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Abstract: The main purpose of this study is to provide new estimations of optical properties for different aerosol species (Elemental (EC) and Organic Carbon (OC), sulfate (S), ammonium (AM) and nitrate (N)) over the Western Mediterranean Sea. This study is based on chemical measurements obtained over the French Mediterranean coastal region which were used to calculate the main optical properties (i.e., Mass Extinction Efficiency (MEE), Single Scattering Albedo (SSA) and asymmetry parameter (g)), which are relevant for Regional Climate Models (RCMs). Our results indicate that EC particles display averaged MEE (with associated uncertainty range) of 5.7 (4.6–6.9)m2 g−1 (at 550nm), that is significantly lower than the value generally used (~10m2 g−1) in RCM simulations conducted over this region. Such differences are mainly due to the inclusion of additional coarse modes in our optical calculations, which are not taken into account in RCMs that generally treat only fine EC particles. Concerning organics aerosols, we obtained a mean dry MEE (with associated uncertainty) of 2.7 (1.8–3.6)m2 g−1 (at 550nm) lower than usually (~5–7m2 g−1) referenced in RCMs. We also investigated the possible impact of absorbing brown carbon “Cbrown” in our calculations showing large changes on dry MEE (from 2.7 to 4.5m2 g−1, at 550nm) and SSA (from 0.99 to 0.45, at 550nm) for pure scattering and absorbing Cbrown organics, respectively. Nitrate and ammonium particles, which are not well documented over this region, are characterized respectively by dry mean (and associated errors) MEE of 1 (0.8–1.2)m2 g−1 and 4 (2.4–5.6)m2 g−1 (at 550nm), together with SSA of 0.89 (0.88–0.90) and 0.97 (0.96–0.98) at 550nm. Such proposed values could be used to optimize RCMs over the Mediterranean basin for studying “aerosol-climate” interaction through feedbacks of particles on sea-surface fluxes, and hydrological cycle. [Copyright &y& Elsevier]

Measurements of aerosol optical and physical properties, and chemical composition were conducted at Toulouse, an urban site of southwest France, as part of the CAPITOUL experiment. A period of intensive observations was held over 10 days during the summer campaign in June–July, 2004. During this period, PM2.5 concentrations ranged between 1 and 50 µg m−3. Aerosol size distributions exhibit the presence of three distinct modes which could be fitted by lognormal functions. Diurnal variations of aerosol concentration, size distribution, BC concentration, scattering and absorption coefficients, and single scattering albedo show the presence of two maxima corresponding to rush hours due to various urban activities such as vehicle traffic. Over the period of study, the single scattering albedo at 0.52 µm is found to be 0.7 ± 0.1, indicating the dominance of absorbing aerosols over Toulouse. Airborne measurements observed the vertical distribution of aerosols in the atmosphere. These observations clearly show that aerosol is mostly contained within the UBL which contributes significantly to the aerosol optical depth. The GAME radiative transfer model (RTM) has been used to carry out the radiative transfer computations. A synergetic approach was applied to generate spectral values of aerosol parameters required as input for the radiative transfer calculations. Vertical radio soundings and airborne measurements provided in-situ parameters required for the RTM. Simulations indicate that aerosols over Toulouse reduce significantly (−30 W m−2) the solar energy reaching the surface, mainly by absorption of the solar radiation into the atmosphere. At the TOA, aerosol forcing is even found to be positive (+0.8 W m−2). These results confirm that local direct aerosol forcing in urban atmosphere is mainly driven by the absorbing black carbon aerosols. The mean heating rate within the UBL is considerably enhanced, by 4.57 K day−1, due to the presence of absorbing aerosols. [ABSTRACT FROM AUTHOR]

