Identification of early symptoms of endometriosis through the analysis of online social networks: A social media study.

Objective: Endometriosis is a complex full-body inflammation disease with an average time to diagnosis of 7-10 years. Social networks give opportunity to patient to openly discuss about their condition, share experiences, and seek advice. Thus, data from social media may provide insightful data about patient's experience. This study aimed at applying a text-mining approach to online social networks in order to identify early signs associated with endometriosis. Methods: An automated exploration technique of online forums was performed to extract posts. After a cleaning step of the built corpus, we retrieved all symptoms evoked by women, and connected them to the MedDRA dictionary. Then, temporal markers allowed targeting only the earliest symptoms. The latter were those evoked near a marker of precocity. A co-occurrence approach was further applied to better account for the context of evocations. Results: Results were visualised using the graph-oriented database Neo4j. We collected 7148 discussions threads and 78,905 posts from 10 French forums. We extracted 41 groups of contextualised symptoms, including 20 groups of early symptoms associated with endometriosis. Among these groups of early symptoms, 13 were found to portray already known signs of endometriosis. The remaining 7 clusters of early symptoms were limb oedema, muscle pain, neuralgia, haematuria, vaginal itching, altered general condition (i.e. dizziness, fatigue, nausea) and hot flush. Conclusion: We pointed out some additional symptoms of endometriosis qualified as early symptoms, which can serve as a screening tool for prevention and/or treatment purpose. The present findings offer an opportunity for further exploration of early biological processes triggering this disease.

Exploration of the core protein network under endometriosis symptomatology using a computational approach.

Background: Endometriosis is defined by implantation and invasive growth of endometrial tissue in extra-uterine locations causing heterogeneous symptoms, and a unique clinical picture for each patient. Understanding the complex biological mechanisms underlying these symptoms and the protein networks involved may be useful for early diagnosis and identification of pharmacological targets. Methods: In the present study, we combined three approaches (i) a text-mining analysis to perform a systematic search of proteins over existing literature, (ii) a functional enrichment analysis to identify the biological pathways in which proteins are most involved, and (iii) a protein-protein interaction (PPI) network to identify which proteins modulate the most strongly the symptomatology of endometriosis. Results: Two hundred seventy-eight proteins associated with endometriosis symptomatology in the scientific literature were extracted. Thirty-five proteins were selected according to degree and betweenness scores criteria. The most enriched biological pathways associated with these symptoms were (i) Interleukin-4 and Interleukin-13 signaling (p = 1.11 x 10-16), (ii) Signaling by Interleukins (p = 1.11 x 10-16), (iii) Cytokine signaling in Immune system (p = 1.11 x 10-16), and (iv) Interleukin-10 signaling (p = 5.66 x 10-15). Conclusion: Our study identified some key proteins with the ability to modulate endometriosis symptomatology. Our findings indicate that both pro- and anti-inflammatory biological pathways may play important roles in the symptomatology of endometriosis. This approach represents a genuine systemic method that may complement traditional experimental studies. The current data can be used to identify promising biomarkers for early diagnosis and potential therapeutic targets.

Automated Twitter Extraction and Visual Analytics with Dashboards: Development and First Experimentations.

Information found in the social media may help to set up infoveillance and track epidemics, identify high-risk behaviours, or assess trends or feelings about a subject or event. We developed a dashboard to enable novice users to easily and autonomously extract and analyze data from Twitter. Eleven users tested the dashboard and considered the tool to be highly usable and useful. They were able to conduct the research they wanted and appreciated being able to use this tool without having to program.

From SIR to SEAIRD: A novel data-driven modeling approach based on the Grey-box System Theory to predict the dynamics of COVID-19.

