Search

In this paper, physics-based numerical simulation (PBS) is employed to render a broad-band (0–10 Hz) realization of the near-field seismic response of the experimental nuclear site of Cadarache, located nearby the active Middle Durance Fault (southeastern France). The sensitivity of the earthquake numerical model to geological features is investigated by comparison with geophysical measurements and past aftershock and by highlighting the amplification induced by the soft sediments below Cadarache. The blind prediction of an M W6 target earthquake is approached by synthesizing four different finite-fault scenarios. The outcome is compared to the standard ground motion prediction equations (GMPEs), unveiling a possible GMPE overestimation of the pseudospectral acceleration ordinates at short natural periods, supporting the actual need to integrate synthetic and empirical predictions when direct observations are not available. [ABSTRACT FROM AUTHOR]

Terrorist events typically vary along many dimensions, making it difficult to identify their economic effects. This paper analyses the impact of terrorism on international trade by examining a series of three large-scale terrorist incidents in France over the period from January 2015 to July 2016. Using firm-level data at monthly frequency, we document an immediate and lasting decline in cross-border trade after a mass terrorist attack. According to our estimates, France's trade in goods, which accounts for about 70% of the country's trade in goods and services, is reduced by more than 6 billion euros in the first 6 months after an attack. The reduction in trade mainly takes place along the intensive margin, with particularly strong effects for partner countries with low border barriers to France, for firms with less frequent trade activities and for homogeneous products. A possible explanation for these patterns is an increase in trade costs due to stricter security measures. [ABSTRACT FROM AUTHOR]

Seismic hazard assessment (SHA) requires earthquake events characterized in terms of the moment magnitude (M w) scale both in the earthquake catalogues and in the ground motion databases (SHA data sets). However, published M w estimates for the same event may actually differ due to the adoption of different computation methods, input data, or seismic networks. The main objective of this paper is to develop a novel strategy to assign a unique M w value for each earthquake and unified to an M w reference data set that can be applied to low-to-moderate seismicity regions (M w < 4.5) such as Metropolitan France, the target region of our study. The strategy consists of first collecting all M w estimated directly by spectral or temporal inversion in a large area of the European–Mediterranean zone, including regional and specific studies in our target region. Then, the sources of M w estimates are ranked in five different categories, from global to specific studies. A GCMT (Global Centroid Moment Tensor project) standard M w value is recomputed and a quality flag is assigned depending on the level of the information provided by the sources. M w estimates are then compared at the European–Mediterranean scale with those provided by the CMT services, chosen as reference. M w estimates are subsequently corrected for their systematic deviations by progressively including lower magnitude estimates as one moves from high ranked categories to lower ones at each step of the unification procedure. In this work, the collected data set contains 6752 M w estimates of 4454 shallow events (depth < 40 km) that occurred between 1963 and 2019 and computed by 34 sources (bulletins, publications,..., etc). A unified M w value could be attributed to 185 events (2.36 ≤  M w ≤ 5.35) in France and neighbouring regions and 3351 events (3.06 ≤  M w ≤ 7.57) in the European–Mediterranean region. Finally, we showed that this M w data set is consistent with European SHA data sets but leads to slightly larger M w values compared to the French SHA data sets. We also noted that some variability still subsist in M w data set compared to the existing SHA data sets, especially for M w < 5.0. This new unified M w data set is a first step toward the building of future catalogues. It will contribute to greatly improve the coherence of M w definitions in the next generation of SHA data sets for both metropolitan France and Europe. [ABSTRACT FROM AUTHOR]

Since the 1980s, working hours have tended to become more diverse and flexible. These developments impact not only the possibilities of synchronising social time but also pay levels. Duration indicators become less relevant, since they disconnect the time worked and paid from the impact of the work on employees' lives. The objective of this paper is to analyse the effects of this disconnection by measuring the fragmentation of the working day. We propose an indicator of 'density of daily working time' which links two specific durations (the extent of the working day and the average daily duration of working). This indicator shows that a low density of the working day makes it possible to circumvent the minimum wage principle, particularly in the case of lower-skilled service occupations. These results raise questions about how working time is measured and about its regulation. [ABSTRACT FROM AUTHOR]

This paper studies how economic incentives influence cultural transmission, using a crucial expression of cultural identity: child naming decisions. Our focus is on Arabic versus non-Arabic names given in France over the 2003–2007 period. Our model of cultural transmission features three determinants: (i) vertical (parental) cultural transmission culture; (ii) horizontal (neighbourhood) influence; (iii) information on the economic penalty associated with Arabic names. We find that economic incentives largely influence naming choices: if the parental expectation on the economic penalty was zero, the annual number of babies born with an Arabic name would be more than 50% larger. [ABSTRACT FROM AUTHOR]

Background: A nudge corresponds to any procedure that influences choice architecture, without using persuasion or financial incentives. Nudges are effective in increasing vaccination with heterogeneous levels of acceptability.Objective: To evaluate the effectiveness and acceptability of a nudge promoting influenza vaccination for general practice trainees, also called residents.Methods: The hypothesis was that a reminder would be efficient and accepted and that prior exposure to a nudge increases its acceptability. Residents were randomly divided into three parallel experimental arms: a nudge group, a no-nudge group and a control group in order to evaluate the Hawthorne effect. The nudge consisted of providing a paper form for the free delivery of the vaccine and contacts for occupational health services.Results: The analysis included 161 residents. There was a strong consensus among the residents that it is very acceptable to nudge their peers and patients. Acceptability was better with residents exposed to the nudge and with residents included in step 1 (Hawthorne effect). The nudge did not increase vaccination coverage.Conclusion: The failure of this nudge highlights the importance of matching an intervention to the population's needs. The experimental approach is innovative in this context and deserves further attention.Clinicaltrials.gov Pre-registration: NCT03768596. [ABSTRACT FROM AUTHOR]

The differential effective medium (DEM) theory studied in this paper describes elastic moduli of a fractured medium with help of differential equations, where crack density is the independent variable and fluid saturation is a parameter. The effective medium is isotropic for randomly oriented flat ellipsoidal cracks and thus fully characterized by two elastic constants. In this article we derive an analytical solution of the equation for Poisson's ratio and we transform the differential equation for Young's modulus into a non-linear algebraic equation. Fluid saturation and crack density can then be determined from measured wave propagation velocities by a simple algorithm. We also derive approximate solutions for elastic moduli as a function of crack density and saturation, which allows to quantify the uncertainty of the result due to measurement errors. The DEM theory leads to higher crack densities than the self-consistent method and to lower crack densities than the non-interacting theory for measured elastic moduli, while all three methods give similar fluid saturation fractions. As an example of application of our theoretical results, we study weathered granite in the Strengbach water catchment in the Vosges mountains in France. We have performed full waveform sonic logging measurements in an 86-m-deep borehole located at an altitude of 1130 m above sea level, which is used for hydrogeophysical and geochemical studies of a granitic aquifer. The logging data allows us to investigate P and S waves in the depth range between 40 and 80 m. The P - and S -wave propagation velocities take average values of 5.0 and 2.7 km s–1, respectively, with the highest values of 5.8 and 3.2 km s–1 at 75–80 m depth. From these velocities we obtain a water saturation of 75 ± 25 per cent. The crack density describes the degree of weathering of the granite, which generally decreases with depth, but takes high values near layers of strongly weathered granite. Crack density is on average 0.5, with the highest value of 1.0 at 65 m and the lowest value of 0.2 at 75 m depth. The analysis of the full waveform logging data by the DEM method supports results from previous geochemical and hydrological studies in the Strengbach catchment which concluded that water is stored in deeper layers of the granitic aquifer. [ABSTRACT FROM AUTHOR]

