Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Two antifibrotic drugs, pirfenidone and nintedanib, are approved by the European Medicines Agency and the US Food and Drug Administration for the treatment of idiopathic pulmonary fibrosis (IPF). In this analysis, treatment patterns of European patients with IPF were investigated to understand antifibrotic prescribing and identify unmet needs in IPF treatment practice. Methods: Between February and March 2016, respiratory physicians from France, Germany, Italy, Spain, and the UK participated in an online questionnaire designed to collect information on IPF treatment patterns in patients under their care. Patients were categorized as treated (received approved antifibrotics) or untreated (did not receive approved antifibrotics, but may have received other unapproved therapies). Classification of IPF diagnosis (confirmed/suspected) and severity ('mild'/'moderate'/'severe') for each patient was based on the individual physician's report. Patients' perspectives were not recorded in this study. Results: In total, 290 physicians responded to the questionnaire. Overall, 54% of patients with IPF did not receive treatment with an approved antifibrotic. More patients had a confirmed IPF diagnosis in the treated (84%) versus the untreated (51%) population. Of patients with a confirmed diagnosis, 40% did not receive treatment. The treated population was younger than the untreated population (67 vs 70 years, respectively; p = 0.01), with more frequent multidisciplinary team evaluation (83% vs 57%, respectively; p = 0.01). A higher proportion of untreated patients had forced vital capacity > 80% at diagnosis versus treated patients. Of patients with 'mild' IPF, 71% did not receive an approved antifibrotic versus 41% and 60% of patients with 'moderate' and 'severe' IPF, respectively. Conclusions: Despite the availability of antifibrotic therapies, many European patients with confirmed IPF do not receive approved antifibrotic treatment. Importantly, there appears to be a reluctance to treat patients with 'mild' or 'stable' disease, and instead adopt a 'watch and wait' approach. More education is required to address diagnostic uncertainty, poor understanding of IPF and its treatments, and issues of treatment access. There is a need to increase physician awareness of the benefits associated with antifibrotic treatment across the spectrum of IPF severity.
ISSN: 1471-2466

hal-01616061
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01616061
DOI : 10.1186/s12890-017-0468-5
PUBMED : 28915874

Éditeur(s) : HAL CCSD
Résumé : Semi-volatile organic compounds (SVOCs) refer to a broad spectrum of molecules from different chemical families that have numerous properties. They can be used as pesticides, plasticizers, flame retardants, surfactants, lubricants, etc. Consequently, they are introduced in numerous applications in buildings or used daily by the entire population. Once emitted through evaporation or abrasion in the indoor environment or introduced from the outdoors, their chemical or biological degradation is limited, and they persist indoors. This persistence also explains why some SVOCs that were banned a few years ago are still detected in the air and dust inside buildings. In indoor environments, SVOCs are divided between the gas phase, airborne particles, and dust settled on floors and surfaces. SVOCs are of concern due to their established or suspected health effects and their widespread exposure through different environmental media and pathways. The objective of the thesis was to study the concentrations of 66 SVOCs on airborne particles (PM10) and 48 SVOCs in settled dust in two samples of dwellings randomly selected across France. PM10 were sampled during the nationwide housing survey carried out by the French Observatory of indoor air quality in 2003-2005. The dust samples were collected from vacuum cleaner bags during a nationwide survey carried out in French dwellings where at least one child aged 6 months to 6 years lived (2008-2009). The SVOCs to be analyzed had prior been selected using a ranking method based on their toxicity and indoor concentrations. The data analysis focused in particular on the identification of French specificities in terms of detected molecules and measured concentrations. It highlighted some determinants of exposure, e.g., influence of particle size, type of dust collected, dust bioaccessibility, which are not always considered and limit the comparability of results. The measured concentrations were also used to assess the health ranking implemented prior to this work and to confirm its relevance. The concentrations measured both in the air and in settled dust were compared to study the similarities in terms of concentrations and SVOC mixtures. Finally, the exposure doses to SVOCs were calculated for both a child and an adult to assess the respective contributions of inhalation and ingestion to these compounds in particulate phase in dwellings.
Les composés organiques semi-volatils (COSV) font l’objet d’une attention croissante depuis une dizaine d’années. Utilisés dans de nombreux produits et matériaux du quotidien, ils sont émis dans les bâtiments par dispersion lors de l’usage, par évaporation ou abrasion. Du fait de leurs caractéristiques physico-chimiques, ces composés se répartissent à la fois dans l’air, en phases gazeuse et particulaire, et dans les poussières déposées au sol, sur le mobilier et les objets. Compte tenu du temps passé par la population dans les bâtiments, en particulier par les populations sensibles comme les enfants, les femmes enceintes et les personnes âgées, l’exposition à ces substances mérite d’être documentée, tenant compte des voies d’exposition en jeu : inhalation, ingestion et contact cutané. La thèse a porté sur les COSV présents en phase particulaire dans les logements. L’objectif de la thèse visait à exploiter les mesures de 66 COSV dans les particules en suspension de diamètre inférieur à 10 µm (PM10) et de 48 COSV dans les poussières au sol de taille inférieure à 100 µm considérées comme étant celles adhérant à la peau. Ces mesures ont été réalisées dans le cadre de deux campagnes nationales : la campagne « Logements » de l’Observatoire de la qualité de l’air intérieur conduite en 2003-2005 et l’enquête Plomb-Habitat dont les prélèvements ont eu lieu en 2008-2009. Une hiérarchisation des molécules jugées prioritaires au regard de leur impact sanitaire potentiel avait permis au préalable d’établir la liste des COSV à mesurer. L’exploitation de ces données de contamination a notamment porté sur l’identification d’éventuelles spécificités françaises au regard des molécules en présence et/ou des concentrations mesurées. Elle a permis de mettre en lumière un ensemble de facteurs déterminants de l’exposition (influence de la taille des particules, du type de poussières collectées, de leur bioaccessibilité), qui ne sont pas toujours considérés et qui limitent par ailleurs la comparabilité des résultats. Les concentrations mesurées ont aussi permis d’évaluer rétrospectivement la hiérarchisation sanitaire et d’en confirmer la pertinence. Les concentrations des COSV quantifiés à la fois dans l’air et au sol ont été mises en perspective afin d’examiner dans quelle mesure les particules en suspension et les poussières déposées sont similaires en termes de concentrations et de mélanges de COSV en présence. Enfin, l‘estimation des doses d’exposition aux COSV à partir d’équations simples, de variables humaines d’exposition et des données de contamination a permis une première évaluation des contributions respectives de l’inhalation et de l’ingestion aux expositions domestiques des enfants et adultes à ces composés en phase particulaire.
https://tel.archives-ouvertes.fr/tel-01308524

