Hemato-immunological responses of Heros severus fed diets supplemented with different levels of Dunaliella salina.

In this study, the effects of oral administration of different levels of Dunaliella salina (a natural ß-carotene source) on growth parameters, immunological and hematological indices, as well as skin carotenoids, of Heros severus were investigated. One hundred and eighty H. severus weighing 27 ± 0.5 g were divided randomly into four groups in triplicate (15 fish in each replicate). Groups 1-4 received food supplemented with 0, 50, 100 and 200 mg kg⁻¹ D. salina powder, respectively. After 6 weeks, the growth parameters were compared among the groups. Blood samples were taken from each group, and hematological parameters including red blood cell count (RBC), white blood cell count (WBC), hematocrit (PCV), hemoglobin (Hb) and immunological indices (serum and mucus lysozyme and bactericidal activity, resistance against Aeromonas hydrophila infection) as well as carotenoid content of skin were evaluated. Results showed that some growth indices increased significantly in fish fed with 100 and 200 mg kg⁻¹ D. salina-supplemented food (P < 0.05). Although serum lysozyme activity was increased in fish fed with food supplemented with 100 and 200 mg kg⁻¹ D. salina (P < 0.05), no significant change was observed in serum and mucus bactericidal activity and mucus lysozyme activity among the groups (P > 0.05). Most of the hematological parameters such as WBC, RBC, PCV and Hb significantly increased in D. salina-treated fish compared with controls (P < 0.05). Mortality induced after challenge with A. hydrophila in 200 mg kg⁻¹ D. salina-treated fish was 36.67 %, which significantly decreased compared with control (P < 0.05). Skin carotenoid content in all D. salina treatments was statistically higher than that of control (P < 0.05). Conclusively, D. salina as a food additive can affect positively the growth, immunological and hematological parameters of H. severus.

Boosted selective internal radiation therapy with 90Y-loaded glass microspheres (B-SIRT) for hepatocellular carcinoma patients: a new personalized promising concept.

PURPOSE: To evaluate the impact of dosimetry based on MAA SPECT/CT for the prediction of response, toxicity and survival, and for treatment planning in patients with hepatocellular carcinoma (HCC) treated with (90)Y-loaded glass microspheres (TheraSphere®). METHODS: TheraSphere® was administered to 71 patients with inoperable HCC. MAA SPECT/CT quantitative analysis was used for the calculation of the tumour dose (TD), healthy injected liver dose (HILD), and total injected liver dose. Response was evaluated at 3 months using EASL criteria. Time to progression (TTP) and overall survival (OS) were evaluated using the Kaplan-Meier method. Factors potentially associated with liver toxicity were combined to construct a liver toxicity score (LTS). RESULTS: The response rate was 78.8%. Median TD were 342 Gy for responding lesions and 191 Gy for nonresponding lesions (p < 0.001). With a threshold TD of 205 Gy, MAA SPECT/CT predicted response with a sensitivity of 100% and overall accuracy of 90%. Based on TD and HILD, 17 patients underwent treatment intensification resulting in a good response rate (76.4%), without increased grade III liver toxicity. The median TTP and OS were 5.5 months (2-9.5 months) and 11.5 months (2-31 months), respectively, in patients with TD <205 Gy and 13 months (10-16 months) and 23.2 months (17.5-28.5 months), respectively, in those with TD >205 Gy (p = 0.0015 and not significant). Among patients with portal vein thrombosis (PVT) (n = 33), the median TTP and OS were 4.5 months (2-7 months) and 5 months (2-8 months), respectively, in patients with TD <205 Gy and 10 months (6-15.2 months) and 21.5 months (12-28.5 months), respectively, in those with TD >205 Gy (p = 0.039 and 0.005). The median OS was 24.5 months (18-28.5 months) in PVT patients with TD >205 Gy and good PVT targeting on MAA SPECT/CT. The LTS was able to detect severe liver toxicity (n = 6) with a sensitivity of 83% and overall accuracy of 97%. CONCLUSION: Dosimetry based on MAA SPECT/CT was able to accurately predict response and survival in patients treated with glass microspheres. This method can be used to adapt the injected activity without increasing liver toxicity, thus defining a new concept of boosted selective internal radiation therapy (B-SIRT). This new concept and LTS enable fully personalized treatment planning with glass microspheres to be achieved.