Common compartmental modeling for COVID-19 is based on a priori knowledge and numerous assumptions. Additionally, they do not systematically incorporate asymptomatic cases. Our study aimed at providing a framework for data-driven approaches, by leveraging the strengths of the grey-box system theory or grey-box identification, known for its robustness in problem solving under partial, incomplete, or uncertain data. Empirical data on confirmed cases and deaths, extracted from an open source repository were used to develop the SEAIRD compartment model. Adjustments were made to fit current knowledge on the COVID-19 behavior. The model was implemented and solved using an Ordinary Differential Equation solver and an optimization tool. A cross-validation technique was applied, and the coefficient of determination R 2 was computed in order to evaluate the goodness-of-fit of the model. Key epidemiological parameters were finally estimated and we provided the rationale for the construction of SEAIRD model. When applied to Brazil's cases, SEAIRD produced an excellent agreement to the data, with an R 2 ≥ 90%. The probability of COVID-19 transmission was generally high (≥ 95%). On the basis of a 20-day modeling data, the incidence rate of COVID-19 was as low as 3 infected cases per 100,000 exposed persons in Brazil and France. Within the same time frame, the fatality rate of COVID-19 was the highest in France (16.4%) followed by Brazil (6.9%), and the lowest in Russia (≤ 1%). SEAIRD represents an asset for modeling infectious diseases in their dynamical stable phase, especially for new viruses when pathophysiology knowledge is very limited. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10489-021-02379-2.

Fuzzy logic for characterizing the moderate intensity of physical activity in children.

OBJECTIVES: The aim of this study was to better characterize the moderate intensity of PA among children by applying fuzzy logic as the most appropriate analytical approach. In this perspective, the 6-MWT was selected as a pertinent exercise modality, which covers as a whole, this intensity level. DESIGN: Methodological study. METHODS: Fuzzy logic was applied to accelerometer output obtained on 46 children aged 9-11 years. A fuzzy subset A was defined from the reference set E using a membership function (degree of truth). To adequately tap the moderate PA, a core of X¯±σ and a support of X¯±2σ (with X¯ the mean, and σ the standard deviation of the distribution) were selected. RESULTS: The walking speed during the exercise averaged 6.1±0.6kmh(-1) and the mean HR was 135±14bpm. The movement count (419±127 to 433±148 counts) exhibited no significant changes during the test. A value of 260 counts per 5-s (i.e., 3120cpm) had equally 50% of degree of truth to encompass both "light" and "moderate" intensities of PA. Results suggest that the cut-point of >2296cpm covers a low PA at 100% and a moderate PA at 0%. CONCLUSIONS: Fuzzy logic provides a robust basis to processing accelerometer data, and brings a reliable solution to the concern about the in-between of PA intensities. Its application to calibration studies should not support the use of a cut-point of about 2000cpm in children, and linguistic variables should now be preferred to numbered data in defining PA intensities.

Continuous Infusion of Ketamine for Out-of-hospital Isolated Orthopedic Injuries Secondary to Trauma: A Randomized Controlled Trial.

Abstract Objective. Although ketamine has recently been demonstrated to provide a morphine-sparing effect, no previous study reports the effect of continuous infusion of ketamine for analgesia in out-of-hospital environments. The aim of this study was to compare the effect of a continuous infusion of ketamine (IK group) vs. a continuous infusion of saline (IS group) on morphine requirements in out-of-hospital trauma patients suffering from severe acute pain. Methods. In this prospective, multicenter, randomized, single-blind clinical study, patients suffering from isolated orthopedic injuries secondary to trauma with severe acute pain received a low-dose intravenous (IV) bolus of ketamine (0.2 mg·kg-1) combined with an IV bolus of morphine (0.1 mg·kg-1) and were randomized either in the IK group (IV continuous infusion of ketamine 0.2 mg·kg-1·h-1), or in the IS group (IV continuous infusion of saline at the same volume). The primary endpoint was morphine requirements in terms of total dose of morphine (excluding the baseline bolus) injected at the end of prehospital emergency care at hospital admission (final time, Tf). The secondary endpoint was evaluation of pain with visual analogic scale (VAS). Results. Sixty-six patients were enrolled. Total morphine dose was not significantly reduced with continuous infusion of ketamine (0.048 [0.000; 0.150] vs. 0.107 [0.052; 0.150] in IK and IS groups), with similar mean duration of care (median 35.0 min). Analgesia was as efficient without any significant difference in VAS at Tf between groups (3.1 ± 2.3 (IK group) vs. 3.7 ± 2.7 (IS group), p = 0.5). Conclusions. Continuous ketamine infusion did not reduce morphine requirements in severe acute pain trauma patients in the out-of-hospital emergency settings.

