Development and validation of the mindful eating scale (Mind-Eat Scale) in a general population

BACKGROUND

Mindful eating is a concept that is increasingly being used to promote healthy eating. Observational studies have suggested associations with healthier eating behaviors, lower weight status, and favorable cardiovascular biomarkers. However, existing scales assessing mindful eating have some limitations. Our study aimed to develop and validate a scale assessing the level of mindful eating in a general population.

METHODS

The Mind-Eat Scale was developed in four main steps: 1. Generating an initial item pool covering all aspects of mindful eating; 2. Reviewing items with experts and naive individuals; 3. Administering the scale to a large and representative sample from the NutriNet-Santé cohort (N=3,102); 4. Conducting psychometric analyses. Construct validity was assessed using exploratory (EFA) (N1=1,302) and confirmatory (CFA) (N2=1,302, N3=498) factor analyses. Content, discriminant, convergent, and divergent validity, internal consistency, and test-retest reliability were examined.

RESULTS

The initial pool of 95 items was refined to 24 items using EFA. The EFA highlighted six dimensions: Awareness, Non-reactivity, Openness, Gratitude, Non-judgement, and Hunger/Satiety, consisting of four items per dimension. CFAs showed a good fit for first and second-order models. Adequate content validity was confirmed. Discriminant, convergent, and divergent validity were supported by significant differences between subgroups of individuals, and correlations with eating behaviors and psychological well-being scales. The Mind-Eat Scale showed good reliability for all six dimensions, with high McDonald's ω and adequate intraclass correlation coefficients (ICC).

CONCLUSIONS

This study validated the first tool assessing a total mindful eating score and its sub-dimensions in a general population. This scale can be an asset for clinical and epidemiological research on dietary behavior and related chronic diseases.

The association between consideration of future consequences and food intake is mediated by food choice motives in a French adult population

OBJECTIVES

Consideration of future consequences (CFC) distinguishes individuals who adopt behaviours based on immediate needs and concerns from individuals who consider the future consequences of their behaviours. We aimed to assess the association between CFC and diet, and testing the mediating role of food choice motives on this relationship.

DESIGN

Individuals (aged ≥ 18 years) completed the CFC-12 questionnaire in 2014, at least three 24-h dietary records, and a food choice motive questionnaire. A multiple mediator analysis allowed to assess the mediating effect of food choice motives on the cross-sectional association between CFC and diet, adjusted for socio-demographic factors.

SETTING

Data from the NutriNet-Santé cohort study.

PARTICIPANTS

27 330 participants.

RESULTS

CFC was associated with all food choice motives (P < 0·001), with the strongest positive associations for avoidance for environmental reasons, absence of contaminants and health motives and the strongest negative associations for innovation and convenience. Positive total effects were found between CFC and the consumption of healthy food groups (fruits and vegetables, whole-grain foods, legumes), and negative total effects for alcohol, meat and poultry and processed meat (P < 0·001). CFC was positively associated with diet quality (P < 0·001). Across food groups, major mediators of these relationships were higher health (8·4-32·6%), higher environmental (13·7-22·1 %) and lower innovation (7·3-25·1 %) concerns.

CONCLUSIONS

CFC was associated with healthier dietary intake, essentially mediated by a greater motivation of future-oriented participants for self-centred and altruistic outcomes, including health and environment. Focusing on the awareness of future benefits in public health interventions might lead to healthier dietary behaviours.

Cross-sectional and longitudinal associations between self-esteem and BMI depends on baseline BMI category in a population-based study

BACKGROUND

Some studies have reported associations between self-esteem and weight status, but longitudinal data on adults remain scarce. The aim of this population-based study was to analyze the cross-sectional and longitudinal association between self-esteem and body mass index (BMI) and to investigate whether baseline BMI has an impact on this association.

METHODS

In 2016, 29,735 participants aged ≥ 18 years in the NutriNet-Santé cohort completed the Rosenberg Self-Esteem Scale. BMI was self-reported yearly over a 4-year period. Association between self-esteem and BMI was assessed using mixed models and logistic regressions. Analyses were stratified by BMI (categorical) at baseline and adjusted on sociodemographic and lifestyle characteristics.

RESULTS

At baseline, higher self-esteem was associated with higher BMI in normal weight individuals(p = 0.32), and with lower BMI in obese class II and III individuals (p = 0.13). In addition, higher baseline self-esteem was associated with BMI increase over time in normal weight individuals (p = 0.15). Among normal weight individuals, those with higher self-esteem were less likely to show a decrease in their BMI (p = 0.005), while no association was observed with BMI increase (p = 0.81).

DISCUSSION

Our findings suggest that the association between self-esteem and BMI depends on the initial category of BMI, with a negligible effect of self-esteem.

Association between post-operative hPG80 (circulating progastrin) detectable level and worse prognosis in glioblastoma

BACKGROUND

Patients with glioblastomas have a dismal prognosis, and there is no circulating predictive or prognostic biomarker. Circulating progastrin, hPG80, is a tumor-promoting peptide present in the blood of patients with various cancers that has been shown to have prognostic value. We evaluated the prognostic value of plasma hPG80 in patients with isocitrate dehydrogenase-wild type glioblastoma after surgery.

PATIENTS AND METHODS

A multicentric retrospective study in glioblastoma patients treated with standard radio-chemotherapy was conducted. The hPG80 levels were measured in plasma EDTA samples collected after surgery with an ELISA DxPG80.lab kit (Biodena Care, Montpellier, France), which has a detection threshold of 1.2 pM. The relationship between post-operative hPG80 plasma levels, in combination with other known prognostic factors, and patients' progression-free survival (PFS) and overall survival (OS) was evaluated.

RESULTS

Sixty-nine patients were assessable. Plasma samples were collected after tumor biopsy (B), partial resection (PR), and complete resection (CR) for 22, 25, and 22 patients, respectively. At a median concentration of 5.37 pM (interquartile range 0.00-13.90 pM), hPG80 was detected in 48 (70%) patients (hPG80+). CR was associated with significant lower values of hPG80 levels: the median value was 0.7 versus 9.1 pM for PR (P = 0.02) and 8.3 pM for B (P = 0.004). The hPG80 detection rate was also significantly lower: 50% (CR) versus 72% (PR) versus 86% (B) (P = 0.005). The median follow-up was 39 months [22.4 months-not reached]. hPG80 post-operative detection was associated with numerically shorter PFS (6.4 versus 9.4 months, P = 0.13) and OS (14.5 versus 20.9 months, P = 0.11). In multivariate analysis, hPG80 was a prognostic factor for OS (P = 0.034).

CONCLUSIONS

Circulating hPG80 could serve as a new prognostic biomarker after surgery in patients with glioblastoma treated with radio-chemotherapy.

Inequality factors in access to early-phase clinical trials in oncology in France: results of the EGALICAN-2 study

BACKGROUND

Investigation of the disparities in the access to experimental treatment in early-phase clinical trials is lacking. The objective of the EGALICAN-2 study was to identify the factors underpinning such inequalities.