Background: In many countries, epidemiological surveillance of chronic diseases is monitored by local registries (LR) which do not necessarily cover the whole national territory. This gap has fostered interest in using non-registry databases (e.g., health care or mortality databases) available for the whole territory as proxies for incidence at the local level. However, direct counts from these databases do not provide reliable incidence measures. Accordingly, specific methods are needed to correct proxies and assess their epidemiological usefulness.Methods: This study's objective was to implement a three-stage turnkey methodology using national non-registry data to predict incidence in geographical areas without an LR as follows: constructing a calibration model to make predictions including accurate prediction intervals; accuracy assessment of predictions and rationale for the criteria to assess which predictions were epidemiologically useful; mapping after spatial smoothing of the latter predictions. The methodology was applied to a real-world setting, whereby we aimed to predict cancer incidence, by gender, at the district level in France over the 2007-15 period for 24 different cancer sites, using several health care indicators and mortality. In the present paper, the spatial smoothing performed on predicted incidence of epidemiological interest is illustrated for two examples.Results: Predicted incidence of epidemiological interest was possible for 27/34 solid site-gender combinations and for only 2/8 haematological malignancies-gender combinations. Mapping of smoothed predicted incidence provided a clear picture of the main contrasts in incidence between districts.Conclusions: The methodology implemented provides a comprehensive framework to produce valuable predictions of incidence at a district level, using proxy measures and existing LR. [ABSTRACT FROM AUTHOR]

Background This paper studies the evolution of transitions from first cigarette use to daily use by socioeconomic status (SES) among French adolescents over the course of 17 years, in a context of decreasing prevalence of tobacco use. Methods A total of 182 266 adolescents participated in the nationally representative ESCAPAD survey at nine different time points between 2000 and 2017. Discrete time-event analysis was used to model the transition to daily cigarette use as a function of SES, gender, age at onset and the use of other psychoactive substances. Results Although lifetime cigarette smoking and daily cigarette smoking decreased significantly over the studied time span, suggesting a positive impact of prevention policies, disadvantaged adolescents were consistently more prone to engage in daily cigarette smoking, more so in 2017 than 15 years earlier. In the same time span, transitions from initiation to daily cigarette smoking have shortened, with an accelerated pace among underprivileged adolescents. Conclusions Accelerated transitions from initiation to daily cigarette use are a prevalent trend among disadvantaged adolescents in France. Efforts to mitigate the impact of marketing strategies and to promote health literacy should be pursued to reduce social inequalities in health. [ABSTRACT FROM AUTHOR]

Background Antimicrobial resistance (AMR) is a serious threat to humanity. This paper describes the French efforts made since 2001 and presents data on antimicrobial consumption (AC) and AMR. Methods We gathered all data on AC and AMR recorded since 2001 from different national agencies, transferred on a regular basis to standardized European data on AC and resistance in both humans and animals. Results After a large information campaign implemented in France from 2001 to 2005 in humans, AC in the community decreased significantly (18% to 34% according to the calculation method used). It remained at the same level from 2005 to 2010 and increased again from 2010 to 2018 (8%). Contrasting results were observed for AMR. The resistance of Staphylococcus aureus decreased significantly. For gram-negative bacilli, the results were variable according to the microorganism. The resistance of Enterobacteriaceae to third-generation cephalosporins increased, remaining moderate for Escherichia coli (12% in 2017) but reaching 35% in the same year for Klebsiella pneumoniae. Resistance to carbapenems in those 2 microorganisms remained below 1%. Both global AC and resistance to most antibiotics decreased significantly in animals. Conclusions Antibiotic consumption decreased significantly in France after a large public campaign from 2001 to 2005, but this positive effect was temporary. The effect on AMR varied according to the specific microorganism: The effect was very impressive for gram-positive cocci, variable for gram-negative bacilli, and moderate for E. coli , but that for K. pneumoniae was of concern. The consumption of and resistance to antibiotics decreased significantly in animals. [ABSTRACT FROM AUTHOR]

Background The high prevalence of smoking among French women since the 1970s has been reflected over the past decade by a strong impact on the health of women. This paper describes age and gender differences in France of the impact of smoking on morbidity and mortality trends since the 2000s. Methods Smoking prevalence trends were based on estimates from national surveys from 1974 to 2017. Lung cancer incidence were estimated from 2002–12 cancer registry data. Morbidity data for chronic obstructive pulmonary disease (COPD) exacerbation and myocardial infarction were assessed through hospital admissions data, 2002–15. For each disease, number of deaths between 2000 and 2014 came from the national database on medical causes of death. The tobacco-attributable mortality (all causes) was obtained using a population-attributable fraction methodology. Results The incidence of lung cancer and COPD increased by 72% and 100%, respectively, among women between 2002 and 2015. For myocardial infarction before the age of 65, the incidence increased by 50% between 2002 and 2015 in women vs. 16% in men and the highest increase was observed in women of 45–64-year-olds. Mortality from lung cancer and COPD increased by 71% and 3%, respectively, among women. The estimated number of women who died as a result of smoking has more than doubled between 2000 and 2014 (7% vs. 3% of all deaths). Conclusions The increase in the prevalence of smoking among women has a major impact on the morbidity and mortality of tobacco-related diseases in women and will continue to increase for a number of years. [ABSTRACT FROM AUTHOR]

Using an instrument based on a national contest in France determining researchers' location, we find evidence of peer effects in academia, when focusing on precise groups of senders (producing the spillovers) and receivers (benefiting from the spillovers), defined based on field of specialisation, gender and age. These peer effects are present even outside formal co-authorship relationships. Furthermore, the match between the characteristics of senders and receivers plays a critical role. In particular, men benefit a lot from peer effects provided by other men, while all other types of gender combinations produce spillovers twice as small. Part of the peer effects results from researchers switching research fields. [ABSTRACT FROM AUTHOR]

The article provides updates on issues related to the European Public Health Association (EUPHA) as of October 2019. Topics covered include opportunity of the World Health Organization to renew its vision for health in Europe beyond 2020, a white paper published by the European Commission in March 2017 setting out five possible paths for the future of Europe, and EUPHA's statement on what European political parties are stating on health.

This paper explores journalists' reactions to economic constraints and technological transformations in two cities: Toulouse, France, and Seattle, United States. Through semi-structured interviews, we show that journalists in both places either endure these conditions, invest in them as professional opportunities, or ignore them altogether. Drawing on Bourdieu, we argue that these distinct responses are shaped in part by a journalist's position in the field: those in low positions tend to endure; those in intermediate positions generally invest; and those in high positions are likely to ignore. We also suggest that the meanings of these responses vary according to the distinctive fields in which journalists are embedded, with the reactions of Toulouse journalists generally less market-oriented than their Seattle counterparts. These findings, and the theoretical perspective that enables them, are positioned in relation to case studies that analyze journalists' reactions and comparative survey research that explores similarities and differences in such reactions. [ABSTRACT FROM AUTHOR]

This paper assesses the causal effect of partial employment protection on workers' subjective job security via the perceived probability of layoff. We consider the rise in the French Delalande tax, which is paid by private firms if they lay off older workers. This reform was restricted to large firms and therefore allows us to use a difference-in-differences strategy. In ECHP data, we find that the change in the perceived probability of layoffs induced by the higher Delalande tax improved the subjective job security of older (protected) workers, but at the cost of a negative externality on other workers. The changes in job security in both groups are of similar size, but as unprotected workers are the large majority of the sample, the population effect of the tax on layoffs was to reduce job security. [ABSTRACT FROM AUTHOR]

