 annual concentrations, noise levels and proximity to green spaces, to industrial plants, to polluted sites and to road traffic. They were synthesized using Multiple Factor Analysis (MFA), a data-driven technique without a priori modeling, followed by a Hierarchical Clustering to create BG classes. The first components of the MFA explained, respectively, 30, 14, 11 and 9% of the total variance. Clustering in five classes group: (1) a particular type of large BGs without population; (2) BGs of green residential areas, with less negative exposures than average; (3) BGs of residential areas near midtown; (4) BGs close to industries; and (5) midtown urban BGs, with higher negative exposures than average and less green spaces. Other numbers of classes were tested in order to assess a variety of clustering. We present an approach using statistical factor and cluster analyses techniques, which seem overlooked to assess cumulative exposure in complex environmental settings. Although it cannot be applied directly for risk or health effect assessment, the resulting index can help to identify hot spots of cumulative exposure, to prioritize urban policies or to compare the environmental burden across study areas in an epidemiological framework.Journal of Exposure Science and Environmental Epidemiology advance online publication, 24 September 2014; doi:10.1038/jes.2014.66.
ISSN: 1559-0631

hal-01069587
https://hal.archives-ouvertes.fr/hal-01069587
https://hal.archives-ouvertes.fr/hal-01069587/document
https://hal.archives-ouvertes.fr/hal-01069587/file/Article_multiexpo_20140708_c.pdf
DOI : 10.1038/jes.2014.66

Éditeur(s) : HAL CCSD Lippincott, Williams & Wilkins
Résumé : International audience
o abstract
ISSN: 0269-9370

hal-01560146
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560146
DOI : 10.1097/QAD.0000000000001474
PUBMED : 28492398

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : Heat stress is one of the major limiting factors of production efficiency in the swine industry. The aims of the present study were 1) to observe if hemorheological and hematological parameters could be associated to physiological acclimation during the first days of heat stress exposure and 2) to determine if water restriction could modulate the effect of thermal heat stress on physiological, hematological and hemorheological parameters. Twelve Large White male pigs were divided into an ad libitum and a water restricted group. All pigs were submitted to one week at 24 °C (D-7 to D-1). Then, at D0, temperature was progressively increased until 32 °C and maintained during one week (D1 to D7). We performed daily measurements of water and feed intake. Physiological (i.e., skin temperature, rectal temperature, respiratory rate), hematological and hemorheological parameters were measured on D-6, D-5, D0, D1, D2 and D7. Water restriction had no effect on physiological, hematological and hemorheological parameters. The first days of heat stress caused an increase in the three physiological parameters followed by a reduction of these parameters suggesting a successful acclimation of pigs to heat stress. We showed an increase in hematocrit, red blood cell aggregation and red blood cell aggregation strength during heat stress. Further, we observed an important release of reticulocytes, an increase of red blood cell deformability and a reduction of feed intake and blood viscosity under heat stress. This study suggests that physiological acute adaptation to heat stress is accompanied by large hematological and hemorheological changes.
ISSN: 1932-6203

hal-01210648
https://hal.archives-ouvertes.fr/hal-01210648
DOI : 10.1371/journal.pone.0102537
PRODINRA : 269557
PUBMED : 25013960

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: Hepatocellular carcinoma (HCC) is a particularly severe disease characterized by a high rate of recurrence and death even after surgical resection. Molecular characterization of HCC helps refine prognosis and may facilitate the development of improved therapy. Phosphatidylinositol 4-kinases have recently been identified as cellular factors associated with cancer. Also, phosphatidylinositol 4-kinase type IIIα (PI4KA) is necessary for the propagation of the hepatitis C virus, a major etiological factor for HCC. METHODS: Reverse transcription, quantitative real-time PCR was used to assay PI4KA mRNA. The expression levels were investigated both in a collection of molecularly and clinically characterized hepatic tissues from 344 patients with diverse liver diseases and in human hepatocyte cell lines whose proliferative and differentiation status was controlled by specific culture conditions. Analytical microarray data for 60 HCC and six normal liver tissue samples were exploited to study correlations between PI4KA mRNA levels and cell proliferation markers in vivo. Postoperative disease-specific survival and time to recurrence in a set of 214 patients with HCC were studied by univariate and multivariate analyses. RESULTS: PI4KA mRNA was more abundant in HCC than normal healthy tissues. This upregulation correlated significantly with both poor differentiation and the active proliferation rate in HCC. These associations were confirmed with in vitro models. Moreover, patients with HCC who had been treated by surgical resection and had higher PI4KA mRNA concentrations in their tumor tissue exhibited a higher risk of tumor recurrence (median time: 20 months versus 49 months, P = 0.0012) and shorter disease-specific survival (first quartile time: 16 months versus 48 months, P = 0.0004). Finally, the abundance of PI4KA mRNA proved to be an independent prognostic marker of survival for cases of HCC (hazard ratio = 2.36, P = 0.0064). CONCLUSIONS: PI4KA mRNA could be used as a new molecular marker to improve established prognostic models for HCC. These findings also indicate possible new lines of research for the development of innovative therapeutic approaches targeting PI4KA.
ISSN: 1471-2407