Transforming scales of measurement of visual acuity at the group level.

AIM: To provide formulae that may be used to transform sample-based estimates of group-level mean and standard deviation of visual acuity (VA) across different scales of measurement. METHODS: We focused on 3 transformations: (1) ETDRS letters - LogMAR (2) Decimal - LogMAR and (3) Snellen - LogMAR. We assumed that logMAR follows a normal distribution in the underlying population and used the empirical asymptotic normal approximation of the joint distribution of average and standard deviation in order to derive formulae for transformation of group-level estimates. We considered that the true population parameters are not known and are to be estimated using data from a sample of patients (which is essentially always the case). We compared estimates obtained with the proposed sample-based approach with those based on a "naïve" approach in which individual-level formulae are used directly for transformation of means and standard deviations at the group-level. RESULTS: Applying formulae that are appropriate for transformations of scales of measurement for data at the individual- (or patient-) level, to transform VA at the group level, can lead to biased estimates of means and standard deviations. In particular, it could lead to underestimation of the average logMAR VA in studies that use decimal VA. Such bias will be greater in magnitude when disease strongly affects VA. CONCLUSIONS: This paper provides formulae that can be easily implemented in standard spreadsheet software programs, and which allow appropriate transformations of group-level estimates of mean and standard deviation of VA across different scales of measurement. These transformations are helpful for performing meta-analyses or for comparisons of results across studies when VA is expressed in different units.

Treatment Target Test Dementia (3TD).

OBJECTIVE: So far goal-oriented therapy in dementia cannot be measured sufficiently. There are no tests that detect a profile of capacities that could describe the targets of training. Thus, it was aimed to develop a test that uncovers a profile of capacities in patients suffering from dementia. METHODS: Three groups of subjects (n = 156), 30 patients suffering from dementia of the Alzheimer type, 28 from depressive disorder and 98 healthy age-comparable controls were included in the study. Building on already existing tests, items were developed to cover intelligence, visuo-spatial abilities, cognitive and social problem solving, emotional and executive abilities. All subjects were investigated with the Training Target Test Dementia (3TD). To calculate convergence validity, the Test for the Early Detection of Dementia from depression (TE4D) and the Beck Depression Inventory were assessed. Descriptively, profiles were calculated. Group differences were studied with the Kruskal-Wallis and the Mann-Whitney-U-test. RESULTS: Characteristic neuropsychological capacity profiles were found within the three groups. Differences between the groups were significant for all subtests. Significantly, the 3TD separated patients with dementia from controls. It reached high sensitivity and acceptable specificity. The convergence validity to the TE4D was significant (r = 0.77). CONCLUSIONS: The capacity profiles detected may allow for specified therapeutic modules to be scheduled. Moreover, the 3TD will be suitable to discriminate between patients suffering from dementia, depression as well as healthy age-comparable controls. For therapeutic improvement, further investigation will be needed to prove its sensitivity.

Self-reported visual impairment and mortality: a French nationwide perspective.

PURPOSE: To estimate the association between self-reported visual impairment and mortality. METHODS: Two national surveys in community and institutionalized populations were combined. First, 2,075 institutions for children with impairments, adults with impairments aged persons, and psychiatric patients were selected randomly. The sample comprised 15,403 subjects of whom 14,603 (94.9%) were interviewed. Second, a random, stratified sample of 21,760 persons living in the community was selected, and 16,945 (77.9%) were interviewed. Types of impairment were identified by face-to-face interviews. Two years later, 14,497 subjects in institutions and 15,648 in the community were revisited. Data on death were obtained from either the National Register or households. Death rates were related to age, gender, and impairment. A logistic regression was performed including impairments, activities of daily living, age, gender, type of residence, and geographical area. RESULTS: Strong, independent associations were found between particular impairments, institutional residence, activities of daily living, age, gender, and risk of death. Associations between mortality and type of impairment could be ranked as follows: motor (OR = 1.235), brain (OR = 1.552), low vision (OR = 1.681), speech (OR = 2.090), visceral (OR = 2.233) and blindness (OR = 2.262). CONCLUSIONS: Self-reported visual impairment is an independent factor associated with mortality.