Background In 2006, the HPV (Human papillomavirus) 6/11/16/18 quadrivalent vaccine was approved by the European Medicines Agency and obtained its marketing authorization in both girls and boys. Currently, the French guidelines recommend and refund vaccination of girls aged 11 to 14 with a catch-up program for females from 15 to 19 years old. Discussion In France, HPV vaccination coverage tends to decrease. At the end of 2015, the vaccination coverage with three doses reached only 14% in 16-year-old girls (three doses). Although men are also affected by HPV-related diseases such as anal cancer, ano-genital warts, penile cancer or upper aerodigestive tract cancer, vaccine recommendations in France are for girls only. To face the high prevalence of anal cancer and related diseases, the best option is vaccination. Moreover, by offering men a way to prevent diseases against which they do not have any protection yet, universal vaccination could better take into account the ethical issues of prevention. In this paper, we present the point of view of different medical specialties concerning the potential benefit of extending vaccination to boys. Conclusion HPV vaccination of both genders could benefit from a better public acceptance and contribute to a better coverage, especially in countries with low vaccination rates. [ABSTRACT FROM AUTHOR]

Background This study aimed to describe the mortality excess during the three first epidemic periods of COVID-19 in all regions of France. Methods Two complementary approaches were implemented. First, we described the number of death of patients infected with or diagnosed with COVID-19 in health care (HC) and medico-social (MS) institutions. Then, we estimated general all-cause mortality excess (all ages) by comparing the mortality observed with the expected mortality. We used a daily number of death model according to a negative binomial distribution, as a function of the long-term trend in mortality (penalized spline function of time) and its seasonal variation (cyclic spline function). The model provided expected mortality during epidemic periods with a 95% credibility interval. Each region defined three epidemic periods, including the overseas territories. Results The two approaches were consistent in the most affected regions but there are major regional disparities that vary according to the epidemic period. There is an east–west gradient in the relative excess of deaths from all-causes during each epidemic period. The deaths observed in HC and MS institutions alone do not explain the excess (or deficit) of mortality in each region and epidemic period. Conclusion An analysis by age group according to the two approaches and a comparison of death specific causes could provide a better understanding of these differences. Electronic death registration system (mortality by medical causes) would allow a rapid mortality related estimation to an emerging pathology like Coronavirus Disease-2019 (COVID-19) but is still insufficient for real-time medical causes of death monitoring. [ABSTRACT FROM AUTHOR]

Background Health policy-making require careful assessment of chronic kidney disease (CKD) epidemiology to develop efficient and cost-effective care strategies. The aim of the present study was to use the RENALGO-EXPERT algorithm to estimate the global prevalence of CKD in France. Methods An expert group developed the RENALGO-EXPERT algorithm based on healthcare consumption. This algorithm has been applied to the French National Health claims database (SNDS), where no biological test findings are available to estimate a national CKD prevalence for the years 2018–2021. The CONSTANCES cohort (+219 000 adults aged 18–69 with one CKD-EPI eGFR) was used to discuss the limit of using health claims data. Results Between 2018 and 2021, the estimated prevalence in the SNDS increased from 8.1% to 10.5%. The RENALGO-EXPERT algorithm identified 4.5% of the volunteers in the CONSTANCES as CKD. The RENALGO-EXPERT algorithm had a positive predictive value of 6.2% and negative predictive value of 99.1% to detect an eGFR<60 ml/min/1.73 m². Half of 252 false positive cases (ALGO+, eGFR > 90) had been diagnosed with kidney disease during hospitalization, and the other half based on healthcare consumption suggestive of a 'high-risk' profile; 95% of the 1661 false negatives (ALGO−, eGFR < 60) had an eGFR between 45 and 60 ml/min, half had medication and two-thirds had biological exams possibly linked to CKD. Half of them had a hospital stay during the period but none had a diagnosis of kidney disease. Conclusions Our result is in accordance with other estimations of CKD prevalence in the general population. Analysis of diverging cases (FP and FN) suggests using health claims data have inherent limitations. Such an algorithm can identify patients whose care pathway is close to the usual and specific CKD pathways. It does not identify patients who have not been diagnosed or whose care is inappropriate or at early stage with stable GFR. [ABSTRACT FROM AUTHOR]

Background A measles epidemic affected the Nouvelle-Aquitaine region from November 2017 to May 2018 with clusters among Travellers. This indicates that measles vaccination rates among Travellers remain lower than in the general population. The objective of this study was to estimate the 'declarative vaccination' against measles, mumps and rubella (MMR) and to propose a conceptual framework to help identify determinants of MMR vaccination uptake among adult Travellers in Nouvelle-Aquitaine in 2019–20. Methods A cross-sectional study using random sampling was performed and included 612 adult Travellers from 1 November 2019 to 31 March 2020. A conceptual framework to model vaccination adherence was tested among this underserved population by using structural equation modelling. This model included five latent variables: health literacy, attitudes toward preventive measures, stigma, accessibility to care and perceived needs and five measured variables: information received on vaccination, perception of barriers, support for administrative documents, social support and housing conditions. Results Individuals who did not answer all the questions linked to the variables included in the model were excluded, thus 347 adults were included in the final sample. The declared vaccination rate against MMR was 74.0%, and 72.4% of the participants were favorable to vaccination. Vaccination adherence was significantly correlated with favorable attitudes toward preventive measures such as having a history of MMR vaccination and not having already refused a recommended vaccine and finally satisfactory information received on vaccination. Discussion To improve vaccination adherence, health authorities should lean on personal history with vaccination and on transmitting information on vaccination. [ABSTRACT FROM AUTHOR]

Background: To determine appropriate management for individual patients, GPs are supposed to use their knowledge of the patient's socio-economic circumstances.Objective: To analyse factors associated with GPs' knowledge of these circumstances.Methods: Observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire about their own characteristics and randomly selected 70 patients from their patient list. Their knowledge was analysed as the agreement between the patients' and GPs' responses to questions about the patients' socio-economic characteristics in questionnaires completed by both groups. The association between agreement and the GPs' characteristics was analysed with a multilevel model adjusted for age, sex and the duration of the GP-patient relationship.Results: Agreement varied according to the socio-economic characteristics considered (from 51% to 90%) and between GPs. Globally, the GPs overestimated their patients' socio-economic level. GP characteristics associated with better agreement were sex (female), long consultations, the use of paper records or an automatic reminder system and participation in continuing medical education and in meetings to discuss difficult cases.Conclusion: Knowledge of some patient characteristics, such as their complementary health insurance coverage or perceived financial situation, should be improved because their overestimation may lead to care that is too expensive and thus result in the patients' abandonment of the treatment. Besides determining ways to help GPs to organize their work more effectively, it is important to study methods to help doctors identify their patients' social-economic circumstances more accurately in daily practice. [ABSTRACT FROM AUTHOR]

