Translation and validation of the French version of the child perceptions questionnaire for children aged 11 to 14 years old (CPQ11-14) short-form.

OBJECTIVES: The COHQoL is a set of questionnaires used to evaluate the impact of oral health on children's quality of life. Although the CPQ8-10 and the P-CPQ have been translated and validated in French, the CPQ11-14 14 has not yet been validated. The aim was to develop a French version of the CPQ11-14 16-items. MATERIALS AND METHODS: The French version of CPQ11-14 was obtained by a forward-backward translation process and pretested. The final version was tested on children aged 11-14 and divided into three groups: children with orofacial clefts, children with rare dental diseases other than clefts, and children without anomalies. We conducted a cross-sectional study and evaluated the reliability with test-retest and internal consistency, and the questionnaire validity with construct validity and discriminant validity. We performed an Exploratory Factory Analysis (EFA). RESULTS: 187 children tested the questionnaire. The ICC of the test-retest was 0.76 and the Cronbach's alpha was 0.77. The correlation between the CPQ11-14 and self-assessment of oral health and general well-being was > 0.2. Patients with orofacial clefts and rare diseases had significantly higher scores for overall short-form CPQ11-14. The EFA revealed six factors. CONCLUSION: The French CPQ11-14 is valid to assess the impact of oral health on children's quality of life. CLINICAL RELEVANCE: The translation of this questionnaire into French will enable us to assess the impact of oral health on the quality of life of adolescents. This questionnaire complements the 8-10 years version of the CPQ, as well as the parental version that can be used in conjunction with the questionnaire.

Occupational exposure to organic solvents and the risk of developing testicular germ cell tumors (TESTIS study): Effect of combined exposure assessment on risk estimation.

OBJECTIVES: Etiological factors of testicular germ cell tumors (TGCT) remain largely unknown, but a causal role of occupational exposures to solvents has been suggested. Previous studies analyzing these exposures reported discordant results, potentially related to exposure assessment methods. The aim of this study was to investigate the role of occupational exposure to solvents on the risk of developing TGCT among young men. METHODS: This study examined occupational exposures to solvents and TGCT risk based on the lifetime work histories of 454 cases and 670 controls, aged 18-45 years, of the French national TESTIS case-control study. Solvent exposure was estimated using: (i) exposure assignment by job-exposure matrix (JEM) and (ii) JEM combined with self-reported exposure data from specific questionnaires (SQ) and expert assessment (EA). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. RESULTS: Both approaches (JEM and JEM+SQ+EA) showed a consistent association between TGCT and trichloroethylene exposure (exposed versus not exposed; JEM=OR 1.80 [95% confidence interval (CI) 1.12-2.90] and JEM+SQ+EA= OR 2.59 (95% CI 1.42-4.72). Both approaches also observed positive associations with ketone esters and fuels & petroleum-based solvents. CONCLUSION: The results suggest that some organic solvents might be involved in the pathogenesis of TGCT among occupationally exposed men. The combined use of JEM+SQ+EA seemed to limit misclassification by considering individual exposure variability and is, therefore, an appealing approach to assess occupational exposures in epidemiological studies.

Sensorization of microfluidic brain-on-a-chip devices: Towards a new generation of integrated drug screening systems.

Brain-on-a-chip (BoC) devices show typical characteristics of brain complexity, including the presence of different cell types, separation in different compartments, tissue-like three-dimensionality, and inclusion of the extracellular matrix components. Moreover, the incorporation of a vascular system mimicking the blood-brain barrier (BBB) makes BoC particularly attractive, since they can be exploited to test the brain delivery of different drugs and nanoformulations. In this review, we introduce the main innovations in BoC and BBB-on-a-chip models, especially focusing sensorization: electrical, electrochemical, and optical biosensors permit the real-time monitoring of different biological phenomena and markers, such as the release of growth factors, the expression of specific receptors/biomarkers, the activation of immune cells, cell viability, cell-cell interactions, and BBB crossing of drugs and nanoparticles. The recent improvements in signal amplification, miniaturization, and multiplication of the sensors are discussed in an effort to highlight their benefits versus limitations and delineate future challenges in this field.