inserm-00934294
http://www.hal.inserm.fr/inserm-00934294
http://www.hal.inserm.fr/inserm-00934294/document
http://www.hal.inserm.fr/inserm-00934294/file/1471-2407-14-7.pdf
DOI : 10.1186/1471-2407-14-7

Éditeur(s) : HAL CCSD American Society for Microbiology
Résumé : International audience
Anti-Aspergillus IgG antibodies are important biomarkers for the diagnosis of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA). We compared the performance of a new commercial EIA (Bordier Affinity Products) with those of the Bio-Rad and VirionSerion EIAs. This assay is novel in the association of two recombinant antigens with somatic and metabolic antigens of A. fumigatus. In a prospective multicentre study, 436 serum samples from 147 patients diagnosed with CPA (136 sera/104 patients) or ABPA (94 sera/43 patients) and from 205 controls (206 sera) were tested. We obtained sensitivities of 97%, 91.7%, and 86.1%, and specificities of 90.3%, 91.3%, and 81.5% for the Bordier, Bio-Rad and VirionSerion tests, respectively. The Bordier kit was more sensitive than the Bio-Rad kit (p < 0.01), which was itself more sensitive than the VirionSerion kit (p=0.04). The Bordier and Bio-Rad kits had similar specificities (p=0.8), both higher than that of the VirionSerion kit (p=0.02). The areas under the ROC curves confirmed the superiority of the Bordier kit over the Bio-Rad and the VirionSerion kits (0.977, 0.951 and 0.897, respectively; p < 0.01 for each comparison). In a subset analysis of 279 sera tested with the Bordier and Bio-Rad kits and an in-house immunoprecipitin assay (IPD), the Bordier kit had the highest sensitivity (97.7%), but the IPD tended to be more specific (71.2 and 84.7%, respectively; p=0.10).The use of recombinant, somatic and metabolic antigens in a single EIA improved the balance between sensitivity and specificity, resulting in an assay highly suitable for use in the diagnosis of chronic and allergic aspergillosis.
ISSN: 0095-1137

hal-01282328
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01282328
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01282328/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01282328/file/Prospective%20evaluation%20of%20a%20new%20Aspergillus.pdf
DOI : 10.1128/JCM.03261-15

Éditeur(s) : HAL CCSD
Résumé : International audience
BACKGROUND: Africa faces a number of unique environmental challenges. Unfortunately, it lacks the infrastructure needed to support the comprehensive environmental studies that could provide the scientific basis to inform environmental policies. There are a number of known sources of endocrine-disrupting chemicals (EDCs) and other hazardous chemicals in Africa. However, a coordinated approach to identify and monitor these contaminants and to develop strategies for public health interventions has not yet been made. OBJECTIVES: This commentary summarizes the scientific evidence presented by experts at the First African Endocrine Disruptors meeting. We describe a "call to action" to utilize the available scientific knowledge to address the impact of EDCs on human and wildlife health in Africa. DISCUSSION: We identify existing knowledge gaps about exposures to EDCs in Africa and describe how well-designed research strategies are needed to address these gaps. A lack of resources for research and a lag in policy implementation slows down intervention strategies and poses a challenge to advancing future health in Africa. CONCLUSION: To address the many challenges posed by EDCs, we argue that Africans should take the lead in prioritization and evaluation of environmental hazards, including EDCs. We recommend the institution of education and training programs for chemical users, adoption of the precautionary principle, establishment of biomonitoring programs, and funding of community-based epidemiology and wildlife research programs led and funded by African institutes and private companies. https://doi.org/10.1289/EHP1774.
Environmental Health Perspectives

hal-01616487
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01616487
DOI : 10.1289/EHP1774
PUBMED : 28935616

