Search

Background: Police personnel are among the first responders exposed to terrorist attacks, raising in number in the late decades. Due to their profession, they are also exposed to repetitive violence, increasing their vulnerability to PTSD and depression. Objective: Our study aims at comparing the prevalence of PTSD and depression, and the risk factors associated with these conditions among directly and indirectly exposed versus non-exposed police personnel during the Strasbourg Christmas Market terrorist attack. Method: Three months after the attack, participants completed a survey assessing their sociodemographic characteristics, occupational data, degree of exposure, sleep debt around the event, event centrality (CES), and three mental health conditions: PTSD (PCL-5), depression (PHQ-9), and suicide risk (yes/no questions). Results: A total of 475 police personnel responded to the questionnaire: 263 were exposed to the attack (182 of them directly) and 212 were non-exposed. Among directly exposed participants, the prevalences of partial and complete PTSD were 12.6 and 6.6%, and the prevalence of moderate-to-severe depression was 11.5%. Multivariate analysis revealed that direct exposure was associated with a higher risk of PTSD (OR = 2.98 [1.10–8.12], p = .03). Direct exposure was not associated with a higher risk of depression (OR = 0.40 [0.10–1.10], p = .08). A significant sleep debt after the event was not associated with a higher risk of later PTSD (OR = 2.18 [0.81–5.91], p = .13) but was associated with depression (OR = 7.92 [2.40–26.5], p < .001). A higher event centrality was associated with both PTSD and depression (p < .001). Conclusions: Police personnel directly exposed to the Strasbourg Christmas Market terrorist attack were at higher risk of PTSD but not depression. Efforts to prevent and treat PTSD should focus on directly exposed police personnel. However, general mental health should be monitored for every personnel member. Direct exposure to the terrorist attack and gender (female) were significantly associated with a higher risk of PTSD among police personnel.Sleep debt after the attack was significantly associated with depression but not with PTSD.No occupational factor was associated with either PTSD or depression.Both PTSD and depression were significantly associated with a higher suicide risk.A higher event centrality was significantly associated with direct exposure and a higher risk of both PTSD and depression. Direct exposure to the terrorist attack and gender (female) were significantly associated with a higher risk of PTSD among police personnel. Sleep debt after the attack was significantly associated with depression but not with PTSD. No occupational factor was associated with either PTSD or depression. Both PTSD and depression were significantly associated with a higher suicide risk. A higher event centrality was significantly associated with direct exposure and a higher risk of both PTSD and depression.

Additional file 1. The right of access to source data and documents.

Background In survival analysis, data can be modeled using either a multiplicative hazards regression model (such as the Cox model) or an additive hazards regression model (such as Lin’s or Aalen’s model). While several diagnostic tools are available to check the assumptions underpinning each type of model, there is no defined procedure to fit these models optimally. Moreover, the two types of models are rarely combined in survival analysis. Here, we propose a strategy for optimal fitting of multiplicative and additive hazards regression models in survival analysis. Methods This section details our proposed strategy for optimal fitting of multiplicative and additive hazards regression models, with a focus on the assumptions underpinning each type of model, the diagnostic tools used to check these assumptions, and the steps followed to fit the data. The proposed strategy draws on classical diagnostic tools (Schoenfeld and martingale residuals) and less common tools (pseudo-observations, martingale residual processes, and Arjas plots). Results The proposed strategy is applied to a dataset of patients with myocardial infarction (TRACE data frame). The effects of 5 covariates (age, sex, diabetes, ventricular fibrillation, and clinical heart failure) on the hazard of death are analyzed using multiplicative and additive hazards regression models. The proposed strategy is shown to fit the data optimally. Conclusions Survival analysis is improved by using multiplicative and additive hazards regression models together, but specific steps must be followed to fit the data optimally. By providing different measures of the same effect, our proposed strategy allows for better interpretation of the data. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01273-2.

Supplemental Material, sj-pdf-1-sri-10.1177_15533506211001236 for Original Preoperative Localization Technique of Parathyroid Adenomas by 3-Dimensional Virtual Neck Exploration by Mihaela Ignat, Madeleine Pérouse, François Lefebvre, Deborah Kadoche, Alessio Imperiale, Lee Swanstrom, Michel Vix and Didier Mutter in Surgical Innovation

Additional file 1. R codes used in the proposed strategy for optimal fitting of multiplicative and additive hazards regression models applied to the dataset of patients with myocardial infarction (TRACE data frame in the timereg R package).