PAON4 is an L -band (1250–1500 MHz) small interferometer operating in transit mode deployed at the Nançay observatory in France, designed as a prototype instrument for intensity mapping. It features four 5 m diameter dishes in a compact triangular configuration, with a total geometric collecting area of |${\sim} 75\, \mathrm{m^2}$|⁠ , and is equipped with dual polarization receivers. A total of 36 visibilities are computed from the eight independent RF signals by the software correlator over the full 250 MHz RF band. The array operates in transit mode, with the dishes pointed toward a fixed declination, while the sky drifts across the instrument. Sky maps for each frequency channel are then reconstructed by combining the time-dependent visibilities from the different baselines observed at different declinations. This paper presents an overview of the PAON4 instrument design and goals, as a prototype for dish arrays to map the large-scale structure in radio, using intensity mapping of the atomic hydrogen 21 cm line. We operated PAON4 over several years and use data from observations at different periods to assess the array performance. We present a preliminary analysis of a large fraction of these data and discuss crucial issues for this type of instrument, such as the calibration strategy, instrument response stability and noise behaviour. [ABSTRACT FROM AUTHOR]

Background The European Union has used Healthy Life Years (HLY) as an indicator to monitor the health of its aging populations. Scholarly and popular interest in HLY across countries has grown, particularly regarding the ranking of countries. It is important to note that HLY is based on self-assessments of activity limitations, raising the possibility that it might be influenced by differences in health reporting behaviours between populations, a phenomenon known as differential item functioning (DIF). Methods We estimated DIF-adjusted HLY at age 50 for Belgium, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden to determine the extent to which differences in HLY might be influenced by reporting heterogeneity across countries. We used anchoring vignettes, taken from the 2004 Survey of Health, Ageing and Retirement in Europe, to estimate DIF-adjusted prevalence rates of activity limitations measured by the Global Activity Limitations Indicator (GALI). The Sullivan method was used to calculate DIF-adjusted HLY. Results Changes in HLY before and after adjustment ranged from a 1.20-year decrease for men in Italy to a 1.61-year increase for women in Spain. Adjustment for DIF produced changes in the rankings of the countries by HLY, with upward and downward movements of up to three positions. Conclusion Our results show that DIF is likely to affect HLY estimates, thereby posing a challenge to the validity of comparisons of HLY across European countries. The findings suggest that HLY should be used to monitor population health status within a country, rather than to make comparisons across countries. [ABSTRACT FROM AUTHOR]

The Ubaye Region (French Western Alps) is one of the most seismically active regions in France. It is regularly struck by mainshock–aftershocks sequences like in 1959 (M L 5.3), seismic swarms (2003–2004), and complex sequences (2012–2015) characterized by successive mainshocks clustered in time and space. This diversity of seismic behaviour highlights the complex processes at play in this area. To improve our understanding of these processes, in this study, we compile a regional catalogue of existing focal mechanisms, completed by 100 new calculated focal mechanisms of aftershocks following the 07/04/2014 mainshock (M L 5.1). The oriented stress-state we reconstruct for different periods and subareas are similar to each other and to previous published values focusing on swarm periods. We then calculate fluid pressure required to trigger the earthquakes. Most of the events (65 per cent) need fluid overpressure between 15 and 40 MPa (17 to 40 per cent of the hydrostatic pressure) with a median value of 24 per cent. Moreover, even the largest events, like the mainshocks in the 2012–2015 sequence, appear to be triggered by fluid pressure, similarly as events within swarm sequences. However, while fluid overpressure decreases with time in an aftershock sequence, it varies randomly at high levels during a swarm sequence. Therefore, based on a fault-valve model, we propose that: (1) the fluids trapped in the fault plane tend toward lithostatic pressure and trigger the mainshock rupture and (2) part of the aftershocks are induced by the diffusing fluid pressure. On the contrary, swarms need external, likely deep, fluid pressure feedings. Fluid pressure is likely to be a common triggering mechanism of the seismicity in the Ubaye Region, even if the involved processes should differ to explain the different types of seismic sequences. [ABSTRACT FROM AUTHOR]

An unusual seismic activity has recently occurred in the Gripp valley, located in the central part of the French Pyrenees. Since spring 2020, two new swarms appeared, clearly outside the usual location of the seismicity in this area. On 20 September 2020, almost concomitantly with the activation of the second seismic swarm, a hole suddenly opened in the bed of a local river, the Adour de Payolle. This hole drained the water from the river, which dried up over 500 m. We follow and study the spatial and temporal evolution of these clusters, using four temporary stations deployed a few days or months after the beginning of the crisis to complete the regional network. These additional data lead to the construction of a comprehensive catalogue of more than 4900 earthquakes, using both a template matching approach and a deep-learning based phase picking method to complete and improve the initial catalogue available from the French seismological agency. This allows highlighting a slow and clear migration of the seismicity during 1 yr. Precise absolute and relative event locations reveal a dipping faulting structure, confirmed by the focal mechanism estimated for the highest magnitude event of the sequence (M L 3). We propose to explain the observed migration of the seismicity by deep fluids going up through a newly discovered faulting structure. [ABSTRACT FROM AUTHOR]

Studies on the genetic factors involved in binge drinking (BD) and its associated traits are very rare. The aim of this cross-sectional study was to investigate differences in the association between impulsivity, emotion regulation and BD in a sample of young adults according to the rs6265/Val66Met variant in the brain-derived neurotrophic factor (BDNF) gene, a well-known candidate gene in alcohol use disorders. We recruited 226 university students (112 women), aged between 18 and 25 years old, from two centers in France. The participants completed measures related to alcohol consumption, depression severity, state anxiety levels, impulsivity (UPPS-P), and difficulties in emotion regulation [Difficulty in Emotion Regulation Scale (DERS)]. The relationship between the BD score and the clinical characteristics in the BDNF genotype groups was assessed by partial correlation analyses and moderation analyses. The partial correlation analyses showed that, in the Val/Val genotype group, the BD score was positively related to UPPS-P Lack of Premeditation and Sensation Seeking scores. In the Met carriers group, the BD score was positively related to UPPS-P Positive Urgency, lack of Premeditation, lack of Perseverance and Sensation Seeking scores and to Clarity score of the DERS. Moreover, the BD score was positively associated with depression severity and state anxiety scores. The moderation analyses revealed that BDNF Val/Met genotype moderated the relationship between several clinical variables and BD. The results of the present study support the hypothesis of common and specific vulnerability factors regarding impulsivity and emotion regulation difficulties associated with BD according to this BDNF rs6265 polymorphism. [ABSTRACT FROM AUTHOR]

SUMMARY: The local ground motion amplification related to the geology at a specific site (i.e. the so-called site effects) may be classically quantified through the SSR (standard spectral ratio) technique applied on earthquake recordings. However, such a quantification might be challenging to carry out in low-to-moderate seismicity regions. Methods based on background ambient noise, such as noise-based standard spectral ratio (SSRn), might be of great interest in these areas. But noise-derived amplification is particularly sensitive to local anthropogenic sources, which may introduce biases in the evaluation of site effects by dominating the geological effects, especially for frequencies higher than 1 Hz. A hybrid approach (SSRh), developed to reduce biases in noise-based spectral ratios by combining classical earthquake-based spectral ratio (SSR) and SSRn, was recently introduced and relies on a site reference. We here investigate the applicability of SSRn and SSRh in a heavily industrialized environment in the Tricastin Valley (south-east France), where critical facilities are located. We continuously recorded ambient noise from 2020 February to March on a 400-sensor seismic array covering an area of about 10 km by 10 km. We demonstrate that SSRn and SSRh computed below 1 Hz are able to reproduce amplification factors provided by SSR. By contrast, at frequencies higher than 1 Hz, SSRn strongly deviates from SSR. SSRh shows closer results to SSR but presents a dependence to the choice of the local site reference, thereby questioning the possibility to use SSRh blindly to estimate the local amplification in our context. These discrepancies reflect the impact of local anthropogenic sources. We therefore introduced a two-step workflow to mitigate the influence of local sources. The first step is to define a characteristic time window to optimally isolate significant transient signals. The second step consists in selecting the time segments that do not contain these transients with a clustering-based approach. By applying this workflow, we were able to remove some strong anthropogenic transient signals likely to be generated by local sources at some sites and therefore to locally improve the amplification assessment through noise-based spectral ratios. However, stationary sources, whose impact cannot be removed through our procedure, remain a major issue. This study provides some insights into the application of SSRn and SSRh in noisy industrialized areas, especially regarding the impact of local noise sources. It illustrates the difficulty of having a procedure for mitigating the impact of these sources that is efficient everywhere inside such a complex anthropized environment, where different types of sources (including stationary sources) cohabit. [ABSTRACT FROM AUTHOR]

