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Increased out-of-home consumption may elevate sodium (Na) intake, but self-reported dietary assessments limit evidence. This study explored associations between neighbourhood exposure to fast-food and sit-down restaurants and estimated 24-hour urinary Na excretion.
Design:
A cross-sectional analysis from the ORISCAV-LUX 2 study (2016–2017). 24-hour urinary Na was estimated from a morning spot urine sample using the INTERSALT formula. Spatial access to fast-food and sit-down restaurants was derived from GIS data around participants’ addresses within 800-m and 1000-m road network buffers by summing up the inverse of the road network distance between their residential address and all restaurants within the corresponding buffer size. Multi-adjusted linear models were used to assess the association between spatial access to restaurants and estimated 24-hour urinary Na excretion.
Setting:
Luxembourg
Participants:
Urban adults age over 18 years (n 464).
Results:
Fast-food and sit-down restaurants accounted for 58·5 % of total food outlets. Mean 24-hour urinary Na excretion was 3564 mg/d for men and 2493 mg/d for women. Health-conscious eating habits moderated associations between spatial access to fast-food and sit-down restaurants and Na excretion. For participants who did not attach great importance to having a balanced diet, greater spatial access to restaurants, combining both density and accessibility, was associated with increased urinary Na excretion at 800 m (βhighvslow = 259, 95 % CI: 47, 488) and 1000 m (βhighvslow = 270, 95 % CI: 21, 520).
Conclusions:
Neighbourhood exposure to fast-food and sit-down restaurants influences Na intake, especially among individuals with less health-conscious eating habits, potentially exacerbating diet-related health disparities.
Land-use change for crop production is one of the key drivers of habitat loss and fragmentation and consequently biodiversity loss and change in tropical regions. This may impact biodiversity-regulated ecosystem services; birds are important to crop health regulating services (e.g. seed dispersal, pest control) and disservices (e.g. seed predation, grain herbivory). However, knowledge is limited on how birds use heterogeneous agricultural landscapes and the consequences for spatial distribution and flow of services and disservices. We studied crop and non-crop–habitat associations of birds in forest–agricultural landscapes of the Kilombero Valley, Tanzania. We focused on dietary preference as a key trait impacting bird responses to land-use change, services, and disservices to crops. We surveyed birds across four main habitat types using repeated point counts, recording a total of 148 species. We found that crop habitats supported higher species richness and larger communities of potentially beneficial species to crop health, whereby 34.5% of invertebrate-feeding species were recorded in cropland. We found that habitat heterogeneity within the landscape supports bird functional diversity and that each habitat type supported unique communities of species. Furthermore, the number of species unique to forest habitats increased with increasing forest canopy closure. Our findings suggest that management strategies for maintaining trees and shrubs, and enhancing tree cover within the crop production landscape, can be effective approaches for maintaining bird diversity and services. However, in-depth studies on trade-offs with disservices need further exploration to mitigate negative impacts of birds on crop yields.
Measuring surface mass-balance in the accumulation areas of glaciers is challenging because of the high spatial variability of snow accumulation and the difficulty of conducting annual field glaciological measurements. Here, we propose a method that can solve both these problems for many locations. Ground-penetrating radar measurements and firn cores extracted from a site in the French Alps were first used to reconstruct the topography of a buried end-of-summer snow horizon from a past year. Using these data and surface elevation observations from LiDAR and Global Navigation Satellite System instruments, we calculated the submergence velocities over the period between the buried horizon and more recent surface elevation observations. The differences between the changes in surface elevation and the submergence velocities were then used to calculate the annual surface mass-balances with an accuracy of ±0.34 m w.e. Assuming that the submergence velocities remain stable over several years, the surface mass-balance can be reconstructed for subsequent years from the differences in surface elevation alone. As opposed to the glaciological method that requires substantial fieldwork year after year to provide only point observations, this method, once submergence velocities have been calculated, requires only remote-sensing data to provide spatially distributed annual mass-balances in accumulation areas.
While adult outcome in autism spectrum disorder (ASD) is generally measured using socially valued roles, it could also be understood in terms of aspects related to health status – an approach that could inform on potential gender differences.