This study aimed to demonstrate that there was no risk of extension of infection in performing mechanical exsanguination before inflating the tourniquet for surgical treatment of digital flexor tendon sheath phlegmon. The series comprised 96 patients, with a mean age of 47 years (range, 18–87 years) and 37 women. Group I included 47 patients in whom exsanguination was performed with a Velpeau band before inflating the pneumatic tourniquet at the root of the limb. In Group II, which included 49 patients, the tourniquet was inflated after simple elevation of the limb. Six patients underwent revision surgery for recurrence or osteoarticular complications: 4 (8.5%) in Group I and 2 (4.1%) in Group II, the difference between two groups being non-significant (p = 0.6378). In conclusion, mechanical exsanguination before inflating the tourniquet did not incur risk of complications in surgical management of digital flexor tendon sheath phlegmon. Résumé Le but de ce travail était de démontrer qu’il n’y avait aucun risque d’extension de l’infection à procéder à une exsanguination mécanique avant de gonfler le garrot au cours du traitement chirurgical des phlegmons de la gaine des tendons fléchisseurs des doigts. Notre série comprenait 96 patients âgés en moyenne de 47 ans (18-87) dont 37 femmes. Le groupe I comprenait 47 patients chez qui une exsanguination a été réalisée avec une bande Velpeau avant de gonfler le garrot pneumatique à la racine du membre. Dans le groupe II qui comprenait 49 patients, le garrot pneumatique a été gonflé après surélévation du membre seulement. Dans cette série, 6 patients ont été repris pour récidive ou extension ostéoarticulaire, dont 4 (8,5%) pour le groupe I et 2 (4,1%) pour le groupe II. La différence entre les deux groupes était statistiquement non significative (p = 0,6378). En conclusion, l’exsanguination mécanique avant de gonfler le garrot ne présente pas de risque de complication lors de la prise en charge chirurgicale des phlegmons de la gaine des fléchisseurs des doigts.

Supplemental Material, sj-pdf-1-sri-10.1177_15533506211001236 for Original Preoperative Localization Technique of Parathyroid Adenomas by 3-Dimensional Virtual Neck Exploration by Mihaela Ignat, Madeleine Pérouse, François Lefebvre, Deborah Kadoche, Alessio Imperiale, Lee Swanstrom, Michel Vix and Didier Mutter in Surgical Innovation

Objective Recent studies carried out on amyotrophic lateral sclerosis patients suggest that the disease might initiate in the motor cortex and spread to its targets along the corticofugal tracts. In this study, we aimed to test the corticofugal hypothesis of amyotrophic lateral sclerosis experimentally. Methods Sod1G86R and Fezf2 knockout mouse lines were crossed to generate a model that expresses a mutant of the murine Sod1 gene ubiquitously, a condition sufficient to induce progressive motor symptoms and premature death, but genetically lacks corticospinal neurons and other subcerebral projection neurons, one of the main populations of corticofugal neurons. Disease onset and survival were recorded, and weight and motor behavior were followed longitudinally. Hyper-reflexia and spasticity were monitored using electromyographic recordings. Neurodegeneration and gliosis were assessed by histological techniques. Results Absence of subcerebral projection neurons delayed disease onset, reduced weight loss and motor impairment, and increased survival without modifying disease duration. Absence of corticospinal neurons also limited presymptomatic hyper-reflexia, a typical component of the upper motoneuron syndrome. Interpretation Major corticofugal tracts are crucial to the onset and progression of amyotrophic lateral sclerosis. In the context of the disease, subcerebral projection neurons might carry detrimental signals to their downstream targets. In its entirety, this study provides the first experimental arguments in favor of the corticofugal hypothesis of amyotrophic lateral sclerosis. journal article research support, non-u.s. gov't 2020 10 2020 07 11 imported

