Unite´ de Nutrition Humaine (UMR1019), INRA Theix, 63122 Saint Gene`s Champanelle, France
As oestrogen deficiency is the main cause in the pathogenesis of osteoporosis hormone- replacement therapy remains the mainstay for prevention. However, prophylaxis by hormone- replacement therapy is limited. Phyto-oestrogens, which are weakly-oestrogenic compounds present in plants, deserve particular mention because emerging data support the suggestion that they may prevent bone loss associated with the menopause. In the past few years extensive research using animal models has provided convincing data to indicate a significant improve- ment in bone mass or other end points following feeding with soyabean. Moreover, observa- tional studies relate the lower incidence of osteoporosis among women in the Eastern world to a diet rich in phyto-oestrogens. However, it is not valid to extrapolate to the Western situation. The varied clinical trials that have been published suggest that isoflavones reduce bone loss in women in the early period post menopause, but a definitive result requires more investigations of the effect of phyto-oestrogens on bonehealth that have substantial sample size and are of long duration. In addition, the clinical efficacy of soya foods in preventing osteopenia depends on their intestinal metabolism. Thus, phyto-oestrogens are a source for putative innovative dietary health intervention for post-menopausal women. However, more data are necessary, particularly in relation to their effect on the risk of fracture.
This work was supported in part by the « Departement Alimentation Humaine – ANSSD ‐ INRA ». The authors would like to thank Dr. Jean Michel Chardigny (UMR INRA‐ENESAD Flaveur, Vision et Comportement du consommateur, 21065 Dijon Cedex, France.) for providing the SAM mice with the autorisation of Dr. Hosakawa, Aichi, Japan. As well, the authors are grateful to (1) C. Jouve, JP. Rigaudière for their help in in collecting samples and data; (2) to the people from the “Animal lab: Instalation Experimental de Nutrition” who provided every day cares to the mice and (3) Latifa Rbah for her assistance in conducting analysis of bone mineral density.
A Welcoming Cocktail will be organized on May 21 st at 19.30 by Quimper Communauté for all the participants. A visit of the
historical heritage of Quimper will precede the reception at the city hall.
The 5 th edition of MIS symposium will take place in Quimper, in Brittany, an
admitted centre of scientific research in agribusiness. Quimper city and Cornouaille gather various activities in terms of R&D, innovation and education in the food, health and nutrition technologies.
The heavy metal and environmental pollutant cadmium (Cd) has recently been identified as a risk factor for osteoporosis (Staessen et al, 1999). Cd accumulates in humans, mainly in the kidneys, via the food chain. The more Cd contaminates the agricultural environment the more it contaminates the food chain and endangers human health, and its levels in soils have increased continuously during the last century. The diet is the main source of Cd intake in non-smoking non-professionally exposed people. In France, the Cd concentration in human bones rose tenfold during the 20th century (Staessen
B-4000, Liège BELGIUM.
The role of vitamin D (VTD) in maintaining bonehealth has been known for decades.
Recently, however, the discovery that many tissues expressed the VTD receptor and were able to transform the 25-OH VTD into its most active metabolite, 1,25-(OH)2 VTD, has led to a very promising future for this “old” molecule. Indeed, observational studies, and more and more interventional studies, are raising the importance of a significant VTD supplementation for not-only skeletal benefits. Amongst them, 25-OH VTD has been found to play an
According to the European regulation, the use of nutrition and health claims shall only be permitted if the food product has been shown to have a beneficial nutritional or physiological effect in agreement with the health claim. However, it must also be pointed out that during the evaluation of the health claim, besides the characterization of the effect, important elements will be taken into account, such as the characterization of the food and the substanti- ation of the effect. In the field of bonehealth, claimed effects are not sufficiently defined and there are no standardized recommendations for the design and the methodology of clinical studies needed to reach such health claims. The consensus reached by the GREES is that the level of health claim may differ according to the surrogate endpoint used and on additional animal studies provided to support the claim. The ideal study design is a RCT but, is some particular cases, prospective cohort, case-control, or observational studies can be acceptable. In our opinion, general principles of the consensus reached are in line with the principles adopted in the EFSA's published opinions. This consensus is subject to future modifications when new validated surrogate markers will be available.