A middle-aged woman was found dead with multiple empty blisters of midazolam (MDZ) (DORMICUM®), equivalent to 450 mg, near her body. The autopsy revealed that the cause of death was secondary to an asphyxia syndrome. Standard toxicological procedures identified MDZ only in blood, urine and gastric content. A quantitative analytical method for MDZ and 1-hydroxymidazolam (1-OH-MDZ) was validated using protein precipitation, a phospholipid removal Ostro® plates and liquid chromatography coupled to tandem mass spectrometry. MDZ and 1-OH-MDZ were quantified in peripheral blood at 910 and 534 ng/mL, respectively, and superior to 2000 ng/mL in urine. Reported to the body weight, the dose, which was lethal, was estimated to be 6.7 mg/kg. The usual dose used in the intensive care unit is 0.03–0.3 mg/kg. MDZ intoxication outside of hospital is rare given the restricted availably of this drug in France. Nevertheless, MDZ under oral form remains available in several countries. Toxic MDZ blood concentrations are described after intravenous administration for anesthesia and are not suited for oral intoxication. Based on the autopsy findings, police investigation and toxicology results, the cause of death was determined to be a self-inflicted oral MDZ acute intoxication, which is the first to be documented to the best of our knowledge. This fatal intoxication provides analytical data that could support subsequent toxicological result interpretation in similar forensic cases. [ABSTRACT FROM AUTHOR]

Background Ambient temperature, particularly heat, is increasingly acknowledged as a trigger for preterm delivery but study designs have been limited and results mixed. We aimed to comprehensively evaluate the association between ambient temperature throughout pregnancy and preterm delivery. Methods We estimated daily temperature throughout pregnancy using a cutting-edge spatiotemporal model for 5347 live singleton births from three prospective cohorts in France, 2002–2018. We performed Cox regression (survival analysis) with distributed lags to evaluate time-varying associations with preterm birth simultaneously controlling for exposure during the first 26 weeks and last 30 days of pregnancy. We examined weekly mean, daytime, night-time and variability of temperature, and heatwaves accounting for adaptation to location and season. Results Preterm birth risk was higher following cold (5th vs 50th percentile of mean temperature) 7–9 weeks after conception [relative risk (RR): 1.3, 95% CI: 1.0–1.6 for 2°C vs 11.6°C] and 10–4 days before delivery (RR: 1.6, 95% CI: 1.1–2.1 for 1.2°C vs 12.1°C). Night-time heat (95th vs 50th percentile of minimum temperature; 15.7°C vs 7.4°C) increased risk when exposure occurred within 5 weeks of conception (RR: 2.0, 95% CI: 1.05–3.8) or 20–26 weeks after conception (RR: 2.9, 95% CI: 1.2–6.8). Overall and daytime heat (high mean and maximum temperature) showed consistent effects. We found no clear associations with temperature variability or heatwave indicators, suggesting they may be less relevant for preterm birth. Conclusions In a temperate climate, night-time heat and chronic and acute cold exposures were associated with increased risk of preterm birth. These results suggest night-time heat as a relevant indicator. In the context of rising temperatures and more frequent weather hazards, these results should inform public health policies to reduce the growing burden of preterm births. [ABSTRACT FROM AUTHOR]

Tax expenditures are widely used by French governments as employment and social policies. Such programmes together amounted to more than 1.3 points of GDP in 2011. Thanks to a systematic review of academic policy evaluations, we assess the efficiency of the different parts of such policies, showing that at least €6 billion is used for policies whose cost is greater than €62,500 per year and job created, and €0.5 billion for policies whose cost is greater than €160,000 per year and job created. We examine the replacement of these tax expenditures by direct public funding for (publicly or privately delivered) "quality" jobs addressing specific social needs. We discuss the conditions under which at least comparable employment performances could be achieved (factoring in the crowding out of privately funded jobs and the properties of created jobs in terms of the service provided or the characteristics of suppliers and consumers) as well as any positive economic and social externalities. [ABSTRACT FROM AUTHOR]

Infection with the necrotrophic fungus Diplodia sapinea (Fr.) Fuckel is among the economically and ecologically most devastating diseases of conifers in the northern hemisphere and is accelerated by global climate change. This study aims to characterize the changes mediated by D. sapinea infection on its pine host (Pinus sylvestris L.) that lead to the death of its needles. For this purpose, we performed an indoor infection experiment and inoculated shoot tips of pine seedlings with virulent D. sapinea. The consequences for foliar traits, including the phytohormone profile, were characterized at both the metabolite and transcriptome level. Our results showed that D. sapinea infection strongly affected foliar levels of most phytohormones and impaired a multitude of other metabolic and structural foliar traits, such as reactive oxygen species scavenging. Transcriptome analysis revealed that these changes are partially mediated via modified gene expression by fungal exposure. Diplodia sapinea appears to overcome the defense reactions of its pine host by reprogramming gene expression and post-transcriptional controls that determine essential foliar metabolic traits such as the phytohormone profile, cell wall composition and antioxidative system. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Are persistent organic pollutants (POPs) associated with a diminished ovarian reserve (DOR) in women of reproductive age? SUMMARY ANSWER Amongst 17 POPs detected in over 20% of serum samples, only p,p′-DDE was significantly associated with an increased risk of DOR, and β-hexachlorocyclohexane (β-HCH) was significantly associated with a decreased risk of DOR whilst mixture analyses yielded non-significant associations and did not detect any interactions between POPs. WHAT IS KNOWN ALREADY Animal studies have shown that several POPs can alter folliculogenesis and increase follicle depletion. However, only a few studies have been conducted in humans, with small sample sizes and inconsistent results. STUDY DESIGN, SIZE, DURATION Our study included 138 cases and 151 controls from the AROPE case–control study. Study participants were women between 18 and 40 years of age recruited amongst couples consulting for infertility in four fertility centres in western France between 2016 and 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Cases of DOR were defined as women with anti-Müllerian hormone (AMH) levels ≤1.1 ng/ml and/or antral follicle count (AFC) <7, and controls were women with AMH levels between 1.1 and 5 ng/ml and AFC ≥ 7, without genital malformations and with a menstrual cycle length between 26 and 35 days. A total of 43 POPs (including 15 organochlorine pesticides, 17 polychlorinated biphenyls, and 9 polybromodiphenylethers) were measured in the serum at inclusion into the study. We conducted logistic regression adjusted for potential confounders using a directed acyclic graph to study the effect of each POP on DOR as single exposures, and used Bayesian kernel machine regression (BKMR) to measure the mixture effect of POPs on DOR. MAIN RESULTS AND THE ROLE OF CHANCE Of the 43 POPs, 17 were detected in over 20% of the serum samples. In the single-exposure multivariate logistic regressions, p,p′-DDE (median 165.0 IQR 161.0 ng/l in controls) as a continuous exposure was significantly associated with an increased risk of DOR (odds ratio (OR) 1.39, 95% CI 1.10–1.77) and non-significantly associated with an increased risk of DOR for the second and third terciles (OR 1.46, 95% CI 0.74–2.87, and OR 1.72, 95% CI 0.88–3.37, respectively). β-HCH (median 24.2 IQR 21.5 ng/l in controls) was significantly associated with a decreased risk of DOR when β-HCH was treated as a continuous exposure (OR 0.63, 95% CI 0.44–0.89) and for the third tercile of exposure (OR 0.43, 95% CI 0.21–0.84) and non-significantly associated with a decreased risk of DOR for the second tercile (OR 0.77, 95% CI 0.42–1.42). All sensitivity analyses confirmed our results. BKMR showed similar associations for single exposures but found no significant associations for the total mixture effect. In addition, the BKMR results did not suggest any interactions between POPs. LIMITATIONS, REASONS FOR CAUTION Controls were recruited amongst infertile couples and thus may not be representative of all women of reproductive age. However, their POP concentrations were in the same range as in the general French population. WIDER IMPLICATIONS OF THE FINDINGS This study is the first to examine the associations between serum POPs and DOR. The well-recognized anti-androgenic properties of p,p′-DDE and estrogenic properties of β-HCH could explain these associations of opposite direction. If these results are replicated elsewhere, this could have an impact on fertility prevention messages and help in understanding the impact of POPs on the female reproductive system. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Fondation de France (grant numbers 2014-50537 and 00110196) and the French Biomedicine Agency (2016). None of the authors have any conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