Background The efficacy of antitumour necrosis factor alpha (anti-TNF-α) treatment is well recognised in rheumatoid arthritis (RA) but remains controversial in systemic lupus erythematosus (SLE). Therefore, the role of anti-TNF-α treatment in ‘Rhupus’, a disease sharing features of RA and SLE, is still debated. Objective To evaluate the efficacy and tolerance of anti-TNF-α in patients with rhupus. Methods Fifteen patients with rhupus with Disease Activity Score 28 (DAS 28) >3.2 despite conventional disease-modifying anti-rheumatic drugs were included in an open-label study. Patients were monitored at months (M) 3, 6, 12, 24 and 60 with SLE Disease Activity Index (SLEDAI) and DAS 28. Statistical analyses were performed using Bayesian methods and Prob >97.5% was considered significant. Results Twelve patients were treated with etanercept for a median duration of 62.5 (range: 6–112) months and three patients by adalimumab during 36.0 (range: 4–52) months. At baseline, median DAS 28 and SLEDAI were 5.94 (4.83–8.09) and 6 (4–8), respectively. DAS 28 and SLEDAI decreased significantly after 3 months, respectively, to 3.70 (1.80–6.42) and 4 (0–6) (Prob >99.9%, for both). These changes persisted at M6, M12, M24 and M60 (Prob >99.9%, for all). Median prednisone dose decreased significantly from 15 (5–35) mg/day to 5 (0–20) mg/day after 6 months and over the follow-up (Prob >99.9%, for all). Tolerance was acceptable, with a severe infection rate of 3.0 per 100 patient-years. Conclusion This pilot study suggests that anti-TNF-α is effective in patients with rhupus with refractive arthritis and has an acceptable safety profile. journal article 2017 2017 12 29 imported

International audience; BACKGROUND:Sickle cell disease (SCD) has become a major public health issue. Hydroxyurea and red blood cell (RBC) transfusion are the cornerstone treatments. Erythrocytapheresis (ECP) is an automated method for transfusion exchange. Given that ECP requires more blood than conventional transfusion, there is concern about alloimmunization and hemolytic transfusion reactions. We evaluate the incidence of hemolytic transfusion reactions and alloimmunization rates in patients receiving conventional blood transfusions and in patients participating in long-term blood exchange programs with ECP.STUDY DESIGN AND METHODS:All hemolytic transfusion reactions and alloimmunizations in SCD patients were recorded over the period 2006 to 2011. Conventional transfusions and ECP were compared.RESULTS:The cohort consisted of 188 SCD patients. The median (±SD) age was 23 (±14) years. The ECP and conventional transfusion groups comprised 49 and 139 patients, respectively. The prevalence of alloimmunization was 33% in the ECP group and 22% in the conventional transfusion group (p = 0.1797). The alloimmunization/RBC unit (RBCU) ratio was lower in the ECP group than in the conventional transfusion group (1.6 and 11.6 per 1000, respectively; p

International audience; Comptes rendus (avec résumés d'interventions) des journées du 20-21 septembre 2012, ayant réunis à Poitiers experts scientifiques et techniques autour de Gallasellus heilyi (crustacé isopode aquatique), espèce endémique du grand Centre-Ouest de la France

Les Crustacés forment un sous-groupe d'Arthropodes, au même titre que les Hexapodes (insectes) ou les Chélicérates (araignées). Fondamentalement, ils se caractérisent par l'existence d'un stade embryonnaire typique (la larve nauplius), et par une cuticule imprégnée de sels de calcium. Au-delà, c'est un groupe très hétérogène, avec une grande diversité de formes, d'habitats, et de mode de vie. Pour la France continentale métropolitaine, on estime à environ 900 le nombre d'espèces de Crustacés (bords de mers et océans exclus !). En Vienne, au dernier pointage (circulaire Vienne Nature, hiver 2010/2011), seules 8 espèces recensées (pour l'essentiel des écrevisses). C'est qu'il s'agit d'un de ces nombreux " groupes orphelins " pour lesquels il n'y a plus ou peu de naturalistes locaux spécialisés (carcinologues). Pour autant, des données anciennes et disparates existent, mais elles ne sont pas centralisées. En nature comme en toute chose, l'intérêt nait de l'intéressement. Voici un premier essai de synthèse et d'actualisation sur notre faune Crustacé locale.