Background and Aims: Data about the prognosis of salvage transjugular intrahepatic portosystemic shunt (TIPS) using covered stents for refractory variceal bleeding caused by portal hypertension are scarce. We aimed to assess survival and to identify predictors of mortality in these patients., Approach and Results: One hundred sixty-four patients with cirrhosis from five centers treated with salvage TIPS between 2007 and 2017 were retrospectively divided into a derivation cohort (83 patients) and a validation cohort (81 patients). Comparisons were performed using the Mann-Whitney and Fischer's exact test. Six-week overall survival (OS) was correlated with variables on the day of the TIPS using Kaplan-Meier curves with log-rank test and univariate/multivariate analyses using the Cox model. Eighty-three patients were included in the derivation cohort (male, 78%; age, 55 years, alcohol-associated cirrhosis, 88%; Model for End-Stage Liver Disease [MELD], 19 [15-27]; arterial lactate, 3.7 mmol/L [2.0-8.3]). Six-week OS rate was 58%. At multivariate analysis, the MELD score (OR, 1.064; 95% CI, 1.005-1.126; P = 0.028) and arterial lactate (OR, 1.063; 95% CI, 1.013-1.114; P = 0.032) were associated with 6-week OS. Six-week OS rates were 100% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15 and 5% in patients with lactate ≥12 mmol/L and/or MELD score ≥ 30. The 81 patients of the validation cohort had similar MELD and arterial lactate level but lower creatinine level (94 vs 106 µmol/L, P = 0.008); 6-week OS was 67%. Six-week OS rates were 86% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15 and 10% for patients with lactate ≥12 mmol/L and/or MELD score ≥ 30. In the overall cohort, rebleeding rate was 15.8% at 6 weeks, and the acute-on-chronic liver failure grade (OR, 1.699; 95% CI, 1.056-1.663; P = 0.040) was independently associated with rebleeding., Conclusions: After salvage TIPS, 6-week mortality remains high and can be predicted by MELD score and lactate. Survival rate at 6 weeks was >85% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15, while mortality was >90% for lactate ≥12 mmol/L and/or MELD score ≥ 30., (© 2021 by the American Association for the Study of Liver Diseases.)

Background: Notwithstanding the ongoing coronavirus disease-2019 (Covid-19) pandemic, information on its clinical presentation and prognosis in organ transplant recipients remains limited. The aim of this registry-based observational study was to report the characteristics and clinical outcomes of liver transplant (LT) recipients included in the French nationwide Registry of Solid Organ Transplant Recipients with Covid-19., Methods: COVID-19 was diagnosed in patients who had a positive PCR assay for SARS-CoV-2 or in presence of typical lung lesions on imaging or specific SARS-CoV-2 antibodies. Clinical and laboratory characteristics, management of immunosuppression, treatment for Covid-19, and clinical outcomes (hospitalization, admission to intensive care unit, mechanical ventilation, or death) were recorded., Results: Of the 104 patients, 67 were admitted to hospital and 37 were managed at home (including all 13 children). Hospitalized patients had a median age of 65.2 years (IQR: 58.1 - 73.2 years) and two thirds were men. Most common comorbidities included overweight (67.3%), hypertension (61.2%), diabetes (50.7%), cardiovascular disease (20.9%) and respiratory disease (16.4%). SARS-CoV-2 infection was identified after a median of 92.8 months (IQR: 40.1 - 194.7 months) from LT. During hospitalization, antimetabolites, mTOR inhibitor, and CNIs were withdrawn in 41.9%, 30.0% and 12.5% of patients, respectively. The composite endpoint of severe Covid-19 within 30 days after diagnosis was reached by 33.0% of the adult patients. The 30-day mortality rate was 20.0%, and 28.1% for hospitalized patients. Multivariate analysis identified that age was independently associated with mortality., Conclusion: In our large nationwide study, Covid-19 in LT recipients was associated with a high mortality rate., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Objective: To investigate the possible link between Porphyromonas gingivalis infection and rheumatoid arthritis (RA), according to antibody profile, genetic and environmental factors, and RA severity., Methods: For assessing P gingivalis infection, serum levels of antibodies directed against P gingivalis lipopolysaccharide were measured in 694 patients with early RA who were not exposed to steroids or disease-modifying antirheumatic drugs. Anti-P gingivalis antibody titers were compared between patients with early RA and various control groups, and according to various patient characteristics., Results: Anti-P gingivalis antibody titers did not significantly differ between patients with RA and controls and did not significantly differ with anti-citrullinated protein antibody (ACPA), rheumatoid factor (RF), or HLA shared epitope status. Anti-P gingivalis antibody titers were significantly higher among patients who had never smoked compared to patients who had ever smoked (P = 0.0049). Among nonsmokers, high anti-P gingivalis antibody levels were associated with a higher prevalence of erosive change (47.5% versus 33.3% with modified Sharp/van der Heijde score erosion subscale ≥1; P = 0.0135)., Conclusion: In this large early RA cohort, we did not detect any association of anti-P gingivalis antibodies with RA or with ACPA status. These results suggest that the association of periodontitis and RA could be linked to bacterial species other than P gingivalis or to a mechanism other than citrullination. Nevertheless, we found higher anti-P gingivalis antibody titers in nonsmokers. In addition, in this population of nonsmokers, high anti-P gingivalis antibody titers were associated with more severe disease. We hypothesize that the role of tobacco in RA pathogenesis is so high that the effect of P gingivalis could be revealed only in a population not exposed to tobacco., (© 2015, American College of Rheumatology.)

