The effect of tibialis anterior weakness on foot drop and toe clearance in patients with facioscapulohumeral dystrophy.

BACKGROUND: Facioscapulohumeral dystrophy is a genetic disease characterized by progressive muscle weakness leading to a complex combination of postural instability, foot drop during swing and compensatory strategies during gait that have been related to an increased risk of falling. The aim is to assess the effect of tibialis anterior muscle weakness on foot drop and minimum toe clearance of patients with facioscapulohumeral dystrophy during gait. METHODS: Eight patients allocated to a subgroup depending on the severity of tibialis anterior muscle weakness, assessed by manual muscle testing (i.e., severe and mild weakness), and eight matched control participants underwent gait analysis at self-selected walking speeds. FINDINGS: Walking speed, for all facioscapulohumeral dystrophy patients, and step length, for patients with severe weakness only, were significantly decreased compared to control participants. Minimum toe clearance was similar across all groups, but its variability was increased only for patients with severe weakness. A greater foot drop was systematically observed for patients with severe weakness during swing and only in late swing for patients with mild weakness. Individual strategies to compensate for foot drop remain unclear and may depend on other muscle impairment variability. INTERPRETATION: Although all patients were able to control the average height of their foot trajectory during swing, patients with severe tibialis anterior muscle weakness exhibited increased foot drop and minimum toe clearance variability. Manual muscle testing is a simple, cheap and effective method to assess tibialis anterior muscle weakness and seems promising to identify facioscapulohumeral dystrophy patients with an increased risk of tripping.

Risk factors for burnout and depression in healthcare workers: The national AMADEUS study protocol.

CONTEXT: Burnout is an international phenomenon defined as a state of professional exhaustion. It can lead to depression and have major economic and organizational impacts. Previous studies of healthcare professionals in France have focused on physicians, but none to date have explored other healthcare professions. OBJECTIVES: The main objective of our study is to determine the prevalence of burnout among healthcare workers. The secondary objectives are to explore the associations of burnout with professional and psycho-social factors and the risk of depression, professional harassment, sexual harassment, sexual-orientation based discrimination, consumption of antidepressants, anxiolytics and also the lifestyle of the individual: smoking, alcohol consumption, coffee consumption, physical activity and sleep quality. MATERIALS AND METHODS: The survey will take the form of a voluntary and anonymous online questionnaire carried out on the FramaForm1® platform and will be disseminated via social networks, professional networks and mailings. STUDY POPULATION: Senior doctors, interns, directors of care, nurses, head nurses and senior head nurses, physiotherapists and occupational therapists, dieticians, radiology technicians, laboratory technicians, psychologists, nurses' aides, auxiliary nurses and midwives will be included. COLLECTED DATA: Burnout will be measured with the Maslach Inventory burnout (MBI) questionnaire, work environment with the Karasek questionnaire and anxiety, depression risk with the Center for Epidemiologic Studies- Depression (CES-D), physical activity with the Global Physical Activity Questionnaire (GPAQ) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). ETHICS: This protocol has been accepted by the ethical committee (IRB n°C08/21.01.06.93911, CNIL). EXPECTED RESULTS: Based on international studies, we expect a high rate of burnout with disparities according to profession, socio-demographic data, seniority and type of service. We also expect a significant rate of untreated depression. This study will provide evidence for policy makers to implement collective strategies to reduce burnout and depression in the different populations studied.

COVID-19 pandemic in France: health emergency experiences from the field.