A matching pursuit-based signal complexity measure for the analysis of newborn EEG.

This paper presents a new relative measure of signal complexity, referred to here as relative structural complexity (RSC), which is based on the matching pursuit (MP) decomposition. By relative, we refer to the fact that this new measure is highly dependent on the decomposition dictionary used by MP. The structural part of the definition points to the fact that this new measure is related to the structure, or composition, of the signal under analysis. After a formal definition, the proposed RSC measure is used in the analysis of newborn electroencephalogram (EEG). To do this, firstly, a time-frequency decomposition dictionary is specifically designed to compactly represent the newborn EEG seizure state using MP. We then show, through the analysis of synthetic and real newborn EEG data, that the relative structural complexity measure can indicate changes in EEG structure as it transitions between the two EEG states; namely seizure and background (non-seizure).

Investigation of osteocalcin, osteonectin, and dentin sialophosphoprotein in developing human teeth.

Biochemical investigations in rodents have shown that numerous mineralized matrix proteins share expression in bone, dentin, and cementum. Little information is available regarding the expression pattern of these proteins in human tissues, particularly during tooth formation. The aim of this study was to identify the expression pattern of the two major noncollagenous proteins of bone and dentin, osteocalcin (OC) and osteonectin (ON), in comparison to the dentin-specific protein, dentin sialophosphoprotein (DSPP). Mandibles from fetuses (5-26 weeks), neonate autopsies, forming teeth from 10-12-year-old patients, third molars extracted for orthodontic reasons, and bone tumors were collected with approval from the National Ethics Committee. Human OC, ON, and DSPP mRNAs were detected by reverse transcription-polymerase chain reaction (RT-PCR) in fetal mandibles (5-11 weeks) and in primary cell cultures of dental pulp. In addition, OC, ON, and DSPP proteins were localized in forming human mineralized tissues using immunohistochemistry. In vivo, DSPP expression was associated with tooth terminal epithelial-mesenchymal interaction events, amelogenesis and dentinogenesis. Transient DSPP expression was seen in the presecretory ameloblasts with continuous expression in the odontoblasts. In contrast, both osteoblasts and odontoblasts showed a temporal gap between OC and ON expression in early development. ON was expressed in the initial stages of cytodifferentiation, whereas OC was expressed only during the later stages, especially in the teeth. At the maturation stage of enamel formation, both proteins were detected in odontoblasts and their processes within the extracellular matrix. In contrast to bone, OC was not localized extracellularly within the collagen-rich dentin matrix (predentin or intertubular dentin), but was found in the mature enamel. ON was present mostly in the nonmineralized predentin. These results demonstrate for the first time that both OC and ON are produced by human odontoblasts and determine the expression pattern of DSPP in human teeth, and suggest that OC and ON move inside the canalicule via odontoblast cell processes becoming localized to specific extracellular compartments during dentin and enamel formation. These distinct extracellular patterns may be related to the nature of DSPP, OC, and ON interactions with other matrix-specific macromolecules (i.e., amelogenin, dentin matrix protein-1) and/or to the polarized organization of odontoblast secretion as compared with osteoblasts.

Age and cohort effects in adult handedness.

A systematic increase with age of the strong right-handers/mixed right-handers ratio, in normal adults, was found in Algeria, Greece, Italy, France and Spain. This age effect on adult handedness is not easily explained by variations in the social pressure against left-hand use, differential mortality, or information bias. There was no systematic decrease in the frequency of left-handedness with age. Left-hand writing among left-handers was common in the youngest age group and rare after 40 years of age.

Foot and eye preferences in adults: relationship with handedness, sex and age.