There is an unmet need for validated tools to measure sialorrhea in amyotrophic lateral sclerosis, especially to evaluate treatments. We assessed the inter-/intra-rate reviewer reliability of two scales: the Oral Secretion Scale (OSS), specifically developed for ALS patients, and the Sialorrhea Scoring Scale (SSS), initially developed for Parkinson's disease patients. Sialorrhea was rated in 69 ALS consecutive patients by four evaluators: two neurologists, one nurse and one speech therapist. Inter-rater reliability was evaluated by the light kappa coefficient and intra-rater reliability by the weighted kappa coefficient. We also compared patients' and caregivers' answers. Results demonstrated that the two scales present a high inter-/intra-rater reliability: weighted kappas were 0.85 for both scales and light kappas 0.89 for the OSS and 0.88 for the SSS. Both scales also showed a good intra-profession reliability (OSS kappa = 0.84; SSS kappa = 0.79) and agreement between patients' and caregivers' answers. The SSS showed a higher responsiveness compared to OSS. In conclusion, both Oral Secretion Scale and Sialorrhea Scoring Scale are reliable tools to measure sialorrhea in ALS patients. Because of the wide range of salivation degrees, SSS may be more sensitive as a tool to evaluate treatments in patients with severe hypersialorrhea.

In bacteria, normal mutation frequencies are mostly around 10(-10) per base pair. However, there exists natural isolates, called "mutators," that exhibit permanent mutation occurrences up to 1,000-fold greater than usual. As mutations play essential roles, particularly in the evolution of antibiotic resistance, bacteria showing elevated mutation rates could have an important responsibility in the emergence of antibiotic resistance, especially in the clinical background. In this announcement, we report the first complete genome sequence of the Salmonella enterica subsp. enterica serotype Heidelberg B182 mutator strain, isolated from bovine feces (France), which consists of a 4,750,465-bp circular chromosome (cB182_4750; GC, 52.2%) and one circular plasmid of 37,581 bp (pB182_37; GC, 42.8%).

We prospectively assessed stool samples from 370 patients for Campylobacter species by comparing three selective agar media incubated at two temperatures: 42°C and 37°C. Twenty patients (5.4%) were found positive. The chromogenic medium CASA (AES Chemunex, France) proved highly efficient for C. jejuni and C. coli recovery, while lessening the workload in the lab.

Objectives: To evaluate the role of Staphylococcus simulans in bone and joint infections (BJI) and determine their main characteristics., Methods: A search of the database of the microbiology laboratories of Lille hospital and Tourcoing hospital was performed. Only results from blood, bone, and orthopedic device cultures were taken into account for hospitalized patients between January 2004 and January 2009. We considered cases in which S. simulans was the only bacteria isolated in all of the patients' biological samples with clinical and laboratory signs of infection. For patients with complete medical records, we recorded the clinical and epidemiological data., Results: Six cases of BJI due to S. simulans were recorded, with five cases related to orthopedic devices infections. Three patients lived in rural areas. In four out of six patients, S. simulans was isolated in intraoperative biopsy material. In one patient, S. simulans grew in synovial fluid and in another in blood cultures only. The latter patient had a spondylodiscitis, and chronic foot ulcers due to gout disease were suspected to be the origin of the infection. All patients were healed after a mean follow up of 9 ± 3 months. Orthopedic devices were removed in four of the five patients concerned. The combination of rifampicin plus levofloxacin was used in four patients., Conclusion: The present data suggest that, even though S. simulans remains rarely observed in clinical pathology, its role in osteoarticular infections, especially in the case of infected orthopedic devices, is not exceptional. As for the antibiotic treatment, the combination of rifampicin and levofloxacin seems to be an effective strategy according to our clinical results.

We carried out a retrospective multicentre study to assess the safety of home parenteral nutrition (HPN) in patients with ALS. We reviewed the case records of patients from French ALS centres treated with HPN by central venous catheter (CVC) using an implantable port between January 2005 and October 2009. Seventy-three patients received HPN for a total of 11,908 catheter days. Twenty-seven patients experienced a total of 37 CVC related complications resulting in an incidence rate of 3.11 CVC complications/1000 catheter days, including 1.93 septic complications and 1.09 mechanical complications/1000 catheter days. Metabolic complications were frequent but without serious consequences on mortality. The use of the catheter for intravenous therapies in addition to HPN was identified as a septicaemia's risk factor (relative risk (RR) = 2.54, confidence interval (CI) 1.56-4.14, p = 0.04). In conclusion, HPN is an alternative procedure to PEG in advanced ALS patients. The incidence of complications appears to be comparable to data from the literature on HPN in other diseases. A prospective study comparing HPN and radiologic inserted gastrostomy (RIG) would allow comparison of the relative risk-benefit and survival of these procedures. The relation of CVC and RIG placement timing and the complications' occurrence should also be investigated.