In a global context where water will become a scarce resource under temperate latitudes, managing tree plantations with species associations, i.e. forest mixture or agroforestry, could play a major role in optimizing the sustainable use of this resource. Conceptual frameworks in community ecology suggest that, in mixed plantations, environmental resources such as water may be more efficiently used for carbon acquisition and tree growth thanks to niche complementarity among species. To test the hypotheses behind these conceptual frameworks, we estimated water-use efficiency (WUE) for poplar trees grown in a monoculture, in association with alder trees (forest mixture) and in association with clover leys (agroforestry) in an experimental plantation located in northeastern France. Water-use efficiency was estimated (i) at leaf level through gas exchange measurements and analysis of carbon isotope composition, (ii) at wood level through carbon isotope composition and (iii) at tree level with sap flow sensors and growth increment data. We hypothesized that species interactions would increase WUE of poplars in mixtures due to a reduction in competition and/or facilitation effects due to the presence of the N2-fixing species in mixtures. Poplar trees in both mixture types showed higher WUE than those in the monoculture. The differences we found in WUE between the monoculture and the agroforestry treatment were associated to differences in stomatal conductance and light-saturated net CO2 assimilation rate (at the leaf level) and transpiration (at the tree level), while the differences between the monoculture and the forest mixture were more likely due to differences in stomatal conductance at the leaf level and both transpiration and biomass accumulation at the tree level. Moreover, the more WUE was integrated in time (instantaneous gas exchanges < leaf life span < seasonal wood core < whole tree), the more the differences among treatments were marked. [ABSTRACT FROM AUTHOR]

Background As a system of European Reference Networks (ERNs) emerges, the differences in quality of care for patients with rare cancers may increase at national level. We aimed to elucidate the processes and healthcare planning principles through which the reference centres (RCs) for rare cancers are embedded in national health systems. Methods We used a multiple case-study design based on the experiences of Czechia, Finland, France, Italy, Lithuania and Spain. Using sarcoma as an example of rare cancer, 52 semi-structured interviews were conducted during on-site visits, including a multidisciplinary group of professionals, Ministry of Health professionals, patient representatives and European policymakers. Results The comparative analysis showed substantial heterogeneity in the processes for formalizing RCs' status and in their levels of integration in the different health systems, but two models (centre-based and the network-based) can be envisaged at national level. RCs for rare cancers were legally established only in France and Spain. Expert clinicians cooperate in a structured way, using network mechanisms, in France and Italy, and these countries, plus Finland and Lithuania, had a referral system to facilitate patients' access from non-expert centres to RCs. Seven key healthcare planning principles in instituting RCs at the national level were identified. Conclusions The conditions governing patient access to treatment centres—whether RCs or not—are decided at the national level. It is advisable to progressively align the European and national levels so that the RCs that participate in the ERNs also play a significant role at the national level. [ABSTRACT FROM AUTHOR]

In the 1970s, Ruditapes philippinarum was introduced to France at Arcachon Bay for aquaculture. At present, in Europe, R. philippinarum is often found in place of the native species Ruditapes decussatus. The aim of this study is to evaluate the distribution of these two species along the northern Mediterranean coastline using morphological and morphometric analysis. The sampling period was between June and December 2018. Among the 11 French sites, only 2 contained R. philippinarum , whereas only the indigenous species was present at the other sites. Genetic analyses were used to confirm species identity and to confirm this distribution. A site in Italy, Pialassa Baiona, was also added to the sample. This analysis of Ruditapes from multiple French sites and one Italian site highlights species-level differences in shell morphology between R. decussatus and R. philippinarum. The intraspecific morphometric analysis showed the presence of different groups depending on spatial scales (i.e. at the large scale, between the Mediterranean Sea and the Atlantic, and on the small scale, that is within the Berre lagoon in France. No relationship between morphometric and genetic variation was found. This suggests that the differences in the shell shape of Ruditapes are driven by local environmental conditions. [ABSTRACT FROM AUTHOR]

Background Autosomal dominant polycystic kidney disease (ADPKD) is associated with an increased risk for developing intracranial aneurysms (IAs). We aimed to evaluate the frequency of diagnosis of IAs in the cross-sectional, population-based, Genkyst cohort, to describe ADPKD-associated IAs and to analyse the risk factors associated with the occurrence of IAs in ADPKD patients. Methods A cross-sectional study was performed in 26 nephrology centres from the western part of France. All patients underwent genetic testing for PKD1/PKD2 and other cystogenes. Results Among the 2449 Genkyst participants, 114 (4.65%) had a previous diagnosis of ruptured or unruptured IAs at inclusion, and ∼47% of them had a positive familial history for IAs. Most aneurysms were small and saccular and located in the anterior circulation; 26.3% of the patients had multiple IAs. The cumulative probabilities of a previous diagnosis of IAs were 3.9%, 6.2% and 8.1% at 50, 60 and 70 years, respectively. While this risk appeared to be similar in male and female individuals <50 years, after that age, the risk continued to increase more markedly in female patients, reaching 10.8% versus 5.4% at 70 years. The diagnosis rate of IAs was >2-fold higher in PKD1 compared with PKD2 , with no influence of PKD1 mutation type or location. In multivariate analysis, female sex, hypertension <35 years, smoking and PKD1 genotype were associated with an increased risk for diagnosis of IAs. Conclusions This study presents epidemiological data reflecting real-life clinical practice. The increased risk for IAs in postmenopausal women suggests a possible protective role of oestrogen. [ABSTRACT FROM AUTHOR]