AIM: This paper describes the situation regarding COVID-19 emergency in France as of early May 2020, the main policies to fight this virus, and the roles and responsibilities of nurses regarding their work at this time, as well as the challenges facing the profession. BACKGROUND: Europe continues to be affected by the COVID-19 pandemic. At the time of writing France was the fourth country with the highest number of detected cases and cumulative deaths. SOURCES OF EVIDENCE: Websites of the World Health Organization, French Government, French Agency of Public Health, French National Council of Nurses and ClinicalTrials.gov database, as well as the experiences of the authors. DISCUSSION: The history of the development of the pandemic in France helps explain the establishment of the state of health emergency and containment of the population. Many decisions made had undesirable repercussions, particularly in terms of intra-family violence, mental health disorders and the renunciation of care. Hospitals and primary care services, with significant investment by nurses, played a key role in the care of persons with and without COVID-19. CONCLUSION: France has suffered a very high toll in terms of COVID-19 morbidity and mortality, and effects on its people, health systems and health professionals, including nurses. IMPLICATIONS FOR NURSING PRACTICE: Nurses are recognized for their social usefulness in France. However, it is important to consider the collateral effects of this crisis on nurses and nursing and to integrate the health emergency nursing skills established during the pandemic into the standard field of nursing competence. IMPLICATIONS FOR NURSING POLICY: The nursing profession has expectations of a reflection on and revision of nursing skills as well as of its valorization in the French healthcare system, notably carried out by the French National Council Order of Nurses.

Neuromuscular characteristics in trained vs. sedentary male adults with intellectual disability.

BACKGROUND: This study aimed to explore muscle strength production and its underlying neuromuscular characteristics in sedentary and trained individuals with intellectual disability (ID) compared with healthy sedentary individuals. METHODS: Three adult groups (age: 25.07 ± 0.70) consisting of sedentary individuals with ID (IDSG), trained individuals with ID (IDTG) and a control group (CONT) participated in the present study. Peak torque (PT) during maximal voluntary isometric contraction, voluntary activation level (VAL), surface electromyography (sEMG) recordings, electrophysiological (Mmax ) and potentiated twitch torque (PTT responses) of the knee extensor muscles and thigh muscle volume were assessed. RESULTS: Compared with CONT and IDTG, respectively, IDSG presented significantly lower PT (-48% and -42%), VAL (-24% and -9%), sEMG (-49% and -29%), Mmax (-41% and -39%) and PTT (-32% and -28%) values. These deficits were reduced between IDTG compared with CONT (i.e. PT: -10%; VAL: -16%; and sEMG: -28%) or did not differ anymore (PTT and Mmax ). Normalising PT to thigh muscle volume and/or computing theoretical PT value overwhelm strength production differences between IDTG and CONT. Training background influences the outcomes with IDTG exhibiting greater PT, VAL, sEMG, Mmax and PTT than IDSG. CONCLUSIONS: Strength production deficit in IDSG was related to both muscular and neural characteristics compared with healthy controls whereas this deficit mainly arises from neural characteristics for IDTG.

Impact of improved urban environment and coaching on physical condition and quality of life in elderly women: a controlled study.

BACKGROUND: Physical activity can slow the ageing process and preserve autonomy in the elderly. The aim of this study was to assess the combined impact of an organized urban walking circuit and individual coaching on women senior citizens' physical well-being and quality of life. METHODS: Insufficiently physically active women >65 years were included in a quasi-experimental trial. Active arm: District with improved urban environment (IUE). Control arm: District without improved urban environment (WIUE). In each district, subjects were randomly allocated to receive coaching (C+ vs. C-). The main outcome measures were endurance, physical activity score, flexibility, quality of life, physical self-esteem, ageing exercise stereotypes, functional health and perceived health at baseline, three (M3) and six (M6) months. RESULTS: Fifty-two insufficiently physically active women were included, 23 in IUE and 29 in WIUE. Groups were comparable at baseline. At M3, endurance and physical activity score significantly improved compared with baseline in the IUE group and in the C+ group while no statistically significant change was observed for the WIUE group and the C- group. Moreover, endurance score was higher in the IUE group, whether coupled with coaching or not. After the coaching was removed, the IUE group regresses to baseline overall and the WIUE shows a decrement in endurance. CONCLUSION: Our study highlights the positive impact of an improved environment and of individual coaching on the level of physical activity and quality of life of insufficiently physically active elderly women.

The Effect of Whole-body Vibration on Muscle Activity in Active and Inactive Subjects.