La technologie des microarrays demeure à ce jour un outil important pour la mesure de l'expression génique. Au-delà de la technologie elle-même, l'analyse des données provenant des microarrays constitue un problème statistique complexe, ce qui explique la myriade de méthodes proposées pour le pré-traitement et en particulier, l'analyse de l'expression différentielle. Toutefois, l'absence de données de calibration ou de méthodologie de comparaison appropriée a empêché l'émergence d'un consensus quant aux méthodes d'analyse optimales. En conséquence, la décision de l'analyste de choisir telle méthode plutôt qu'une autre se fera la plupart du temps de façon subjective, en se basant par exemple sur la facilité d'utilisation, l'accès au logiciel ou la popularité. Ce mémoire présente une approche nouvelle au problème de la comparaison des méthodes d'analyse de l'expression différentielle. Plus de 800 pipelines d'analyse sont appliqués à plus d'une centaine d'expériences sur deux plateformes Affymetrix différentes. La performance de chacun des pipelines est évaluée en calculant le niveau moyen de co-régulation par l'entremise de scores d'enrichissements pour différentes collections de signatures moléculaires. L'approche comparative proposée repose donc sur un ensemble varié de données biologiques pertinentes, ne confond pas la reproductibilité avec l'exactitude et peut facilement être appliquée à de nouvelles méthodes. Parmi les méthodes testées, la supériorité de la sommarisation FARMS et de la statistique de l'expression différentielle TREAT est sans équivoque. De plus, les résultats obtenus quant à la statistique d'expression différentielle corroborent les conclusions d'autres études récentes à propos de l'importance de prendre en compte la grandeur du changement en plus de sa significativité statistique., Microarrays remain an important tool for the measurement of gene expression, and a myriad of methods for their pre-processing or statistical testing of differential expression has been proposed in the past. However, insufficient and sometimes contradictory evidence has prevented the emergence of a strong consensus over a preferred methodology. This leaves microarray practitioners to somewhat arbitrarily decide which method should be used to analyze their data. Here we present a novel approach to the problem of comparing methods for the identification of differentially expressed genes. Over eight hundred analytic pipelines were applied to more than a hundred independent microarray experiments. The accuracy of each analytic pipeline was assessed by measuring the average level of co-regulation uncovered across all data sets. This analysis thus relies on a varied set of biologically relevant data, does not confound reproducibility for accuracy and can easily be extended to future analytic pipelines. This procedure identified FARMS summarization and the TREAT gene ordering statistic as algorithms significantly more accurate than other alternatives. Most interestingly, our results corroborate recent findings about the importance of taking the magnitude of change into account along with an assessment of statistical significance.

National audience; L'étude porte sur le devenir des agriculteurs installés aidés de 1993 à 2002 dans six départements (Dordogne, Doubs, Maine-et-Loire, Pyrénées Atlantiques, Vienne, Yonne). Dans ces départements le pourcentage de hors cadres familiaux (HCF) varie de 8 à 24% pour cette période. Dans l'ensemble les HCF aidés s'installent plus en individuel qu'en société et ne regrettent pas leur installation. Certes ils font état des difficultés rencontrées mais ils ont réussi à les surmonter, 97% d'entre eux pensent continuer dans ce métier et ils ne se sentent pas pénalisés pas leur statut de HCF.

Le contrat territorial d'exploitation, d'une durée de cinq ans, vise à associer le développement économique de l'exploitation et la protection de l'environnement en favorisant une agriculture multifonctionnelle répondant aux nouvelles attentes de la société. Plus de vingt mille CTE ont déjà été signés et le nombre de signatures, en forte progression, atteint les deux mille par mois. Les aides financières, qui se répartissent entre les aspects socio-économiques et envi ronnementaux, s'élèvent en moyenne à 38 110 euros par contrat. La population bénéficiaire est tout à fait représentative de l'ensemble des agriculteurs de moins de 55 ans. Toutefois, les exploitations sous statut sociétaire sont surreprésentées. Si toutes les filières de production sont proportionnellement bien impliquées, la taille moyenne des exploitations individuelles reste plus grande que la moyenne nationale. Le CTE joue un rôle important dans la création d'emplois puisqu'un emploi est créé pour quinze CTE signés. Parmi les mesures agro-environnementales, les contractants sont sensibles à l'amélioration de la qualité de l'eau (plus de la moitié des CTE) et au maintien de la biodiversité et des paysages. Les actions liées au tourisme sont choisies dans près d'un CTE sur dix, soit trois fois plus qu'au niveau national. En particulier, la préservation du patrimoine est incluse dans la moitié des CTE contenant des actions touristiques. Les CTE contenant des mesures de conversion à l'agriculture biologique sont nombreux (13%), et les CTE collectifs dont la mise en place a été plus tardive sont désormais en pleine expansion. La France des CTE est donc riche de diversités tant par les hommes qui la composent que par les actions que le monde agricole, sans exclusion, a choisi de mener. Si l'agriculture reste avant tout une activité économique à part entière, les agriculteurs montrent, à travers le CTE, leur préoccupation, identique à celle des urbains, de préserver un monde rural vivant et respectueux de l'environnement.

Sign.: A8, B6, Anteportada, Enc. en pasta valenciana con marco dorado en tapas, Sello de la Biblioteca de Santa Cruz en portada, Ant. sign.: 10522 en etiqueta impresa de la Biblioteca Universitaria en contraguarda anterior