METHODS

A national prospective survey was conducted in 11 early-phase clinical trial centers (CLIP2) certified by the French National Cancer Institute. Sociodemographic, socioeconomic and medical data were collected. Univariate logistic regression models were carried out to estimate odds ratios and 90% confidence intervals associated with the effect of each study variable. A multivariate logistic regression model was built to explore the independent factors associated with the administration of the experimental treatment (C1D1). A post hoc analysis was carried out excluding female cancer patients.

RESULTS

Between 2015 and 2016, 1355 patients referred from 11 CLIP2 centers in France were included in the study. Eight hundred and forty-eight patients received C1D1 (73%) and 320 patients (27%) were screening failure. Median age was 58 years (range 17-97 years) and 667 patients (54%) were female. Most patients had a metastatic disease (n = 751, 87%). In the multivariate logistic regression analysis, the significant independent factors associated with C1D1 were male sex, initial care received in a hospital with an early-phase unit and living in wealthy metropolitan areas (P values <0.05). In the post hoc analysis, the sex factor was no longer significant [odds ratio = 1.21 (95% confidence interval 0.86-1.70), P value = 0.271].

CONCLUSIONS

This study investigated the factors producing social inequalities in the context of early-phase clinical trials in oncology. Our research highlights factors of sex, care pathway and geographic location. Gynecological cancer was found to impact C1D1 significantly, unlike breast cancer. The results of this study should contribute to improve patient access to early-phase clinical trials.

Development and evaluation of automated synovial fluid total cell count on an Iris iQ® 200 for identifying patients at risk of septic arthritis

Septic arthritis is a diagnostic emergency. The white blood cell (WBC) count, in synovial fluid (SF), can guide the diagnosis. From November 2021 to November 2022, we included 350 SF. The WBC count was performed with the Iris iQ® 200 compared with the manual method. Automated and manual counts displayed good correlation. However, a Bland Altman plot demonstrates a higher percentage difference at higher WBC counts. The use of Iris iQ® 200 for SF analysis enables a rapid and accurate assessment for WBC count. Its implementation would advantageously replace the long and tedious optical analysis in daily routine.

Factors influencing bariatric surgery outcomes

The outcomes of bariatric surgery, while often impressive, are not universally satisfactory; they vary from patient to patient and from operation to operation. Between 20-30% of patients experience suboptimal weight loss or substantial weight regain early in their postoperative course. Confronted with this chronic disease, and given that failures are difficult to manage, it is essential to better characterize obesity preoperatively, considering other metrics beyond just the body mass index (BMI), to select the best candidates for surgery and optimize the benefit/risk ratio. Based on the data of the most recent studies on bariatric surgery, our objective is to identify the predictive factors of weight loss as well as the risk factors of failure. Our analysis indicates that the choice of the surgical technique, age, initial BMI, ethnic origin, the presence of eating disorders and metabolic factors all have an impact on weight-loss outcomes after bariatric surgery. Thus, it is of major importance to carefully select patients during a preoperative multidisciplinary discussion in order to optimize weight loss and metabolic outcomes.

Which typical floor movements of men's artistic gymnastics result in the most extreme lumbar lordosis and ground reaction forces?

Back pain is prevalent among gymnast populations and extreme flexion or extension of the lumbar spine along with high ground reaction forces (GRFs) are known to increase intervertebral stress. The aim of this study was to determine which postures and dynamic conditions among common floor movements provide the greatest risk of injury in men's artistic gymnastics (MAG). For this purpose, lumbar spine curvatures, obtained through a full-body subject-specific kinematic model fed by motion capture data, and GRFs on feet and hands were compared between typical floor movements of MAG (pike jump, round off back handspring, front handspring, forward and backward tucked somersaults) performed by six adolescent gymnasts. The round off back handspring and the pike jump resulted respectively in the largest lumbar extension and flexion, and the forward tucked somersault take-off in the highest GRF. At ground impacts, the largest lumbar flexion was during the backward tucked somersault landing and only the back handspring hands ground contact phase led to lumbar extension. Such identification of high-risk conditions should enable better back pain management in gymnastics through more tailored training adaptations, particularly in case of pathologies or musculoskeletal specificities.

Sleep decreases neuronal activity control of microglial dynamics in mice

Microglia, the brain-resident immune cells, are highly ramified with dynamic processes transiently contacting synapses. These contacts have been reported to be activity-dependent, but this has not been thoroughly studied yet, especially in physiological conditions. Here we investigate neuron-microglia contacts and microglia morphodynamics in mice in an activity-dependent context such as the vigilance states. We report that microglial morphodynamics and microglia-spine contacts are regulated by spontaneous and evoked neuronal activity. We also found that sleep modulates microglial morphodynamics through Cx3cr1 signaling. At the synaptic level, microglial processes are attracted towards active spines during wake, and this relationship is hindered during sleep. Finally, microglial contact increases spine activity, mainly during NREM sleep. Altogether, these results indicate that microglial function at synapses is dependent on neuronal activity and the vigilance states, providing evidence that microglia could be important for synaptic homeostasis and plasticity.

Validation of the Flexible and Rigid Cognitive Restraint Scales in a General French Population

Distinguishing between flexible and rigid cognitive restraint (CR) may be useful for understanding the role of CR in dietary behavior and weight status. This study aimed to translate and adapt the flexible and rigid CR scales to the French context and test their psychometric properties. Construct validity, internal consistency, and test-retest reliability were examined in a sample of 620 individuals. Confirmatory factor analysis of the scales found a two-factor structure (flexible CR: 12 items; rigid CR: 15 items) that provided a good fit and supported the initial solution (χ² = 584.7, df = 322, CFI = 0.96, RMSEA = 0.052 [0.045, 0.059], TLI = 0.95). Higher flexible and rigid CR were associated with higher CR overall, emotional eating (TFEQ-R21) and eating disorders (SCOFF), and lower intuitive eating (IES-2). In addition, higher flexible CR was associated with lower impulsivity (BIS-11) while higher rigid CR was associated with higher uncontrolled eating (TFEQ-R21) and lower self-esteem (RSES), satisfaction with life (SWLS), and optimism (LOT-R). Flexible and rigid CR internal consistency was satisfactory (McDonald ω = 0.77 and 0.74, respectively) and test-retest reliability was good (ICC = 0.81 and 0.79, respectively). This study validated a flexible and rigid CR tool in a French population and confirmed that these two types of CR represent distinct eating behaviors.

Associations between Resilience and Food Intake Are Mediated by Emotional Eating in the NutriNet-Santé Study

BACKGROUND

Resilience, the ability to bounce back or recover from stress, has been associated with several health-related behaviors. However, data on food intake and emotional eating are lacking.

OBJECTIVES

The objective of this cross-sectional study was to analyze the associations between resilience and diet quality and ultraprocessed food (UPF) and food group consumption, and to assess whether emotional eating was a mediator of these associations.