Parental occupational exposure to solvents and risk of developing testicular germ cell tumors among sons: a French nationwide case-control study (TESTIS study).

OBJECTIVES: The etiology of testicular germ cell tumors (TGCT) is suspected to be related to prenatal environmental risk factors. Some solvents have potential endocrine disrupting or carcinogenic properties and may disrupt male genital development in utero. The aim of this study was to examine the association between parental occupational exposure to solvents and TGCT risk among their offspring. METHODS: A French nationwide case-control study, TESTIS included 454 TGCT cases and 670 controls frequency-matched on region and 5-year age strata. Participants were interviewed via telephone and provided information on parental occupations at birth. Job-exposure matrices (JEM) developed in the French Matgéné program were used to assign exposure to five petroleum-based solvents, five solvents or groups of oxygenated solvents, and five chlorinated solvents. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. RESULTS: Occupational exposure to at least one solvent during the year of their son's birth was 41% among fathers and 21% among mothers. Paternal exposure to at least one solvent showed OR 0.89 (95% CI 0.68-1.15). Exposure to perchloroethylene (OR 1.41, 95% CI 0.55-3.61), methylene chloride (OR 1.13, 95% CI 0.54-2.34) and diesel/kerosene/fuel oil (OR 1.17, 95% CI 0.80-1.73) disclosed OR >1 but with low precision. Our results suggest a possible modest increase in non-seminoma risk for sons whose fathers were highly exposed to trichloroethylene (OR 1.44, 95% CI 0.79-2.63). Maternal exposure to at least one solvent showed OR 0.90 (95% CI 0.65-1.24). When stratifying by birth year, men born in the 1970s experienced an increased TGCT risk following maternal exposure to fuels and petroleum-based solvents (OR 2.74, 95% CI 1.11-6.76). CONCLUSION: Overall, no solid association was found between parental occupational exposure to solvents and TGCT risk. The association found with maternal occupational exposure to fuels and petroleum solvents among older men needs further investigation.

Harnessing the Power of Enteric Glial Cells' Plasticity and Multipotency for Advancing Regenerative Medicine.

The enteric nervous system (ENS), known as the intrinsic nervous system of the gastrointestinal tract, is composed of a diverse array of neuronal and glial cell subtypes. Fascinating questions surrounding the generation of cellular diversity in the ENS have captivated ENS biologists for a considerable time, particularly with recent advancements in cell type-specific transcriptomics at both population and single-cell levels. However, the current focus of research in this field is predominantly restricted to the study of enteric neuron subtypes, while the investigation of enteric glia subtypes significantly lags behind. Despite this, enteric glial cells (EGCs) are increasingly recognized as equally important regulators of numerous bowel functions. Moreover, a subset of postnatal EGCs exhibits remarkable plasticity and multipotency, distinguishing them as critical entities in the context of advancing regenerative medicine. In this review, we aim to provide an updated overview of the current knowledge on this subject, while also identifying key questions that necessitate future exploration.

Testicular germ cell tumour risk by occupation and industry: a French case-control study - TESTIS.

OBJECTIVE: Testicular germ cell tumours (TGCT) are the most common cancer in men of working age and its incidence has increased notably over the past 40 years. Several occupations have been identified as potentially associated with TGCT risk. The aim of this study was to further explore the relationship between occupations, industries and TGCT risk in men aged 18-45 years. METHODS: The TESTIS study is a multicenter case-control study conducted between January 2015 and April 2018 in 20 of 23 university hospital centers in metropolitan France. A total of 454 TGCT cases and 670 controls were included. Full job histories were collected. Occupations were coded according to the International Standard Classification of Occupation 1968 version (ISCO-1968) and industry according to the 1999 version of Nomenclature d'Activités Française (NAF-1999). For each job held, ORs and 95% CIs were estimated using conditional logistic regression. RESULTS: A positive association was observed between TGCT and occupation as agricultural, animal husbandry worker (ISCO: 6-2; OR 1.71; 95% CI (1.02 to 2.82)), as well as salesman (ISCO: 4-51; OR 1.84; 95% CI (1.20 to 2.82)). An increased risk was further observed among electrical fitters and related, electrical and electronics workers employed for 2 years or more (ISCO: 8-5; OR≥2 years 1.83; 95% CI (1.01 to 3.32)). Analyses by industry supported these findings. CONCLUSIONS: Our findings suggest that agricultural, electrical and electronics workers, and salesmen workers experience an increased risk of TGCT. Further research is needed to identify the agents or chemicals in these high-risk occupations which are relevant in the TGCT development. TRIAL REGISTRATION NUMBER: NCT02109926.

