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Despite the impossibility of face-to-face teaching during the COVID-19 pandemic lockdown, many physical education teachers used remote activity pedagogical monitoring (PM) to keep students engaged in physical activity (PA). The aim of this study was to explore students' experiences of remote PM practices during lockdown to engage in PA. A sequential explanatory mixed methods design was used, with a qualitative investigation (students' experience of PM) informed by a quantitative investigation (relationship between PA and PM as a function of diligence). First, 644 French students (16.32 ± 1.01 years) participated in a longitudinal survey to collect retrospective data about their reported PA levels during a typical week before lockdown and four weeks after. A second step consisted of identifying clusters, based on how PA emerged in participants and diligence in PM. Five clusters were identified from which eight paragons accepted to be interviewed. Interviews were conducted with paragons from each cluster to understand their different lived experiences during PM. Results showed a significant decrease in PA during lockdown, with PM serving to limit the drop-out from PA. Positive experiences in PA engagement were associated with: (a) family and video support, (b) variety in the PA program, (c) requests for work, (d) provision of feedback, and (e) use of personalised training. Results are encouraging in terms of developing hybrid pedagogical practice which includes face-to-face activity and use of PM. Further research is needed to ensure these pedagogical principles lead to positive experiences of PA engagement at a distance.

Purpose: Despite its relevance for the training of a well-rounded physically literate individual, the development of knowledge about physical activity (KPA) is understudied. We examined how KPA is differentiated and evolves according to grade level, gender, and type of school attended by an adolescent. Method: A reliable KPA assessment tool was developed. A three-way analysis of variance was used to analyze z scores on the effects of gender, grade level, and type of school on five different dimensions of knowledge. Results: The reliability was validated. Statistically significant interactions were revealed between grade and school institution on KPA z scores. Main results showed that vocational schools displayed significantly lower levels, compared to traditional ones. The only increase in knowledge according to grade was noticeable only in traditional schools. Results revealed no significant gender differences. Discussion: The French physical education system does not seem to provide an adequate level of KPA, especially in vocational schools.

Objectives This study aimed to estimate the prevalence of ANCA-associated vasculitis (AAV). That is, granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA), in Southern France in 2018, and evaluate differences among Europeans and non-Europeans. Methods This population-based, cross-sectional study used four sources (hospitals, community-based physicians, laboratories, National Health Insurance) to identify adults ≥15 years diagnosed with GPA, MPA or EGPA, living in Hérault and Gard in 2018. Cases were defined using the ACR/EULAR classification criteria, and if necessary, the European Medicines Agency algorithm. Prevalence estimates were standardised to the world population and capture-recapture analysis was used to assess the comprehensiveness of the estimation. The influence of geographical origin was evaluated. Results A total of 202 patients were selected, with 86 cases of GPA (42.6%), 85 cases of MPA (42.1%) and 31 cases of EGPA (15.3%). The standardised prevalence estimates per million inhabitants for 2018 were: 103 (95%CI 84–125) for AAV, 48 (95%CI 35–64) for GPA, 39 (95%CI 28–53) for MPA and 16 (95%CI 9–26) for EGPA, 36 (95%CI 25–50) for anti-PR3 positive AAV, 46 (95%CI 34–61) for anti-MPO positive AAV, and 16 (95%CI 9–26) for ANCA-negative AAV. The global estimation of comprehensiveness by capture-recapture analysis was 80.5%. The number of AAV cases was higher for non-European residents (P  = 0.001), particularly for MPA (P   <  0.0001). Conclusion We provide a new estimate of AAV prevalence in France and show a higher prevalence of MPA in non-European patients. [ABSTRACT FROM AUTHOR]

Background This study aimed to characterize the demographics, microbiology, management and treatment outcomes of mediastinitis according to the origin of the infection. Methods This retrospective observational study enrolled patients who had mediastinitis diagnosed according to the criteria defined by the Centers for Disease Control and Prevention and were treated in Strasbourg University Hospital, France, between 1 January 2010 and 31 December 2020. Results We investigated 151 cases, including 63 cases of poststernotomy mediastinitis (PSM), 60 cases of mediastinitis due to esophageal perforation (MEP) and 17 cases of descending necrotizing mediastinitis (DNM). The mean patient age (standard deviation) was 63 (14.5) years, and 109 of 151 patients were male. Microbiological documentation varied according to the origin of the infection. When documented, PSM cases were mostly monomicrobial (36 of 53 cases [67.9%]) and involved staphylococci (36 of 53 [67.9%]), whereas MEP and DNM cases were mostly plurimicrobial (38 of 48 [79.2%] and 8 of 12 [66.7%], respectively) and involved digestive or oral flora microorganisms, respectively. The median duration of anti-infective treatment was 41 days (interquartile range, 21–56 days), and 122 of 151 patients (80.8%) benefited from early surgical management. The overall 1-year survival rate was estimated to be 64.8% (95% confidence interval, 56.6%–74.3%), but varied from 80.1% for DNM to 61.5% for MEP. Conclusions Mediastinitis represents a rare yet deadly infection. The present cohort study exhibited the different patterns observed according to the origin of the infection. Greater insight and knowledge on these differences may help guide the management of these complex infections, especially with respect to empirical anti-infective treatments. [ABSTRACT FROM AUTHOR]

Rodents are recognized as the main reservoirs of Leptospira spp. Rats, in particular, serve as hosts for the widely predominant Leptospira interrogans serovar Icterohaemorrhagiae, found worldwide. Several studies have shown the importance of other reservoirs, such as mice or hedgehogs, which harbor other leptospires' serovars. Nevertheless, our knowledge of circulating Leptospira spp. in reservoirs other than rats remains limited. In this context, we proposed an eco-health approach to assess the health hazard associated with leptospires in urban green spaces, where contacts between human/small mammals and domestic animals are likely. We studied the prevalence, the diversity of circulating strains, and epidemiology of pathogenic Leptospira species in small terrestrial mammal communities (rodents and shrews), between 2020–2022, in two parks in Lyon metropolis, France. Our study showed a significant carriage of Leptospira spp. in small terrestrial mammals in these parks and unveiled a global prevalence rate of 11.4%. Significant variations of prevalence were observed among the small mammal species (from 0 to 26.1%), with Rattus norvegicus exhibiting the highest infection levels (26.1%). We also observed strong spatio-temporal variations in Leptospira spp. circulation in its reservoirs. Prevalence seems to be higher in the peri-urban park and in autumn in 2021 and 2022. This is potentially due to differences in landscape, abiotic conditions and small mammal communities' composition. Our study suggests an important public health relevance of rats and in a lesser extent of other rodents (Apodemus spp., Clethrionomys glareolus and Mus musculus) as reservoirs of L. interrogans, with rodent species carrying specific serogroups/serovars. We also emphasize the potential hazard associated between the shrew Crocidura russula and L. kirschneri. Altogether, these results improve our knowledge about the prevalence of leptospirosis in an urban environment, which is an essential prerequisite for the implementation of prevention of associated risks. [ABSTRACT FROM AUTHOR]