NNT : 2015REN1B033
tel-01308524
https://tel.archives-ouvertes.fr/tel-01308524
https://tel.archives-ouvertes.fr/tel-01308524/document
https://tel.archives-ouvertes.fr/tel-01308524/file/MANDINCorinne.pdf

Résumé : Penaeus stylirostris shrimp imported from Hawaii for a genetic program and kept at the Saint-Vincent research facility had progressively developed a high sensitivity to IHHNV, the etiological agent of the Infectious, Hypodermic, and Hematopoietic Necrosis. Fears were that the virus could not only be transferred to their offspring, but also that the New Caledonian strain of Penaeus stylirostris, so far considered as resistant, could become sensitive by an off balance of its hosts/pathogen equilibrium. In October 2008, a joint decision between Uprac (shimp owner), Davar (New Caledonian Animal Health Authority) and Ifremer (scientific partner) was taken to terminate all pure breed and hybrid Hawaiian populations remaining in the ponds, and to implement an intensive fallowing protocol, and controlled restocking. IHHNV was also suspected to trouble experiments carried out in the research facility (mortalities, deformities, slow growth), thus affecting research programs. Difficulties pointed out by IHHNV have triggered since 2008 some awareness on biosecurity issues at some level of the New Caledonian shrimp industry. At the St-Vincent research station, it led to a risk assessment and implementation of biosecurity procedures (fallowing, propagation, grow out and use of screened animals) which minimizes the risk of expression of IHHNV. The use of a brand new hatchery building on site also helped in resetting routine hygiene procedures during production and in controlling incoming and outgoing items (shrimp, water, feed, personnel, equipment, pests and wastes). IHHNV has not been detected on analysed samples since then nor have any symptoms been found during experimental or broodstock growout. Keeping this control alive is considered as a useful tool to lower the risk of potential health threats, to get a better understanding in case of an outbreak, and to increase the reliability of experimental results.
Les crevettes originaires d’Hawaii et conservées au LEAD St-Vincent, dans le cadre du programme d’introduction de variabilité génétique dans le cheptel Calédonien, ont progressivement montré une sensibilité importante au virus IHHNV, agent de la Nécrose Hypodermale et Hématopoïétique Infectieuse (mortalité, croissance ralentie, déformations). Les risques d’une transmission génétique de cette sensibilité à leur descendance à moyen terme, et de son développement par rupture de l’équilibre hôte/pathogène sur la souche dite « Calédonienne » jusqu’alors considérée comme résistante à l’IHHN, ont conduit à partir d’octobre 2008, avec l’accord et l’appui de l’UPRAC et de la DAVAR, à la suppression des animaux hawaiiens ou hybrides encore présents dans les bassins de terre du LEAD St-Vincent, au vide sanitaire de ces derniers, et au repeuplement contrôlé du site. D’autre part, le virus IHHN est soupçonné d’avoir pu affecter les animaux utilisés dans les expérimentations menées au LEAD-St-Vincent (mortalités, déformations, croissance réduite), influençant donc potentiellement leur bon déroulement et celui des programmes de recherches. Les obstacles soulevés par l’expression du virus IHHN ont donc initié depuis 2008 une prise de conscience et la mise en place de démarches de biosécurité dans certains points de la filière. A la station de St-Vincent, cette démarche s’est traduite par une identification/évaluation des risques et l’application de mesures (vide sanitaire, reproduction, élevage et utilisation des animaux contrôlés) chacune dotée de procédures qui regroupées, minimisent le risque d’introduction et de dissémination de l’IHHNV. La prise en main de la nouvelle structure d’écloserie sur le site de la SASV a également été mise à profit pour revoir les procédures d’hygiène de routine dans la conduite des productions et dans le contrôle des flux intrants et sortants (animaux, eau, aliments, personnel, équipement, nuisibles, déchets). Aucune détection d’IHHNV sur les échantillons prélevés n’a depuis été observée, de même qu’aucun symptôme de l’expression de cette maladie sur les animaux en élevage sur le site de Saint-Vincent. La poursuite de ces mesures est envisagée comme un outil d’aide à la minimisation des problèmes potentiels, à leur compréhension en cas d’apparition, et à la fiabilisation des résultats.