Age, sex, and handedness effects in foot and eye preferences were studied by questionnaire in large samples of normal adult populations from five different countries (total sample, n = 5064). Foot and eye preference were significantly associated with handedness category (right or left) in all the 10 sex by country samples for foot, and in 9/10 samples for eye. The overall frequencies of crossed preferences were 5% between hand and foot and 19.5% between hand and eye. In right-handers, a gradual shift toward the "right" with increasing age was systematically observed, both for footedness and eyedness. The proportion of crossed hand-foot preference was higher in men than women (7.4% vs 2.5%), and higher in left-handers than right-handers (16.3% vs 4.1%). Sex differences in the proportion of crossed hand-eye preference were variable from one country to the other.

Blindness, low vision, and other handicaps as risk factors attached to institutional residence.

AIMS: To estimate the risk of living in an institution and being visually impaired. METHODS: Two national surveys were pooled: (1) 2075 institutions (for children or adults with handicaps, old people, and psychiatric centres) were selected randomly, in 18 predefined strata, from the French health ministry files. From these institutions, 15 403 subjects were selected randomly and handicap was documented by interview in 14 603 (94.9%) of them; (2) level of handicap was documented in a randomised, stratified sample of 356 208 citizens living in the community; from this sample, 21 760 subjects were further selected at random and 16 945 people were interviewed. Data on handicaps (visual, auditory, speech, brain, visceral, motor, and other) and activities of daily living (ADL) were extracted. The odds ratio (OR) of living in an institution was estimated, using stepwise logistic regressions with age, geographical area, handicaps, and ADL as co-variables. RESULTS: Subjects in institutions, compared to those living at home, were, respectively, more often female (64.3% v 52.4%) and older (68.7 v 38.0 years); they more often had handicaps (ORs: speech, 6.59; brain, 10.17; motor, 8.86; visceral, 3.49; auditory, 2.66; other, 1.53); and were less often able to perform their ADL (46.2% v 97.1%) without assistance. Below 80 years, blind people were more often in institutions (ORs 0.239 to 0.306); whereas in older people the association was reversed (OR: 3.277). Low vision was always significantly associated with institutional residence (ORs from 0.262 to 0.752). CONCLUSION: Visual handicap was associated with institutional residence. The link persisted after adjustment for known confounding factors.

Prevention of recurrent depressive episodes with milnacipran: consequences on quality of life.

BACKGROUND: Depression is now seen as a chronic disabling condition that spans the patient's lifetime and creates significant medical, economic and quality of life consequences. METHODS: 500 depressed patients were treated with milnacipran for 6 months. A total of 214 recovered patients were randomised to receive either milnacipran (50 mg bid) or a matching placebo for a 1-year recurrence prevention phase. Recurrence rate was the primary criteria; quality of life (QoL) consequences were evaluated through a shortened version of the French Sickness Impact Profile (SIP), the Depression Impact Profile (DIP). RESULTS: Milnacipran demonstrated its ability to reduce recurrences (Odds-Ratio=1.5; P<0.05), with a more marked effect in recovered patients with few residual symptoms (Odds-Ratio=3.0). Responders who continued treatment with milnacipran had a dramatic improvement in their quality of life, although patients with residual symptoms still experienced some deterioration in their QoL (recreation, emotional, social, alertness and home assistance scores). Even recovered patients having zero scores on the Hamilton Depression Rating Scale-21 items (HDRS) had some QoL deterioration. The DIP emotional score was found to be more predictive of recurrence than the HDRS. Overall, the QoL was improved for those in the milnacipran group in comparison to placebo on the mobility, communication, psycho-social and total scores. LIMITATIONS: The QoL evaluation was a secondary criteria; no a priori sample size estimate was performed. The choice of a generic QoL instrument might have reduced the sensitivity to clinical changes in depression. CONCLUSIONS: Prevention of recurrence in MDD with milnacipran contributes to an improvement in the QoL.

Equilibrium studies on tetracycline-metal ion systems.