• Wood is always a top material for beams. • 40 million of slender young oak trees are available in French forest. • Round-wood squared at the minimum keeps the high resistance of trunks. • Using green wood is the fastest and most energy-saving method. • High tech modern techniques can be used for the best sorting of trees. During the fire of Notre-Dame de Paris, all timber frames coming from the Middle ages period, in the nave and choir, were burnt. It was decided to proceed as possible to an identical reconstruction, but many questions arise about the timber frame. Is wood outdated as a material for beams? Is oak wood the best solution for timber frame? Are we able to find similar long slender oak beams in today French forest? Is it safe to use green wood for the building? In fact, the forested area in France is the same today as in the Middle ages period, but two times higher than during the 19th century. Results from the forest inventory proves that 40 million slender oak trees are available in order to sort around 1500 trees for the restoration. Cathedral heritage provided a demonstration of the high efficiency of carpenter's know-how. Most of oak beams kept their functionality for more than 800 years. This is a nice experimental result for a very long mechanical testing. Wood, emerged as material 300 million years ago as a result of long time evolution, is used to build trees, which are a collection of wooden beams able to resist flexure forces, for a long time. Technical know-how about timber frame is old in human societies and was improved during the Middle ages, but scientific knowledge about wood as an anisotropic material is very recent. The background in mechanics for such material has been developed in early 20th century and observation tools for material structures at the nanometre scale appeared in late 20th century. Wood can be considered as an archetypal high-tech material using polymer-with-additive technology combined to nanostructured fibre-composite within a honeycomb-like micro-structured material. This explains why nature solution for tree beams is very efficient in terms of bending resistance per weight. The mechanical behaviour of wooden beams is highly sensitive to the orientation of the main direction of anisotropy (grain direction) relative to bending forces. Natural beams in trees are built by a kind of 3D printing process so that grain orientation at beam periphery is always optimum. Mechanical bending performance of these beams (round-wood), in spite of branching, is equivalent to the performance of standard clear-wood specimens documented in databases. Squaring at the minimum this round-wood should be done while keeping grain angle closest to zero-degree value, which is performed by specific axe-hewn log squaring. The result is "coarse" slightly curved beams much more resistant than "nicely" straight sawn beams with local grain angle above 10° Using directly green wood in the building process is effective for time of building and energy consumption. The drying of wood induces long deep longitudinal cracks and a reduction in beam section but a bigger increase in wood mechanical performance. If the green frame resists, the dried one will resist all the following years. Finally, today carpenters have kept the building know-how and there are many modern non-destructive techniques available for the best sorting of trees and mechanical evaluation of beams. [ABSTRACT FROM AUTHOR]

Aim: Preterm children are highly vulnerable to sensorial impairments through Retinopathy Of Prematurity (ROP). The objective was to determine whether some cases of ROP requiring surgery could be secondary to deficiencies in care pathways. Methods: Descriptive study of neonatal characteristics and the screening/treatment pathways of children treated for stage ≥4A ROP from 2009 to 2020 in a referral unit in France. Results: Twenty‐five preterm children (44 eyes) were included: median gestational age was 25 weeks, and median birthweight was 700 grams. Eighty‐four per cent had received at least one fundus examination, 50% of which were completed on time. At the time of retinal detachment diagnosis, only 36% of the children had received laser or anti‐vascular endothelial growth factor (VEGF) intra‐vitreal injection. ROP stage was only reported in 8%, and the zone or type was reported in 16% of the files. Conclusion: The risk of blindness and the effectiveness of laser or anti‐VEGF treatment highlight the need to enhance screening and treatment practices in France. [ABSTRACT FROM AUTHOR]

Research Findings: In 2 experiments, we tested whether children generalize psychological and biological properties to novel foods. We used an induction task in which a property (either biological or psychological) was associated with a target food. Children were then asked whether a taxonomically related and a script-related food would also have the property. In a yes/no task (Experiment 1) 9-year-olds preferentially generalized the property to taxonomically related foods, but 4- and 6-year-olds did not. In a forced-choice task (Experiment 2; 4- to 6-year-olds), children preferred the taxonomic choice over the script choice. This preference was weak at age 4 but established by age 5. In both experiments, and all age groups, biological properties, and psychological properties were treated similarly. It is argued that the children do not distinguish biological and psychological properties of food most likely because they believe that psychological properties are caused by biological dispositions. Practice or Policy: We argue that nutrition education should take advantage of children's existing knowledge of food categories and how children generalize knowledge from 1 food to another. In particular, children have good knowledge of taxonomic categories and can best access that knowledge when they are required to compare different foods.

Many current biogeochemical models rely on an autotrophic versus heterotrophic food web representation. However, in recent years, an increasing number of studies have begun to challenge this approach. Several authors have highlighted the importance of protists capable of combining photoautotrophic and heterotrophic nutrition in a single cell. These mixotrophic protists are known to play an important role in the carbon cycle. Here, we present a new biogeochemical model that represents the food web using variable stoichiometry. It contains the classic compartments such as zooplankton, phytoplankton, and heterotrophic bacteria and a newly added compartment to represent two types of mixotrophic protists: non-constitutive mixotrophs (NCMs) and constitutive mixotrophs (CMs). We demonstrate that the model correctly reproduces the characteristics of NCMs and CMs and proceed to study the impact of light and nutrient limitation on planktonic ecosystem structure in a highly dynamic Mediterranean coastal area, namely the Bay of Marseille (BoM, France), paying special attention to the dynamics of mixotrophic protists in these limiting conditions. In addition, we investigate the carbon, nitrogen, and phosphorus fluxes associated with mixotrophic protists and showed the following: (i) the portion of the ecosystem in terms of the percentage of carbon biomass occupied by NCMs decreases when resources (nutrient and prey concentrations) decrease, although their mixotrophy allows them to maintain a carbon biomass almost as significant as the copepod one (129.8 and 148.7 mmolCm-3 , respectively), as photosynthesis increases as a food source, and (ii) the portion of the ecosystem in terms of the percentage of carbon biomass occupied by CM increases when nutrient concentrations decrease due to their capability to ingest prey to supplement their N and P needs. In addition to providing new insights regarding the conditions that lead to the emergence of mixotrophs in the BoM, this work provides a new tool to perform long-term studies and predictions of mixotroph dynamics in coastal environments under different environmental forcings. [ABSTRACT FROM AUTHOR]

Background: Following the results of randomized controlled trials on levosimendan, French health authorities requested an update of the current use and side-effects of this medication on a national scale. Method: The France-LEVO registry was a prospective observational cohort study reflecting the indications, dosing regimens, and side-effects of levosimendan, as well as patient outcomes over a year. Results: The patients included (n = 602) represented 29.6% of the national yearly use of levosimendan in France. They were treated for cardiogenic shock (n = 250, 41.5%), decompensated heart failure (n = 127, 21.1%), cardiac surgery-related low cardiac output prophylaxis and/or treatment (n = 86, 14.3%), and weaning from veno-arterial extracorporeal membrane oxygenation (n = 82, 13.6%). They received 0.18 ± 0.07 µg/kg/min levosimendan over 26 ± 8 h. An initial bolus was administered in 45 patients (7.5%), 103 (17.1%) received repeated infusions, and 461 (76.6%) received inotropes and or vasoactive agents concomitantly. Hypotension was reported in 218 patients (36.2%), atrial fibrillation in 85 (14.1%), and serious adverse events in 17 (2.8%). 136 patients (22.6%) died in hospital, and 26 (4.3%) during the 90-day follow-up. Conclusions: We observed that levosimendan was used in accordance with recent recommendations by French physicians. Hypotension and atrial fibrillation remained the most frequent side-effects, while serious adverse event potentially attributable to levosimendan were infrequent. The results suggest that this medication was safe and potentially associated with some benefit in the population studied. [ABSTRACT FROM AUTHOR]