Parental occupations at birth and risk of adult testicular germ cell tumors in offspring: a French nationwide case-control study.

Background: Testicular germ cell tumors (TGCT) are the most frequent cancer in young men in developed countries. Parental occupational exposures during early-life periods are suspected to increase TGCT risk. The objective was to estimate the association between parental occupations at birth and adult TGCT. Methods: A case-control study was conducted, including 454 TGCT cases aged 18-45 from 20 French university hospitals, matched to 670 controls based on region and year of birth. Data collected from participants included parental jobs at birth coded according to the International Standard Classification of Occupation-1968 and the French nomenclature of activities-1999. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. Results: Paternal jobs at birth as service workers (OR = 1.98, CI 1.18-3.30), protective service workers (OR = 2.40, CI 1.20-4.81), transport equipment operators (OR = 1.96, CI 1.14-3.37), specialized farmers (OR = 2.66, CI 1.03-6.90), and maternal jobs as secondary education teachers (OR = 2.27, CI 1.09-4.76) or in secondary education (OR = 2.35, CI 1.13-4.88) were significantly associated with adult TGCT. The risk of seminoma was increased for the above-mentioned paternal jobs and that of non-seminomas for public administration and defence; compulsory social security (OR = 1.99, CI 1.09-3.65); general, economic, and social administration (OR = 3.21, CI 1.23-8.39) for fathers; and secondary education teacher (OR = 4.67, CI 1.87-11.67) and secondary education (OR = 3.50, CI 1.36-9.01) for mothers. Conclusion: Some paternal jobs, such as service workers, transport equipment operators, or specialized farmers, and maternal jobs in secondary education seem to be associated with an increased risk of TGCT with specific features depending on the histological type. These data allow hypotheses to be put forward for further studies as to the involvement of occupational exposures in the risk of developing TGCT, such as exposure to pesticides, solvents, or heavy metals.

Paternal Occupational Exposure to Heavy Metals and Welding Fumes and Testicular Germ Cell Tumours in Sons in France.

Testicular cancer is the most common cancer in young men. Its causes are largely unknown, although prenatal occupational and environmental exposures have been suggested. We investigated paternal occupational exposure to heavy metals and welding fumes and the risk of testicular germ cell tumors (TGCT) in their offspring. A total of 454 cases and 670 controls were included from a French nationwide case-control study. The INTEROCC job exposure matrix was used to assign occupational exposures (cadmium, chromium, iron, nickel, lead, and welding fumes) to the fathers' jobs. Odds ratios (ORs) for TGCT were estimated using conditional logistic regression models for frequency-matched sets. Three complementary analytical approaches were used: (1) single-agent analysis, (2) analysis by groups, and (3) principal component analysis (PCA). The proportion of paternal exposure to different heavy metals and welding fumes ranged from 0.7% (cadmium) to 11.3% (lead). Based on PCA, three principal components explained 93.5% of the cumulative variance. No associations were found between heavy metals or welding fumes and TGCT. In this study, paternal occupational exposure to heavy metals or welding fumes was not associated with TGCT development in their sons.

Flexible Organic Electronic Devices for Pulsed Electric Field Therapy of Glioblastoma.