METHODS

In 2017, 17,840 participants (73.5% female, mean age = 55.4 ± 14.0 y) of the NutriNet-Santé study completed the Brief Resilience Scale, the revised 21-item Three-Factor Eating Questionnaire, and ≥3 self-administered 24-h dietary records. Diet quality was assessed with the modified French National Nutrition and Health Program Guideline Score. Foods and beverages consumed were categorized according to their degree of processing by the NOVA classification. We assessed the association between resilience and emotional eating using linear regression models. We also assessed the mediating role of emotional eating in the associations between resilience and diet quality, energy intake, and UPF and food group consumption, controlling for sociodemographic characteristics.

RESULTS

In our study, resilience was negatively associated with emotional eating (P < 0.0001). More resilient participants had greater overall diet quality, greater intakes of seafood, whole-grain foods, fats, unsalted oleaginous fruits, and alcoholic beverages, and lower intakes of UPFs, starchy foods, dairy desserts, sugary fatty products, and sugar and confectionery (all P < 0.05). Emotional eating was a mediator of the inverse associations between resilience and intake of energy, UPFs, dairy desserts, sugary fatty products, and of the positive associations between resilience and alcoholic beverages (all P < 0.05), with a 20-70% mediation.

CONCLUSIONS

Our findings showed that resilience was associated with an overall better diet quality in the NutriNet-Santé population-based study. These associations were partially explained by emotional eating. These findings suggest that resilience should be considered in the promotion of healthy dietary habits.The study is registered at clinicaltrials.gov as #NCT03335644.

Impact of myocardial injury on regional left ventricular function in the course of acute myocarditis with preserved ejection fraction: insights from segmental feature tracking strain analysis using cine cardiac MRI

The aim of this study was to provide insights into myocardial adaptation over time in myocyte injury caused by acute myocarditis with preserved ejection fraction. The effect of myocardial injury, as defined by the presence of late gadolinium enhancement (LGE), on the change of left ventricular (LV) segmental strain parameters was evaluated in a longitudinal analysis. Patients with a first episode of acute myocarditis were enrolled retrospectively. Peak radial (PRS), longitudinal (PLS) and circumferential (PCS) LV segmental strain values at baseline and at follow-up were computed using feature tracking cine cardiac magnetic resonance imaging. The change of segmental strain values in LGE positive (LGE+) and LGE negative (LGE-) segments was compared over a course of 89 ± 20 days. In 24 patients, 100 LGE+ segments and 284 LGE- segments were analysed. Between LGE+ and LGE- segments, significant differences were found for the change of segmental PCS (p < 0.001) and segmental PRS (p = 0.006). LGE + segments showed an increase in contractility, indicating recovery, and LGE- segments showed a decrease in contractility, indicating normalisation after a hypercontractile state or impairment of an initially normal contracting segment. No significant difference between LGE+ and LGE- segments was found for the change in segmental PLS. In the course of acute myocarditis with preserved ejection fraction, regional myocardial function adapts inversely in segments with and without LGE. As these effects seem to counterbalance each other, global functional parameters might be of limited use in monitoring functional recovery of these patients.

[National protocol for diagnosis and care of congenital aniridia: Summary for the attending physician]

Congenital aniridia is a rare panocular disease defined by a national diagnostic and care protocol (PNDS) validated by the HAS. In most cases, it is due to an abnormality in the PAX6 gene, located at 11p13. Aniridia is a potentially blinding autosomal dominant disease with high penetrance. The prevalence varies from 1/40,000 births to 1/96,000 births. Approximately one third of cases are sporadic. Ocular involvement includes complete or partial absence of iris tissue, corneal opacification with neovascularization, glaucoma, cataract, foveal hypoplasia, optic disc hypoplasia and ptosis. These ocular disorders coexist to varying degrees and progress with age. Congenital aniridia manifests in the first months of life as nystagmus, visual impairment and photophobia. A syndromic form such as WAGR syndrome, WAGRO syndrome (due to the risk of renal Wilms tumor) or Gillespie syndrome (cerebellar ataxia) must be ruled out. Systemic associations may include diabetes, due to expression of the PAX6 gene in the pancreas, as well as other extraocular manifestations. Initial assessment is best carried out in a referral center specialized in rare ophthalmologic diseases, with annual follow-up. The management of progressive ocular involvement must be both proactive and responsive, with medical and surgical management. Visual impairment and photophobia result in disability, leading to difficulties in mobility, movement, communication, learning, fine motor skills, and autonomy, with consequences in personal, school, professional, socio-cultural and athletic life. Medico-socio-educational care involves a multidisciplinary team. Disability rehabilitation must be implemented to prevent and limit situations of handicap in activities of daily living, relying on the Commission for the Rights and Autonomy of People with Disabilities (CDAPH) within the Departmental House of People with Disabilities (MDPH). The general practitioner coordinates multidisciplinary medical and paramedical care.

Access to early-phase clinical trials in older patients with cancer in France: the EGALICAN-2 study

Background

Patients and methods

Results

Conclusions

•

Older patients are underrepresented in early-phase clinical trials (17.7%) compared with the number of new cases (50%).

•

The rate of signed informed consent was similar across age groups (92.7% in younger patients versus 90.6% in older patients).

•

The rate of screening failure was consistent across all age groups (28.5% in younger patients versus 24.3% in older patients).

•

In older patients the initial care received in the center having a phase I unit was associated with study drug administration.

POS0490 USEFULNESS OF MHC-II IMMUNO-STAINING ON MUSCLE BIOPSIES IN IDIOPATHIC INFLAMMATORY MYOPATHIES

Background

Idiopathic inflammatory myopathies (IIMs) constitute a group of acquired muscular diseases that occur during childhood and adulthood, exhibit a variety of phenotypes and are potentially life-threatening. IIM diagnosis considers clinical, serological, and histological data. Muscle pathological analysis of IIM patients gives relevant elements for the diagnosis (immune cell infiltrate, vascular and connective tissues, as well as myofiber morphology). Immunochemistry (IHC) labeling for major histocompatibility complex class I (MHC-I), and C5b9, that are negative in normal muscle, appeared of interest in IIM diagnosis and the understanding of IIM pathogenesis. In normal muscle, myofibers are negative for MHC-II IHC. Its interest in the neuropathological exam of IIM muscle remains to be better characterized.

Objectives

This study aims to analyze the pattern of MHC-II expression in various IIMs.

Methods

A historical cohort was designed using the MYOLYON register (IIM patients diagnosed between 2016 and 2020 at the University Hospital of Lyon, France). Inclusion criteria were IIM diagnosis that was established histologically and available frozen muscle samples for additional analyses. Exclusion criterium was any treatment before muscle biopsy. Demographical data and final diagnosis were collected retrospectively from medical records. A centralized, standardized, and blind analysis of muscle MHC-II immuno-staining was conducted to define the various patterns of MHC-II by myofibers and by capillaries. The study complied with ethical requirements.