Background This study was conducted to estimate the direct effect of sex on the proportion of hemodialysis (HD) catheters used at dialysis initiation and to investigate whether predialysis care or socioeconomic status acted as a mediator of the sex effect. Methods Patients who started dialysis between January 1, 2017, and June 30, 2018, in France were included using the data of the Renal Epidemiology and Information Network (REIN) registry. We performed logistic regression to study the association between sex and the proportion of HD catheters used. A mediation analysis with a counterfactual approach was carried out to evaluate whether there was an indirect effect of sex through the proxies of predialysis care {hemoglobin, albumin levels, glomerular filtration rate [GFR] at dialysis initiation} and socioeconomic status. Because an interaction between sex and social deprivation has been identified, we performed a subgroup analysis on deprived and nondeprived patients. Results The study included 16 032 patients, and the sex ratio (male to female) was 10 405:5627. In the multivariable analysis, women were associated with a greater risk of starting dialysis with a catheter {odds ratio [OR], 1.32 [95% confidence interval (CI): 1.23–1.42]}. There was an indirect effect of sex on the proportion of HD catheters through proxies for predialysis care {albuminemia <30 g/L [OR, 1.08 (95% CI: 1.05–1.10)], hemoglobin <11 g/dL [OR, 1.03 (95% CI: 1.02–1.04)], glomerular filtration rate <7 mL/min [OR, 1.05 (95% CI: 1.04–1.07)]}. Among deprived patients, there was no direct effect of sex on catheter proportion. Conclusions Women were associated with a higher risk of starting dialysis through an HD catheter. The effect of sex was mediated by predialysis care, particularly for deprived patients. [ABSTRACT FROM AUTHOR]

Objective The detection of somatic mutations among the genes of myeloid cells in asymptomatic patients—defining clonal haematopoiesis of indeterminate potential (CHIP)—is associated with a predisposition to cardiovascular events (CVEs) in the general population. We aimed to determine whether CHIP was associated with CVEs in SLE patients. Methods The study is an ancillary study of the randomized, double-blind, placebo-controlled, multicentre PLUS trial conducted from June 2007 through August 2010 at 37 centres in France, involving 573 SLE patients. The search for somatic mutations by high-throughput sequencing of 53 genes involved in clonal haematopoiesis was performed on genomic DNA collected at PLUS inclusion. CHIP prevalence was assessed in SLE and in a retrospective cohort of 479 patients free of haematological malignancy. The primary outcome was an incident CVE in SLE. Results Screening for CHIP was performed in 438 SLE patients [38 (29–47) years, 91.8% female]. Overall, 63 somatic mutations were identified in 47 patients, defining a CHIP prevalence of 10.7% in SLE. Most SLE patients (78.7%) carried a single mutation. Most variants (62.5%) were located in the DNMT3A gene. CHIP frequency was related to age and to age at SLE diagnosis, and was associated with a lower frequency of aPLs. CHIP occurred >20 years earlier (P  < 0.00001) in SLE than in controls. The detection of CHIP at inclusion was not found to be associated with occurrence of CVEs during follow-up [HR = 0.42 (0.06–3.21), P  = 0.406]. Conclusion The prevalence of CHIP is relatively high in SLE for a given age, but was not found to be associated with incident CVEs. Trial registration ClinicalTrials.gov, https://clinicaltrials.gov , NCT05146414. [ABSTRACT FROM AUTHOR]

Background The prevalence of overweight and obesity has increased in various countries. Normal weight before pregnancy is important to protect maternal and newborn health. This study aimed to describe the evolution of body mass index (BMI) before pregnancy in France and explore its association with two measures of socioeconomic status (SES), education and household income. Methods Data were from four national perinatal surveys in France in 1998, 2003, 2010 and 2016 to describe the time evolution of maternal BMI. We explored the links between BMI and women's characteristics in the most recent period (2010–2016 surveys) since income information was not available before. Risk ratios (RRs) of underweight, overweight and obesity for each measure of SES were computed by using multivariable Poisson regression models. Results Overweight and obesity prevalence increased between 1998 and 2016, from 6% to 12% for obesity. Both were inversely associated with SES (higher prevalence among least educated and poorest women), with strong variations for each social indicator, even in multivariable analyses including both. Combining education and income revealed a wide gradient; RR for obesity was 6.01 (95% confidence interval 4.89–7.38) with low education and income <2000 euros/month vs. high education and income ≥4000 euros/month. Conclusions Public policies must implement programs to limit the increase in overweight and its unequal distribution in the population, alongside other policies to address the societal determinants of the obesogenic environment. Health professionals need to advise women to improve their eating and physical activity to limit weight gain from childhood to early adulthood. [ABSTRACT FROM AUTHOR]

We estimate the contribution of intergenerational transfers (inheritances and gifts) and family background to wealth inequality in four OECD countries: France, Spain, Great Britain, and the USA. We compare the observed wealth distribution with a non-parametric counterfactual distribution where all differences in wealth associated with intergenerational transfers and family background are removed. Despite the diversity of the countries analysed, we find similar patterns. The combined contribution of intergenerational transfers and family background to wealth inequality is sizeable in the four countries, ranging from 36% in Great Britain to 49% in the USA. When interactions between the two factors are accounted for, and the Shapley value decomposition is used to fully disentangle the contribution of each factor based on its marginal contribution, intergenerational transfers account for between 26% in Great Britain and 36% of wealth inequality in France, with family background ranging from 9% in France to 17% in the USA. [ABSTRACT FROM AUTHOR]

Aldicarb, a carbamate pesticide banned in France since 2008, represents a persistent risk of human poisoning. There is no up-to-date picture of aldicarb intentional poisonings associated to detailed diagnosis and clinical management of cases to evaluate the effect of its ban on intoxication risk reduction, including suicide. This retrospective epidemiological study describes cases of suicidal intoxication from the Hauts-de-France region between 2012 and 2021 and illustrates this situation through one analytically documented case. 60 cases were collected, mostly presenting a pathognomonic symptomatology. Thirty-five victims presented a muscarinic syndrome (58.3%), 14 a nicotinic syndrome (23.3%), and 37 a central nervous system impairment (61.7%). Hospitalization was necessary for 44 cases (73.3%), with 2 fatal evolutions. Diagnosis was based on the blood cholinesterase activities. Among the 25 cases with toxicology results, 45.8% presented a moderate decrease of acetylcholinesterase activity, whereas 87.5% presented a strong decrease of butyrylcholinesterase activity. Blood or urine detection of aldicarb and its metabolites may be considered in therapeutic management, although their quantification is unlikely to change the emergency medical care. Our study updates epidemiology of aldicarb poisoning at a regional level, highlighting a persisting health threatening situation with banned pesticides. More than 65% of national cases occurred in this agricultural area, aldicarb remaining available from storage of previously purchased products. Robust evidence is presented that acute poisoning is an ongoing major global public health challenge. There is a need for continued international efforts in risk reduction, knowledge, and information strategies. [ABSTRACT FROM AUTHOR]