The purpose of this study was to compare lower limb muscle activity between physically active and inactive individuals during whole-body vibration exercises. Additionally, transmissibility of the vertical acceleration to the head was quantified. 30 active and 28 inactive participants volunteered to stand in a relaxed (20°) and a squat (60°) position on a side-alternating WBV platform that induced vibrations at 16 Hz and 4 mm amplitude. Surface electromyography (sEMG) was measured in selected lower limb muscles and was normalized to the corresponding sEMG recorded during a maximal voluntary contraction. The vertical acceleration on the head was evaluated and divided by the vertical platform acceleration to obtain transmissibility values. Control trials without vibration were also assessed. The outcomes of this study showed that (1) WBV significantly increased muscle activity in the active (absolute increase: +7%, P <0.05) and inactive participants (+8%, P <0.05), (2) with no differences in sEMG increases between the groups (P>0.05). However, (3), transmissibility to the head was greater in the active (0.080) than the inactive participants (0.065, P <0.05). In conclusion, inactive individuals show similar responses in sEMG due to WBV as their active counterparts, but are at lower risk for potential side-effects of vibration exposure.

Lower limbs power and stiffness after whole-body vibration.

The interest in whole-body vibration (WBV) for the enhancement of neuromuscular performance has received considerable attention. However, scientific evidence supporting the optimal prescription of WBV settings is lacking. This study investigated the acute effect of WBV combining high frequency/high peak-to-peak displacement (HH) or low frequency/low peak-to-peak displacement (LL) vs. sham intervention (SHAM) on lower limb muscle power and stiffness. A total of 223 volunteers were randomly assigned to either the HH, LL or SHAM group. Countermovement jump (CMJ) height, maximal and average power, maximal and average lower limbs stiffness obtained during a hopping test were recorded before and after the respective intervention. After the intervention, the HH group showed an increase of 4.64% in CMJ height (p<0.001) whereas the values of both the LL and SHAM groups did not change. In addition, maximal and average power of the lower limbs were significantly increased in all groups (p<0.001; 10.89% and 12.82%, respectively) while no effect on lower limbs stiffness was observed. Our data show that high frequency combined with high peak-to-peak displacement is the most optimal WBV setting for CMJ height enhancement. Further investigation should be undertaken to ascertain the effectiveness of WBV on lower limbs stiffness.

Whole body vibration does not enhance muscle activation.

Whether a whole body vibration session can enhance muscle voluntary activation remains debated. This pilot study thus investigated the acute effects of an intervention with whole body vibration versus a "sham" intervention on the voluntary activation of knee extensor muscles. Ten healthy subjects volunteered to participate in two interventions, vibration and sham, in randomized order. Knee extensor muscle voluntary activation, contractile properties and maximal voluntary isometric contraction were assessed before and immediately after each intervention. No significant differences were found for any of the variables. After both interventions, muscle activation remained unchanged, whereas maximal voluntary isometric contraction was significantly reduced (p<0.05). In conclusion, the two interventions induced the same adaptations in the knee extensors. These findings can be useful in conceiving whole body vibration protocols, although future research is warranted to address the influence of vibration on neural adaptation.

Positive attitudes of farmers and pen-group conservation reduce adverse reactions of bulls during transfer for slaughter.

Transfer to slaughter may be very stressful for cattle and negatively affect their ultimate carcass pH. A potential link between farmers' attitudes, farmers' behaviour, responses of animals to handling and carcass pH in beef bull production was questioned. Whether carcass pH depends on experiences in handling and social mixing was analysed. We conducted a survey on commercial farms where we questioned farmers on their work and beliefs about bulls. Farmers' behaviour with bulls during a test and bulls' behaviour during loading in the truck for transport to the slaughterhouse were observed. The ultimate carcass pH was measured. Farmers tended to behave more gently with their bulls when they had positive attitudes towards gentle contacts with bulls (P = 0.07). The loading of bulls in the truck tended to be more difficult when the farmer was more ready to approach his bulls (P = 0.07). Carcass pH was higher for bulls that had not been transferred from a breeding to a finishing unit (P = 0.03). It tended to be higher when the farmer did not display a gentle behaviour (P = 0.09). The link between farmers' attitudes and farmers' behaviour and the lower meat pH resulting from a gentle farmers' behaviour during finishing are consistent with previous findings in pig, veal or dairy productions. However, the present links were weaker than in the other productions, probably due to the low frequency of close contacts between farmers and beef bulls. When loading bulls into a truck, handlers use the tendency of animals to avoid people, hence overly positive behaviour with the animals during finishing may result in more difficulties at loading. In that case, use of alternative driving aids should be recommended. Our results on carcass pH suggest some habituation to transport among bulls transferred between breeding and finishing, even though the two experiences are several months apart. In view of our results, it seems that contacts with bulls, when they are needed, should be gentle.