Results

Seventy-three patients were included: 23 dermatomyositis (DM), 13 anti-synthetase syndrome (ASS), 13 immune-mediated necrotizing myopathies (IMNM), 13 inclusion body myositis (IBM), and 11 overlap myositis (OM). MHC-II immuno-staining of myofibers or capillaries was abnormal for 91.8% of the analyzed biopsies (Figure 1). The analysis of MHC-II myofiber immuno-staining revealed distinguishable patterns according to IIM subtype: the labeling was diffuse in IBM (69.2%, n=9/13), perifascicular in ASS (61.5%, n=8/13), and variable in OM (patchy for 27.3% n=3/11 or clustered for 36.4%, n=4/11). MHC-II immuno-staining was negative in IMNM (84.6%, n=11/13) and in DM (47.8%, n=11/23). DM exhibiting positive MHC-II myofibers (n=12) were associated with the presence of anti-TIF1γ, anti-NXP2 and anti-SAE auto antibodies (n=5, n=3 and n=2, respectively). Among the 12 patients, there were juvenile cases (n=5, 41.7%) or DM associated with ongoing neoplasia (n=4, 33.3%). Three main architectures were described for capillaries: giant, leaky and capillary dropout. Patterns of MHC-II positive capillaries were the following: DM was characterized by capillary dropout (68.2%), IMNM showed leaky capillaries (75.0%), IBM giant capillaries (66.7%), ASS exhibited both giant (61.5%) and/or leaky (58.3%) capillaries, while OM showed giant (63.6%) or/and leaky (80.0%) capillaries and capillaries dropout (60.0%).

Conclusion

The present work establishes the usefulness of MHC-II immuno-staining for IIM diagnosis, and gives additional elements on the impairment of myofibers and capillaries in the various IIM subgroups. MHC-II expression is known to be induced by inflammatory cytokine such as interferon type II. This could be linked to myofiber and/or capillary impairment in some IIMs, such as IBM, ASS and OM. These results also support the implication of vasculopathy in IIM pathogenesis, with various structural and cellular consequences regarding the different subgroups. Finally, MHC-II immuno-staining in IIM muscle biopsies enables a foremost analysis of myofibers and capillaries, and represents an additional biomarker to distinguish IIM subgroups.

References

[1]De Bleecker, J.L. et al. 205th ENMC International Workshop: Pathology diagnosis of idiopathic inflammatory myopathies part II 28-30 March 2014, Naarden, The Netherlands. Neuromuscul Disord 2015, 25, 268-272.

Disclosure of Interests

None declared.

AB0143 CHARACTERIZATION OF CELLULAR INFILTRATE IN TEMPORAL ARTERITIS USING IMAGING MASS CYTOMETRY IN GIANT CELL ARTERITIS

Background

Imaging mass cytometry (IMC) is a high-plex imaging technique that incorporates flow cytometry principles while preserving the histological and architectural components of the tissue sample. Characterizing the entire cellular component of temporal artery (TA) in patients with giant cell arteritis (GCA) may provide clues towards novel diagnostic and therapeutic approaches.

Objectives

We aimed at a comprehensive summary of the immune cells and pathways involved GCA by using IMC approach.

Methods

TA samples from biopsy-proven GCA patients (n=2) and controls (CTLs, n=2) were analyzed using IMC with a panel of 15 staining antibodies.

Results

Eleven cell populations were identified in arterial wall from GCA patients including both immune (CD20+ B cells, CD8+ T cells, CD4+ T cells, FOXP3+ Tregs, CD66b+ granulocytes, CD11b+ myeloid cells, CD14+ monocytes, CD68+ macrophages) and non-immune (aSMA+ smooth muscle cells, CD31+ endothelial cells, Vimentin+ fibroblasts) cells (Figure 1). The 3 layers (intima, media and adventitia) of the arterial wall was enriched by all the immune cell subsets in GCA except for granulocytes and myeloid cells. CD8+, CD4+ and FOXP3+ regulatory T cells were significantly increased in any layer of the TA. The proportion of B cells was also enhanced in both intima and adventitia and displayed a high level of Ki67 expression.

Figure 1.

Unbiased clustering of cellular infiltrate in temporal arteritis using Imaging Mass Cytometry.

Heatmap of different cell type markers expressed by the 11 cell populations identified in the arterial wall of GCA patients: CD20+ B cells, CD8+ T cells, CD4+ T cells, FOXP3+ Tregs, CD66b+ granulocytes, CD11b+ myeloid cells, CD14+ monocytes, CD68+ macrophages, Vimentin+ fibroblasts, aSMA+ smooth muscle cells and CD31+ endothelial cells. A population of unidentified cells is also represented (A). Donut chart representing the relative composition of immune cells in the arterial wall of GCA patients (B). tSNE dimensional plots of the different cell clusters identified in the arterial wall of CTL and GCA patients (C). Percent and Heatmap of immune cells identified in the arterial wall of each patient (D).

GCA: giant cell arteritis, CTL: controls, Tregs: regulatory T cells.

Conclusion

Our study provides an exhaustive overview of the distinct cell lineages involved in GCA and supports IMC approach to further characterize the immune networks active in GCA.

Disclosure of Interests

None declared

POS0862 INAUGURAL DROPPED HEAD SYNDROME AND CAMPTOCORMIA IN INFLAMMATORY MYOPATHIES

Background

The idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of diseases that can affect the muscles, skin, lungs, heart, and joints. Increase knowledge about histopathological findings, clinical manifestations and auto-antibodies have allowed further novel classification of IIMs. Today, the main IMs subgroups are: dermatomyositis (DM), inclusion body myositis (IBM), immune-mediated necrotizing myopathies (IMNM), overlap myositis (OM) and immune-checkpoint inhibitor-related myositis (ICIrm). Axial muscle involvement results either in a “Dropped Head Syndrome (DHS)”, with a marked weakness of the neck extensors, or in a camptocormia (CC), with a weakness of the thoracolumbar paraspinal muscles. This atypical presentation is poorly described in the course of IMs while it may results in a major disability, and may lead to myositis diagnosis delay.

Objectives

This study aimed to describe IMs revealed by DHS and/or CC. Secondary outcomes were to define subgroups of patients according to clinical, biological and histopathological characteristics. Then, the effects of treatments used were analyzed.

Methods

A historical cohort was designed using the register MYOLYON which includes all IMs followed at the University Hospital of Lyon (France) between 2000 and 2021. All patients with IM revealed by DHS and/or CC and having an histologically proven IMs were included, after exclusion of alternative (e.g., myasthenia gravis, motoneuron disease). Clinical, biological, immunological, histopathological data as well as outcome and care were collected through a standardized form. Agreement for the study was obtained from the French Ministry of the Research and the study was approved by the Local Research Ethics Committee.

Results

Twenty-two patients were fully characterized: DM (n=4), IBM (n=7), OM (n=8), ICIrm (n=2) and one myositis with anti-Hu antibodies. Two groups of patients were identified according to the age at first symptoms and to the type of muscle axial involvement (e.g, DHS and/or CC). Before the age of 70 (n=13/22), the two most common diagnoses (n=11/13) were DM (n=4/4) and OM (n=7/8). Axial muscle involvement was diffuse (DHS and CC) in 10/13 patients. After 70 years old (n=9/22), there were a majority of IBM (n=6/9) and all cases of ICIrm (n=2). Axial involvement was restricted to one group of muscles (DHS or CC) in 5/9 patients. Finally, 77% (17/22) of patients had refractory disease and required a second line treatment (e.g, immunoglobulins). All of these results are summarized in the Figure 1.