Droits : 2010 Ifremer
http://archimer.ifremer.fr/doc/00118/22949/20776.pdf
http://archimer.ifremer.fr/doc/00118/22949/

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Background: The impact of hepatitis B virus (HBV) genomic variability on the measurement of HBsAg level has been poorly evaluated. Objective: This study was designed to compare the performance of all the available assays measuring HBsAg level in this setting. Study design: A large selection of wild type HBV genotypes (n = 184) and HBsAg strains harboring mutations in the S gene (n = 81) from clinical samples was studied with three HBsAg quantification assays: Architect HBsAg (Abbott), LiaisonXL Murex HBsAg Quant (DiaSorin) and the Elecsys HBsAgII (Roche). Results: The overall percentage of positive results was 99.2% for Abbott, 98.9% for DiaSorin and 98.1% for Roche. Abbott and Roche assays provided an excellent concordance in HBsAg quantification (global mean bias of -0.006 logIU/mL). By contrast, DiaSorin underestimated HBsAg level with values 0.112 logIU/ml and 0.103 logIU/ml lower than Abbott and Roche, respectively. By contrast, DiaSorin slightly over quantified gtC(2.5% over the expected value) while Abbott provided values 6.2% lower than expected and 16.2% lower than what observed for the other genotypes. HBsAg quantitative assays were influenced by HBs protein substitutions irrespective to the genotype but no specific protein pattern that would particularly impair the quantification by one technique has been identified. However, Roche seemed to be particularly impacted by substitutions at 145 residue: 75% of under quantified samples carried a substituted 145 residue. Conclusion: This head-to-head comparison indicates a good correlation between all current systems used to quantify HBsAg but clearly shows an influence of both the genotype and the presence of "a" determinant variants in the absolute quantification of HBsAg. While these discrepancies may not translate into major clinical consequence, they may explain an absence of detection of weak concentration of HBsAg on some systems. (C) 2017 Elsevier B.V. All rights reserved.
ISSN: 1386-6532

hal-01588395
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01588395
DOI : 10.1016/j.jcv.2017.02.001
PUBMED : 28189936

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 Elsevier
Résumé : International audience
A recent study suggested that adenosine signaling pathway could promote hemolysis in patients with sickle cell anemia (SCA). This signaling pathway involves several gene coding enzymes for which variants have been described. In this study, we analyzed the genotype-phenotype relationships between functional polymorphisms or polymorphisms associated with altered expression of adenosine pathway genes, namely adenosine deaminase (ada; rs73598374), adenosine A2b receptor (adora2b; rs7208480), adenylyl cyclase6 (adcy6; rs3730071, rs3730070, rs7300155), and hemolytic rate in SCA patients. One hundred and fifty SCA patients were genotyped for adcy6, ada, and adora2b variants as well as alpha-globin gene, a genetic factor known to modulate hemolytic rate. Hematological and biochemical data were obtained at steady-state. Lactate dehydrogenase, aspartate aminotransferase, reticulocytes and total bilirubin were used to calculate a hemolytic index. Genotype-phenotype relationships were investigated using parametric tests and multivariate analysis. SCA patients carrying at least one allele of adcy6 rs3730070-G exhibited lower hemolytic rate than non-carriers in univariate analysis (p=0.006). The presence of adcy6 rs3730070-G variant was associated with a decreased hemolytic rate in adjusted model for age and alpha-thalassemia (p=0.032). Our results support a protective effect of adcy6 rs3730070-G variant on hemolysis in SCA patients.
ISSN: 1079-9796

hal-01668332
https://hal.univ-antilles.fr/hal-01668332
DOI : 10.1016/j.bcmd.2016.02.006