Protonation and equilibrium constant for oxytetracycline (OTC) and doxycycline (DOX) with Zn2+, Ca2+ and Mg2+ ions have been determined with Calvin-type pH-metric titrations under physiological conditions (37 degrees C, 0.15 M NaCl ionic strength). Even though OTC and DOX are similar in structure, major differences were found in complex composition with regard to the protonation state: OTC generally formed species with less protons compared to those with DOX. Studies of parent complexes were followed by investigations of ternary complexes where ascorbic acid was used as a secondary ligand. Again, OTC showed a tendency to form complexes in which fewer protons are bound than in those with DOX. This equilibrium difference between OTC and DOX might be because DOX has a better pharmacodynamic effect relative to that of OTC.

Heterotopic triplet pregnancy. Report of a case with successful twin intrauterine gestation.

BACKGROUND: Reports of coexisting multiple intrauterine pregnancies and ectopic pregnancy are extremely rare. We present one case with early sonographic diagnosis of heterotopic pregnancy, successful laparoscopic treatment and a subsequent normal pregnancy course and outcome of the intrauterine twin gestation. CASE: A 29-year-old woman, gravida 1, para 0, presented for her first prenatal visit at 5 weeks of gestation with pelvic pain. She had conceived with 75 IU leutinizing hormone and follicle-stimulating hormone and homologous intrauterine insemination. The sonogram confirmed a dichorionic twin intrauterine pregnancy and left tubal pregnancy at 7 weeks of gestation. The patient underwent a laparoscopic left salpingostomy and removal of the ectopic pregnancy. Level II sonogram showed a grossly unremarkable twin gestation at 20 weeks. Labor was induced at 37 weeks of gestation due to mild preeclampsia and underwent vaginal delivery without difficulties. The first twin was a girl, weighing 2,722 g, with Apgar scores of 9/9. The second twin, a boy, was delivered 10 minutes later, weighing 2,863 g, with Apgar scores of 9/9. CONCLUSION: Early sonography is essential for the diagnosis of heterotopic pregnancy, and timely surgical intervention can save the intrauterine twin gestation, with a subsequent normal pregnancy course and outcome.

[Internal statistical validation of a quality of life questionnaire]. / Validation statistique interne d'un questionnaire de qualité de vie.

In this paper we present two different statistical approaches to evaluate the psychometric properties of a quality of life questionnaire. First the study of the factorial structure is briefly exposed. Then we present the unidimensional classical models. They are based on the linear relationship between the observed score and the true score. The definition of the reliability was first addressed in this classical framework. Its estimation with the Cronbach alpha coefficient is one important feature of the evaluation of an instrument. More recently, modern response theory gives a better statistical framework to deal with unidimensional latent traits. These models describe the probability of positive answer to an item as a function of the actual value of the latent trait and an item parameter. We expose the principles of the Rasch model: hypothesis, estimations methods and fit tests. Finally practical applications to the validation process of a questionnaire are explored with data from a study of a short French version of the SIP questionnaire.

[Preliminary analysis of the psychometric properties of the French version of an international questionnaire measuring the quality of life: the MOS SF-36 (version 1.1)]. / Analyse préliminaire des propriétés psychométriques de la version française d'un questionnaire international de mesure de qualité de vie: le MOS SF-36 (version 1.1).

The International Quality of Life Assessment (IQOLA) Project is a 4 year project initiated in 1991 to translate and adapt the Medical Outcome Study Short Form 36 item Health Survey (SF-36) in at least 15 countries. This paper reports on the preliminary psychometric assessment of the SF-36 in French (version 1.1). The validation data come from two studies: a phase IV study of 121 patients with arthritis and a phase IV study of 159 patients with angina. In both cases, the patients were surveyed using the SF-36 and a disease specific module. The main objective of this analysis was to determine how well the scaling assumptions (summated rating or Likert type scaling construction) of the SF-36 were satisfied. Item convergent validity was supported as items-scale correlation range from 0.47-0.87. Item discriminant validity was supported as all items were more correlated with their hypothesised scales than with scales measuring other concepts. Our data support the assumption that the items measuring the same concept had approximately equal variance. Items in a given scale contained about the same proportion of information about the concept being measured, as most items of any given dimension had approximately the same correlation with that dimension. The Cronbach alpha coefficient ranged between 0.79 and 0.95. The correlation between two scales was less than the reliability coefficient for those scales, and these correlations adjusted for attenuation were less than 1. These preliminary results are encouraging. They indicate that the items are linearly related to the underlying concept being measured.(ABSTRACT TRUNCATED AT 250 WORDS)

Association between criminality and psychosis: a retrospective study of 3984 expert psychiatric evaluations.

