Universal School-Based Intervention Does Not Reduce Socioeconomic Inequalities in Weight Status among Adolescents

Background: Differences in weight status by socioeconomic position occur during adolescence and is known as weight social gradient (WSG). The PRALIMAP (Promotion de l'ALIMentation et de l'Activité Physique) trial highlighted that a universal intervention was effective in reducing overweight and obesity prevalence among adolescents. However, its ability to reduce the WSG is unclear. This study aimed to evaluate the impact of the PRALIMAP intervention on the WSG among adolescents. Methods: Data were obtained from 3504 adolescents who participated in the school-based PRALIMAP trial between 2006 and 2009. The PRALIMAP study consisted of three interventional strategies: educational, environmental, screening and care. Weight status was assessed by body mass index (BMI) z-score and overweight and obesity prevalence. The "indice de position sociale des élèves" was used to measure adolescents' socioeconomic status. Linear regression and hierarchical models were used to assess the WSG and its evolution, respectively. Results: Among all adolescents (14-18 years old), significant WSG was identified at baseline: BMI z-score (β = -0.06; p < 0.0001), overweight and obesity prevalence (β = -2.86; p < 0.0001). Overall, the intervention conferred no significant reduction in the WSG: BMI z-score (β = -0.01 [-0.02 to 0.01], p = 0.48), overweight and obesity prevalence (β = -0.01 [-0.07 to 0.05], p = 0.73). Similar results were observed for adolescents whatever the interventional strategy they benefited from in the PRALIMAP trial. Conclusions: This study provided no evidence that the PRALIMAP universal intervention was effective in reducing the socioeconomic inequalities in weight status among adolescents. Different interventions that account for social differences should be considered to tackle these inequalities.

Determination of Glyphosate and Aminomethylphosphonic Acid in Crops by Capillary Gas Chromatography with Mass-Selective Detection: Collaborative Study

A collaborative study was conducted to validate a method for the determination of glyphosate and aminomethylphosphonic acid (AMPA) in crops. The analytes are extracted from crops with water, and the crude extracts are then subjected to a cation exchange cleanup. The analytes are derivatized by the direct addition of the aqueous extract into a mixture of heptafluorobutanol and trifluoroacetic anhydride. The derivatized analytes are quantitated by capillary gas chromatography with mass-selective detection (MSD). The collaborative study involved 13 laboratories located in 5 countries 12 laboratories returned valid data sets. The crops tested were field corn grain, soya forage, and walnut nutmeat at concentrations of 0.050, 0.40, and 2.0 mg/kg. The study used a split-level pair replication scheme with blindly coded laboratory samples. Twelve materials were analyzed, including 1 control and 3 split-level pairs for each matrix, 1 pair at each nominal concentration. For glyphosate, the mean recovery was 91%, the average intralaboratory variance, the repeatability relative standard deviation (RSDr), was 11%, and the interlaboratory variance, the reproducibility relative standard deviation (RSDR), was 16%. For AMPA, the mean recovery was 87%, the RSDr was 16%, and the RSDR was 25% at mg/kg levels.

P1843Transcatheter aortic valve implantation in patients with uninterrupted vitamin k antagonist

Background

Bridging of vitamin K antagonist (VKA) with heparin is usually not promoted during interventional or surgical procedures related to increased risk of bleeding and thrombotic events but this strategy has not been evaluated during TAVI.

Purpose

The aim of this study was to evaluate the rate of major bleeding and vascular complications after TAVI performed in patients with uninterrupted VKA.

Methods

From January 2016 to October 2017, consecutive patients who underwent TAVI with uninterrupted VKA (INR between 1.5 and 3.5) were prospectively included in a monocentric registry. TAVI were performed according to current guidelines and a 50UI/kg bolus of heparin was injected at the beginning of the procedure for all patients. Vascular and bleeding complications were assessed using the Valve Academic Research Consortium 2 (VARC2) and the Bleeding Academic Research Consortium (BARC) definitions at 30 day follow-up.

Results

A total of 88 patients were included with a median age of 84 years [81.8–87], 42% being female, the median STS score was 5.1 [4.1–7.5], the median CHADS2-VASc was 5.5 [5–6] and 60.2% had a chronic kidney failure. Median INR at time of implantation was at 2.1 [1.8–2.6]. VKA were used for atrial fibrillation (89.8%), mechanic mitral prosthesis (5.7%) or venous thromboembolic disease (4.5%). Trans femoral access was used in 88.6% of the patients. Major bleeding (BARC ≥3b) occurred in 5 patients (5,7%) and major vascular complications occurred in 7 patients (8%). Peripheral arterial disease (RR = 10.95; 95% CI: 1.63 to 73.75; p=0.014) and carotid access (RR=8.56; 95% CI: 1.19 to 61.51; p=0.033) were significantly associated with major bleeding. INR >2.5 was significantly associated with vascular complications (RR=7.14; 95% CI: 1.29 to 39.63; p=0.025). In multivariate analysis, Body mass index (OR=1.26; 95% CI: 1.02 to 1.57; p=0.032) and INR >2.5 (OR=18.91; 95% CI: 1.62 to 221.26; p=0.010) were independent factor significantly associated with vascular complications or major bleeding. Mortality rate at 30 days follow-up was 2.3%, there was no myocardial infarction and stroke rate was 4.5%.