Introduction: Primary spontaneous pneumothorax (PSP) is the presence of air in the pleural space, occurring in the absence of trauma and known lung disease. Standardized expert guidelines on PSP are needed due to the variety of diagnostic methods, therapeutic strategies and medical and surgical disciplines involved in its management. Methods: Literature review, analysis of the literature according to the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) methodology; proposals for guidelines rated by experts, patients and organizers to reach a consensus. Only expert opinions with strong agreement were selected. Results: A large PSP is defined as presence of a visible rim along the entire axillary line between the lung margin and the chest wall and ≥ 2 cm at the hilum level on frontal chest X-ray. The therapeutic strategy depends on the clinical presentation: emergency needle aspiration for tension PSP; in the absence of signs of severity: conservative management (small PSP), needle aspiration or chest tube drainage (large PSP). Outpatient treatment is possible if a dedicated outpatient care system is previously organized. Indications, surgical procedures and perioperative analgesia are detailed. Associated measures, including smoking cessation, are described. Conclusion: These guidelines are a step towards PSP treatment and follow-up strategy optimization in France. [ABSTRACT FROM AUTHOR]

To describe clinical features, management, and outcomes of posterior persistent fetal vasculature (PFV) and suggest a management algorithm. Retrospective, consecutive case series. All children diagnosed with posterior PFV and treated or followed at the Rothschild Foundation Hospital in France between June 2011 and September 2021. Retrospective analysis of the clinical characteristics of posterior PFV. We reported age, gender, presenting symptoms, intraocular pressure, and visual acuity (VA) at diagnosis. Patients were divided into 4 groups depending on the severity and involvement or not of anterior segment. We reported the vitreoretinal surgical techniques used. Anatomic results, ocular hypertension, best-corrected distance visual acuity (BCDVA), presence of postoperative adverse events, and additional surgical interventions were recorded at each follow-up visit. Ninety-six patients were included. The median age at diagnosis was 8 months (IQR = 12), mean 18.9 ± 30.9 months) with a mean follow-up of 27 ± 31.2 months. Although PFV is often an isolated disease, it was associated with a systemic disease in 8% of cases. There was anterior involvement in 62 (64%) of eyes. Forty-one eyes (42.7%) were microphthalmic and more frequently associated with severe PFV (53% vs. 25%; P = 0.01). Surgery was performed in 85 patients (89%). Of them, 69 (81%) had a total success, 5 (6%) had a partial success due to persistent limited peripheral retinal detachment (RD), and 11 (13%) had a failure due to persistent total RD after surgery. Postoperative adverse events occured in 38 eyes including ocular hypertension requiring eye drop medication (7.1%), secondary cell proliferation around the intraocular lens (8.2%), intravitreal hemorrhages (7.1%), and persistent tractional RD (10.6%). Second surgery was performed in 18 patients (21%). At last follow-up, VA could be measured in logarithm of the minimum angle of resolution in 43 children (45%), light perception in 21 eyes (22%), and no light perception or impossible to assess in 32 eyes (33%). In our case series, most patients presenting with posterior PFV received complex vitreoretinal surgery. Goals of the surgery vary and include retinal flattening, reduction of vitreoretinal traction, freeing of visual axis, and aesthetic concerns. We propose a surgical and medical management algorithm for PFV. Proprietary or commercial disclosure may be found after the references. [ABSTRACT FROM AUTHOR]

Background and Objectives: Since the advent of AIDS, men who have sex with men (MSM) have often been deferred from blood donation. In France, quarantine plasma donation by MSM donors with the same deferral rules as for other donors was introduced in July 2016 and continued up to March 2022. At this time, MSM‐specific deferral criteria were lifted for all blood or plasma donation. The donor deferral, as well as rate of infectious markers in plasma donors who would have been otherwise deferred for MSM activity, was evaluated and compared with those of the other donors during the same time period from June 2016 to March 2022. Results: A total of 8843 MSM donors made 12,250 plasma donation applications. The overall deferral rate was very high (75.2%), mainly due to the absence of apheresis capacity at the donation site. The deferral criteria for sexual risk were present in 12.1% of MSM donors compared with 1.0% in other plasma and blood donors (p < 0.001). Overall, 994 MSM donors made 2880 plasma donations. Of these, one donation was HIV positive (34.7 vs. 0.6/105 donations by other donors, relative risk [RR]: 61.0 [95% confidence interval [CI]: 8.5–437.7]), one was HBV positive (34.7 vs. 4.5/105, RR: 7.7 [95% CI: 1.1–54.6]) and none were HCV positive (0 vs. 2.4/105). Additionally, 21 donations were syphilis positive (729.2 vs. 10.7/105, RR: 67.9 [95% CI: 44.2–104.4]). A post hoc analysis of eligible MSM donors who were unable to donate plasma due to logistic constraints yielded similar findings. Conclusion: Plasma donation by donors who would have been otherwise deferred for MSM activity was associated with both an increased deferral rate for sexual risk and an increased rate of infectious markers, notably syphilis. [ABSTRACT FROM AUTHOR]