Résumé : Ce travail est l'expression d'une volonté de chercheurs, de la Carabe d'améliorer les connaissances scientifiques méso- et micro-météorologiques appliquées aux milieux insulaires sous influence des alizés et de développer la recherche dans ces domaines.On sait que le phénomène météorologique le plus remarquable impactant les îles de la Caraïbe reste le cyclone tropical. Mais d'autres phénomènes, a des échelles inferieures, telles que les pluies intenses, les houles, la dégradation de la qualité de l'air ont une importance aigüe en termes de risques naturels ou de risques sur la sante. Ces exemples attestent la nécessité d'utiliser des méthodes de descente d'échelle pour exploiter l'information météorologique et/ou climatique de grande échelle et dériver des scenarios locaux et régionaux appliques aux territoires insulaires. Ce défi est important car l'attente d'analyses scientifiques pertinentes dans ces domaines est grande.Les travaux présentés dans ce mémoire ont pour principaux objectifs la simulation numérique puis l'analyse des mécanismes méso- et micro-échelles qui induisent des circulations locales diurnes et nocturnes sur l'archipel de la Guadeloupe à l'aide de codes numériques météorologiques éprouves car largement utilises en recherche et en prévision opérationnelle.Ils constituent donc la première étude de modélisation numérique à haute résolution en basse atmosphère, par descente d'échelle dynamique, pour des intervalles d'espace compris entre 1 km et 111 m sur cet archipel.Le modelé atmosphérique Weather Research and Forecasting ARW V3.4 (WRF ARW), non-hydrostatique, a été utilise pour l'ensemble des simulations pour modéliser la troposphère depuis l'échelle globale à l'échelle de la turbulence.Trois situations météorologiques classiques réelles d'une durée de 48 heures, correspondant à 80 % des situations météorologiques observées dans la zone, alizes soutenus (AS), alizes moyens (AM), alizes faibles (AF) ont été examinées. Ces situations sont caractérisées par les valeurs du nombre de Froude local suivantes : 0,82 (AS), 0,41 (AM) et 0,21 (AF). Six domaines de modélisation ont été sélectionnés pour effectuer les descentes d'échelle dynamiques : D01 (maille de 27 km), D02 (maille de 9 km), D03 (maille de 3 km), D04 (maille de 1 km), D05 (maille de 333 m) et D06 (maille de 111 m) avec soixante-dix niveaux verticaux. Les quatre premiers domaines (D01 à D04) couvrent l'archipel de la Guadeloupe et sont utilisés en mode méso-échelle à l'aide d'un schéma d'ensemble de couche limite planétaire YSU. Les domaines D05 (couvrant l'île de la Basse-Terre et le centre de l'archipel) et D06 (couvrant la zone littorale et rurale du Petit Cul-de-Sac Marin et la zone urbaine de l'agglomération pointoise) sont utilisés en mode Large Eddy Simulation avec une fermeture de la turbulence 1,5 TKE 3D. Le modèle WRF a été forcé toutes les six heures par l'assimilation des champs d'analyses globales du modèle NCEP FNL (1° de résolution). Les simulations effectuées ont permis d'obtenir des champs de variables météorologiques 10-minutes à très hautes résolutions spatiales.Les résultats des simulations méso- et micro-échelles ont été confrontés aux valeurs expérimentales obtenues à l'aide de capteurs places sur des mâts météorologiques (campagne Atmo-Mangrov et réseau de mesure Météo-France). Il s'agissait d'optimiser l'utilisation des couplages de codes numériques tout en conservant la possibilité de les confronter aux observations expérimentales.Les résultats des simulations numériques micro-échelles, des différents cas (AS, AM, AF) sont utilisées pour forcer (c'est-à-dire définir les conditions limites) un modèle lagrangien de dispersion de particules : FLEXPART. Le système couple FLEXPART-WRF a été employé dans le domaine D06 pour étudier la dispersion du panache d'oxydes d'azote émis par la principale usine de production d'électricité de l'île.
The present work expresses the will of Caribbean researchers to improve the meso- and micro-meteorological scientific knowledge of the trade winds influenced island areas, and to develop research in these domains.It is well known that tropical hurricanes remain the most remarkable meteorological phenomena that affect the Caribbean islands. But some other phenomena, of smaller scale, such as intense rainfall events, swells, or air quality degradation, are of extreme importance for natural or health hazards. These examples show the need to use downscaling methods to exploit large scale meteorological or climatic information, and to obtain local and regional scenarios for the island areas. This is an important challenge, as sound scientific studies in these matters are eagerly expected. The aim of the research works exposed in the present dissertation is numerical simulation and analysis of the meso- and microscale mechanisms that induce diurnal and nocturnal local circulations in the Guadeloupe archipelago, using numerical meteorological models that are widely used in research and in operational forecasting.These works represent the first high-resolution (1 km to 111 m) numerical study of the lower atmosphere over the Guadeloupe archipelago. The Weather Research and Forecasting ARW 3.4 (WRF-ARW) model is used to simulate the troposphere from global scale to turbulence scale. Real cases of three typical weather types (80% of cases during a year) are examined during 48 hours : strong trade winds (STW), medium trade winds (MTW) and weak trade winds (WTW). These weather types are characterized by values of the local Froude number : 0.82 (STW), 0.41 (MTW) and 0.21 (WTW). Six domains have been selected for the dynamical downscaling : D01 (grid spacing of 27 km), D02 (grid spacing of 9 km), D03 (grid spacing of 3 km), D04 (grid spacing of 1 km), D05 (grid spacing of 333 m) and D06 (grid spacing of 111 m), including 70 vertical levels. The first four domains (D01 to D04) cover the Guadeloupe archipelago and are used in the meso-scale simulations with the planetary boundary layer scheme YSU (ensemble mean). Domain D05 (covering the Basse-Terre island and the middle of the archipelago) and domain D06 (covering the coastal and rural area of Le Petit Cul-de-Sac Marin and the urban area of Pointe-à-Pitre), are employed in the micro-scale simulation (LES) with the 3D TKE 1.5 order closure scheme. WRF has been 6 hourly reinitialized with the NCEP FNL global analyses (resolution of 1°). These simulations permitted to obtain 10-minutes meteorological variable fields with a very high resolution (111 m).Meso-scale and micro-scale model results have been evaluated with observational data from meteorological stations (field campaign Atmo-Mangrov, French Met Office).Once validated, the micro-scale model outputs have been used for the assimilation of the lagrangian particle dispersion model : FLEXPART. The coupling FLEXPART-WRF has been employed in domain D06, in order to analyze the dispersion of the nitrogen oxide plume emitted by the main power plant of the archipelago.

http://www.theses.fr/2014AGUY0735/document

Éditeur(s) : PSIC 11 - 11th Pacific Science Inter-Congress : Pacific Countries and their Ocean: Facing Local and Global Changes / 2nd Symposium on French Research in the Pacific. March 2 - 6, 2009 Tahiti, French Polynesia.
Résumé : In recent years the biological control of diseases by environmental friendly methods such as probiotics has become an important subject of investigation in aquaculture research. Probiotics are live microorganisms which when administrated in adequate amounts confer a health benefit on the host . In the last 4 years, IFREMER in collaboration with Lallemand company, have carried out researchs in New Caledonia with the aim to assess the probiotic strain P. acidilactici MA 18/5M on farmed shrimp Litopenaeus stylirostris.This project started in 2005 demonstrated the beneficial effects of the probiotic Pediococcus acidilactici dietary supplementation on the nutrition and the health status of peneid shrimps and highlighted that its use as probiotic can be part of the natural solutions proposed to face the challenge of today’s shrimp farming industry.

Droits : info:eu-repo/semantics/openAccess
http://archimer.ifremer.fr/doc/00197/30873/29241.pdf
http://archimer.ifremer.fr/doc/00197/30873/

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
BACKGROUND: The exposure of children to lead has decreased in recent years, thanks notably to the banning of leaded gasoline. However, lead exposure remains a matter of public health concern, because no toxicity threshold has been observed, cognitive effects having been demonstrated even at low levels. It is therefore important to update exposure assessments. A national study was conducted, in 2008-2009, to determine the blood lead level (BLL) distribution in children between the ages of six months and six years in France. We also assessed the contribution of environmental factors. METHODS: This cross-sectional survey included 3831 children recruited at hospitals. Two-stage probability sampling was carried out, with stratification by hospital and French region. Sociodemographic characteristics were recorded, and blood samples and environmental data were collected by questionnaire. Generalized linear model and quantile regression were used to quantify the association between BLL and environmental risk factors. RESULTS: The geometric mean BLL was 14.9μg/l (95% confidence interval (CI)=[14.5-15.4]) and 0.09% of the children (95% CI=[0.03-0.15]) had BLLs exceeding 100μg/l, 1.5% (95% CI=[0.9-2.1] exceeding 50μg/l. Only slight differences were observed between French regions. Environmental factors significantly associated with BLL were the consumption of tap water in homes with lead service connections, peeling paint or recent renovations in old housing, hand-mouth behavior, passive smoking and having a mother born in a country where lead is often used. CONCLUSIONS: In children between the ages of one and six years in France, lead exposure has decreased over the last 15 years as in the US and other European countries. Nevertheless still 76,000 children have BLL over 50μg/l and prevention policies must be pursued, especially keeping in mind there is no known toxicity threshold.
ISSN: 1438-4639

hal-01009847
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01009847
PUBMED : 24262290
DOI : 10.1016/j.ijheh.2013.10.002