Figure 1. Study flowchart

Conclusion

TAVI with uninterrupted VKA treatment seems to be feasible and safe with low risk of bleeding and vascular complications in this first single centre experience. Particular caution is advocated in low BMI patients and to keep INR<2.5.

Redox Systemic Signaling and Induced Tolerance Responses During Soybean-Bradyrhizobium japonicum Interaction: Involvement of Nod Factor Receptor and Autoregulation of Nodulation

The symbiotic relationship between legumes and nitrogen-fixing rhizobia induces local and systemic responses, which ultimately lead to nodule formation. The autoregulation of nodulation (AON) is a systemic mechanism related to innate immunity that controls nodule development and involves different components ranging from hormones, peptides, receptors to small RNAs. Here, we characterized a rapid systemic redox changes induced during soybean-Bradyrhizobium japonicum symbiotic interaction. A transient peak of reactive oxygen species (ROS) generation was found in soybean leaves after 30 min of root inoculation with B. japonicum. The ROS response was accompanied by changes in the redox state of glutathione and by activation of antioxidant enzymes. Moreover, the ROS peak and antioxidant enzyme activation were abolished in leaves by the addition, in either root or leaf, of DPI, an NADPH oxidase inhibitor. Likewise, these systemic redox changes primed the plant increasing its tolerance to photooxidative stress. With the use of non-nodulating nfr5-mutant and hyper-nodulating nark-mutant soybean plants, we subsequently studied the systemic redox changes. The nfr5-mutant lacked the systemic redox changes after inoculation, whereas the nark-mutant showed a similar redox systemic signaling than the wild type plants. However, neither nfr5- nor nark-mutant exhibited tolerance to photooxidative stress condition. Altogether, these results demonstrated that (i) the early redox systemic signaling during symbiotic interaction depends on a Nod factor receptor, and that (ii) the induced tolerance response depends on the AON mechanisms.

91 Can propylene glycol modulate insulin and insulin-like growth factor-1 in superovulated dairy heifers?

The aim of this study was to determine the effect of propylene glycol (PPG) on serum concentrations of insulin and insulin-like growth factor (IGF)-1 in superovulated dairy heifers. We hypothesised that administration of PPG would have a positive effect on superovulation results via increased insulin and IGF-1. A total of 20 clinically healthy Holstein heifers with an average age of 12 months were used for this experiment. Superovulation was performed using a standard protocol. Briefly, each heifer received 3mg of oestradiol-17β IM and an intravaginal progesterone-releasing insert (CIDR) containing 1.9g of progesterone at random stages of the oestrous cycle (designated Day 0). From Day 4 to 8, heifers received a total of 200mg of NIH-follicle-stimulating hormone-P1 administered intramuscularly through 9 injections of decreasing doses (from 50 to 10mg) at 12-h intervals. On Day 7, heifers received 2 injections of 500µg of cloprostenol, a PGF2α analogue, at ~6-h intervals, after which intravaginal inserts were removed. Artificial insemination was performed on Day 10, 12h after treatment with 100µg of gonadotropin-releasing hormone IM. Embryos were flushed from the uterus of donor heifers 6 days after AI. The method consisted of simultaneously using 1 catheter per uterine horn. Catheters were maintained in place to perform 2 flushes 1h apart. A total of 1L of flushing medium was used, 700 and 300mL for the first and the second flush, respectively. Embryos were assessed for viability immediately after collection using the IETS classification. Heifers were divided into 2 groups (PPG and control group). From Day 4 to 14 of the superovulation protocol, PPG group received a daily dose of 400mL of a 66.7% propylene glycol solution, whereas the control group received the same amount of water. Two months later, the same experiment was conducted by inverting the groups. At Day 4 and 14, four blood samples were collected to measure insulin and IGF-1 at 25-min intervals. The first sample (0) was taken before heifers received PPG or water. Insulin was analysed using an ELISA kit following manufacturer’s instructions, whereas IGF-1 was determined using a chemiluminescence immunoassay. Embryo associated data were analysed using t-test. Both IGF-1 and insulin data were analysed using a two-way ANOVA, followed by Bonferroni post-hoc test. Treatment with PPG had no effect on the number of transferable embryos (8±5.1v. 7±5.5), degenerated embryos (0.5±0.8v. 1.5±2.4), or unfertilized oocytes (0.3±0.7v. 0.7±1.2) recovered. There was also no effect of PPG on IGF-1 serum concentrations at the beginning (Day 4) or the end (Day 14) of the treatment regimen. However, PPG treatment enhanced (P = 0.02) serum insulin concentrations 50min after administration on Day 4 (10.69 v. 6.88 pmol/L), as well as at 25 (19.58 v. 9.64 pmol/L) and 50min (16.67v. 8.21 pmol/L) on Day 14. It has been suggested that PPG metabolism may stimulate insulin and IGF-1 secretion, which can promote embryo development. However, in the present study, there was no effect of oral doses of PPG on IGF-1. Although higher serum concentrations of insulin were observed after PPG treatment, there was no effect of PPG treatment on the number of transferable embryos recovered following superovulation.