The quagga mussel (Dreissena rostriformis bugensis) was first recorded in France in the Moselle River in 2011. The objective of this study was to obtain a better understanding of the species' demographic and genetic structure ten years after its first observation. To do this, we examined quagga mussel (i) relative abundance/biomass (compared with the zebra mussel (Dreissena polymorpha), (ii) population structure, and (iii) genetic structure along the navigable stretch of the Moselle during four sampling events conducted between May 2021 and May 2022. The results indicate that, while zebra mussels are still the dominant species (ca. 2/3 of all dreissenid species), quagga mussels represent, on average, 60% of dreissenid biomass. A typical quagga population was composed of five different cohorts with wide, overlapping size ranges, suggesting that the mussels breed for much of the year. Growth in quagga mussel shell length was at least 1.4x greater than that for zebra mussels, regardless of season, with no interruption in growth observed during winter. Unlike zebra mussels, we failed to record any small quagga individuals (4-14 mm shell length) in our samples, possibly indicating high mortality induced by selective predation by invasive round gobies Neogobius melanostomus. Genetically, the three Moselle quagga mussel populations examined were highly homogeneous among themselves (based on microsatellite analysis), and very similar to those found elsewhere in Europe (diversity of CO1 haplotypes). A comparison with previous data suggests that the Moselle quagga population comprises haplotypes introduced over several successive introduction waves, a process that may continue in the future. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate real-world efficacy, safety, and treatment patterns with the dexamethasone intravitreal implant (DEX) in diabetic macular edema (DME) in France. Methods: In this prospective, multicenter, observational, noncomparative, post-reimbursement study, consecutively enrolled patients with DME had a baseline evaluation on day 0. Those treated with DEX on day 0 were to be reevaluated at week 6 and months 6, 12, 18, and 24. DEX retreatment and/or alternative therapies were allowed during follow-up. The primary outcome measure was the maximum best corrected visual acuity (BCVA) gain from baseline during follow-up. Secondary outcome measures included time to maximum BCVA gain, patients (%) with prespecified BCVA gains from baseline at each visit, maximum central retinal thickness (CRT) reduction from baseline, patients (%) with CRT reduction ≥ 20% from baseline at each visit, patients (%) with DME resolution (per investigator judgement), and adverse events (AEs). Results: Of 112 patients/eyes with DME for 3.5 years (mean) at baseline, 80 (including 86.1% previously treated) received DEX on day 0 and were analyzed for efficacy. Early study termination precluded collection of ≥ 12-month efficacy data. Patients received 1.4 DEX injections over 8.3 months (averages). The maximum BCVA gain from baseline was 3.6 letters, reached after 77.2 days (averages); 24.6% (week 6) and 15.0% (month 6) of patients experienced ≥ 10-letter BCVA gains from baseline. The mean maximum CRT reduction from baseline was −146.4 µm; 61.4% (week 6) and 36.0% (month 6) of patients had CRT reductions ≥ 20% from baseline, and 68.1% reported DME resolution at least once during follow-up. Ocular hypertension (n = 8, 12.1%) was the most frequent treatment-related AE. Conclusions: LOUVRE 3 confirmed that DEX improves BCVA and CRT, even in a patient population that had predominantly received DEX before enrollment in the study, and showed that DME resolution was observed during follow-up. DEX tolerability was consistent with published data, supporting treatment benefits in DME. ClinicalTrials.gov Identifier: NCT03003416. [ABSTRACT FROM AUTHOR]

Background: In France, addiction care in prison usually consists of nurses' interventions, medical care and socio-educational programs, but new alternatives have arisen, namely the therapeutic community (TC) model. This pilot study aims to evaluate the effectiveness of this prison-based TC in comparison with classic and socio-educational care offered in French prisons. Methods: To compare these three types of prison-based care, two detention centers' files were screened for use of multiple drugs, willingness to participate and absence of psychiatric comorbidities incompatible with group therapy. A custom questionnaire was built based on the fifth version of the Addiction Severity Index. It investigates medical status, employment and support, primary addiction status, legal status, social/familial status and psychiatric status through various items. Results: Our sample only consisted of male repeat offenders with a mean age of 37.7 ± (9.1) years. Primary addiction status improvement was observed for all care studied but was more important in TC than in classic care. Self-esteem and social/familial status saw significant improvement throughout TC care. Conclusions: The TC model represents an alternative to classic and socio-educational care in French prisons. More studies are needed to assess the extent of the benefits provided on both the medical side and economic side. [ABSTRACT FROM AUTHOR]

The aim of the study is to compare, in coronary artery disease patients, physical activity (PA) assessed with the Dijon Physical Activity Questionnaire (DPAQ) and the true PA objectively measured using an accelerometer. Seventy patients wore an accelerometer (MyWellness Key actimeter) throughout 1 week after a cardiac rehabilitation program that included therapeutic education about regular PA. Patients completed the DPAQ at the end of the week. The mean weekly active energy expenditure was 619.9 [plus or minus] 374.6 kcal, and the mean DPAQ score was 21.3 [plus or minus] 3.1/30 points. There were low but significant correlations between total active energy expenditure and the DPAQ score ([rho]=0.4, P=0.009). There were no correlations between peak power output and total DPAQ score. The DPAQ significantly correlates with objective measures given by the MyWellness Key actimeter. The choice between these tools relies on the clinician's appreciation, taking into account patients' characteristics and goals as well as the cost of the method and availability of the tool. (Contains 2 tables.)

The Bay of Marseille (BoM), located in the north-western Mediterranean Sea, is affected by various hydrodynamic processes (e.g., Rhône River intrusion and upwelling events) that result in a highly complex local carbonate system. In any complex environment, the use of models is advantageous since it allows to identify the different environmental 15 forcings, thereby facilitating a better understanding. By combining approaches from two biogeochemical ocean models and improving the formulation of total alkalinity, we develop a more realistic representation of the carbonate system variables at high temporal resolution which enables us study air-sea CO2 fluxes and seawater pCO2 variations more reliably. We apply this new formulation to two particular scenarios, typical for the BoM: (i) summer upwelling and (ii) Rhône River intrusion events. In both scenarios, our model was able to correctly reproduce the observed patterns of pCO2 variability. Summer upwelling events are typically associated with pCO2 decrease that mainly results from decreasing near-surface temperatures. Furthermore, Rhône River intrusion events are typically associated with pCO2 decrease, although in this case the pCO2 decrease results from a decrease in salinity and an overall increase in total alkalinity. While our model was able to correctly represent the daily range of air-sea CO2 fluxes, we were unable to correctly estimate the yearly total air-sea CO2 flux. Although the model consistent with observations, predicted the BoM to be a sink of CO2 on a yearly basis, the magnitude of this CO2 sink was underestimated which may be an indication of the limitations inherent in dimensionless models for representing air-sea CO2 fluxes. [ABSTRACT FROM AUTHOR]

Salivary gland cancers are rare tumors comprising a large group of heterogeneous tumors with variable prognosis. Their therapeutic management at a metastatic stage is challenging due to the lack of therapeutic lines and the toxicity of treatments. [177Lu]Lu-PSMA-617 (prostate-specific membrane antigen) is a vectored radioligand therapy (RLT) initially developed to treat castration-resistant metastatic prostate cancer with encouraging results in terms of efficacy and toxicity. Many malignant cells could be treated with [177Lu]Lu-PSMA-617 as long as they express PSMA as a consequence of androgenic pathway activation. RLT may be used when anti-androgen hormonal treatment has failed, particularly in prostate cancer. [177Lu]Lu-PSMA-617 has been proposed in certain salivary gland cancers, though the expression of PSMA is demonstrated by a significant uptake using [68Ga]Ga-PSMA-11 PET scan. This theranostic approach could be a new therapeutic option, warranting prospective investigation in a larger cohort. We review the literature on this subject and offer a clinical illustration of compassionate use in France as a perspective for administering [177Lu]Lu-PSMA-617 in salivary gland cancer. [ABSTRACT FROM AUTHOR]

Initialization of condensate water variables for convective‐scale weather forecasting has been a topic of active research for the last few years. In this article, we present the addition of hydrometeor fields as control variables of a three‐dimensional ensemble variational scheme (3DEnVar) for the cloud‐resolving model AROME‐France. Even without any direct assimilation of hydrometeor observations, analysis increments of hydrometeors can be produced via covariances with observed variables in the ensemble‐derived background‐error covariance matrix. Cycled forecast–analysis experiments in near‐operational conditions have been performed over a three‐month summer period. Three configurations are compared: (i) a control experiment without hydrometeor control variables, (ii) a test experiment with hydrometeor control variables but without cycling the resulting forecasts, and (iii) an experiment with hydrometeor variables and cycled forecasts. Compared with the control experiment, both hydrometeor experiments show a positive impact up to 9 hr of forecasts in terms of cloud cover, and in the first hour for precipitation. The spin‐up period, as evidenced by a reduction of precipitation forecast skill at the beginning of the forecasts, is reduced in length and intensity in the hydrometeor experiments. [ABSTRACT FROM AUTHOR]