Glioblastoma is difficult to eradicate with standard oncology therapies due to its high degree of invasiveness. Bioelectric treatments based on pulsed electric fields (PEFs) are promising for the improvement of treatment efficiency. However, they rely on rigid electrodes that cause acute and chronic damage, especially in soft tissues such as the brain. In this work, flexible electronics were used to deliver PEFs to tumors and the biological response was evaluated with fluorescent microscopy. Interdigitated gold electrodes on a thin, transparent parylene-C substrate were coated with the conducting polymer PEDOT:PSS, resulting in a conformable and biocompatible device. The effects of PEFs on tumors and their microenvironment were examined using various biological models. First, monolayers of glioblastoma cells were cultured on top of the electrodes to investigate phenomena in vitro. As an intermediate step, an in ovo model was developed where engineered tumor spheroids were grafted in the embryonic membrane of a quail. Due to the absence of an immune system, this led to highly vascularized tumors. At this early stage of development, embryos have no immune system, and tumors are not recognized as foreign bodies. Thus, they can develop fast while developing their own vessels from the existing embryo vascular system, which represents a valuable 3D cancer model. Finally, flexible electrode delivery of PEFs was evaluated in a complete organism with a functional immune system, using a syngenic, orthograft (intracranial) mouse model. Tumor spheroids were grafted into the brain of transgenic multi-fluorescent mice prior to the implantation of flexible organic electrode devices. A sealed cranial window enabled multiphoton imaging of the tumor and its microenvironment during treatment with PEFs over a period of several weeks.

PEDOT:PSS coated electrodes reduce intracellular oxidation and cell damage with pulsed electric field application.

Glioblastoma Multiforme is a highly lethal form of brain cancer, resistant to traditional therapeutic approaches and oftentimes hardly resectable. The application of pulsed electric fields (PEF) is gaining prominence as a highly effective approach for combating malignant tumors. However, PEF application at high voltages can generate reactive oxygen species through electrochemical events at electrodes, which can greatly affect intracellular processes and damage healthy cells. Here, we present an in depth study on the cellular impact of coating metal electrodes with an organic polymer PEDOT:PSS. We compared the effect of PEF application through coated and uncoated gold electrodes on the U87 human glioblastoma cell line. The results show that PEF application using PEDOT:PSS-coated electrodes does not induce intracellular ROS generation, even at high voltages, contrary to that observed with uncoated electrodes. PEF delivery with PEDOT:PSS coated electrodes results in minimal cell electroporation and a lower intracellular calcium response than uncoated metal electrodes. The application of the antioxidant MnTBAP allowed us to establish that superoxide generation is partially responsible for the higher intracellular calcium response observed in uncoated metal electrodes. The results demonstrate that PEDOT-coated electrodes allow for PEF application without intracellular ROS generation, with the trade-off being a diminished electroporation efficiency. These electrodes could therefore be useful for PEF application in ROS-sensitive tissues, as well as for disentangling the effect of PEFs on cells from the metabolic impact of electrolytic events arising from the electrode material.

Incident hypertension in relation to aircraft noise exposure: results of the DEBATS longitudinal study in France.

BACKGROUND: Although several cross-sectional studies have shown that aircraft noise exposure was associated with an increased risk of hypertension, a limited number of longitudinal studies have addressed this issue. This study is part of the DEBATS (Discussion on the health effect of aircraft noise) research programme and aimed to investigate the association between aircraft noise exposure and the incidence of hypertension. METHODS: In 2013, 1244 adults living near three major French airports were included in this longitudinal study. Systolic and diastolic blood pressure, as well as demographic and lifestyle factors, were collected at baseline and after 2 and 4 years of follow-up during face-to-face interviews. Exposure to aircraft noise was estimated for each participant's home address using noise maps. Statistical analyses were performed using mixed Poisson and linear regression models adjusted for potential confounding factors. RESULTS: A 10 dB(A) increase in aircraft noise levels in terms of Lden was associated with a higher incidence of hypertension (incidence rate ratio (IRR)=1.36, 95% CI 1.02 to 1.82). The association was also significant for Lday (IRR 1.41, 95% CI 1.07; to 1.85) and Lnight (IRR 1.31, 95% CI 1.01 to 1.71). Systolic and diastolic blood pressure increased with all noise indicators. CONCLUSION: These results strengthen those obtained from the cross-sectional analysis of the data collected at the time of inclusion in DEBATS, as well as those from previous studies conducted in other countries. Hence, they support the hypothesis that aircraft noise exposure may be considered as a risk factor for hypertension.