Éditeur(s) : HAL CCSD
Résumé : International audience
BACKGROUND: There is increasing evidence that reproductive abnormalities are increasing in frequency in both human population and among wild fauna. This increase is probably related to exposure to toxic contaminants in the environment. The use of sentinel species to raise alarms relating to human reproductive health has been strongly recommended. However, no simultaneous studies at the same site have been carried out in recent decades to evaluate the utility of wild animals for monitoring human reproductive disorders. We carried out a joint study in Guadeloupe assessing the reproductive function of workers exposed to pesticides in banana plantations and of male wild rats living in these plantations. METHODS: A cross-sectional study was performed to assess semen quality and reproductive hormones in banana workers and in men working in non-agricultural sectors. These reproductive parameters were also assessed in wild rats captured in the plantations and were compared with those in rats from areas not directly polluted by humans. RESULTS: No significant difference in sperm characteristics and/or hormones was found between workers exposed and not exposed to pesticide. By contrast, rats captured in the banana plantations had lower testosterone levels and gonadosomatic indices than control rats. CONCLUSION: Wild rats seem to be more sensitive than humans to the effects of pesticide exposure on reproductive health. We conclude that the concept of sentinel species must be carefully validated as the actual nature of exposure may varies between human and wild species as well as the vulnerable time period of exposure and various ecological factors.
Environmental health : a global access science source [electronic resource]

hal-00669505
https://hal.archives-ouvertes.fr/hal-00669505
DOI : 10.1186/1476-069X-7-40
PUBMED : 18667078

Éditeur(s) : HAL CCSD Awwa American Water Works Association
Résumé : International audience
A three-year study was conducted on the occurrence of disinfection by-products (DBPs) - trihalomethanes (THMs), haloacetic acids (HAAs), and haloacetonitriles - in drinking water of regions of Europe where epidemiology studies were being carried out. Thirteen systems in six countries (i.e., Italy, France, Greece, Lithuania, Spain, United Kingdom) were sampled. Typically chlorinated DBPs dominated. However, in most of Catalonia (Spain) and in Heraklion (Greece), brominated DBPs dominated. The degree of bromine incorporation into the DBP classes was in general similar among them. This is important, as brominated DBPs are a greater health concern. In parts of Catalonia, the reported levels of tribromoacetic acid were higher than in other parts of the world. In some regions, the levels of HAAs tended to be peaked in concentration in a different time period than when the levels of THMs peaked. In most epidemiology studies, THMs are used as a surrogate for other halogenated DBPs. This study provides exposure assessment information for epidemiology studies. © 2016 American Water Works Association.
ISSN: 0003-150X

hal-01406069
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01406069
DOI : 10.5942/jawwa.2016.108.0152

Éditeur(s) : HAL CCSD American Medical Association (AMA)
Résumé : International audience
IMPORTANCE Although frequently used in treating intensive care unit (ICU) patients with sepsis, empirical antifungal therapy, initiated for suspected fungal infection, has not been shown to improve outcome. OBJECTIVE To determine whether empirical micafungin reduces invasive fungal infection (IFI)-free survival at day 28. DESIGN, SETTING, AND PARTICIPANTS Multicenter double-blind placebo-controlled study of 260 nonneutropenic, nontransplanted, critically ill patients with ICU-acquired sepsis, multiple Candida colonization, multiple organ failure, exposed to broad-spectrum antibacterial agents, and enrolled between July 2012 and February 2015 in 19 French ICUs. INTERVENTIONS Empirical treatment with micafungin (100mg, once daily, for 14 days) (n = 131) vs placebo (n = 129). MAIN OUTCOMES AND MEASURES The primary end pointwas survival without proven IFI 28 days after randomization. Key secondary end points included new proven fungal infections, survival at day 28 and day 90, organ failure, serum (1-3)-beta-D-glucan level evolution, and incidence of ventilator-associated bacterial pneumonia. RESULTS Among 260 patients (mean age 63 years; 91 [35%] women), 251 (128, micafungin group; 123, placebo group) were included in the modified intent-to-treat analysis. Median values were 8 for Sequential Organ Failure Assessment (SOFA) score, 3 for number of Candida-colonized sites, and 99 pg/mL for level of (1-3)-beta-D-glucan. On day 28, there were 82 (68%) patients in the micafungin group vs 79 (60.2%) in the placebo group who were alive and IFI free (hazard ratio [HR], 1.35 [95% CI, 0.87-2.08]). Results were similar among patients with a (1-3)-beta-D-glucan level of greater than 80 pg/mL (n = 175; HR, 1.41 [95% CI, 0.85-2.33]). Day-28 IFI-free survival in patients with a high SOFA score (> 8) was not significantly different when compared between the micafungin vs placebo groups (HR, 1.69 [95% CI, 0.96-2.94]). Use of empirical micafungin decreased the rate of new invasive fungal infection in 4 of 128 patients (3%) in the micafungin group vs placebo (15/123 patients [12%]) (P =.008). CONCLUSIONS AND RELEVANCE Among nonneutropenic critically ill patients with ICU-acquired sepsis, Candida species colonization at multiple sites, and multiple organ failure, empirical treatment with micafungin, compared with placebo, did not increase fungal infection-free survival at day 28.
ISSN: 0098-7484

hal-01405822
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01405822
DOI : 10.1001/jama.2016.14655
PUBMED : 27706483