Deaf sign language speakers face barriers to medical care and this population has poorer health indicators than the general population. The aim of this study is to take stock of the existing international, national and territorial systems. A first article described the birth of the reception and care units for the Deaf in France and proposed a narrative review of the literature in order to compare the modalities of action with those deployed in developed countries. This second article describes the French system, the actors, the missions and highlights what remains of the community health model which had contributed to the setting up of the first French systems. [ABSTRACT FROM AUTHOR]

Mealybugs (Hemiptera: Coccomorpha: Pseudococcidae) constitute important agricultural pests that often require control measures. Different mealybug taxa might, however, react differently to natural enemies and pesticides so that appropriate control measures against mealybugs rely heavily on the correct species identification. The mealybug Planococcus ficus (Signoret) is the most damaging scale insect infesting vineyards worldwide. Despite its economic impact, the taxonomic status of this mealybug species is still unclear, and recent studies suggest the possibility that P. ficus from eastern (i.e., Egypt) and western (i.e., France) Mediterranean regions may correspond in fact to two distinct species. The purpose of this work was to deepen our current knowledge of putative P. ficus from eastern Mediterranean using molecular tools and morphological analysis and test for the existence of cryptic species within P. ficus. Mealybug samples were collected from Egyptian vineyards to better characterize the genetic diversity and analyze the population structure of putative P. ficus along the eastern Mediterranean. We also estimated the phylogenetic relationships among the P. ficus complex haplotypes in different vineyard regions worldwide and analyzed the morphological characters of the different clades obtained. Morphological and molecular analyses confirmed the existence of two species: P. ficus (Signoret) s.str. and P. vitis (Niedielski), a species that was previously synonymized as P. ficus. These results have direct implications for pest management and could explain the lack of success in previous implementations of biological control programs against this pest in several vineyard regions. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis with nasal polyps (CRSwNPs) is associated with otitis media with effusion (OME) in about 25% of cases. The objective of this study was to assess the clinical efficacy of the 4 biologic agents currently available in France for severe asthma (omalizumab, mepolizumab, benralizumab and dupilumab) in 17 patients followed for both asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) and presenting otitis media with effusion (OME) on otoscopy. Methods: It was a multicenter retrospective study performed in 4 academic ENT and respiratory departments in Paris, France, with assessment of the clinical evolution of 17 patients with severe eosinophilic asthma and with chronic refractory OME and CRSwNPs treated by biologic agents. Global evaluation of treatment effectiveness (GETE) on asthma, CRSwNP and OME was classified on a 5-point scale as 1, excellent; 2, good; 3, moderate; 4, poor; or 5, symptoms worsening. Response was defined as an excellent/good score (1 or 2). Results: 17 patients were prescribed a total of 30 biologics. The evolution of OME did not follow that of asthma and CRSwNPs in 15 (88%) and 12 (70%) cases, respectively. Concerning OME, 19/30 (63%) patients were non-responders. Among the 10 patients who successively received ≥ 2 biologic agents, the OME response differed, depending on the considered agent Dupilumab had the highest response rate. Conclusions: Resistant OME, associated with asthma and chronic rhinosinusitis with nasal polyps, can present a disconnected evolution under biologics. CRSwNP-associated OME requires a specific evaluation to define the best treatment. [ABSTRACT FROM AUTHOR]

Introduction This study aimed to assess satisfaction of patients affected by various fluid regimes during uncomplicated labor; to identify factors possibly associated with the level of satisfaction; to compare obstetrical and neonatal outcomes between the intervention groups. Methods Between October and December 2014, 40 women were included in the study set at the Poitiers University Hospital, France. Women were randomly allocated to two study arms: 20 to strict and 20 to liberal fluid regime group. Women’s satisfaction was assessed using visual analog scale. Categorical obstetrical and neonatal outcomes were analyzed using Chi-squared test and Fischer’s exact test. The between-group difference was assessed with Mann–Whitney U-test. Results Overall satisfaction was higher among women from the liberal fluid regime than from the strict fluid regime group (median score: 88, interquartile range [IQR]: 21 vs. 72, IQR: 21; p = 0.03). The active phase of the second stage of labor was shorter in the liberal fluid regime than in the strict fluid regime group (median 9 min, IQR: 7 vs. 17 min, IQR: 12; p = 0.02). The length of stay in the delivery room was significantly shorter in liberal fluid regime than in strict fluid regime group (median 190 min, IQR: 128 vs. 340 min, IQR: 195, p = 0.04). There were no significant differences in other obstetrical and neonatal outcomes. Conclusion Liberal fluid regime during labor was associated with significantly higher satisfaction of women. The active phase of the second stage of labor and the length of stay in the delivery room were significantly shorter in the liberal fluid regime group. [ABSTRACT FROM AUTHOR]

BACKGROUND: Clinical diagnosis of ICU-acquired pneumonia after cardiothoracic surgery is challenging. Johanson criteria (chest radiograph infiltrate, purulent tracheal secretions, fever, and leukocytosis) fail in half the cases. A high Clinical Pulmonary Infection Score (CPIS) and ≥ 2-point increase in Sequential Organ Failure Assessment (SOFA) score (SOFA ↑ ≥ 2) may improve diagnosis. The aim of the study was to evaluate whether CPIS or SOFA ↑ ≥ 2 contributes to predict ICU-acquired pneumonia in subjects after cardiothoracic surgery. METHODS: We used a prospective observational design. Spiegelhalter-Knill-Jones scoring systems including CPIS or SOFA ↑ ≥ 2, together with other clinical and laboratory variables, were developed in a derivation cohort. A positive quantitative pulmonary sample culture was required to confirm ICU-acquired pneumonia. Area under the receiver operating characteristic curve (AUROC) was computed for each of the 2 scoring systems. The best system was evaluated in a validation cohort. RESULTS: Derivation and validation cohorts included 172 and 108 subjects, with 410 and 216 suspected ICU-acquired pneumonia episodes, respectively. AUROC was 0.53 ± 0.03 for CPIS (P = .29) and 0.54 ± 0.03 for SOFA ↑ ≥ 2 (P = .29). Adding purulent tracheal secretions and leukocytosis to SOFA↑ ≥ 2 (SOFA model) increased AUROC to 0.65 ± 0.03 (P < .001). Adding catecholamine use to CPIS (CPIS model) increased AUROC only slightly, to 0.57 ± 0.03. The probabilities predicted by the SOFA model were reliable, especially when high or low. CONCLUSIONS: A clinical scoring system including at least SOFA ↑ ≥ 2 increase barely improved ICU-acquired pneumonia prediction in subjects after cardiothoracic surgery. [ABSTRACT FROM AUTHOR]