Methods
We investigated gender differences in two aspects of outcome related to health-status, i.e. general functioning and self-perceived health status, and co-occurring health conditions in a large multi-center sample of autistic adults. Three hundred and eighty-three participants were consecutively recruited from the FondaMental Advanced Centers of Expertise for ASD cohort (a French network of seven expert centers) between 2013 and 2020. Evaluation included a medical interview, standardized scales for autism diagnosis, clinical and functional outcomes, self-perceived health status and verbal ability. Psychosocial function was measured using the Global Assessment of Functioning scale.
Results
While autistic women in this study were more likely than men to have socially valued roles, female gender was associated with poorer physical and mental health (e.g. a 7-fold risk for having three or more co-occurring physical health conditions) and a poorer self-perceived health status. Psychosocial function was negatively associated with depression and impairment in social communication. Half of the sample had multiple co-occurring health conditions but more than 70% reported that their visit at the Expert Center was their first contact with mental health services.
Conclusions
To improve objective and subjective aspects of health outcome, gender differences and a wide range of co-occurring health conditions should be taken into account when designing healthcare provision for autistic adults.
Le vieillissement démographique est un des défis majeurs du 21e siècle. Il pose directement la question du « vieillissement en santé », un processus aidant les personnes âgées à rester en bonne santé et indépendantes le plus longtemps possible. L’influence des facteurs environnementaux sur ce processus peut varier selon les individus et leurs comportements. L’enchevêtrement de ces facteurs représente un défi autant théorique que méthodologique. Cet article a pour objectifs i) de quantifier les associations entre l’environnement physique et social du quartier des personnes âgées et leur vieillissement en santé et ii) d’examiner si leur activité physique et leur participation sociale jouent un rôle de médiation dans ces associations. Si certaines caractéristiques du quartier relatives à la réputation, l’accès aux services, et la cohésion sociale sont associées au vieillissement en santé, il existe un soutien limité à l’idée que les comportements tiennent un rôle d’intermédiaire dans cette relation.
Patients with psychiatric disorders are exposed to high risk of COVID-19 and increased mortality. In this study, we set out to assess the clinical features and outcomes of patients with current psychiatric disorders exposed to COVID-19.
Methods
This multi-center prospective study was conducted in 22 psychiatric wards dedicated to COVID-19 inpatients between 28 February and 30 May 2020. The main outcomes were the number of patients transferred to somatic care units, the number of deaths, and the number of patients developing a confusional state. The risk factors of confusional state and transfer to somatic care units were assessed by a multivariate logistic model. The risk of death was analyzed by a univariate analysis.
Results
In total, 350 patients were included in the study. Overall, 24 (7%) were transferred to medicine units, 7 (2%) died, and 51 (15%) patients presented a confusional state. Severe respiratory symptoms predicted the transfer to a medicine unit [odds ratio (OR) 17.1; confidence interval (CI) 4.9–59.3]. Older age, an organic mental disorder, a confusional state, and severe respiratory symptoms predicted mortality in univariate analysis. Age >55 (OR 4.9; CI 2.1–11.4), an affective disorder (OR 4.1; CI 1.6–10.9), and severe respiratory symptoms (OR 4.6; CI 2.2–9.7) predicted a higher risk, whereas smoking (OR 0.3; CI 0.1–0.9) predicted a lower risk of a confusional state.
Conclusion
COVID-19 patients with severe psychiatric disorders have multiple somatic comorbidities and have a risk of developing a confusional state. These data underline the need for extreme caution given the risks of COVID-19 in patients hospitalized for psychiatric disorders.
Recent European Society of Parenteral and Enteral Nutrition guidelines highlighted the interest of prevention, diagnosis and treatment of malnutrition in the management of coronavirus disease 19 (COVID-19) patients. The aim of our study was to evaluate the prevalence of malnutrition in patients hospitalised for COVID-19. In a prospective observational cohort study malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) two-step approach. Patients were divided into two groups according to the diagnosis of malnutrition. Covariate selection for the multivariate analysis was based on P <0·2 in univariate analysis, with a logistic regression model and a backward elimination procedure. A partitioning of the population was realised. Eighty patients were prospectively enrolled. Thirty patients (37·5 %) had criteria for malnutrition. The need for intensive care unit admission (n 46, 57·5 %) was similar in the two groups. Three patients who died (3·75 %) were malnourished. Multivariate analysis exhibited that low BMI (OR 0·83, 95 % CI 0·73, 0·96, P = 0·0083), dyslipidaemia (OR 29·45, 95 % CI 3·12, 277·73, P = 0·0031), oral intake reduction <50 % (OR 3·169, 95 % CI 1·04, 9·64, P = 0·0422) and glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration; CKD-EPI) at admission (OR 0·979, 95 % CI 0·96, 0·998, P = 0·0297) were associated with the occurrence of malnutrition. We demonstrate the existence of a high prevalence of malnutrition in a general cohort of COVID-19 inpatients according to GLIM criteria. Nutritional support in COVID-19 care seems an essential element.