Rationale, methodology, implementation, and first results of the French out-of-hospital cardiac arrest registry.

INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is an important public health issue with an estimated incidence of 50,000 cases per year in France. Community survival rates for OHCA are still low (approximately 5%). An effective, recognized way to study, assess, and improve OHCA care is to create a standard-format database. OBJECTIVE: The aim of this work is to present the French OHCA registry (RéAC). METHODS: RéAC is a secure, web-based data management system that was initiated in 2009 and deployed nationally in June 2012. The main goal of this registry is to improve the care and survival rate of OHCA patients. The survey form is in compliance with the requirements of French organizations and is organized in accordance with the Utstein universal style. RéAC provides real-time statistical analyses and enables all French mobile emergency and resuscitation services (MERS) to assess and improve their professional OHCA care practices. RESULTS: In June 2012, the RéAC was nationally opened for all French MERSs. In June 2013, 221 of a possible 320 MERS participated in the RéAC. A total of 15,944 OHCA have been collected (14,939 cases closed with follow-up monitoring). The current rate of inclusion is approximately 1,500 cases per month. Since August 2012, the inclusion rate has increased by 9.5% per month, while the participation rate has increased by 9% per month. The first results show that the population is mainly male (65.4%) and the mean age is 65 ± 19 years. On MERS arrival, 73.5% of the patients were in asystole. The rates of return of spontaneous circulation, survival to hospital admission, and 30-day survival are low (respectively 21.1%, 17.2%, 4.6%). Of those who survived 30 days, 84.0% had a good neurological recovery. CONCLUSIONS: The RéAC registry is a reliable observation tool to improve public health management of OHCA. It provides relevant information to adapt or to develop diagnosis, treatments, and prognostic resources. Moreover, it enables the development of targeted awareness programs for the unique purpose of increasing the survival rates of OHCA patients.

Compliance of children in northern France with physical activity recommendations.

AIMS: This study examined the compliance of French children with physical activity (PA) guidelines, using objective assessments of PA. METHODS: The study involved 252 children aged 9.9 +/- 0.9 years, with mean height and weight of 1.39 +/- 0.08 m and 35.8 +/- 8.8 kg, respectively. Their usual PA was evaluated during a week using an Actigraph accelerometer. RESULTS: The time spent in a moderate-to-vigorous PA (MVPA) ranged from 142 +/- 44 min x d(-1) to 25 +/- 18 min/day according to the cut-offs used. Boys were significantly more active than girls (p < or = .001). Overweight/obese children spent significantly less time in MVPA as determined with cut-off points at 3200 cpm (-26%) or 3600 cpm (-35%) (p < .01). Between 5% (8% of boys vs 1% of girls, p < .0001) and 9% (14% of boys vs 3% of girls, p < .0001) of children probably met the PA guidelines. No relationships were found with socioeconomic status. CONCLUSIONS: This high proportion of insufficiently active children (> 90%), together with the relatively high proportion of overweight children in this area, advocates a more aggressive PA promotion project, which should target all children whatever their social origins.

Maturity negates the gender-related difference in physical activity among youth. Is this equally justified whatever the accelerometer cut-off point used?