Figure 1.

Conclusion

While IM diagnosis is challenging in the presence of inaugural axial involvement, these results highlight the subset of IM to be considered according to the age at first symptoms and the type of axial involvement (e.g., DHS and/or CC).

References

[1]Mariampillai, K. et al. Development of a New Classification System for Idiopathic Inflammatory Myopathies Based on Clinical Manifestations and Myositis-Specific Autoantibodies. JAMA Neurol75, 1528-1537 (2018).

[2]Landon-Cardinal, O. et al. Recognising the spectrum of scleromyositis: HEp-2 ANA patterns allow identification of a novel clinical subset with anti-SMN autoantibodies. RMD Open6 (2020).

[3]Suarez, G.A. & Kelly, J.J., Jr. The dropped head syndrome. Neurology42, 1625-1627 (1992).

[4]Oerlemans, W.G. & de Visser, M. Dropped head syndrome and bent spine syndrome: two separate clinical entities or different manifestations of axial myopathy? J Neurol Neurosurg Psychiatry65, 258-259 (1998).

Disclosure of Interests

None declared

POS1325 CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS (CRMO): NEW INSIGHTS INTO EXTRA-OSSEOUS MANIFESTATIONS

Background

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare inflammatory disease of the skeleton characterized by chronic and recurrent episodes of osteo-articular inflammation. The median age of onset is 10 years old. Clinical manifestations include musculoskeletal symptoms that are well described (pain, tenderness, swelling). Sometimes, skin lesions or digestive manifestations occur. Whole body magnetic resonance imaging (MRI) is the gold standard for assessing the multifocal pattern of the CRMO. Treatment is still empirical and mainly relies on non-steroidal anti-inflammatory drugs (NSAIDs). Bisphosphonates and biologics are used as second-line treatments. To date, the focus has been set on bone involvement and very few data are available on extra-osseous manifestations in CRMO.

Objectives

This study aims to further describe these extra-osseous clinical manifestations in CRMO.

Methods

A historical cohort was designed using 61 CRMO patients at the Pediatric Rheumatology Department in a tertiary university hospital in Paris (Hôpital Bicêtre, France). All patients underwent a MRI that confirmed the diagnosis according to the criteria of Jansson. Skeletal involvement was characterized with 1/axial, 2/ peripheral, 3/ axial and peripheral lesions. Extra-osseous manifestations were divided into 1/ skin lesions, 2/ gastro-intestinal manifestations, 3/ enthesitis and 4/ others. Pain was evaluated thanks to the Visual Analog Scale (VAS, from 0 to 10). Treatments used were recorded. The study complied with ethical requirements.

Results

Forty one patients were included in the study, with 31 females (75.6%). The mean ± SD age at onset was 79.1 ± 59.8 months, with a delay at diagnosis beyond six months (6.71 ± 6.96). Twenty-one patients had a familial history of inflammatory diseases (51.2%), with a majority of psoriasis or ankylosing spondylitis (n=13/21, 61.9%). At diagnosis, the level of pain was 5.71 ± 3.24. Eleven patients (42.3%) had blood inflammation. Bone lesions were reviewed thanks to whole body MRI: four patients had isolated axial involvement (10.0%), nine had peripheral involvement (22.5%) and 27 patients harbored both types of lesions (67.5%). The mean number of lesions was 6.65 ± 4.23. After 12 months of follow-up, all parameters regarding disease’s activity decreased (pain, blood inflammation, number of lesions). Regarding extra-osseous symptoms, fever occurred in seven patients (17.1%). Twenty-four patients had skin manifestations (58.5%) with palmoplantar lesions (n=3, 12.5%), acne (n=6, 25.0%), psoriasis (n=5, 20.8%) and aphthous (n=10, 41.7%). Four patients (9.76%) had gastro-intestinal symptoms and seven (17.1%) had enthesitis. One patient had uveitis. Almost all patients received NSAIDs (n=39/41, 95.1%) and half of the cohort were treated with bisphosphonates (n=21/41, 51.2%). Nine patients (22.0%) received biologics with a majority of TNF inhibitors. All patients that received TNF inhibitors had either a cutaneous involvement or digestive symptoms or enthesitis (Figure 1).

Conclusion

Extra-osseous manifestations have to be carefully searched in CRMO, especially in the presence of familial history of inflammatory diseases. While the severity of bone involvement can lead to use bisphosphonates, the introduction of biologics seems to rely on extra-osseous symptoms. These conclusions are drawn on a retrospective study and need to be confirmed in larger cohort.

References

[1]Wipff J, et al. A large national cohort of French patients with chronic recurrent multifocal osteitis. Arthritis Rheumatol 67, 1128-1137 (2015).

[2]Jansson A, et al. Classification of Non-Bacterial Osteitis: Retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatology 46, 154-160 (2006).

Disclosure of Interests

None declared

Mastery Is Associated With Weight Status, Food Intake, Snacking, and Eating Disorder Symptoms in the NutriNet-Santé Cohort Study

Mastery is a psychological resource that is defined as the extent to which individuals perceive having control over important circumstances of their lives. Although mastery has been associated with various physical and psychological health outcomes, studies assessing its relationship with weight status and dietary behavior are lacking. The aim of this cross-sectional study was to assess the relationship between mastery and weight status, food intake, snacking, and eating disorder (ED) symptoms in the NutriNet-Santé cohort study. Mastery was measured with the Pearlin Mastery Scale (PMS) in 32,588 adults (77.45% female), the mean age was 50.04 (14.53) years. Height and weight were self-reported. Overall diet quality and food group consumption were evaluated with ≥3 self-reported 24-h dietary records (range: 3-27). Snacking was assessed with an ad-hoc question. ED symptoms were assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF). Linear and logistic regression analyses were conducted to assess the relationship between mastery and weight status, food intake, snacking, and ED symptoms, controlling for sociodemographic and lifestyle characteristics. Females with a higher level of mastery were less likely to be underweight (OR: 0.88; 95%CI: 0.84, 0.93), overweight [OR: 0.94 (0.91, 0.97)], or obese [class I: OR: 0.86 (0.82, 0.90); class II: OR: 0.76 (0.71, 0.82); class III: OR: 0.77 (0.69, 0.86)]. Males with a higher level of mastery were less likely to be obese [class III: OR: 0.75 (0.57, 0.99)]. Mastery was associated with better diet quality overall, a higher consumption of fruit and vegetables, seafood, wholegrain foods, legumes, non-salted oleaginous fruits, and alcoholic beverages and with a lower consumption of meat and poultry, dairy products, sugary and fatty products, milk-based desserts, and sweetened beverages. Mastery was also associated with lower snacking frequency [OR: 0.89 (0.86, 0.91)] and less ED symptoms [OR: 0.73 (0.71, 0.75)]. As mastery was associated with favorable dietary behavior and weight status, targeting mastery might be a promising approach in promoting healthy behaviors.