Host–microbial co-metabolism products are being increasingly recognised to play important roles in physiological processes. However, studies undertaking a comprehensive approach to consider host–microbial metabolic relationships remain scarce. Metabolomic analysis yielding detailed information regarding metabolites found in a given biological compartment holds promise for such an approach. This work aimed to explore the associations between host plasma metabolomic signatures and gut microbiota composition in healthy adults of the Milieu Intérieur study. For 846 subjects, gut microbiota composition was profiled through sequencing of the 16S rRNA gene in stools. Metabolomic signatures were generated through proton NMR analysis of plasma. The associations between metabolomic variables and α- and β-diversity indexes and relative taxa abundances were tested using multi-adjusted partial Spearman correlations, permutational ANOVA and multivariate associations with linear models, respectively. A multiple testing correction was applied (Benjamini–Hochberg, 10 % false discovery rate). Microbial richness was negatively associated with lipid-related signals and positively associated with amino acids, choline, creatinine, glucose and citrate (−0·133 ≤ Spearman’s ρ ≤ 0·126). Specific associations between metabolomic signals and abundances of taxa were detected (twenty-five at the genus level and nineteen at the species level): notably, numerous associations were observed for creatinine (positively associated with eleven species and negatively associated with Faecalibacterium prausnitzii). This large-scale population-based study highlights metabolites associated with gut microbial features and provides new insights into the understanding of complex host–gut microbiota metabolic relationships. In particular, our results support the implication of a ‘gut–kidney axis’. More studies providing a detailed exploration of these complex interactions and their implications for host health are needed.
Spatio-temporal variability of the winter surface mass balance is a major uncertainty in the modelling of annual surface mass balance. Moreover, its measurement at high spatio-temporal resolution (sub-200 m) is very useful to force, calibrate or validate models. This study presents the results of year-round field campaigns to study the evolution of the surface mass balance in a ~2 km2 portion of the accumulation zone of the Mer de Glace (France). It is based on repeated LiDAR acquisitions, submergence-velocity measurements and meteorological records. The two methods used to quantify submergence velocities show good agreement. They present a linear temporal evolution without significant seasonal changes but display significant spatial variability. We conclude that a dense network of submergence velocity measurements is required to reduce the uncertainties when computing winter and annual surface mass balance from digital elevation model differencing. Finally, a hight spatio-temporal variability of the winter surface mass balance is highlighted (e.g., a std dev. of 0.92 m in April) even though the topography is homogeneous (std dev. of 25 m). Attempts to relate this variability to different morpho-topographic variables and wind-related indexes show the need for studies conducted at the snowfall event scale to obtain a better understanding of the variability in mass balance at the glacier scale.
To evaluate resilience and frequency of behavioral symptoms in Haitian children internationally adopted before and after the earthquake of January 12, 2010.
Methods
We conducted a retrospective quantitative study in 40 Haitian children. Families were also asked to participate in a qualitative study (individual interview at 18-24 months after the earthquake) and to complete State-Trait Anxiety Inventory (STAI) and STAI for children (STAI-C) questionnaires.
Results
Demographic and clinical characteristics were similar in the group who experienced the earthquake (n=22) and in the group who did not (n=18). The families of 30 adoptees were interviewed. There was no statistical difference between the two groups for the STAI (P=0.53) and STAI-C (P=0.75) or for the frequency of behavioral problems. Plenary adoption was pronounced for 84.6% and 33.3% of the children adopted in the pre- and post-earthquake group, respectively (P=0.02). Children rarely talked about the experience of the earthquake, which, by contrast, was a stressful experience for the adoptive families.