OBJECTIVES: To examine the consistency in findings about the influence of maturity on the gender-difference in moderate-to-vigorous physical activity (MVPA) of children using different cut-off points for MVPA. DESIGN: Cross-sectional observation study. METHODS: The sample involved 253 children (139 boys) of 9.9±0.9 years. Their physical activity was evaluated using an Actigraph accelerometer. The biological age of children was determined with their estimated age at the peak height velocity, and maturity categories were gender-specific defined. RESULTS: Boys spent more time in MVPA than girls (P<0.0001), and no maturity-related differences were obtained on the whole sample. It was only among boys that differences were found between maturity groups with cut-off points of 3000 cpm (P=0.034), 3200 cpm (P=0.024), and 3600 cpm (P=0.011). At a given maturity level, boys spent significantly more time in MVPA than girls, except with the cut-off point of 1000 cpm (P=0.07). There were higher proportions of sufficiently active boys, but significances were reached only with cut-off points above 3000 cpm. There were no maturity-related differences in the proportion of sufficiently active children as MVPA was computed using cut-off points of 1000 cpm, 2000 cpm or 3000 cpm. CONCLUSIONS: The role of maturity in the gender-difference in MVPA seems unclear as one another cut-off point is used among children. Even if a relatively greater consistency was found with the three cut-off points above 3000 cpm, data comparison may require a conversion system until a consensus is reached about the exact value to be used among children.

Evidence of the influence of physical activity on the metabolic syndrome and/or on insulin resistance in pediatric populations: a systematic review.

This study is aimed at updating the relationships between physical activity (PA) and the metabolic syndrome (MetS) and/or insulin resistance (IR) in youth. Cross-sectional, prospective cohort and intervention studies, which examined the effect of PA on MetS, its components and IR in children and adolescents (<18 yrs), were searched by applying a combination of criteria in the PubMed database. The electronic search of studies published from 2000-2010 yielded >150 references. Of these, 37 studies were included. Twenty-six studies (70%) were cross-sectional observation studies, and two studies (8%) were prospective cohort studies. The remaining eight studies (22%) were interventions, of which three (<10% of all included studies) were randomized controlled trials. Commonly, higher PA levels were consistently associated with an improved metabolic profile and a reduced risk for MetS and/or IR in these populations. The impact of PA on MetS and/or IR appeared to be either independent of other factors, or alternatively or simultaneously mediated by the physical fitness and adiposity of youth. However, more-robustly designed interventions (i.e., some mega-randomized controlled trials based on lifestyle interventions) and additional cohort studies are required to make definitive inference about the magnitude and role of PA as a single genuine preventive and treatment strategy for the metabolic and cardiovascular risk of youth in the current obesogenic context.

[An alternative method to describe an "obesogenic" environment for children: Relevance of a multiple correspondence analysis (MCA) (corrected)]. / Une méthode alternative pour caractériser l'environnement "obésogénique" de l'enfant: Pertinence d'une analyse factorielle des correspondances multiples (AFCM). [corrected]

The purpose of this study was to describe an "obesogenic" environment for a group of schoolchildren using a multiple correspondence analysis (MCA) as an alternative approach to traditional methodological choices. MCA is applicable even for small samples. Ninety-one children (39 girls and 52 boys) aged 10.0 +/- 0.9 years were randomly recruited from two French public schools. Data on their family context, parental involvement, television time and their eating habits were obtained through questionnaires. Their level of physical activity and sedentary time were assessed using an accelerometer (MTI Actigraph model 7164) for three days, including a holiday. The data were processed using an MCA together with a technique for estimating relative risks (RRs) of overweight/obesity according to the distribution of children in the factorial plane produced by the MCA. The "obesogenic" factors appeared as four possible combinations between family environments and various behaviours with regard to physical activity, sedentary behaviour and diet. The RR of overweight/obesity was 2.64 [1.52, 4.57] (P < 0.0001) for a combined association of a "disadvantaged" family environment + low physical activity and high fat diet. The RR of overweight/obesity was 0.36 [0.14, 0.94] (P < 0.05) for an association of a "privileged" family environment + high physical activity and low fat diet. Thus, MCA appears sufficiently robust and relevant to effectively guide etiological hypotheses and decisions about individual and collective intervention strategies.