Clinical Trial Registry Number

NCT03335644 at Clinicaltrials.gov.

Les traits psychologiques positifs sont associés aux changements de comportement alimentaire liés au confinement du COVID-19 dans la cohorte NutriNet-Santé

Introduction et but de l’étude

La propagation du coronavirus (COVID-19) a eue pour conséquence la mise en place de mesures strictes de confinement, ayant entraîné des changements dans les comportements alimentaires. Les traits psychologiques sont des déterminants bien connus du comportement alimentaire. L’objectif de cette étude était donc d’étudier les associations entre les traits psychologiques positifs et les changements dans le grignotage et la consommation de groupes alimentaires pendant la période du confinement.

Méthodes

En 2016, les niveaux d’optimisme, de résilience, d’estime de soi, de satisfaction de la vie, de pleine conscience et de maîtrise ont été mesurés chez 33 766 adultes de la cohorte NutriNet-Santé. Le grignotage et la consommation de groupes d’aliments ont été évalués en avril–mai 2020. L’association entre les traits psychologiques et les changements dans le grignotage et la consommation de groupes alimentaires a été évaluée à l’aide de régressions logistiques, ajustées sur les caractéristiques sociodémographiques et le mode de vie, l’anxiété et la symptomatologie dépressive.

Résultats

Les participants présentant des niveaux plus élevés d’optimisme, de résilience, d’estime de soi, de satisfaction de la vie, de pleine conscience ou de maîtrise étaient moins susceptibles d’avoir des changements dans leur comportement de grignotage et leur consommation de divers groupes alimentaires.

Conclusion

Les personnes présentant des niveaux de traits psychologiques plus élevés ont été moins affectées par le confinement en termes de comportement alimentaire, alors que les personnes ayant des niveaux plus faibles ont montré des changements favorables et défavorables dans leur comportement alimentaire global.

Resilience Is Associated with Less Eating Disorder Symptoms in the NutriNet-Santé Cohort Study

Resilience is a positive psychological trait associated with a lower risk of some physical and mental chronic diseases and could be an important protective factor against eating disorders (EDs). The aim of this study was to assess cross-sectional and longitudinal associations between resilience and ED in a large cohort of French adults. In 2017, a total of 25,000 adults from the NutriNet-Santé cohort completed the Brief Resilience Scale (BRS). ED symptoms were measured in 2017 and 2020, with the Sick-Control-One-Fat-Food (SCOFF) questionnaire. Cross-sectional and longitudinal associations between resilience and EDs were analyzed using logistic regression, controlling for sociodemographic and lifestyle characteristics. Cross-sectional analyses showed that more resilient participants exhibited EDs less frequently than did less resilient participants (p < 0.0001). Longitudinal analyses showed that, during the three years of follow up, higher resilience was negatively associated with incident EDs (OR: 0.67, 95%CI: 0.61–0.74), persistent EDs (0.46 (0.42–0.51)), and intermittent EDs (0.66 (0.62–0.71)), compared with no ED. More resilient participants were also less likely to have a persistent ED than to recover from EDs (0.73 (0.65–0.82)). This study showed that resilience was associated with less ED symptoms and a higher chance of recovery.

Association between positive psychological traits and changes in dietary behaviour related to first COVID-19 lockdown: A general population-based study

Background

The spread of the coronavirus disease (COVID-19) led many countries to implement lockdown measures, which resulted in changes in dietary behaviours that could persist over the long term and have associated health consequences. Psychological traits may impact these changes given their known association with dietary behaviours. We aimed to investigate in a population-based study, whether positive psychological traits were associated with changes of snacking behaviour and food consumption observed during the first COVID-19 lockdown period.

Design

In 2016, levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness and mastery were assessed in 33,766 adults of the French NutriNet-Santé cohort. Snacking and food group consumption were assessed in April–May 2020. Association between psychological traits and changes (no change, increase, decrease) in snacking and food group consumption were assessed using logistic regressions. Multiple correspondence analysis followed by ascending hierarchical classification were used to derive clusters of dietary behaviours. Covariance analyses were used to compare mean scores of psychological traits between clusters. Analyses were adjusted for sociodemographic and lifestyle characteristics, anxiety and depressive symptomatology.

Results

Participants with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less likely to change their snacking behaviour and food group consumption of various food groups. Individuals with lower levels were more likely to make changes, with either unhealthy (e.g., less fruits and vegetables, more processed meat) or healthy (e.g., more pasta/rice (whole-grain)) changes. Overall, individuals showed higher levels of positive psychological traits in the “no change” cluster, followed by the “healthy” and the “unhealthy” cluster (all P < 0.05).

Conclusions

Individuals with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less impacted by the lockdown in terms of dietary behaviours.

[Importance of cognitive disorders in internal medicine: Pathophysiology, diagnosis, management. The example of systemic lupus erythematosus]

Systemic diseases, which are in France mainly monitored in internal medicine, affect multiple organs or tissues. While cutaneous or articular manifestations are the most common, neurological involvement is often associated with severity. Diagnosis of peripheral (e.g, neuropathies) or central (e.g, myelitis) nervous disorders is quite easy through clinical examination and dedicated complementary tests. However, neuropsychological manifestations that affect cognition, including memory, attention, executive functions or reasoning, are difficult to diagnose, sometimes trivialized by practitioners. Their causes are often numerous and interrelated. Nevertheless, these cognitive manifestations are closely related to patients' quality of life, affecting their social life, family dynamics and professional integration but also the treatment adherence. The purpose of this review, focused on the example of systemic lupus erythematosus, is to raise awareness of cognitive dysfunction in systemic diseases including their management from diagnosis to treatments. The final aim is to go further into setting up research groups and care programs for patients with cognitive impairment followed in internal medicine.

P04.15 Radiomics features in prediction of pseudo-progression and response to hypofractionated stereotactic radiotherapy and anti-PDL1 Durvalumab combination in recurrent glioblastoma from STERIMGLI phase I trial

BACKGROUND

Due to the risk of pseudo-progression, evaluating the response of such combined treatment with anti-PDL1 immunotherapy and hypofractionated stereotactic radiotherapy (hFSRT) in patients with recurrent glioblastoma (GBM) is difficult even with iRANO criteria. We aim to analyze multi-modal MRI radiomic features in recurrent GBM patients included in the phase I STERIMGLI (NCT02866747) clinical trial.

MATERIAL AND METHODS

In phase I trial STERIMGLI, six patients received hFSRT 24 Gy in 3 fractions of 8 Gy prescribed to the 80% covering isodose in combination with Durvalumab IV 1500mg the same day following the third fraction of radiation then every 4 weeks for a maximum of 12 months. All patients underwent multi-modal MRI acquisitions. Contrast-enhancement on post-gadolinium T1 MRI (Gd-T1) and hyper-T2 signal on FLAIR MRI were manually segmented as volume-of-interest (VOIs) from baseline at week 0 (W0) and every eight weeks until weeks sixteen (W16). For patient 05, segmentation was performed until progression (W40). First order radiomics were extracted and normalized from these longitudinal VOIs in a total of 42 MRI: volume (in cm3), mean and median intensity, entropy, skewness and kurtosis were computed for each VOI. In total 504 (2 x 42 x 6) features were extracted.