Motivation to dust-bathe of laying hens housed in cages and in aviaries.

New housing systems for commercial egg production, furnished cages and non-cage systems, should improve the welfare of laying hens. In particular, thanks to the presence of a litter area, these new housing systems are thought to satisfy the dust-bathing motivation of hens more than in conventional cages, in which no litter area is present. However, although apparently obvious, there is no concrete evidence that non-cage systems, particularly aviaries, satisfy hens' motivation to dust-bathe and thus improve hens' welfare in terms of dust-bathing behaviour. The aim of this study was to compare hens' dust-bathing motivation when housed for a long time under similar conditions to commercial conditions in laying aviaries (with litter) and in conventional cages (without litter). Three treatments were compared: hens reared in floor pens then housed in conventional cages, hens reared in furnished floor pens then housed in a laying aviary, and hens reared in rearing aviaries then housed in a laying aviary. All three treatments provided access to litter during the rearing period. After transfer to the laying systems, access to litter was maintained for the aviary hens but stopped for the cage hens. Twelve groups of four hens per treatment were tested 36 to 43 weeks after transfer. The hens were placed in sawdust-filled testing arenas, and latency to dust-bathe, duration and number of dust baths, and number of hens dust-bathing were recorded. Latency to dust-bathe was shorter, dust baths were longer and more numerous and more hens dust-bathed among cage hens than among aviary hens. Our results indicate that hens' motivation to dust-bathe was more satisfied in laying aviaries than in conventional cages. Thus, laying aviaries improve hens' welfare in term of dust-bathing behaviour compared with conventional cages.

Time course of mechanical and neuromuscular characteristics of cyclists and triathletes during a fatiguing exercise.

This study examined the impact of sport specificity on the time course of fatigue during maximal voluntary eccentric, concentric and isometric torque production following a submaximal isokinetic fatiguing exercise. Seven cyclists and seven triathletes performed a fatiguing exercise consisting of nine sets of 31 isokinetic concentric knee extensions at 1.05 rad . s (-1). Fatigue was assessed pre-exercise, after three and six sets, and post-exercise. The maximal knee extension torque associated with electromyographic (EMG) activity was recorded during voluntary contractions and electrically induced contractions (single and paired twitches). The maximal voluntary eccentric torque production declined in cyclists (18 +/- 3.5 %, p < 0.05) and was not significantly affected in triathletes (5 +/- 2.5 %, p > 0.05). The decrease in cyclists was associated with an increase in the sum of the normalized EMG (nRMS) values of the three agonist muscles (p < 0.01). Although no significant difference was observed between groups, the two-way repeated-measure analysis of variance revealed a time effect on maximal concentric and isometric torque, twitch contractile and electrophysiological response (M (max)) properties. No modification in the activation and coactivation levels was observed. In conclusion, these results indicate that the time course of fatigue, especially during eccentric contractions, is mediated by sport-specific adaptations likely due to the mode of muscle contraction used in the activity.

Achieving molecular selectivity in imaging using multiphoton Raman spectroscopy techniques.

In the case of most optical imaging methods, contrast is generated either by physical properties of the sample (Differential Image Contrast, Phase Contrast), or by fluorescent labels that are localized to a particular protein or organelle. Standard Raman and infrared methods for obtaining images are based upon the intrinsic vibrational properties of molecules, and thus obviate the need for attached fluorophores. Unfortunately, they have significant limitations for live-cell imaging. However, an active Raman method, called Coherent Anti-Stokes Raman Scattering (CARS), is well suited for microscopy, and provides a new means for imaging specific molecules. Vibrational imaging techniques, such as CARS, avoid problems associated with photobleaching and photo-induced toxicity often associated with the use of fluorescent labels with live cells. Because the laser configuration needed to implement CARS technology is similar to that used in other multiphoton microscopy methods, such as two-photon fluorescence and harmonic generation, it is possible to combine imaging modalities, thus generating simultaneous CARS and fluorescence images. A particularly powerful aspect of CARS microscopy is its ability to selectively image deuterated compounds, thus allowing the visualization of molecules, such as lipids, that are chemically indistinguishable from the native species.