Éditeur(s) : HAL CCSD
Résumé : National audience
Epidemiological researches in the field of DOHaD are in favor of a role of early environment, including chemical (pesticides), physical (air pollution), nutritional or psychosocial environment, on child and adult health. Disentangling the different factors of environment that may affect health, especially over time, and identifying critical periods of exposure remains a major challenge. The biological mechanisms involved remain elusive in human beings. Nevertheless, it seems that whatever the nature of the exposure, epigenetic mechanisms are currently discussed to explain how the environment may alter biological systems over time.
Les résultats épidémiologiques dans le domaine de la DOHaD (developmental origins of health and disease) sont en faveur d’un rôle de l’environnement précoce sur la santé immédiate mais aussi future, qu’il s’agisse de l’environnement physique, chimique, nutritionnel ou encore psychosocial. Faire la part des différents facteurs de l’environnement susceptibles de modifier la santé, notamment sur le long terme, et des périodes critiques d’exposition reste un enjeu majeur. De même, les multiples mécanismes biologiques impliqués restent encore, pour une grande part, à identifier chez l’homme. Il semble néanmoins que, quelle que soit la nature de l’exposition considérée, des mécanismes épigénétiques sont actuellement évoqués pour expliquer comment l’environnement est susceptible de modifier des systèmes biologiques sur le long terme.
Médecine Sciences: M/S

hal-01274219
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01274219
DOI : 10.1051/medsci/20163201005
PUBMED : 26850603

Éditeur(s) : HAL CCSD International Medical Press
Résumé : International audience
Background: Although the role of clinical/biological factors associated with mortality has already been explored in HIV-infected patients on antiretroviral therapy (ART), to date little attention has been given to the potential role of social vulnerability. This study aimed to construct an appropriate measure of social vulnerability and to evaluate whether this measure is predictive of increased mortality risk in ART-treated patients followed up in the ANRS CO8 APROCO-COPILOTE cohort.Methods: The cohort enrolled 1,281 patients initiating a protease inhibitor-based regimen in 1997–1999. Clinical/laboratory data were collected every 4 months. Self-administered questionnaires collected psycho-social/behavioural characteristics at enrolment (month [M] 0), M4 and every 8–12 months thereafter. A multiple correspondence analysis using education, employment and housing indicators helped construct a composite indicator measuring social vulnerability. The outcome studied was all-cause deaths occurring after M4. The relationship between social vulnerability and mortality, after adjustment for other predictors, was studied using a shared-frailty Cox model, taking into account informative study dropout.Results: Over a median (IQR) follow-up of 7.9 (3.0–11.2) years, 121 deaths occurred among 1,057 eligible patients, corresponding to a mortality rate (95% CI) of 1.64 (1.37, 1.96)/100 person-years. Leading causes of death were non-AIDS defining cancers (n=26), AIDS (n=23) and cardiovascular diseases (n=12). Social vulnerability (HR [95% CI] =1.2 [1.0, 1.5]) was associated with increased mortality risk, after adjustment for other known behavioural and bio-medical predictors.Conclusions: Social vulnerability remains a major mortality predictor in ART-treated patients. A real need exists for innovative interventions targeting individuals cumulating several sources of social vulnerability, to ensure that social inequalities do not continue to lead to higher mortality.
ISSN: 1359-6535

hal-01299300
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01299300
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01299300/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01299300/file/Twelve-year%20mortality%20in%20HIV-infected%20patients_accepted.pdf
DOI : 10.3851/IMP2960

Éditeur(s) : HAL CCSD Scientific Research Publishing
Résumé : International audience
In order to study social inequalities, indices can be used to summarize the multiple dimensions of the socioeconomic status. As a part of the Equit'Area Project, a public health program focused on social and environmental health inequalities; a statistical procedure to create (neighborhood) socioeconomic indices was developed. This procedure uses successive principal components analyses to select variables and create the index. In order to simplify the application of the procedure for non-specialists, the R package SesIndexCreatoR was created. It allows the creation of the index with all the possible options of the procedure, the classification of the resulting index in categories using several classical methods, the visualization of the results, and the generation of automatic reports.
ISSN: 2161-718X

hal-01161775
https://hal.archives-ouvertes.fr/hal-01161775
https://hal.archives-ouvertes.fr/hal-01161775/document
https://hal.archives-ouvertes.fr/hal-01161775/file/OJS_2015060814030742.pdf
DOI : 10.4236/ojs.2015.54031