Conclusions
Haitian children adopted after the earthquake did not express more stress or behavioral problems than those adopted before it. However, the possibility of a resurgence of mental disorders after age 10 should be borne in mind. (Disaster Med Public Health Preparedness. 2018;12:450–454)
To determine the sensitivity and specificity of clinical and laboratory signs for the diagnosis of septic arthritis (SA).
Patients and methods
This prospective study included all adult patients with suspected SA seen in the emergency department or rheumatology department at the University Hospital, Clermont-Ferrand, France, over a period of 18 months.
Results
In total, 105 patients with suspected SA were included, 38 (36%) presenting with SA (29 [28%] with bacteriologically documented SA). In the univariate analysis, chills (p=0.015), gradual onset (p=0.04), local redness (p=0.01), as well as an entry site for infection (p=0.01) were most often identified in SA. A history of crystal-induced arthritis (p=0.004) was more frequent in non-SA cases. An erythrocyte sedimentation rate (ESR)>50 mm (p=0.005), a C-reactive protein (CRP) level >100 mg/L (p=0.019), and radiological signs suggestive of SA (p=0.001) were more frequent in the SA cases. Synovial fluid appearance: purulent (p<0.001) and clear (p=0.007), synovial white blood cell (WBC) count >50,000/μL (p < 0.001), differentiated between SA and non-SA.
In multivariate analysis, only chills (odds ration [OR]=4.7, 95% confidence interval [CI] 1.3–17.1), a history of crystal-induced arthritis (OR=0.09, 95% CI 0.01–0.9), purulent appearance of the joint fluid (OR=8.4, 95% CI 2.4–28.5), synovial WBC count >50,000/mm3 (OR=6.8, 95% CI 1.3–36), and radiological findings (OR=7.1, 95% CI 13–37.9) remained significant.
Conclusion
No clinical sign or laboratory test (excluding bacteriological test), taken alone, is conclusive for the differentiation between SA and non-SA, but the association of several signs, notably chills, history of crystal-induced arthritis, radiological findings, and the appearance and cellularity of joint fluid may be suggestive.
In this paper, we investigate the different parameters that affect the distribution of the transmembrane potential of cells brought into contact before electrofusion in a miniaturized fluidic device. In particular, we discuss the deviation of the effective transmembrane voltage compared to the one predicted by Schwan’s law. The application of electric field pulses to biological cells induces a transmembrane potential which leads to cell permeabilization. Electrofusion occurs when several cells are brought into contact while they are electropermeabilized. Nevertheless, we show that in this case, the mutual presence of cells interferes on Schwan’s equation. Consequently, the transmembrane voltage at the cell contacting point is drastically reduced, which is not favorable for an electrofusion in smooth conditions, as the applied voltage needs to be increased to compensate this phenomenon. We show that the introduction of polymer obstacles reverses this trend, as the high electric field region is focused on the fusion zone. To confirm the theory we developed, quantitative biological experiments are presented in which murine melanoma cells were paired and fused in both conditions (with and without obstacles).
We used 6 years of surgical site infection (SSI) data collected by a surveillance system in northern France to compare targeted and pooled surveillance models. Digestive tract surgery wards were ranked according to SSI risk for herniorraphy, appendectomy, and cholecystectomy. The pooled and targeted models were correlated, despite differences in the number of outlier wards detected, indicating that the ranking of wards according to whether they have met a specified benchmark SSI rate depends on the strategy chosen.
The present paper aims at identifying and assessing indicators of the
effects of Marine Protected Areas (MPAs) in coral reef regions, based on a
bibliography review in ecology, economics and social sciences. First the
various effects studied within each of these domains and the variables used
to measure them were censused. Potential ecological indicators were assessed
through their link with the question used (here termed “relevance”) and
their “effectiveness” which encompasses the issues of precision, accuracy
and statistical power. Relevance and effectiveness were respectively
measured by the frequency of use of each indicator and the proportion of
significant results in the reviewed articles. For social and economic
effects, the approach was not possible due to the low number of references;
we thus discussed the issue of finding appropriate indicators for those
fields. Results indicate: 1- the unbalance in literature between
disciplines; 2- the need for protocols and methodologies which include
controls in order to assess MPA effects; 3- an important proportion of
ecological indicators with low effectiveness; 4- the large number of
ecological effects still not studied or not demonstrated at present.
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