The role of aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and medication use: results of a pooled-analysis from seven European countries.

BACKGROUND: Few studies have considered aircraft noise annoyance and noise sensitivity in analyses of the health effects of aircraft noise, especially in relation to medication use. This study aims to investigate the moderating and mediating role of these two factors in the relationship between aircraft noise levels and medication use among 5860 residents of ten European airports included in the HYENA and DEBATS studies. METHODS: Information on aircraft noise annoyance, noise sensitivity, medication use, and demographic, socio-economic and lifestyle factors was collected during a face-to-face interview at home. Medication was coded according to the Anatomical Therapeutic Chemical (ATC) classification. Outdoor aircraft noise exposure was estimated by linking the participant's home address to noise contours using Geographical Information Systems (GIS) methods. Logistic regressions with adjustment for potential confounding factors were used. In addition, Baron and Kenny's recommendations were followed to investigate the moderating and mediating effects of aircraft noise annoyance and noise sensitivity. RESULTS: A significant association was found between aircraft noise levels at night and antihypertensive medication only in the UK (OR = 1.43, 95%CI 1.19-1.73 for a 10 dB(A)-increase in Lnight). No association was found with other medications. Aircraft noise annoyance was significantly associated with the use of antihypertensive medication (OR = 1.33, 95%CI 1.14-1.56), anxiolytics (OR = 1.48, 95%CI 1.08-2.05), hypnotics and sedatives (OR = 1.60, 95%CI 1.07-2.39), and antasthmatics (OR = 1.44, 95%CI 1.07-1.96), with no difference between countries. Noise sensitivity was significantly associated with almost all medications, with the exception of the use of antasthmatics, showing an increase in ORs with the level of noise sensitivity, with differences in ORs among countries only for the use of antihypertensive medication. The results also suggested a mediating role of aircraft noise annoyance and a modifying role of both aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and medication use. CONCLUSIONS: The present study is consistent with the results of the small number of studies available to date suggesting that both aircraft noise annoyance and noise sensitivity should be taken into account in analyses of the health effects of exposure to aircraft noise.

Self-rated health status in relation to aircraft noise exposure, noise annoyance or noise sensitivity: the results of a cross-sectional study in France.

BACKGROUND: Noise is a major public health issue because of its negative impacts on health, including annoyance, sleep disturbance, cardiovascular diseases and altered cognitive performance among children. Self-rated health status (SRHS) can be considered as a reliable indicator of quality of life, morbidity and mortality but few studies have considered SRHS in relation to aircraft noise exposure. The present study aims to investigate the association between this exposure and SRHS of people living near airports in France, and to consider the mediating or moderating role of aircraft noise annoyance and noise sensitivity in this association. METHODS: This cross-sectional study included 1242 participants older than 18 and living near three major French airports. Information on their SRHS, aircraft noise annoyance, noise sensitivity and demographic, socioeconomic and lifestyle factors was collected during a face-to-face interview performed at home. Outdoor aircraft noise levels were estimated for each participant's home address using noise maps. Logistic regressions with adjustment for potential confounders were used. The moderating and mediating effects of aircraft noise annoyance and noise sensitivity were investigated following Baron and Kenny's recommendations. RESULTS: A significant association was shown between aircraft noise levels and a fair/poor SRHS, only in men (OR=1.55, 95%CI 1.01-2.39, for a 10 dB(A)-increase in Lden). This relationship was higher in men highly sensitive to noise (OR=3.26, 95%CI 1.19-8.88, for a 10 dB(A)-increase in Lden). Noise sensitivity was associated with a fair/poor SRHS significantly in women (OR=1.74, 95%CI 1.12-2.68) and at the borderline of significance in men (OR=1.68, 95% CI 0.94-3.00), whereas aircraft noise annoyance was associated with a fair/poor SRHS only in men (OR=1.81, 95%CI 1.00-3.27). CONCLUSION: The present study confirms findings in the small number of available studies to date suggesting a positive association between aircraft noise levels and a fair/poor SRHS. These results also support the hypothesis that noise sensitivity would moderate this association. However, a mediating effect of annoyance cannot be excluded.

Understanding the relationship between air traffic noise exposure and annoyance in populations living near airports in France.