Éditeur(s) : HAL CCSD
Résumé : International audience
Background: Everyone is subject to environmental exposures from various sources, with negative health impacts (air, water and soil contamination, noise...) or with positive effects (e.g. green space). Studies considering such complex environmental settings in a global manner are rare.Aims: We propose to use data mining techniques 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 on a large French metropolitan area.Methods: The study was carried out in the Great Lyon area (France, 1,260,348 inhabitants in 2007, 527 km²) at the census block group (BG) scale. Indicators on NO2 annual concentrations, noise levels, proximity to green spaces and to industrial plants, and road traffic were synthetized using Multiple Factor Analysis (MFA), which allows to explore the relations between exposures and BGs without a priori knowledge, and to synthetize indicators of different types. Hierarchical clustering was then used to create BG classes. Results: The four first components of the MFA explained respectively 23, 14, 13 and 12% of the total variance. Clustering in 3 classes group: 1) BGs far from industries, greener and with less noise and air pollution than the average; 2) BGs close to industries with less green spaces and air pollution than the average; and 3)BGs far from industries but with higher levels of noise, air pollution and traffic. Greater numbers of classes were tested in order to assess a variety of clustering.Conclusions: We present a data driven approach using data mining techniques, which seem overlooked for cumulative exposure assessment 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.
Environment and Health – Bridging South, North, East and West. Conference of ISEE, ISES and ISIAQ.
Basel, Switzerland

hal-01432884
https://hal.archives-ouvertes.fr/hal-01432884
https://hal.archives-ouvertes.fr/hal-01432884/document
https://hal.archives-ouvertes.fr/hal-01432884/file/Poster_2013_ISEE_20130711.pdf

Éditeur(s) : HAL CCSD
Résumé : International audience
BACKGROUND: The aim of this systematic review was to evaluate and compare the pros and cons of using living donors or brain-dead donors in uterus transplantation programs, 2 years after the first worldwide live birth after uterus transplantation. METHODS: The Medline database and the Central Cochrane Library were used to locate uterine transplantation studies carried out in human or nonhuman primates. All types of articles (case reports, original studies, meta-analyses, reviews) in English or French were considered for inclusion. RESULTS: Overall, 92 articles were screened and 44 were retained for review. Proof of concept for human uterine transplantation was demonstrated in 2014 with a living donor. Compared with a brain-dead donor strategy, a living donor strategy offers greater possibilities for planning surgery and also decreases cold ischemia time, potentially translating into a higher success rate. However, this approach poses ethical problems, given that the donor is exposed to surgery risks but does not derive any direct benefit. A brain-dead donor strategy is more acceptable from an ethical viewpoint, but its feasibility is currently unproven, potentially owing to a lack of compatible donors, and is associated with a longer cold ischemia time and a potentially higher rejection rate. CONCLUSIONS: The systematic review demonstrates that uterine transplantation is a major surgical innovation for the treatment of absolute uterine factor infertility. Living and brain-dead donor strategies are not mutually exclusive and, in view of the current scarcity of uterine grafts and the anticipated future rise in demand, both will probably be necessary.
Transplantation

hal-01447062
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01447062
DOI : 10.1097/TP.0000000000001481
PUBMED : 27607535

Résumé : Cette étude a pour missions essentielles de comprendre et d’expliquer comment le passage d’une langue à une autre voire le mélange des deux codes langagiers qui se côtoient au sein de la population de la Guadeloupe, département français d’outre-mer, le français et le créole, peuvent, dans le cadre des échanges médicaux éducatifs, influencer la compréhension des mécanismes de la maladie par le patient, son acceptation et sa gestion.La justification de cette étude tient du constat que la prévalence de cette maladie chronique en Guadeloupe, l’asthme bronchique, est relativement importante, que la prise en charge reste perfectible malgré les recommandations de bonnes pratiques édictées par les sociétés savantes, et que certains patients ont du mal à comprendre les termes utilisés en français par leur médecin lors de l’annonce du diagnostic, ainsi que par les éducateurs chargés de leur apporter les outils de bonne gestion de cette maladie, ce qui n’est pas sans incidents en termes de morbidité et de mortalité.L’auteur décompose sa recherche autour de cinq grands thèmes :- La description du territoire d’étude, sur le plan géographico-climatique, historico-économique, sanitaire et social, la naissance d’une ère culturelle nouvelle générant une langue partagée par plus de 95% de la population et transmise au sein des familles et dans la communauté.- La présentation de l’éducation thérapeutique, démarche considérée par la communauté scientifique comme essentielle pour améliorer la prise en charge du patient et l’autogestion de la maladie, les plans gouvernementaux successifs traitant de cette matière.- L’état des connaissances sur l’asthme bronchique en France, dans le monde et en Guadeloupe plus particulièrement.- L’impact de la langue créole dans le processus de compréhension de la maladie à travers la relation soignant-soigné, et ses conséquences chez les natifs bilingues en termes d’acquisitions des outils d’autogestion en comparaison à l’utilisation du français.- La formulation de propositions de contextualisation didactique, tant en termes de formation des professionnels de santé par la préconisation de l’utilisation de la langue créole, par l’adaptation des outils psychopédagogiques au contexte local, que d’encouragement du patient à utiliser sa langue maternelle dans l’expression de ses ressentis.La recherche montre que la langue créole, utilisée autant au cours de la consultation par le médecin traitant et par le malade que pendant les séances d’éducation thérapeutique par les éducateurs et le public, influence les indicateurs de gestion de cette maladie.En conclusion, l’auteur défend l’hypothèse selon laquelle l’utilisation de la langue créole dans les échanges médicaux éducatifs chez les adolescents asthmatiques bilingues français-créole favoriserait la compréhension des mécanismes de la maladie asthmatique, la prise de conscience de sa gravité et la nécessité de se soigner pour éviter les complications, corollaire d’une bonne qualité de vie.
In Guadeloupe, a French Overseas Territory, the population uses French and Creole linguistic codes. The main goals of this thesis are to understand and to explain how a better use of French and Creole, within the framework of educational medical exchanges, can improve the understanding of the mechanisms of the disease by the patient, its acceptance and its management.The bronchial asthma is a chronic disease, which affects an important part of the Guadeloupian population. In spite of the recommendations promulgated by the medical scholars, the care of the patients can be improved in Guadeloupe. Certain patients have difficulty understanding the terms used in French by their doctor during the announcement of the diagnosis, as well as by the educators in charge of bringing them the tools of good management of this disease what is not without incidents in terms of morbidity and mortality.The author elaborates his research around five main themes:- The thorough description of the space studied in this thesis; the geography of the land, the history of the population, the impact of the economic; the presentation of the social and health care infrastructures; and furthermore the birth of a new cultural era generating a language shared by more than 95 % of the population and passed on within families and communities.- The presentation of the therapeutic education, the approach considered by the scientific community as essential to improve the management of the patient and the self-management of the disease, the successive governmental plans dealing with this subject.- The state of the knowledge on the bronchial asthma in France, in the world and in Guadeloupe more particularly.- The impact of the Creole language in the process of understanding of the disease within the healthcare relationships and its consequences at the bilingual natives in terms of acquisitions of the tools of self-management in comparison to the use of French.- The formulation of proposals of didactic contextualization regarding the training of the healthcare professionals; the recommendation to the healthcare workers to use the Creole language; the adaptation of the psycho-pedagogical tools to the local context; the encouragement to the patients to use their native language in the expression of their feelings.- Researches show that the Creole language used during the consultation by the regular doctor, but also during the educational sessions therapeutics by the educators influence the indicators of management of this disease. In conclusion, the author defends the hypothesis according to which, the use of the Creole language in the educational medical exchanges at the bilingual asthmatic teenagers French-Creole would favor the understanding of the mechanisms of the asthmatic disease, the awareness of its gravity and the necessity of looking after oneself to avoid the complications, corollary of a good quality of life.