The 2019, M w 4.9 Le Teil earthquake occurred in southeastern France, causing substantial damage in this slow deforming region. Field observations, remote sensing and seismological studies following the event revealed that coseismic slip concentrates at shallow depth along a ∼5 km long rupture associated with surface breaks and a thrusting mechanism. We further investigate this earthquake by combining geological field mapping, 3-D geology, InSAR time-series analysis and a coseismic slip inversion. From structural, stratigraphic and geological data collected around the epicentre, we first produce a 3-D geological model of the region surrounding the rupture using the GeoModeller software. Our model includes the geometry of the geological layers and the main faults, including the La Rouvière Fault, (LRF) the Oligocene normal fault that ruptured during the earthquake. We generate a time-series of surface displacement from Sentinel-1 SAR data ranging from early 2019 January to late 2020 January using the NSBAS processing chain. The spatio-temporal patterns of surface displacement for this time span show neither a clear pre-seismic signal nor significant post-seismic transient deformation. We extract the coseismic displacement pattern from the InSAR time-series, highlighting along-strike variations of coseismic surface slip. The maximum relative displacement along the line of sight is up to ∼16 cm and is located in the southwestern part of the rupture. We invert for the slip distribution on the fault from the InSAR coseismic surface displacement field. Constraining our fault geometry from the geological model, acceptable fault dip ranges between 55° and 60°. Our model confirms the reactivation of LRF, with reverse slip at very shallow depth and two main slip patches reaching, respectively, 30 and 24 cm of slip, both around 500 m depth. We finally discuss how the 3-D fault geometry and geological structure may have impacted the slip distribution and propagation during the earthquake. This study is a step to reassess the seismic hazard of the many faults similar to the La Rouvière one along the Cévennes fault system, in a densely populated area hosting several sensitive nuclear sites. [ABSTRACT FROM AUTHOR]

I quantify the welfare and environmental gains and losses from a policy establishing an environmental tax/subsidy for new cars in France in 2008. I estimate a structural model of demand and supply that features heterogeneity in consumer preferences to go beyond the average policy effects and analyse distributional aspects. The policy reduces average carbon emissions by 1.6% at the cost of additional emissions of local pollutants. The regulation favours middle-income individuals but has redistributive effects when combined with a tax that is proportional to income. Moreover, local pollutant emissions increase least in poor and rural areas, suggesting another redistribution channel. [ABSTRACT FROM AUTHOR]

The author reflects on the terrorist attacks in Paris, France on November 13, 2015 and expresses solidarity within the public health community. He discusses a paper entitled "The implications of terrorism for public health," some basic public health principles, and how public health is underpinned by solidarity.

Objective Digital ulcers related to digital occlusive arterial disease (DOAD) are frequent in patients with SSc. Finger systolic blood pressure (FSBP) and digital-brachial pressure index (DBI) using laser Doppler flowmetry constitute a non-invasive means of detecting DOAD in SSc, although thresholds have yet to be established for defining DOAD. The purpose of this study was to ascertain FSBP and DBI thresholds to detect DOAD in SSc patients. The intra/interday reproducibility of curve reading by four vascular physicians in relation to finger pressure measurement was also investigated. Methods SSc patients were followed in this single-centre study (Rennes University Hospital, France) between November 2017 and October 2019.These patients underwent tests before and after heating at two visits spaced 10 days apart. DOAD was diagnosed on the basis of post-warming skin blood flow of ≤206 arbitrary units measured by laser Doppler flowmetry, contingent on previous results validated by arteriography as a gold standard. An interday kappa coefficient with a 95% confidence interval was used to assess reproducibility. Results Sixteen [10 females; mean age: 63 (9) years] SSc patients were included. Mean time interval between visits was 9 (5) days. The best FSBP threshold for DOAD diagnosis was 76 mmHg and DBI was 0.74 after warming. FSBP and DBI sensitivity/specificity were 59.1% (95% CI: 49.6, 68.5%)/92.5% (95% CI: 85.3, 99.6%) and 73.3% (95% CI: 64.9, 81.8%)/83.0% (95% CI: 72.9, 93.1%), respectively. Intra/interday reproducibility ranged from fair to good. Conclusion The conclusions drawn from this study suggest that FSBP ≤ 76 mmHg and DBI ≤ 0.74 thresholds are potentially reliable indicators of DOAD and demonstrate fair to good intra- and interday reproducibility. Trial registration ClinicalTrials.gov, www.clinicaltrials.gov , NCT03264820. [ABSTRACT FROM AUTHOR]

Objective To compare the risk of diverticulitis and gastrointestinal perforation (GIP) in RA treated with tocilizumab (TCZ) compared with rituximab (RTX) and abatacept (ABA). Methods We conducted a population-based study using three observational French registries on TCZ, RTX and ABA in RA. Using a propensity score approach, we compared the risk of diverticulitis or GIP in these patients. Results With inverse probability weighting, there was an increased risk of diverticulitis in TCZ-treated patients compared with RTX- or ABA-treated patients [hazard ratio (HR)=3.1 (95% CI: 1.5, 6.3), P =0.002]. Moreover, patients treated with TCZ had also an increased risk of GIP due to diverticulitis compared with those treated with RTX or ABA [HR=3.8 (1.1–13.6), P =0.04], resulting in an overall increased risk of GIP [HR=2.9 (1.1–7.8), P =0.03], while no significant increased risk of GIP due to any other aetiology was found in TCZ treated patients. Diverticulitis and GIP occurred earlier with TCZ than other drugs after the last perfusion (P =0.01), with atypical clinical presentation (slow transit in 30%, P =0.04) and lower acute-phase reactants at the time of the event (P =0.005). Conclusion TCZ for RA was associated with increased odds of diverticulitis as well as GIP due to diverticulitis as compared with RTX and ABA. Our study confirms the increased odds of GIP in patients receiving TCZ, which might be explained by an increased risk of diverticulitis with misleading clinical presentation. [ABSTRACT FROM AUTHOR]

Background people approaching the end-of-life frequently face inappropriate care. With Alzheimer Disease or Related Syndromes (ADRS), end-of-life is characterised by progressive decline, but this period remains difficult to identify. This leads to a lack of anticipation and sometimes with unfavourable healthcare utilisation trajectories (HUTs). Objective to quantify unfavourable HUTs during the last year of life and identify their potential determinants in both community and nursing-home settings. Design nationwide cohort study using administrative database. Setting French community and nursing-home residents. Subjects incident ADRS people identified in 2012, who died up to 31 December 2017. Methods we used multidimensional clustering to identify 15 clusters of HUTs, using 11 longitudinal healthcare dimensions during the last year of life. Clusters were qualitatively assessed by pluri-disciplinary experts as favourable or unfavourable HUTs. Individual and contextual potential determinants of unfavourable HUTs were studied by setting using logistic random-effect regression models. Results 62,243 individuals died before 31 December 2017; 46.8% faced unfavourable end-of-life HUTs: 55.2% in the community and 31.8% in nursing-homes. Individual potential determinants were identified: younger age, male gender, ADRS identification through hospitalisation, shorter survival, life-limiting comorbidities, psychiatric disorders, acute hospitalisations and polypharmacy. In the community, deprivation and autonomy were identified as potential determinants. Contextual potential determinants raised mostly in the community, such as low nurse or physiotherapist accessibilities. Conclusions Nearly half of people with ADRS faced unfavourable HUTs during their last year of life. Individual potential determinants should help anticipate advance care planning and palliative care needs assessment. Contextual potential determinants suggest geographical disparities and health inequalities. [ABSTRACT FROM AUTHOR]

In this brief communication, we discuss the confusion of mortality with fatality in the interpretation of evidence in the coronavirus disease 2019 (COVID-19) pandemic, and how this confusion affects the translation of science into policy and practice. We discuss how this confusion has influenced COVID-19 policy in France, Sweden, and the United Kingdom and discuss the implications for decision-making about COVID-19 vaccine distribution. We also discuss how this confusion is an example of a more general statistical fallacy we term the "Missing Link Fallacy." [ABSTRACT FROM AUTHOR]