An integrated confocal and magnetic resonance microscope for cellular research.

Complementary data acquired with different microscopy techniques provide a basis for establishing a more comprehensive understanding of health and disease at a cellular level, particularly when data acquired with different methodologies can be correlated in both time and space. In this Communication, a brief description of a novel instrument capable of simultaneously performing confocal optical and magnetic resonance microscopy is presented, and the first combined images of live Xenopus laevis oocytes are shown. Also, the potential benefits of combined microscopy are discussed, and it is shown that the a priori knowledge of the high-resolution optical images can be used to enhance the boundary resolution and contrast of the MR images.

Supercooling of the disordered vortex lattice in Bi(2)Sr(2)CaCu(2)O(8+delta)

Time-resolved local induction measurements near the vortex lattice order-disorder transition in optimally doped Bi(2)Sr(2)CaCu(2)O(8+delta) crystals show that the high-field, disordered phase can be quenched to fields as low as half the transition field. Over an important range of fields, the electrodynamical behavior of the vortex system is governed by the coexistence of ordered and disordered vortex phases in the sample. We interpret the results as supercooling of the high-field phase and the possible first-order nature of the order-disorder transition at the "second magnetization peak."

Re-examination of training effects by electrostimulation in the human elbow musculoskeletal system.

This study examines the effects of a 7 weeks sub-maximal training period of electrostimulation on the maximal isometric, concentric, eccentric voluntary torque and muscle contractile properties of the elbow flexor muscles of nine subjects. The daily program consisted of five series of six 6-s isometric actions (60 to 70% of maximal isometric voluntary action) at an elbow angle of 90 . After training the maximal voluntary isometric flexion torque increased significantly whereas the maximal voluntary isometric extension torque decreased significantly. Increases in isometric flexion torque were linked to an increase of the myoelectrical activity of the biceps brachii muscle. Under dynamic conditions flexion torque was significantly increased throughout the whole spectrum of angular velocities. These changes were accompanied by an increase in the myoelectrical activity of the agonist muscle under eccentric conditions and at two fast concentric angular velocities, without modifications of the myoelectrical activity of the antagonist muscle. The analysis of the electrical and mechanical twitches indicated that modifications of the muscle membrane electrical activity were also present at the muscle level. These results indicate that torque gains were attributed to neural adaptations and/or to a modification of the relative part of agonist and antagonist muscles in elbow flexion torque production.

Isokinetic elbow flexion and coactivation following eccentric training.

The influence of an eccentric training on torque/angular velocity relationships and coactivation level during maximal voluntary isokinetic elbow flexion was examined. Seventeen subjects divided into two groups (Eccentric Group EG, n = 9 Control Group CG, n = 8) performed on an isokinetic dynamometer, before and after training, maximal isokinetic elbow flexions at eight angular velocities (from - 120 degrees s(-1) under eccentric conditions to 240 degrees s(-1) under concentric conditions), and held maximal and submaximal isometric actions. Under all conditions, the myoelectric activities (EMG) of the biceps and the triceps brachii muscles were recorded and quantified as the RMS value. Eccentric training of the EG consisted of 5x6 eccentric muscle actions at 100 and 120% of one maximal repetition (IRM) for 21 sessions and lasted 7 weeks. In the EG after training, torque was significantly increased at all angular velocities tested (ranging from 11.4% at 30 degrees (s-1) to 45.5% at - 120 degrees s(-1)) (p < 0.05). These changes were accompanied by an increase in the RMS activities of the BB muscle under eccentric conditions (from - 120 to - 30 degrees (s-1)) and at the highest concentric angular velocities (180 and 24 degrees s(-1)) (p < 0.05). The RMS activity of the TB muscle was not affected by the angular velocity in either group for all action modes. The influence of eccentric training on the torque gains under eccentric conditions and for the highest velocities was attributed essentially to neural adaptations.