In France, all patients followed by Rare Disease (RD) expert centers have to be registered in the National Rare Disease Registry (BNDMR). This database collects a minimum data set including diagnosis coded using the Orphanet nomenclature. Overall, 753,660 patients were recorded from 2007 to March 2022 including 493,740 with at least one rare disease diagnosis. Among these rare disease diagnoses, 1,300 diagnoses gathered between 10 and 70 patients and 792 gathered more than 70 patients, corresponding to more than one patient per million inhabitants. A total of 47 rare disease diagnoses with point prevalence or incidence reported in the literature below 1/1,000,000 have more than 70 patients in the BNDMR, suggesting larger BNDMR cohorts than expected from reported literature. As a conclusion, our national RD registry is a great resource to facilitate patients' recruitment in clinical research and a better understanding of RD natural history and epidemiology. [ABSTRACT FROM AUTHOR]

Hereditary ataxias are common among canine breeds with various molecular etiology. We identified a hereditary ataxia in young‐adult Australian Shepherd dogs characterized by uncoordinated movements and spasticity, worsening progressively and leading to inability to walk. Pedigree analysis suggested an autosomal recessive transmission. By whole genome sequencing and variant filtering of an affected dog we identified a PNPLA8:c.1169_1170dupTT variant. This variant, located in PNPLA8 (Patatin Like Phospholipase Domain Containing 8), was predicted to induce a PNPLA8:p.(His391PhefsTer394) frameshift, leading to a premature stop codon in the protein. The truncated protein was predicted to lack the functional patatin catalytic domain of PNPLA8, a calcium‐independent phospholipase. PNPLA8 is known to be essential for maintaining mitochondrial energy production through tailoring mitochondrial membrane lipid metabolism and composition. The Australian Shepherd ataxia shares molecular and clinical features with Weaver syndrome in cattle and the mitochondrial‐related neurodegeneration associated with PNPLA8 loss‐of‐function variants in humans. By genotyping a cohort of 85 control Australian Shepherd dogs sampled in France, we found a 4.7% carrier frequency. The PNPLA8:c.[1169_1170dupTT] allele is easily detectable with a genetic test to avoid at‐risk matings. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic modified the management of myocardial infarction (MI) and stroke. We aimed to evaluate the effect of the COVID-19 pandemic on the volume and spatial distribution of hospitalizations for MI and stroke, before, during and after the first nationwide lockdown in France in 2020, compared with 2019. Hospitalization data were extracted from the French National Discharge database. Patient's characteristics were compared according to COVID-19 status. Changes in hospitalization rates over time were measured using interrupted time series analysis. Possible spatial patterns of over or under-hospitalization rates were investigated using Moran's indices. We observed a rapid and significant drop in hospitalizations just before the beginning of the lockdown with a nadir at 36.5% for MI and 31.2% for stroke. Hospitalization volumes returned to those seen in 2019 four weeks after the end of the lockdown, except for MI, which rebounded excessively. Older age, male sex, elevated rate of hypertension, diabetes, obesity and mortality characterized COVID-19 patients. There was no evidence of a change in the spatial pattern of over- or under-hospitalization clusters over the three periods. After a steep drop, only MI showed a significant rebound after the first lockdown with no change in the spatial distribution of hospitalizations. [ABSTRACT FROM AUTHOR]

(1) Background: This study evaluated the effects of a plant bioactive (Phyto Ax'Cell, Phytosynthese, Mozac, France) on the inflammatory status and health of dairy cows during calving. (2) Methods: 46 Holstein crossbred cows were randomized into a control group (CON, n = 23) and the Phyto Ax'Cell group (PAC, n = 23). PAC received Phyto Ax'Cell at 25 g/cow/day, from 15 days prepartum to 7 days postpartum. Blood analyses were performed weekly from D-7 to D14 to evaluate the energy metabolism and inflammatory status; rectal temperature was measured daily within 14 days from calving day (D0). (3) Results: PAC showed lower serum haptoglobin at D7 (0.55 vs. 0.79 mg/mL; p < 0.05) and D14 (0.44 vs. 0.66 mg/mL; p < 0.05). CON had a higher number of circulating white blood cells and granulocytes on D7 (p < 0.05). Fewer cows from PAC showed hyperthermia (≥39 °C) during the first 2 weeks postpartum (−7%, p < 0.05). Energy metabolism, which was represented by the NEFA/cholesterol ratio, improved (0.21 vs. 0.36 at D0, p < 0.1; 0.19 and 0.15 vs. 0.36 and 0.32, respectively, at D+7 and D+14, p < 0.05) under the plant bioactive supplementation. (4) Conclusions: The results suggest that the anti-inflammatory plant bioactive compound with Brazilian green propolis administered during calving had a beneficial effect on the energy and inflammatory status of dairy cows. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus disease 2019 (COVID-19) pandemic continues to have great impacts on the care of non-COVID-19 patients. This was especially true during the first epidemic peak in France, which coincided with the national lockdown. The aim of this study was to identify whether a decrease in stroke admissions occurred in spring 2020, by analyzing the evolution of all stroke admissions in France from January 2019 to June 2020. Methods: We conducted a nationwide cohort study using the French national database of hospital admissions (Information Systems Medicalization Program) to extract exhaustive data on all hospitalizations in France with at least one stroke diagnosis between January 1, 2019, and June 30, 2020. The primary endpoint was the difference in the slope gradients of stroke hospitalizations between pre-epidemic, epidemic peak, and post-epidemic peak phases. Modeling was carried out using Bayesian techniques. Results: Stroke hospitalizations dropped from March 10, 2020 (slope gradient: −11.70), and began to rise again from March 22 (slope gradient: 2.090) to May 7. In total, there were 23,873 stroke admissions during the period March–April 2020, compared to 29,263 at the same period in 2019, representing a decrease of 18.42%. The percentage change was −15.63%, −25.19%, −18.62% for ischemic strokes, transient ischemic attacks, and hemorrhagic strokes, respectively. Discussion/Conclusion: Stroke hospitalizations in France experienced a decline during the first lockdown period, which cannot be explained by a sudden change in stroke incidence. This decline is therefore likely to be a direct, or indirect, result of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background. The impact of the COVID-19 pandemic on hospitalization for cardiac infections is not well known. We aimed to evaluate the nationwide trends in hospital stays for myocarditis and endocarditis cases before, during and after the nationwide lockdown for the COVID-19 pandemic in France. We then aimed to describe the proportion of myocarditis and endocarditis patients with and without COVID-19 and their clinical characteristics. Methods. Hospitalized cases of cardiac infection were extracted from the French National Discharge database, which collects the medical records of all patients discharged from all public and private hospitals in France. Age, sex, and available cardiovascular risk factors were compared between stays with and without COVID-19 during the lockdown. Results. The number of myocarditis cases was 11% higher in 2020, compared to the average of the three prior years. In 2020, 439 of 3727 cases of myocarditis were associated with COVID-19. For endocarditis, there was an increase in cases by 7% in 2020 versus prior years. For endocarditis, 3% (240 of 8128 cases) of patients with endocarditis had COVID-19. For myocarditis, older age, hypertension, diabetes, obesity, and atrial fibrillation were more frequent in patients with COVID-19 than in those without. For endocarditis, only hypertension was more frequent in patients with COVID-19 than in those without. Conclusion. Our study reports an increase in hospitalizations for both myocarditis and endocarditis in 2020, possibly related to the COVID-19 pandemic. Interestingly, the trends differ according to the COVID-19 status. Knowledge of the factors associating myocarditis or endocarditis and COVID-19 may improve the quality and the type of monitoring for people with COVID-19, the identification of patients at risk of cardiac infections, and the treatment of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Despite national and international recommendations and while there is no evidence for increased efficacy of higher doses, several studies suggested that the prescribed doses in routine practice are higher than the maximal recommended doses in 20–40% of schizophrenia patients worldwide. Methods: the aims of the present study were: (1) to describe the patterns of antipsychotic daily dose prescriptions in routine clinical practice in a large and representative cohort of French schizophrenia patients and, (2) to study the characteristics of patients receiving higher doses. Results: in all cases, regardless of the antipsychotic treatment used, the average dose was greater than 1.0 defined daily dose (DDDeq), which is the average recommended dose. For SGA, the mean DDDeq ranged from 1.2 for aripiprazole to 1.6 for olanzapine and clozapine, respectively. For a given patient, the mean ± S.D. total daily cumulative dose (TCD) of antipsychotic was 1.9 ± 2.4 DDDeq. A "high dose" was defined as a TCD ≥ 1.5 DDDeq, 789 (45.2%) patients received a "high dose". Patients in the "high dose" group were more frequently suffering from a more severe paranoid schizophrenia, had more often a comorbid antisocial personality disorder and/or a substance use disorder. Conclusions: the present study suggests that in France, antipsychotic drugs doses prescribed by psychiatrists are higher, compared to other countries. All recommendations agree on the fact that the preferential dose should be the "minimum-effective" dose. Optimizing prescribing practices would be important to optimize the benefit/risk ratio and to minimize the risks side effects. [ABSTRACT FROM AUTHOR]

