Walking and running cadence estimation using a single trunk-fixed accelerometer for daily physical activities assessment

Accurate assessment of the type, duration, and intensity of physical activity (PA) in daily life is considered very important because of the close relationship between PA level, health, and well-being. Therefore, the assessment of PA using lightweight wearable sensors has gained interest in recent years. In particular, the use of activity monitors could help to measure the health-related effects of specific PA interventions. Our study, named as Run4Vit, focuses on evaluating the acute and longterm effects of an eight-week running intervention on PA behaviour and vitality. To achieve this goal, we developed an algorithm to detect running and estimate instantaneous cadence using a single trunk-fixed accelerometer. Cadence was computed using time and frequency domain approaches. Validation was performed over a wide range of locomotion speeds using an open-source gait database. Across all subjects, the cadence estimation algorithms achieved a mean bias and precision of - 0.01 ± 0.69 steps/min for the temporal method and 0.02 ± 1.33 steps/min for the frequency method. The running detection algorithm demonstrated very good performance, with an accuracy of 98% and a precision superior to 99%. These algorithms could be used to extract metrics related to the multiple dimensions of PA, and provide reliable outcome measures for the Run4Vit longitudinal running intervention program. Clinical Relevance- This work aims at validating a multi-dimensional physical activity (PA) classification algorithm for assessing the acute and long-term effects of eight weeks running intervention on PA behaviours and vitality.

Bacterial colonization of healthcare workers' mobile phones in the ICU and effectiveness of sanitization

Extra-European studies report high rates of multi-drug resistant bacteria colonization of healthcare workers' mobile phones in intensive care units. We aimed to assess the prevalence of bacterial colonization of healthcare workers' mobile phones in an intensive care unit in France and the effectiveness of a sanitization product. We designed a prospective, monocentric study in a 15-bed intensive care unit within a 300-bed private hospital. Bacterial colonization was assessed on 56 healthcare workers' mobile phones immediately before and 5 min after sanitization of the phones with bactericidal wipes. The mobile phones of 42 administrative staff acted as controls. All mobile phones in both groups were colonized. Healthcare workers' phones had a higher number of different bacterial species per phone (2.45 ± 1.34 vs. 1.81 ± 0.74, p = 0.02). Colonization with pathogens did not differ significantly between healthcare workers' and controls' phones (39.3% vs. 28.6%, p = 0.37). Excluding coagulase negative Staphylococcus, Staphylococcus aureus was the most common pathogen found in both groups (19.6% and 11.9%, p = 0.41). Only one healthcare workers' mobile phone was colonized by methicillin-resistant Staphylococcus aureus, and no other multi-drug resistant bacteria was detected. No covariate was associated with pathogen colonization. After sanitization, 8.9% of mobile phones were sterilized, and colonization with pathogenic bacteria decreased (21.4% vs. 39.3%, p = 0.04) as did the number of CFUs/mL (367 ± 404 vs. 733 ± 356, p < 0.001). Colonization of intensive care unit healthcare workers' and administrative staff's mobile phones was similar. Colonization with pathogens was frequent but colonization with multi-drug resistant bacteria was rare. Disinfecting the phones with bactericidal wipes is not completely effective. Specific sanitization protocols and recommendations regarding the management of healthcare workers' mobile phones in intensive care units should be developed. Additionally, good hand hygiene after touching mobile phones should be kept in mind to prevent cross-infections.

Actinobaculum schaalii: A truly emerging pathogen?: Actinobaculum schaalii: un pathogène réellement émergent?

Actinobaculum schaalii is a Gram-positive facultative anaerobe bacillus. It is a commensal organism of the genitourinary tract. Its morphology is nonspecific. Aerobic culture is tedious, and identification techniques have long been inadequate. Thus, A. schaalii has often been considered as a nonpathogen bacterium or a contaminant. Its pathogenicity is now well described in urinary tract infections, and infections in other sites have been reported. This pathogen is considered as an emerging one following the growing use of mass spectrometry identification. In this context, the aim of our study was to evaluate the number of isolations of A. schaalii before and after the introduction of mass spectrometry in our hospital and to study the clinical circumstances in which isolates were found.

Late superior mesenteric artery syndrome in paraplegia: case report and review

STUDY DESIGN

A case report of superior mesenteric artery syndrome (SMA syndrome) occurring in a paraplegic patient 3 months after injury.

OBJECTIVES

To report an unusual case and review the literature of SMA syndrome in spinal cord injured patients, focusing on paraplegic subjects and on tardive presentations.

SETTING

A Physical Medicine and Rehabilitation Center in Garches (France).

METHOD

Current medical literature includes reports of only 14 spinal cord injured patients with SMA syndrome. This syndrome has been often described in anorexia nervosa, burns or other causes of cachexia, following correction of spinal deformities or after application of body casts.

RESULTS

In spinal cord injured patients SMA usually occurs in tetraplegic patients during the first weeks after injury. Only four cases of SMA syndrome in paraplegic patients have been described. Late forms are less common than acute ones: only three cases among 14. SMA syndrome consists of a vascular compression of the third part of the duodenum between the ventrally oriented SMA and the aorta. The normal aorto-mesenteric angle ranges between 38 degrees and 65 degrees and can be as low as 6 degrees in patients with SMA syndrome. The diagnosis is usually based on upper gastro-intestinal contrast X-ray study, which shows abrupt vertical compression of the third part of the duodenum. CT scan with angiography is useful in some difficult cases. Conservative management includes early correction of dehydration and electrolyte imbalance, insertion of a nasojejunal tube beyond the obstruction and renutrition. Duodenojejunostomy may be necessary in case of failure of conservative treatment.

CONCLUSION

SMA syndrome is an unusual gastro-intestinal complication that may occur in paraplegic patients, even late after injury.