Since the 2000s, increased aircraft noise annoyance has been observed in the populations living near airports. The DEBATS-study compared the exposure-response relationship estimated among airports' residents in France with old and new EU standard curves. It also examines whether non-acoustical factors may explain this annoyance. For 1244 adults living near three French airports, information about demographic and socio-economic factors as well as aircraft noise annoyance, situational, personal and attitudinal factors was collected with a face-to-face questionnaire. Outdoor aircraft noise exposure was estimated by linking home address to noise exposure maps. Logistic regression models were used to investigate the association between annoyance and a broad range of other variables in addition to the Lden. Severe noise annoyance was associated not only with increased aircraft noise levels, but also with non-acoustical factors. Annoyance was higher than predicted by the old EU standard curve when estimated with the model including non-acoustical factors in addition to the Lden. It was even higher when only noise exposure was considered. However, annoyance was lower in DEBATS than predicted by the new EU standard curve provided by WHO. The increase of noise annoyance does not seem to be explained by the factors already mentioned in the literature as possible explanations. However, it cannot be ruled out that methodological differences in the HA assessment may be the reason for changes in annoyance over the years. For this reason, we argue for a definition of HA derived substantially as recommended by ICBEN. The findings of the DEBATS study also confirm that taking into account non-acoustical factors such as situational, personal and attitudinal factors would improve annoyance predictions.

The role of aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and hypertension risk: Results of a pooled analysis from seven European countries.

INTRODUCTION: Many studies, including the HYENA and the DEBATS studies, showed a significant association between aircraft noise exposure and the risk of hypertension. Few studies have considered aircraft noise annoyance and noise sensitivity as factors of interest, especially in relation to hypertension risk, or as mediating or modifying factors. The present study aims 1) to investigate the risk of hypertension in relation to aircraft noise annoyance or noise sensitivity; and 2) to examine the role of modifier or mediator of these two factors in the association between aircraft noise levels and the risk of hypertension. METHODS: This study included 6,105 residents of ten European airports from the HYENA and DEBATS studies. Information on aircraft noise annoyance, noise sensitivity, and demographic, socioeconomic and lifestyle factors was collected during an interview performed at home. Participants were classified as hypertensive if they had either blood pressure levels above the WHO cut-off points or physician-diagnosed hypertension in conjunction with the use of antihypertensive medication. Outdoor aircraft noise exposure was estimated for each participant's home address. Poisson regression models with adjustment for potential confounders were used. Interactions between noise exposure and country were tested to consider possible differences between countries. RESULTS: An increase in aircraft noise levels at night was weekly but significantly associated with an increased risk of hypertension (RR = 1.03, 95% CI 1.01-1.06 for a 10-dB(A) increase in Lnight). A significant association was found between aircraft noise annoyance and hypertension risk (RR = 1.06, 95%CI 1.00-1.13 for highly annoyed people compared to those who were not highly annoyed). The risk of hypertension was slightly higher for people highly sensitive to noise compared to people with low sensitivity in the UK (RR = 1.29, 95%CI 1.05-1.59) and in France (RR = 1.11, 95%CI 0.68-1.82), but not in the other countries. The association between aircraft noise levels and the risk of hypertension was higher among highly sensitive participants (RR = 1.00, 95%CI 0.96-1.04; RR = 1.03, 95%CI 0.90-1.11; RR = 1.12, 95%CI 1.01-1.24, with a 10-dB(A) increase in Lnight for low, medium, and high sensitive people respectively) or, to a lesser extent, among highly annoyed participants (RR = 1.06, 95%CI 0.95-1.18 for a 10-dB(A) increase in Lnight among highly annoyed participants, and RR = 1.02, 95%CI 0.99-1.06 among those not highly annoyed). CONCLUSIONS: The present study confirms findings in the small number of available studies to date suggesting adverse health effects associated with aircraft noise annoyance and noise sensitivity. The findings also indicate possible modifier effects of aircraft noise annoyance and noise sensitivity in the relationship between aircraft noise levels and the risk of hypertension. However, further investigations are needed to better understand this role using specific methodology and tools related to mediation analysis and causal inference.