Unité de Nutrition Humaine (UMR1019), Saint Genès-Champanelle, France
Phytoestrogens are a source for putative new and innovative dietary health intervention for postmenopausal women. They deserve special mention because emerging data support the hypothesis that these weakly oestrogenic compounds present in plants may represent a potential alternative therapy for a range of hormone-dependent conditions, a lower incidence of such diseases being associated with high intakes. Indeed, targeting bonehealth, in Asian countries, soy isoflavones consumption helps to prevent the demineralisation pro- cesses demonstrated in situations of estrogen deficiency and is associ- ated with a lower risk of fracture. Furthermore, lifestyle westernization induces loss of protection. However, conspicuous differences are encountered in Caucasian people, probably due to the very low aver- age intake. In such a population, supplementation studies investigat- ing bone turnover are not consistent. Nevertheless, substantial body of work has provided some evidence for significant improvement of bone mineral density after 6 months of supplementation. However recent studies carried out on longer term do not further confirm those potential promises. Anyway, because no clinical trial focussing on the effect of phytoestrogens on the risk of fracture (which is the ultimate hallmark for bonehealth) is available, a recommendation cannot be given at the current time. Moreover, before health professionals can actively advocate the increased consumption of soy, we need to gather more data on safety issues in order to rule out unknown metabolic effects with undesirable consequences.
Several health monitoring systems have been designed and developed based on the OSGi framework and Web Ser- vices. A wireless health monitoring system was proposed in  to measure, process, and transmit patient’s phys- iological data to a centralized remote platform for data collection. The data referred to information such as the glucose level in the blood, the arterial saturation of oxy- gen, the blood pressure, the heart rate, and weight of the subject. The system was built based on OSGi to man- age the biomedical devices and define a service-oriented architecture. In this system, users can interact with Tele- vision by using a multimedia home platform (MHP) mid- dleware to browse personal physiological data. The AAL framework presented in  provides for remote monitor- ing, emergency detection, activity logging and personal notifications dispatching services. The proposed service- oriented architecture is based on a heterogeneous sensor network composed of WSN nodes and personal mobile de- vices. The middleware is integrated into an OSGi frame- work that processes the collected data in order to pro- vide context-aware services and enable network control. In , a ubiquitous home healthcare environment archi- tecture is presented. This architecture is composed of four main building blocks, which are the healthcare gateway (based on OSGi), the Zigbee portable medical devices, the remote management server, and the data center. Message formats were defined between the Zigbee coordinator and the Zigbee portable medical device and devices were dy- namically converted into UPnP devices. Since the software in the healthcare gateway was managed by OSGi, it can be remotely configured, managed, monitored, and diagnosed. Authors in  proposed an integrated OSGi-based service platform to aggregate diverse safety and health related ser- vices and to provide personalized assistive support for the elderly. By leveraging the component-based architecture of the OSGI service framework, the platform aimed to in- tegrate heterogeneous devices, networks and data modal- ities, to provide assistive services for the elderly and to promote collaboration between devices and services from various sources.
To assist implementation of health monitoring and convey harmonization, the ICAR Functional Traits Working Group has compiled the ICAR guidelines for Recording, Evaluation and Genetic Improvement of Health Traits, which were approved in June 2012. Disease diagnoses and observations of impaired health can be classified as direct health data, providing the basis for targeted approaches to improve the animal health status. Data sources need to be taken into account because of their impact on information content and specificity. The key for health data recording is characterized by a hierarchical structure that makes it possible to record on different levels of detail and includes comprehensive recording options with coverage of all organ systems and types of diseases. Important features are compatibility with other recording systems and broad usability as a reference regardless of specific intentions and contexts of health data collection. Input can range from very specific diagnoses of veterinarians to very general diagnoses or observations by producers, and the unique coding of clearly defined health incidents minimizes the risk of misinterpretations and facilitates analyses of different types of health data. The overall quality and success of health monitoring is substantially influenced by
Nutrition and Health Department, Nestlé Research Center, 1000 Lausanne 26, Switzerland
Osteopaenia is a common complication of inflammatory bowel diseases (IBD). However, the mechanisms of bone loss are still the subject of debate. The aims of this study were to investigate bone loss in HLA-B27 transgenic rats, a spontaneous model of colitis and to compare the results provided by the usual markers of bone remodelling and by direct measurement of bone protein synthesis. Systemic inflammation was evaluated in HLA-B27 rats and control rats from 18 to 27 months of age. Then bone min- eral density, femoral failure load, biochemical markers of bone remodelling and protein synthesis in tibial epiphysis were meas- ured. Bone mineral density was lower in HLA-B27 rats than in controls. Plasma osteocalcin, a marker of bone formation, and fractional protein synthesis rate in tibial epiphysis did not differ between the two groups of rats. In contrast, urinary excretion of deoxypyridinoline, a marker of bone resorption, was significantly increased in HLA-B27 rats. The present results indicate that bone fragility occurs in HLA-B27 rats and mainly results from an increase in bone resorption. Systemic inflammation may be the major cause of the disruption in bone remodelling homeostasis observed in this experimental model of human IBD.