http://www.theses.fr/2015AGUY0827/document

Résumé : La tuberculose, maladie très ancienne, est plus que jamais présentée sur la scène sanitaire mondiale avec 9 millions de nouveaux cas par an. Cette maladie, qui demeure une cause majeure de mortalité, est un des problèmes les plus difficiles à résoudre en santé publique et à échelle internationale. Les diverses programmes de lutte, lancés par l’Organisation Mondiale de la Santé (OMS), pour prévenir et garantir la guérison des patients tuberculeux, se heurtent à des difficultés qui hypothèquent leur efficacité. En effet, l'expansion du virus de rinimunodéficience humaine (VIII) et son influence néfaste sur la susceptibilité à la tuberculose, l'accroissement rapide de la tuberculose multirésistante, la pauvreté ainsi que la croissance démographique, sont un ensemble de facteurs préjudiciables à l'application des mesures préventives et curatives. Les contextes économiques difficiles conduisant indubitablement au cumul de ces facteurs, ont fait une césure entre les pays riches et les pays pauvres quant à l'incidence et la révolution de la tuberculose à échelle mondiale. Pour atténuer la disparité des résultats des luttes antituberculeuses, les méthodologies employées en épidémiologie de la tuberculose doivent s'inscrire dans une démarche d'efficacité. Les marqueurs moléculaires, indispensables à l'identification et à la classification des souches appartenant au complexe Mycobacterium tuberculosis (MTC) ont chacun des potentialités qui leur sont propres dont il convient de cerner pour une utilisation adéquate dans les études épidémiologiques et phylogénétiques. Le but de cette thèse consiste à extraire des connaissances nouvelles des résultats de génotypage stockées dans les bases de données, connaissances relatives au polymorphisme du support génomique pour estimer la contribution de chaque marqueur dans la classification de MTC. Le recours à différentes méthodes de reconstruction phylogénétique et de modélisation des données fut indispensable. A la lumière des résultats obtenus, cette thèse propose une nouvelle méthodologie de classification, pour rétablissement d'une phylogéographie robuste de MTC en relation avec l'histoire des migrations humaines qui aurait débutée en Afrique subsaharienne. Chaque méthode de génotypage ayant une efficience et un cout propres, qu'il convient de mesurer par rapport aux moyens disponibles et aux résultats escomptes, il est donc intéressant de renforcer la connaissance des marqueurs et de proposer différentes alternatives menant à la classification des mycobactéries. Ainsi, les résultats obtenus dans cette thèse apportent plus de cohérence aux solutions proposées pour la caractérisation des clones de MTC circulant dans le monde.
Tuberculosis, very old disease, is more than ever presented on the global health scene with 9 million new cases per year. This disease, which remains a major cause of mortality is one of the most intractable public health and international issues. The various control programs, launched by the World Health Organization (WHO) to prevent and guarantee the cure of tuberculosis patients face difficulties that undermine their effectiveness. Indeed, the expansion of human virus rinimunodéficience (VIII) and its negative influence on susceptibility to tuberculosis, the rapid growth of multidrug-resistant tuberculosis, poverty and population growth, are a set of factors detrimental to application of preventive and curative measures. The difficult economic circumstances undoubtedly leading to accumulation of these factors have a break between rich and poor countries about the impact and the revolution of tuberculosis worldwide. To address the disparity of the results of tuberculosis struggles, the methodologies used in epidemiology of tuberculosis must be part of a process efficiency. Molecular indispensable to the identification and classification of strains belonging to the Mycobacterium tuberculosis complex (MTC) markers each have their own potentials that need to be identified for proper use in epidemiological and phylogenetic studies. The purpose of this thesis is to extract new knowledge of the results of genotyping data stored in databases, knowledge of the polymorphism of genomic carrier to estimate the contribution of each marker in the classification of TCM. The use of different methods of phylogenetic reconstruction and modeling data was essential. In light of the results obtained, the thesis proposes a new classification methodology for a robust recovery phylogeography of TCM in connection with the history of human migration have started in sub-Saharan Africa. Each genotyping method with cost efficiency and equity, should be measured in relation to the resources available and discounts results, it is interesting to strengthen the knowledge of markers and propose alternatives leading to the classification of mycobacteria. Thus, the results obtained in this thesis bring more coherence to the proposed characterization of clones MTC circulating worldwide solutions.