Center of pressure displacement characteristics differentiate fall risk in older people: A systematic review with meta-analysis.

Falling is the second most prevalent cause of accidental death in the world. Currently available clinical tests to assess balance in older people are insufficiently sensitive to screen for fall risk in this population. Laboratory tests that record the center of pressure (COP) trajectory could overcome this problem but despite their widespread use, the choice of COP trajectory features for use as a biomarker of fall risk lacks consensus. This systematic review and meta-analysis aimed at identifying the best COP characteristics to predict risk of falling in older adults. More than 4000 articles were screened; 44 (7176 older adults) were included in this study. Several COP parameters emerged as good indices to discriminate fallers from non-fallers. From sensitivity analysis, Sway area per unit time, anteroposterior mean velocity, and radial mean velocity were the best traditional features. In this study, identification of older people with a high fall risk was demonstrated using quiet-standing recordings. Such screening would also be useful for routine follow-up of balance changes in older fallers in clinical practice.

Postadychute-AG, Detection, and Prevention of the Risk of Falling Among Elderly People in Nursing Homes: Protocol of a Multicentre and Prospective Intervention Study.

Introduction: While falls among the elderly is a public health issue, because of the social, medical, and economic burden they represent, the tools to predict falls are limited. Posturography has been developed to distinguish fallers from non-fallers, however, there is too little data to show how predictions change as older adults' physical abilities improve. The Postadychute-AG clinical trial aims to evaluate the evolution of posturographic parameters in relation to the improvement of balance through adapted physical activity (APA) programs. Methods: In this prospective, multicentre clinical trial, institutionalized seniors over 65 years of age will be followed for a period of 6 months through computer-assisted posturography and automatic gait analysis. During the entire duration of the follow-up, they will benefit from a monthly measurement of their postural and locomotion capacities through a recording of their static balance and gait thanks to a software developed for this purpose. The data gathered will be correlated with the daily record of falls in the institution. Static and dynamic balance measurements aim to extract biomechanical markers and compare them with functional assessments of motor skills (Berg Balance Scale and Mini Motor Test), expecting their superiority in predicting the number of falls. Participants will be followed for 3 months without APA and 3 months with APA in homogeneous group exercises. An analysis of variance will evaluate the variability of monthly measures of balance in order to record the minimum clinically detectable change (MDC) as participants improve their physical condition through APA. Discussion: Previous studies have stated the MDC through repeated measurements of balance but, to our knowledge, none appear to have implemented monthly measurements of balance and gait. Combined with a reliable measure of the number of falls per person, motor capacities and other precipitating factors, this study aims to provide biomechanical markers predictive of fall risk with their sensitivity to improvement in clinical status over the medium term. This trial could provide the basis for posturographic and gait variable values for these elderly people and provide a solution to distinguish those most at risk to be implemented in current practice in nursing homes. Trial Registration: ID-RCB 2017-A02545-48. Protocol Version: Version 4.2 dated January 8, 2020.

Saliva cortisol in relation to aircraft noise exposure: pooled-analysis results from seven European countries.