Taken together, the data indicate that the culture procedure may select for cells with large differentiation potential. Some of the differentiations are compatible with the mesodermal origin of the MSCs while others fit with the well-evidenced neuroectodermal origin of a MSC subpopulation. Differentiation into cells of endodermal origin might indicate that MSCs have undergone a mesenchymal-to-epithelial transition (MET), an instance common during development, but less frequent in the adult (Prindull and Zipori, 2004). Indeed, such MET have been described in MSC-like cells generated from the fetal liver (Chagraoui et al., 2003; Dan et al., 2006; Inada et al., 2008). Finally, the generation of pluripotent cells might result from the selection of rare vestigial embryonic stem cells having homed to the bone marrow. Alternatively, this population might result from reprogrammation, similarly to what occurs for induced Pluripotent Cells from dermal fibroblasts (Takahashi and Yamanaka, 2006).
and reported that the girls playing the high-impact sport of soccer exhibited greater cortical thickness than swimmers due to increased bone section (width). The authors suggested that the “unloading” environment of the swimming pool may have a deleterious effect on bone geometry. We observed no alteration in the bone geometry of swimmers as compared with age-paired controls. The discrepancy between our data and Ferry's may be related to the training volume (mean 14 h/ wk vs. 10 h/wk), the type of training (associated with or without resistance training), the age of the participants, and the number of years of practice. It is possible that the normal/ low aBMD associated with normal bone geometry conferred an advantage in terms of buoyancy for these athletes [39,40] . The HSA results seem particularly pertinent in sport because they reinforce those obtained by direct evaluation of bone geometry such as pQCT at the tibial cortical site in preme- narcheal rhythmic gymnasts  . Independently, the modifi- cation in bone geometry and strength as evaluated by pQCT was also observed in artistic gymnasts at the forearm  .
As we previously showed that bone formation can be related to hBMSC number  , we count cells present on grafted scaffolds at different time post-transplantation. Interestingly, as early as 24 h post-graft more than 50% of initially grafted cells disappeared on HA/ bTCP versus only 20% on TPB. Cell loss was not due to a higher apoptosis or inflammation on HA/ bTCP but to an increase of grafted hBMSC migration to adjacent tissues like skin and muscle. Contrary to systemic administration  , we confirmed that cells loaded on biomaterials did not migrate further into organs like heart, kidney, spleen, liver or lung which is an important safety consideration to initiate clinical trials [34,36] . Moreover, migrated cells on adjacent tissues disappeared after 1 W, probably by a local inflammation or by anoikis (apoptosis induced by loss of cell anchorage)  , whereas they were still present until 6 W on biomaterials reflect- ing a better microenvironment to their survival. Lower cell migra- tion from TPB was due to their higher seeding efficiency on this scaffold as showed by in vitro analysis. Despite the same surface area and macropores size >100 mm that represent appropriate con- ditions for cell adhesion  , we showed that TPB presents a higher accessible surface area for cell invasion as it is composed of 85% of open pores. Our in vitro and SEM analysis confirmed that this property favors hBMSC attachment, fast spreading and allows their physical contact by cytoplasmic extensions  . Further- more, TPB present numerous flat areas similar to natural endos- teum structure where MSC preferentially attach  . The spongy architecture of TPB represents a better conformation to guide new bone formation compared to the single bloc structure of HA/ bTCP. In addition, the high level of closed pores on HA/bTCP con- centrate cell adherence on the outer surface area  and can hin- der new bone invasion which may explain the major bone
Commentary on: Davies E, Mu¨ller KH, Wong WC, Pickard CJ, Reid DG, Skepper JN, Duer MH. Citrate bridges between mineral platelets in bone. Proc Natl Acad Sci USA 2014;111:E1354–E1363.
The interactions between constituents of the bone composite, at the molecular level, have long been investigated for their potential role in the cohesion and mechanical properties of the tissue. Despite recent efforts involving sophisticated techni- ques, the nature of interactions, at the chemical level, between the two main bone components—collagen matrix and calcium phosphate apatite nanocrystals—has not yet been clarified. Another question is that of interactions between the apatite nanocrystals, which is addressed in the paper of Davies et al. 1 As it is often the case, regarding bone mineral, the work of the authors relies strongly on the analyses of synthetic samples, which are considered to represent more or less bone mineral crystals, in this case octacalcium phosphate (OCP) incorpor- ating citrate anions. Two main questions arise: is OCP a good model for bone crystals? Is the crystal structure of OCP-citrate a pertinent representation of an intercrystalline chemical bonding between bone crystals?
Temporal bone dissection guide: second edition , edited by H. W. Francis and J. K. Niparko, New York, Thieme Publishers, 2016, 96 pages, ISBN: 978-1-62623-113-9
The temporal bone is an anatomical structure of an extraordinary complexity. The minuscule scale of its critical neurovascular structures combined with their convoluted three-dimensional relationships make micro- surgery of this region one of the most technically demanding of all operative endeavours. Tumours and erosive lesions create additional anatomical barriers that make effective access and resection of the pathological areas difficult. At the same time, the surgical skills required to navigate this anatomy are indispensable to the management of ear disease and associated disabil- ity, and provide alternative approaches with less mor- bidity to intracranial pathology.