• On third of patients with ischemic stroke (IS) have atrial fibrillation (AF). • The prevalence of prestroke cognitive impairment is greater in patients with AF. • Prior mild cognitive impairment and dementia are independently associated with AF. • Preexisting brain lesions do not fully account for this association. Atrial Fibrillation (AF) is a common cause of ischemic stroke (IS), and is associated with cognitive impairment in the general population. We aimed to compare the prevalence of preexisting cognitive impairment between IS patients with and without AF, and to assess whether prior brain damage could contribute to the observed differences. Patients with acute IS were prospectively identified from the population-based Dijon Stroke Registry, France. Patients who had a CT-scan as brain imaging modality were included in this analysis to assess the presence of preexisting leukoaraiosis, old vascular brain lesions, and cerebral atrophy. Characteristics of patients including prior-to-stroke cognitive status (normal cognition, mild cognitive impairment (MCI), or dementia) were compared between those with and without AF. Among 916 IS patients, 288 (31.4 %) had AF, of whom 88 had newly diagnosed AF. AF patients had more frequent prior MCI (17.8 % versus 10.2 %) or dementia (22.4 % versus 13.1 %) (p = 0.001), vascular risk factors, and preexisting brain damage. In unadjusted model, preexisting cognitive impairment was associated with AF (OR=2.24; 95 % CI: 1.49–3.37, p < 0.001 for MCI; OR=2.20; 95 % CI: 1.52–3.18, p < 0.001 for dementia). After adjustment for clinical and imaging variables, preexisting mild cognitive impairment (OR=1.87; 95 % CI: 1.06–3.32, p = 0.032) and dementia (OR=1.98; 95 % CI: 1.15–3.40, p = 0.013) were independently associated with AF. AF is a common condition in IS patients and is associated with preexisting cognitive impairment. Brain lesions visible on imaging did not seem to fully account for this association that may involve other mechanisms yet to be elucidated. [ABSTRACT FROM AUTHOR]

We report the 51/2 year prevalence of visual and oculomotor impairments in preterm children born at 24–34 weeks' gestation (WG) using the population-based cohort study EPIPAGE-2, set in France, 2011. The main outcomes were imputed prevalence of refractive errors (REs), strabismus, and binocular visual acuity (VA). Children were clinically assessed by specially trained pediatricians. The population was also analyzed in terms of cerebral palsy at 51/2 years (no CP, stage 1, stage 2, or stage 3–5) and retinopathy of prematurity in the neonatal period (no ROP, stage 1 or 2, or severe ROP). Among the 4441 children included, 2718 (weighted percentage 58.7%) were clinically assessed. REs were reported in 43.1% (95% confidence interval 37.6–48.4), 35.2% (32.7–37.6), and 28.4% (25.0–31.8) of children born at 24–26, 27–31, and 32–34 WG (p < 0.01), respectively; strabismus rates were 19.5% (14.6–24.4), 14.8% (12.9–16.7), and 8.3% (6.2–10.4) (p < 0.001), respectively. Moderate/severe visual deficiencies (VA < 3.2/10) were present in 1.7% (0.2–3.3) of children born at 24–26 WG, and in less than 1% in other groups. A suboptimal VA 5/10–6.3/10 was measured in 40.6% (35.3–45.8) of children born at 24–26 WG, 35.8% (33.5–38.1) at 27–31 WG, and 33.7% (30.4–37.0) at 32–34 WG. CP and ROP were associated with strabismus and RE. The association between CP and VA was strong, while it was not observed for ROP. In this large cohort of preterm-born children, we found a high prevalence of RE and strabismus regardless of WG, supporting the need for specific attention in this population. High prevalence of suboptimal VA could be challenging for these children at the age of reading and writing acquisition. [ABSTRACT FROM AUTHOR]

Copyright of Hydrogeology Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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ELISA methods are the diagnostic tools recommended for the serological diagnosis of Coxiella burnetii infection in ruminants but their respective diagnostic performances are difficult to assess because of the absence of a gold standard. This study focused on three commercial ELISA tests with the following objectives (1) assess their sensitivity and specificity in sheep, goats and cattle, (2) assess the between- and within-herd seroprevalence distribution in these species, accounting for diagnostic errors, and (3) estimate optimal sample sizes considering sensitivity and specificity at herd level. We comparatively tested 1413 cattle, 1474 goat and 1432 sheep serum samples collected in France. We analyzed the cross-classified test results with a hierarchical zero-inflated beta-binomial latent class model considering each herd as a population and conditional dependence as a fixed effect. Potential biases and coverage probabilities of the model were assessed by simulation. Conditional dependence for truly seropositive animals was high in all species for two of the three ELISA methods. Specificity estimates were high, ranging from 94.8% [92.1; 97.8] to 99.2% [98.5; 99.7], whereas sensitivity estimates were generally low, ranging from 39.3 [30.7; 47.0] to 90.5% [83.3; 93.8]. Between- and within-herd seroprevalence estimates varied greatly among geographic areas and herds. Overall, goats showed higher within-herd seroprevalence levels than sheep and cattle. The optimal sample size maximizing both herd sensitivity and herd specificity varied from 3 to at least 20 animals depending on the test and ruminant species. This study provides better interpretation of three widely used commercial ELISA tests and will make it possible to optimize their implementation in future studies. The methodology developed may likewise be applied to other human or animal diseases. [ABSTRACT FROM AUTHOR]