This study reports on 3984 expert psychiatric evaluations in eastern Algeria over a period of 23 years. Factors associated with different types of crimes or misdemeanors, particularly those associated with a diagnosis of psychosis in the case of a homicide or attempted homicide committed by male subjects are described. Among the 1007 cases of homicide and attempted homicide, the diagnosis of psychosis was made 200 times (19.9%). Psychotic subjects were older, more likely to have a previous psychiatric history, less likely to come from very large families, and less likely to have been raised by both their parents.

[Internal validation of a measurement scale: relation between principal component analysis, Cronbach's alpha coefficient and intra-class correlation coefficient]. / Validation interne d'une échelle de mesure: relation entre analyse en composantes principales, coefficient alpha de Cronbach et coefficient de corrélation intra-classe.

The objective is to establish a simple relationship between two frequently used validation techniques which have been developed in the literature along the same lines: Principal Component Analysis and Cronbach's alpha. We have shown that under certain conditions, it is possible to estimate the reliability by using the results of a Principal Component Analysis only. Moreover, we report the relation between Cronbach's alpha and intraclass correlation coefficient, which are both used to estimate the reliability of continuous measures.

Prevalence of non-insulin dependent diabetes as perceived by general practitioners in France.

A representative, random sample of French general practitioners, reported the number of diabetic patients they treated in their practices. The resulting NIDDM prevalence rate for France was 1.71% (SE +/- 0.03), compatible with the rates found in other studies. Prevalence rates for NIDDM were also calculated by region and a multivariate covariance model was used to correlate the prevalence with known risk factors. The three significant factors were: the quantity of wine consumed, the female/male sex ratio of people over 45 years of age, both positively correlated, and the consumption of animal fats, which was negatively correlated with NIDDM prevalence.

[Validation in the French language of an evaluation scale for family functioning (FACES III): a tool for research and for clinical practice]. / Validation en langue française d'une échelle d'évaluation du fonctionnement familial (FACES III): un outil pour la recherche et la pratique clinique.

Valid and reliable scales are necessary to describe the numerous factors associated with health status. Multiple studies have shown the impact of familial factors, i.e. family functioning (FF) on health indicators. As no scale exists in french to assess FF, we performed a study to validate the Family Adaptability and Cohesion Evaluation Scale (FACES III, Olson et al.) in french. This scale has a high level of validity and reliability and has been widely used. After 2 translations and back-translations and a pilot study to establish face validity, the final version was studied in 976 healthy subjects (457 families) who attended a preventive medical center in Nancy, France. Parents and adolescents each filled out two 20 item self-administered questionnaires. There were few missing values (0-3% per item). Construct validity was assessed by principal component factor analysis, which found the same two individualized axes as in the original scale. The reliability of the french version was excellent and comparable to Olson's scale. This study demonstrates the validity and reliability of a french version of FACES III in a french population. It provides researchers and clinicians in France with a validated instrument for assessing, in a quantified way, factors associated with family functioning that influence health status in adults, adolescents and children, particularly those with chronic diseases. This scale is especially useful for developing and evaluating health programs.

Accelerometer-based fetal movement detection.

Monitoring fetal wellbeing is a compelling problem in modern obstetrics. Clinicians have become increasingly aware of the link between fetal activity (movement), well-being, and later developmental outcome. We have recently developed an ambulatory accelerometer-based fetal activity monitor (AFAM) to record 24-hour fetal movement. Using this system, we aim at developing signal processing methods to automatically detect and quantitatively characterize fetal movements. The first step in this direction is to test the performance of the accelerometer in detecting fetal movement against real-time ultrasound imaging (taken as the gold standard). This paper reports first results of this performance analysis.