http://www.theses.fr/2012AGUY0518/document

Éditeur(s) : HAL CCSD
Résumé : International audience
This study aims at understanding the presence of regulated and emerging micropollutants, particularly pesticides and pharmaceuticals, in surface water, regarding spatial and temporal influences at a watershed scale. The study of relations between micropollutants and other water quality and hydroclimatic parameters was carried out from a statistical analysis on historical and experimental data of different sampling sites from the main watershed of Brittany, western France. The outcomes point out the influence of urban and rural areas of the watershed as well as the impact of seasons on contamination variations. This work contributes to health risk assessment related to surface water contamination by micropollutants. This approach is particularly interesting in the case of agricultural watersheds such as the one studied, where more than 80% of surface water is used to produce drinking water.
International Journal of Environmental Research and Public Health

hal-00878078
https://hal.archives-ouvertes.fr/hal-00878078
https://hal.archives-ouvertes.fr/hal-00878078/document
DOI : 10.3390/ijerph9124433

Éditeur(s) : HAL CCSD
Résumé : International audience
Background: Sleep disturbances are one of the main complaints of patients with trauma-related disorders. The original Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A) is self-report instrument developed to evaluate posttraumatic stress disorder (PTSD)-specific sleep disturbances in trauma-exposed individuals. However, to date, the PSQI-A has not yet been translated nor validated in French.Objective: The present study aims to: a) translate the PSQI-A into French, and b) examine its psychometric properties.Method: Seventy-three adult patients (mean age=40.3 [SD=15.0], 75% females) evaluated in a specialized psychotraumatology unit completed the French versions of the PSQI-A, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and Impact Event Scale-Revised (IES-R).Results: The French version of the PSQI-A showed satisfactory internal consistency, inter-item correlations, item correlations with the total score, convergent validity with PTSD and anxiety measures, and divergent validity with a depression measure.Conclusion: Our findings support the use of the French version of the PSQI-A for both clinical care and research. The French version of the PSQI-A is an important addition to the currently available instruments that can be used to examine trauma-related sleep disturbances among French-speaking individuals.
ISSN: 2000-8066

Droits : info:eu-repo/semantics/OpenAccess
hal-01532051
http://hal.upmc.fr/hal-01532051
http://hal.upmc.fr/hal-01532051/document
http://hal.upmc.fr/hal-01532051/file/02_06_2017_Validation.pdf
DOI : 10.3402/ejpt.v4i0.19298

Éditeur(s) : HAL CCSD Taylor & Francis
Résumé : International audience
Humans may be exposed via their environment to multiple chemicals as a consequence of human activities and use of synthetic products. Little knowledge is routinely generated on the hazards of these chemical mixtures. The metabolomic approach is widely used to identify metabolic pathways modified by diseases, drugs, or exposures to toxicants. This review, based on the state of the art of the current applications of metabolomics in environmental health, attempts to determine whether metabolomics might constitute an original approach to the study of associations between multiple, low-dose environmental exposures in humans. Studying the biochemical consequences of complex environmental exposures is a challenge demanding the development of careful experimental and epidemiological designs, in order to take into account possible confounders associated with the high level of interindividual variability induced by different lifestyles. The choices of populations studied, sampling and storage procedures, statistical tools used, and system biology need to be considered. Suggestions for improved experimental and epidemiological designs are described. Evidence indicates that metabolomics may be a powerful tool in environmental health in the identification of both complex exposure biomarkers directly in human populations and modified metabolic pathways, in an attempt to improve understanding the underlying environmental causes of diseases. Nevertheless, the validity of biomarkers and relevancy of animal-to-human extrapolation remain key challenges that need to be properly explored.
ISSN: 1093-7404

hal-00976116
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00976116
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00976116/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00976116/file/Potential_input_from_metabolomics_accepted.pdf
DOI : 10.1080/10937404.2013.860318

Éditeur(s) : HAL CCSD
Résumé : International audience
“Affective Computing is computing that relates to, arises from, or deliberately influences emotions” (R.W. Picard, MIT Press, 1997). Specifically, psychosocial equilibrium is now considered as a major issue for both individual and public health. Predicting human emotions via non-intrusive methods is a great challenge triggered by the rise of intelligent assisting systems. In order to determine the emotional state of a subject having a potential psychosocial disorder, it is required to process both neutral and expressive emotions. A computer-engineered method aiming to provide emotional information from videos is proposed. An original approach for affect classification and its interpretation is presented.The database is part of the HUMAINE database, and consists of a large volume of video clips, each displaying individuals, depressed or not, talking with a conversational agent. Both the high-dimensionality of data and its temporal aspect require a pre-training that consists of cleaning, sorting and feature selection, in order to make relevant information usable for further processing by MachineLearning methods. Next step consists in classifying the affective state of subjects according to their positivity or negativity (Russell's model, 1980). By means of six independent classifiers, each running a Support Vector Machine algorithm, separate performances are obtained for each class of emotions. The results reveal an interesting “neutral area phenomenon”, where emotions tend to be harder to be detected.Though more frequent, neutral emotions seem to carry less discriminant information than expressive ones. This issue will be a key for designing a tuning step in further research.
Caribbean Academy Of Science
Deshaies, France

hal-01408029
https://hal.univ-antilles.fr/hal-01408029