BACKGROUND: Many studies have demonstrated adverse effects of exposure to aircraft noise on health. Possible biological pathways for these effects include hormonal disturbances. Few studies deal with aircraft noise effects on saliva cortisol in adults, and results are inconsistent. OBJECTIVE: We aimed to assess the effects of aircraft noise exposure on saliva cortisol levels and its variation in people living near airports. METHODS: This study focused on the 1300 residents included in the HYENA and DEBATS cross-sectional studies, with complete information on cortisol sampling. All the participants followed a similar procedure aiming to collect both a morning and an evening saliva cortisol samples. Socioeconomic and lifestyle information were obtained during a face-to-face interview. Outdoor aircraft noise exposure was estimated for each participant's home address. Associations between aircraft noise exposure and cortisol outcomes were investigated a priori for male and female separately, using linear regression models adjusted for relevant confounders. Different approaches were used to characterize cortisol levels, such as morning and evening cortisol concentrations and the absolute and relative variations between morning and evening levels. RESULTS: Statistically significant increases of evening cortisol levels were shown in women with a 10-dB(A) increase in aircraft noise exposure in terms of LAeq, 16h (exp(ß) = 1.08; CI95% = 1.00-1.16), Lden (exp(ß) = 1.09; CI95% = 1.01-1.18), Lnight (exp(ß) = 1.11; CI95% = 1.02-1.20). A statistically significant association was also found in women between a 10-dB(A) increase in terms of Lnight and the absolute variation per hour (exp(ß) = 0.90; CI95% = 0.80-1.00). Statistically significant decreases in relative variation per hour were also evidenced in women, with stronger effects with the Lnight (exp(ß) = 0.89; CI95% = 0.83-0.96) than with other noise indicators. The morning cortisol levels were unchanged whatever noise exposure indicator considered. There was no statistically significant association between aircraft noise exposure and cortisol outcomes in men. CONCLUSIONS: The results of the present study show statistically significant associations between aircraft noise exposure and evening cortisol levels and related flattening in the (absolute and relative) variations per hour in women. Further biological research is needed to deepen knowledge of the pathway between noise exposure and disturbed hormonal regulation, and specially the difference in effects between genders.

Center of pressure characteristics from quiet standing measures to predict the risk of falling in older adults: a protocol for a systematic review and meta-analysis.

BACKGROUND: Falling is the most common accident of daily living and the second most prevalent cause of accidental death in the world. The complex nature of risk factors associated with falling makes those at risk amongst the elderly population difficult to identify. Commonly used clinical tests have limitations when it comes to reliably detecting the risk of falling, but existing laboratory tests, such as force platform measurements, represent one method of overcoming this lack of a test. Despite their widespread use, however, Center of Pressure (COP) signal analysis techniques vary and there is currently no consensus on which features should be used diagnostically. Our objective is to identify, through a systematic review and meta-analysis, the COP characteristics of older adults (≥ 60 years old) during quiet bipedal stance which will allow fallers to be distinguished from non-fallers. METHODS: The systematic review will include both prospective and retrospective articles. Five databases will be searched: PubMed, Cochrane CENTRAL, EMBASE, and ScienceDirect. In addition, a search of gray literature will be performed using Google Scholar and ClinicalTrials.gov. Searches will be circumscribed to include only older adults (aged over 60 years) who underwent a bipedal quiet standing measure of their balance and for whom the number of falls was reported. Two authors will independently assess the risk of bias for each included article using a 26-item checklist. Funnel plots will be drawn to attest of possible publication biases for each COP parameters. The results will be synthesized descriptively and a meta-analysis will be undertaken. When trial methodological heterogeneity is too great for pooling of the data into a meta-analysis, evidence strength will be evaluated using best evidence analysis. DISCUSSION: Despite the numerous advantages of posturography, the diversity of studies exploring balance in older fallers has led to uncertainty regarding the method's ability to reliably identify fall-prone older adults. It is expected that the findings from this systematic review will help clinicians use bipedal quiet standing measures as a diagnostic test and allow researchers to explore COP characteristics to create better models for fall prevention care. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018098671.

Elements of morphology: Standard terminology for the teeth and classifying genetic dental disorders.

Dental anomalies occur frequently in a number of genetic disorders and act as major signs in diagnosing these disorders. We present definitions of the most common dental signs and propose a classification usable as a diagnostic tool by dentists, clinical geneticists, and other health care providers. The definitions are part of the series Elements of Morphology and have been established after careful discussions within an international group of experienced dentists and geneticists. The classification system was elaborated in the French collaborative network "TÊTECOU" and the affiliated O-Rares reference/competence centers. The classification includes isolated and syndromic disorders with oral and dental anomalies, to which causative genes and main extraoral signs and symptoms are added. A systematic literature analysis yielded 408 entities of which a causal gene has been identified in 79%. We classified dental disorders in eight groups: dental agenesis, supernumerary teeth, dental size and/or shape, enamel, dentin, dental eruption, periodontal and gingival, and tumor-like anomalies. We aim the classification to act as a shared reference for clinical and epidemiological studies. We welcome critical evaluations of the definitions and classification and will regularly update the classification for newly recognized conditions.