RESULTS

Two patients underwent pseudoprogression (patients 04 and 05).

All patients but one (patient 05) presented an early relapse with an increase of FLAIR and Gd-T1 volumes and respective entropies from the first evaluation without decrease during follow up (until W16).

Patient 05 presented a Dose Limiting Toxicities and had the longest time to progression after Durvalumab and hFSRT. Contrary to the other patients, his FLAIR radiomics features presented a decrease of volume, intensity and entropy between W0 and W16 then, interestingly an increase between W24 and W40, date of progression. Moreover, patient 05 presented the lowest tumor volume and the lowest Gd-T1entropy. The intensity of the Gd-T1 followed the same trend as the hyper intense signal on the FLAIR in all patients, in particular for patient 05.

CONCLUSION

In our study, entropy and tumor volume for both FLAIR and Gd-T1, and FLAIR intensity seems to be the most interesting parameters to access the response of combined treatment. FLAIR signal may be more specific to the tumor microenvironment.

First order radiomics allowed us to follow tumor heterogeneity and identify the patient with the longest time to progression.

A French National Study on Gastropleural and Gastrobronchial Fistulas After Bariatric Surgery: the Impact of Therapeutic Strategy on Healing

PURPOSE

Gastropleural and gastrobronchial fistulas (GPF/GBFs) are serious but rare complications after bariatric surgery whose management is not consensual. The aim was to establish a cohort and evaluate different clinical presentations and therapeutic options.

MATERIALS AND METHODS

A multicenter and retrospective study analyzing GPF/GBFs after bariatric surgery in France between 2007 and 2018, via a questionnaire sent to digestive and thoracic surgery departments.

RESULTS

The study included 24 patients from 9 surgical departments after initial bariatric surgery (21 sleeve gastrectomies; 3 gastric bypass) for morbid obesity (mean BMI = 42 ± 8 kg/m²). The GPF/GBFs occurred, on average, 124 days after bariatric surgery, complicating an initial post-operative gastric fistula (POGF) in 66% of cases. Endoscopic digestive treatment was performed in 79% of cases (n = 19) associated in 25% of cases (n = 6) with thoracic endoscopy. Surgical treatment was performed in 83% of cases (n = 20): thoracic surgery (n = 5), digestive surgery (n = 8), and combined surgery (n = 7). No patient died. Overall morbidity was 42%. The overall success rate of the initial and secondary strategies was 58.5% and 90%, respectively. The average healing time was approximately 7 months. Patients who had undergone thoracic surgery (n = 12) had more initial management failures (n = 9/12) than patients who had not (n = 3/12), p = 0.001.

CONCLUSION

Complex and life-threatening fistulas that are revealed late require a multidisciplinary strategy. Thoracic surgery should be reserved once the abdominal leak heals; otherwise, it is associated with a higher risk of failure.

Incidental findings in a series of 2500 gene panel tests for a genetic predisposition to cancer: Results and impact on patients

With next generation sequencing, physicians are faced with more complex and uncertain data, particularly incidental findings (IF). Guidelines for the return of IF have been published by learned societies. However, little is known about how patients are affected by these results in a context of oncogenetic testing. Over 4 years, 2500 patients with an indication for genetic testing underwent a gene cancer panel. If an IF was detected, patients were contacted by a physician/genetic counsellor and invited to take part in a semi-structured interview to assess their understanding of the result, the change in medical care, the psychological impact, and the transmission of results to the family. Fourteen patients (0.56%) were delivered an IF in a cancer predisposition gene (RAD51C, PMS2, SDHC, RET, BRCA2, CHEK2, CDKN2A, CDH1, SUFU). Two patients did not collect the results and another two died before the return of results. Within the 10 patients recontacted, most of them reported surprise at the delivery of IF, but not anxiety. The majority felt they had chosen to obtain the result and enough information to understand it. They all initiated the recommended follow-up and did not regret the procedure. Information regarding the IF was transmitted to their offspring but siblings or second-degree relatives were not consistently informed. No major adverse psychological events were found in our experience. IF will be inherent to the development of sequencing, even for restricted gene panels, so it is important to increase our knowledge on the impact of such results in different contexts.

Dispositional optimism is associated with weight status, eating behavior, and eating disorders in a general population-based study

OBJECTIVE

The objective of this cross-sectional study was to assess whether optimism is associated with body mass index (BMI), eating behavior and eating disorders (EDs) in a population-based study.

METHOD

In 2016, a total of 32,805 participants aged ≥18 years from the NutriNet-Santé cohort completed the Life Orientation Test-Revised, assessing dispositional optimism. Height and weight were self-reported. Eating behavior was assessed with the revised 21-item Three-Factor Eating Questionnaire. Risk of EDs was evaluated with the Sick-Control-One-Fat-Food Questionnaire. Linear and Logistic regression was used to analyze the association between optimism, BMI categories, eating behavior and ED risk, controlling for sociodemographic, lifestyle and depressive symptom characteristics.

RESULTS

Our sample was composed of 73.5% women, and the mean age was 55.39 ± 13.70 years. More optimistic participants were less likely to be underweight (OR = 0.82; 95% CI: 0.75, 0.89), or obese, particularly class III obese (BMI ≥40 kg/m² ) (OR = 0.69; 95% CI: 0.56, 0.84) compared with less optimistic individuals. Optimism was negatively associated with cognitive restraint (β = -.07; 95%CI: -0.08; -0.06), emotional eating (β = -.17; 95% CI: -0.19, -0.16) and uncontrolled eating (β = -.10; 95% CI: -0.11, -0.09). In addition, more optimistic participants had a lower risk of EDs (OR = 0.60; 95% CI: 0.56, 0.64).

DISCUSSION

Our findings showed that optimism was associated with weight status, eating behavior and risk of EDs in both women and men. The causal structure of the underlying observed association remains unclear and should be further investigated.

Molecular catalysis of CO2 reduction: recent advances and perspectives in electrochemical and light-driven processes with selected Fe, Ni and Co aza macrocyclic and polypyridine complexes

Earth-abundant Fe, Ni, and Co aza macrocyclic and polypyridine complexes have been thoroughly investigated for CO2 electrochemical and visible-light-driven reduction. Since the first reports in the 1970s, an enormous body of work has been accumulated regarding the two-electron two-proton reduction of the gas, along with mechanistic and spectroscopic efforts to rationalize the reactivity and establish guidelines for structure-reactivity relationships. The ability to fine tune the ligand structure and the almost unlimited possibilities of designing new complexes have led to highly selective and efficient catalysts. Recent efforts toward developing hybrid systems upon combining molecular catalysts with conductive or semi-conductive materials have converged to high catalytic performances in water solutions, to the inclusion of these catalysts into CO2 electrolyzers and photo-electrochemical devices, and to the discovery of catalytic pathways beyond two electrons. Combined with the continuous mechanistic efforts and new developments for in situ and in operando spectroscopic studies, molecular catalysis of CO2 reduction remains a highly creative approach.