In the figure above, the bold arrow (i) corresponds to the creation, by the institution that performed a medical procedure for a patient, to the creation of a new block on the blockchain. The dotted arrow (ii) corresponds to the recording in the health wallet of informations relating to the medical act. In the vocabulary of the cryptographic science, patients and medical institutions in this architecture are called nodes. In this decentralized network, data are located in the network of personal computers of patients, caregivers or others medical institutions public and private (called nodes) without any central control. Adding a new block to the blockchain proceeds from a "trust-in-the-third-party" mechanism where a medical act is decided when the willing parties approve it by a digital signature. Proof of zero knowledge is a security measure that verifies the veracity of the information entered on the health blockchain. Without going into details here, proof of zero knowledge is a security measure that allows a controller to show that it knows confidential information on the network without actually revealing it. Already, many privacy-based cryptocurrencies such as ZCash and Monero use this zero knowledge proof method to secure their transactions and make them private between users. For example, by using this zero knowledge proof method in the field of a health blockchain, it is possible in cryptography to answer the question "Have I been close to someone with Covid-19?" with a specific "yes" without disclosing who that person is.
regarding this point seem to support Brown’s view and synthetic nanocrystalline apatites, free of carbonate ions, exhibit FTIR spectra close, although not identical, to that of OCP. 7 This
hydrated surface structure appears, however, very fragile and is altered by reversible surface ion exchange preserving the bulk characteristics of apatite crystals. 8 In the presence of foreign ions such as carbonate and magnesium, the surface hydrated layer may remain structured (carbonate), but with alterations, or become amorphous-like (Mg 2 þ ). The very fast ion exchange reactions justify the term ‘labile’ often used to characterise the hydrated layer. This does not mean that ionic species are moving in the hydrated layer, which appears often well structured: they are immobile, but they are loosely bound and can be easily exchanged. Therefore, the surface model of OCP for biomimetic nanocrystalline apatite surfaces, including bone mineral, has some relevance, but it needs to be adapted to take into account variable ion content with potential ionic substituents.
MESH Keywords Bias (Epidemiology) ; Health Status ; Insurance, Disability ; statistics & numerical data ; Norway ; Socioeconomic Factors
In their interesting article in which they compared the health of participants with that of nonparticipants in a population-based survey in Norway, Knudsen et al. ( 1 ) were able to link their eligible population sample with the Norwegian national registry of disability pensions, which includes information about diagnoses. They found that the likelihood of receiving a disability pension was higher among nonparticipants, and this was especially true for persons receiving disability pensions as a result of mental disorders. One of the most important features of their study was that the use of a registry-based outcome provided information on health status several years after inception, and the authors claim that this was the first study to obtain information about nonparticipation bias using a longitudinal design “ ” (1, p. 1310).
measures were complex in practice, they did ratify the possibility of building a generic medicines market to cover the public health needs defined by states.
The 2000s were marked by decisions taken by countries of the South to implement compulsory licenses, whereas until then such decisions had been taken only by countries of the North (Scherer 2000). Compulsory licenses were decreed in Thailand in 2006 and then Brazil in 2007, following intense mobilization by civil society and local health ministries. In Brazil the state president authorized the local production of Efavirenz, an AIDS anti-retroviral (ARV), for “a public non-commercial use.” The aim was to supply Brazil’s national AIDS programme which distributed these medicines freely to patients (Cassier and Correa 2008). In Brazil and India, sometimes jointly, patient organizations and generics laboratories initiated opposition procedures to obtain the cancellation of certain patents. In 2008 this opposition resulted in patents on Tenofovir, another HIV/AIDS ARV, falling into the public domain, in both India and Brazil. Generic drugs producers in these two countries can now produce freely. In India an opposition procedure initiated by a cancer patient organization and several generic drugs producers resulted in cancellation of Novartis’s patent on Glivec, in the name of public health. This decision was upheld on appeal: “Thus, we also observe that a grant of product patent on this application can create havoc to the lives of poor people and their families affected with the cancer for which this medicine is effective. This will have a disastrous effect on society as well” (Novartis v. Union of India, Intellectual Property Appellate Board, may 2009). On 3rd april 2013, The Supreme Court of India confirmed the rejection of the Novartis patent on Glivec (Novartis v. Union of India, Supreme Court of India, april 2013).
2 Pediatrician endocrinologist, Pediatrics unit, CHR Citadelle, 4000 Liège
Primary hypothyroidism is a common endocrine disease. Although the diagnosis is often simple, some clinical presentations are rarer. The association of short stature, epiphysis bone lesions and severe retarded bone age in children should lead to the diagnosis of severe, long-standing acquired hypothyroidism.