Gil Boudet

'Do Well B.': Design Of WELL Being monitoring systems. A study protocol for the application in autism.

Introduction Individuals with autism spectrum disorder (ASD) have difficulties in communication and social interaction resulting from atypical perceptual and cognitive information processing, leading to an accumulation of anxiety. Extreme overloading experienced internally may not be externally visible. Identifying stressful situations at an early stage may avoid socially problematic behaviour from occurring, such as self-injurious behaviour. Activation of the autonomous nervous system (ANS) is involved in the response to anxiety, which can be measured through heart rate variability and skin conductance with the use of portable devices, non-intrusively and pain-free. Thus, developing innovative analysis of signal perception and reaction is necessary, mainly for non-communicative individuals with autism. Methods and analysis The protocol will take place in real life (home and social environments). We aim to associate modifications of the ANS with external events that will be recorded in a synchronous manner through a specific design (spy glasses with video/audio recording). Four phases will be carried out on ASD participants and aged-matched controls: (1) 24-hour baseline pre-experiment (physical activity, sleep), (2) 2 h in a real life situation, (3) 30 min in a quiet environment, interrupted by a few seconds of stressful sound, (4) an interview to record feelings about events triggering anxiety. ASD and control participants will be together for phases 2 and 3, revealing different physiological responses to the same situations, and thus identifying potentially problematic events. The novelty will be to apply time-series analyses (which led to several Nobel Prizes in quantitative finance) on ANS series (heart rate, heart rate variability, skin conductance) and wrist motion. Ethics and dissemination Ethical approval has been obtained from Ethics Committee of Clermont-Ferrand (South-East I), France (2014-A00611–46). Trial findings will be disseminated via open-access peer-reviewed publications, conferences, clinical networks, public lectures and our websites. Trial registration number ClinicalTrials identifier NCT02275455.

Paradoxical dissociation between heart rate and heart rate variability following different modalities of exercise in individuals with metabolic syndrome: The RESOLVE study.

Aims To analyse the effects of different modalities of exercise training on heart rate variability (HRV) in individuals with metabolic syndrome (MetS). Methods and results Eighty MetS participants (aged 50–70 years) were housed and managed in an inpatient medical centre for 21 days, including weekends. Physical activity and food intake/diet were intensively monitored. Participants were randomly assigned into three training groups, differing only by intensity of exercise: moderate-endurance-moderate-resistance (re), high-resistance-moderate-endurance (Re), and moderate-resistance-high-endurance (rE). HRV was recorded before and after the intervention by 24-hour Holter electrocardiogram. Although mean 24-hour heart rate decreased more in Re than re (–11.6 ± 1.6 vs. –4.8 ± 2.1%; P = 0.010), low frequency/high frequency decreased more in re than Re (–20.4 ± 5.5% vs. + 20.4 ± 9.1%; P = 0.002) and rE (–20.4 ± 5.5% vs. –0.3 ± 11.1%; P = 0.003). Very low frequency increased more in Re than re (+121.2 ± 35.7 vs. 42.9 ± 11.3%; P = 0.004). For all HRV parameters, rE ranged between re and Re values. Low frequency/high frequency changes were linked with visceral fat loss only in re (coefficient 5.9, 95% CI 1.9–10.0; P = 0.004). By day 21, HRV parameters of MetS groups (heart rate –8.6 ± 1.0%, standard deviation of R-R intervals + 34.0 ± 6.6%, total power + 63.3 ± 11.1%; P < 0.001) became closer to values of 50 aged-matched healthy controls. Conclusions A 3-week residential programme with intensive volumes of physical activity (15–20 hours per week) enhanced HRV in individuals with MetS. Participants with moderate intensity of training had greater improvements in sympathovagal balance, whereas those with high intensity in resistance training had greater decreases in heart rate and greater increases in very low frequency. Modality-specific relationships were observed between enhanced HRV and visceral fat loss. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00917917.

A Dimensionally Reduced Clustering Methodology for Heterogeneous Occupational Medicine Data Mining

Clustering is a set of techniques of the statistical learning aimed at finding structures of heterogeneous partitions grouping homogenous data called clusters. There are several fields in which clustering was successfully applied, such as medicine, biology, finance, economics, etc. In this paper, we introduce the notion of clustering in multifactorial data analysis problems. A case study is conducted for an occupational medicine problem with the purpose of analyzing patterns in a population of 813 individuals. To reduce the data set dimensionality, we base our approach on the Principal Component Analysis (PCA), which is the statistical tool most commonly used in factorial analysis. However, the problems in nature, especially in medicine, are often based on heterogeneous-type qualitative-quantitative measurements, whereas PCA only processes quantitative ones. Besides, qualitative data are originally unobservable quantitative responses that are usually binary-coded. Hence, we propose a new set of strategies allowing to simultaneously handle quantitative and qualitative data. The principle of this approach is to perform a projection of the qualitative variables on the subspaces spanned by quantitative ones. Subsequently, an optimal model is allocated to the resulting PCA-regressed subspaces.

Report of three cases of renal oncocytoma in the same French chemical industrial factory.

To the Editor: Renal oncocytoma is a rare benign tumor, accounting for 3% to 7% of primary renal tumors. There are no clearly established etiological factors. Three cases of renal oncocytoma detected between 2000 and 2008 in employees or subcontractors working for the same factory “F” in central France during a systematic screening campaign by ultrasonography are reported. The company specializes in vitamin and amino acid synthesis, in particular, vitamin A, vitamin E, and methionine. The factory is currently undergoing epidemiological investigations by the National Health and Work Department of the National Health Watch Institute (InVS) following nine cases of renal cell carcinoma (RCC) detected in workers between 1994 and 2002, at first by chance and later by systematic ultrasonography. The company began systematic screening for hepatic angiosarcoma in 1986 by yearly abdominal ultrasonography of employees exposed to monomer vinyl chloride (MVC). In 1992, the screening program was extended to workers exposed to chloracetal C5. This molecule is an intermediate chemical produced in the course of a new process for vitamin A synthesis called NAVAS (new vitamin A synthesis) first implemented in the factory in 1982. At that time, the molecule was known to be mutagenic in vitro. Since 2002, all company employees undergo ultrasound screening on a voluntary basis. To date, 28 cases of RCC have been detected in this company; most were clear-cell and papillary RCC, but there were also three cases of oncocytoma and one angiomyolipoma. We describe the cases of oncocytoma with particular focus on the possible relation to occupational exposure.