Efficacy and cardiorespiratory effects of lumbosacral intrathecal 2% procaine and 2% xylazine with or without sedation in calves undergoing umbilical surgery

Aims: To compare the effects of intrathecal anaesthesia using procaine and xylazine, with and without sedation with I/V xylazine and butorphanol, on sedation and cardiorespiratory measures in calves undergoing umbilical surgery. Methods: Male dairy calves, aged <3 months, were recruited that had enlargement of the umbilical stalk which was abnormal when palpated. They were assigned to receive either intrathecal injection between the sixth lumbar and first sacral vertebrae of 4 mg/kg of 2% procaine and 0.2 mg/kg 2% xylazine, with I/V injection of 0.02 mg/kg xylazine and 0.1 mg/kg of butorphanol (IT + SED group; n = 6), or the same intrathecal injection and I/V injection of 0.9% saline (IT group; n = 7). Surgery to correct abnormalities was carried out with calves positioned in dorsal recumbency. Rescue analgesia with injections of 2% procaine around the surgical wound was administered when movements triggered by surgery were observed. Post-operative analgesia was provided using I/V 0.5 mg/kg meloxicam. Duration of surgery was recorded, as well as degree of sedation, heart rate, systolic (SAP), diastolic (DAP) and mean (MAP) arterial blood pressure during surgery. Results: All anaesthetic and surgical procedures were successfully performed. Mean total duration of surgery was similar for the IT + SED and the IT groups (30.33 (SD 10.09) and 31.00 (SD 10.21) minutes, respectively) (p = 0.92). All calves were at least mildly sedated from 5 minutes after injections to the end of the surgery. One calf in the IT + SED group and three calves in the IT group required rescue analgesia when the umbilicus was manipulated. Between 0 and 10-15 minutes after injection, decreases in mean heart rate, SAP, MAP and DAP were observed in both groups. Mean SAP was lower in the IT + SED than the IT group. Hypotension (MAP<60 mm Hg) was present in four calves from the IT + SED group and in one from the IT group. Conclusions and clinical relevance: Intrathecal administration of 2% procaine and 2% xylazine allowed the successful completion of umbilical surgery, but 30% of calves needed rescue analgesia during surgery. Clinically, the addition of I/V sedation seemed to provide better analgesia than intrathecal block alone but resulted in greater hypotension.

Optimism is associated with diet quality, food group consumption and snacking behavior in a general population

BACKGROUND

Dispositional optimism is a psychological trait that has been associated with positive health outcomes such as reduced risk of cardiovascular diseases. However, there is little knowledge on the relationship between optimism and dietary intake in the population. The objective of this cross-sectional study was to assess whether optimism was associated with overall diet quality, food group consumption and snacking.

METHODS

In 2016, 32,806 adult participants from the NutriNet-Santé study completed the Life-Orientation Test Revised (LOT-R) which assesses dispositional optimism. Overall diet quality (assessed by the mPNNS-Guideline Score) and consumption of 22 food groups were evaluated using at least three self-reported 24-h dietary records. Snacking behavior was evaluated by an ad-hoc question. Logistic and linear regressions were used to analyze the associations between optimism and these dietary behaviors, taking into account socio-demographic, lifestyle and depressive symptomatology characteristics.

RESULTS

Optimism was associated with greater overall diet quality (β (95% CI) = 0.07 (0.004-0.11), P < 0.0001) and higher consumption of fruit and vegetables, seafood, whole grains, fats, dairy and meat substitutes, legumes, non-salted oleaginous fruits, and negatively associated with consumption of meat and poultry, dairy products, milk-based desserts, sugar and confectionery. In addition, optimism was associated with less snacking (OR (95% CI) = 0.89 (0.84, 0.95)). In contrast, optimism was associated with higher consumption of alcoholic beverage (β (95% CI) = 5.71 (2.54-8.88), P = 0.0004) and appetizers (OR (95% CI) = 1.09 (1.04, 1.14)). Finally, no association was observed between optimism and energy intake.

CONCLUSIONS

Optimism was associated with better overall diet quality and less snacking. It was also associated with consumption of healthy food groups as well as unhealthy food groups typically consumed in social eating occasions. These findings suggest that optimism could be taken into account in the promotion of a healthy eating behavior.

Interleukin-17 and lupus: enough to be a target? For which patients?

The involvement of the interleukin (IL)-17 axis in many inflammatory and autoimmune diseases is now well established, and this has led to the development of successful targeted therapies. Its role in systemic lupus erythematosus (SLE) is less described, since SLE is characterized by the impairment of many other immune actors. However, results from animal models and patients strongly suggest that IL-17 and its producing cells are involved in SLE pathogenesis. Circulating levels of IL-17 are increased in lupus, and tissue staining shows the presence of IL-17-producing cells in organ lesions. Through different mechanisms, the IL-17 axis promotes autoantibody production, immune complex deposition, complement activation and then tissue damage. There are also many interactions with other immune and non-immune actors, which account for the broad spectrum of clinical manifestations and disease heterogeneity. SLE treatment faces challenges with many disappointing trials and persistent unmet needs. The identification of subsets of SLE patients with an IL-17-driven disease now constitutes the key priority before starting trials. More preclinical studies are needed to improve the selection of the right patients able to respond and tolerate the many inhibitors that are already available.

Usefulness of the results of a surveillance program for uncompensated work-related diseases in France

Background

French employees receive compensations for diseases officially recognized as professionnal disease. Reimbursment data are thus used to produce statistics. Such data do not integrate uncompensated work-related diseases (UUWRD) defined as likely to be of occupational origin but not recognized as well. In 2003, the National Public Health Agency implemented a surveillance program on UWRD. This program is a complement to the compensation system for occupational diseases.

This communication presents results UWRD program can provide.

Methods

Twice a year, a network of volunteer occupational physicians (OP) reports ill health and associated work exposures of employees. Employee sociodemographics are notified. In 2018, half of French regions are integrated in the program.

Prevalence rates are calculated for UWRD. Chi-squared tests are used to compare prevalence rates between groups. Multivariate logistic regressions are conducted to evaluate:1- risks to report UWRD between groups, 2- prevalence rates trends. Underreporting rates of UWRD are approximated using an indicator capturing differences between figures produced by UWRD program and the compensation system.

Results

Over the 2009-2014 period, women working in mass food retail were observed at higher risk to present musuculoskeletical disorders than women of other sectors (ORa = 2.0). Same results were noted for men (ORa = 1.3). In mass food retail, decreases in musculoskeletal disorder prevalence rates were reported. Estimated average annual change rates were of 7.0 % for women and 11.0% for men. In 2011, UWRD data highlighted that between half and three-quarter of work-related musculoskeletal disorders were unreported by the compensation system.

Conclusions

UWRD data are used to identify vulnerable groups, analyse temporal trends and evaluate underreporting of professionnal disease.

Key messages

URWD program is a complement to the compensation system and let to better monitor health status of communities. Such informations are of interest to guide prevention policies.