Entomological studies often aim to estimate species distribution, community composition, or species‐richness patterns. False absences can, however, bias these estimates and should consequently not be overlooked in insect studies. Multi‐species occupancy models (MSOMs) afford a flexible solution to cover the main topics in ecological entomology while dealing with detectability issues.We sampled Orthoptera communities at 81 mountain grasslands sites in France, using three sampling techniques: sighting, listening, and sweep netting. Five plots were sampled per site. This sampling design allowed MSOMs to be used to estimate richness, occupancy, and detection probabilities while accounting for the effect of covariates. We also used MSOMs to evaluate the efficiency of the survey design and to assess the effects of sampling optimisation.The estimates obtained for altitudinal distribution were reliable, with known species distributions confirming the relevance of MSOMs to model the effects of covariates on Orthoptera communities. The species‐specific detection probability was often less than one and varied with the detection technique used and the grass height, confirming the need to deal with detection issues in orthopteran studies.We estimated an inventory completeness superior to 0.80 for 93% of the sites, and an overall detection probability superior to 0.95 for 52% of the species, suggesting the sampling design was suitable for studying occupancy in Orthoptera communities. We also found that the sweep netting step may be omitted or the number of plots reduced without affecting species detectability or inventory completeness. Those recommendations may help to optimise future sampling strategies. [ABSTRACT FROM AUTHOR]

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Background: Noise levels are monitored in call centres. A maximum of 52 to 55 dB(A) is recommended in order to prevent adverse events. We aimed at assessing the noise level and the impact of a visual noise indicator on the ambient noise level in a French Regional Emergency Medical Dispatch Centre (EMDC).Methods: We conducted an observational study in the EMDC of the SAMU25 (University Hospital of Besancon). We measured the noise level using a SoundEarII® noise indicator (Dräger Medical SAS, France). The measurement took place in two phases on three consecutive days from 00:00 to 11:59 PM. At baseline, phase 1, the device recorded the average ambient noise for each minute without visual indication. Secondly, phase 2 included a sensor mounted with a light that would turn on green if noise was below 65 dB(A), orange if noise ever exceeded 65 and red if it exceeded 75 dB(A).Results: In the presence of the visual noise indicator, the LAeq was significantly lower than in the absence of visual noise indicator (a mean difference of - 4.19 dB; P < 10-3). It was higher than 55 dB(A) in 84.9 and 43.9% of the time in phases 1 and 2, respectively.Conclusions: The noise levels were frequently higher than the standards, and sometimes close to recommended limits, requiring preventive measures. The noise indicator had a positive effect on the ambient noise level. This work will allow the implementation of effective prevention solutions and, based on future assessments, could improve operators' well-being and better care for patient. [ABSTRACT FROM AUTHOR]

A carbonate chemistry balance module was implemented into a biogeochemical model of the planktonic food web. The model, named Eco3M-CarbOx, includes 22 state variables that are dispatched into 5 compartments: phytoplankton, heterotrophic bacteria, detrital particulate organic matter, labile dissolved organic, and inorganic matter. This model is applied to and evaluated in the Bay of Marseille (BoM, France), which is a coastal zone impacted by the urbanized and industrialized Aix–Marseille Metropolis, and subject to significant increases in anthropogenic emissions of CO2. The model was evaluated over the year 2017, for which in situ data of the carbonate system are available in the study site. The biogeochemical state variables of the model only change with time, to represent the time evolution of a sea surface water cell in response to the implemented realistic forcing conditions. The model correctly simulates the value ranges and seasonal dynamics of most of the variables of the carbonate system except for the total alkalinity. Several numerical experiments were conducted to test the response of carbonate system to (i) a seawater temperature increase, (ii) wind events, (iii) Rhône River plume intrusions, and (iv) different levels of atmospheric CO2 contents. This set of numerical experiments shows that the Eco3M-CarbOx model provides expected responses in the alteration of the marine carbonate balance regarding each of the considered perturbation. When the seawater temperature changes quickly, the behavior of the BoM waters alters within a few days from a source of CO2 to the atmosphere to a sink into the ocean. Moreover, the higher the wind speed is, the higher the air–sea CO2 gas exchange fluxes are. The river intrusions with nitrate supplies lead to a decrease in the p CO2 value, favoring the conditions of a sink for atmospheric CO2 into the BoM. A scenario of high atmospheric concentrations of CO2 also favors the conditions of a sink for atmospheric CO2 into the waters of the BoM. Thus the model results suggest that external forcings have an important impact on the carbonate equilibrium in this coastal area. [ABSTRACT FROM AUTHOR]

Importance: Clinical guidelines for the early management of acute heart failure in the emergency department (ED) setting are based on only moderate levels of evidence, with subsequent low adherence to these guidelines.Objective: To test the effect of an early guideline-recommended care bundle on short-term prognosis in older patients with acute heart failure in the ED.Design, Setting, and Participants: Stepped-wedge cluster randomized trial in 15 EDs in France of 503 patients 75 years and older with a diagnosis of acute heart failure in the ED from December 2018 to September 2019 and followed up for 30 days until October 2019.Interventions: A care bundle that included early intravenous nitrate boluses; management of precipitating factors, such as acute coronary syndrome, infection, or atrial fibrillation; and moderate dose of intravenous diuretics (n = 200). In the control group, patient care was left to the discretion of the treating emergency physician (n = 303). Each center was randomized to the order in which they switched to the "intervention period." After the initial 4-week control period for all centers, 1 center entered in the intervention period every 2 weeks.Main Outcomes and Measures: The primary end point was the number of days alive and out of hospital at 30 days. Secondary outcomes included 30-day all-cause mortality, 30-day cardiovascular mortality, unscheduled readmission, length of hospital stay, and kidney impairment.Results: Among 503 patients who were randomized (median age, 87 years; 298 [59%] women), 502 were analyzed. In the intervention group, patients received a median (interquartile range) of 27.0 (9-54) mg of intravenous nitrates in the first 4 hours vs 4.0 (2.0-6.0) mg in the control group (adjusted difference, 23.8 [95% CI, 13.5-34.1]). There was a significantly higher percentage of patients in the intervention group treated for their precipitating factors than in the control group (58.8% vs 31.9%; adjusted difference, 31.1% [95% CI, 14.3%-47.9%]). There was no statistically significant difference in the primary end point of the number of days alive and out of hospital at 30 days (median [interquartile range], 19 [0- 24] d in both groups; adjusted difference, -1.9 [95% CI, -6.6 to 2.8]; adjusted ratio, 0.88 [95% CI, 0.64-1.21]). At 30 days, there was no significant difference between the intervention and control groups in mortality (8.0% vs 9.7%; adjusted difference, 4.1% [95% CI, -17.2% to 25.3%]), cardiovascular mortality (5.0% vs 7.4%; adjusted difference, 2.1% [95% CI, -15.5% to 19.8%]), unscheduled readmission (14.3% vs 15.7%; adjusted difference, -1.3% [95% CI, -26.3% to 23.7%]), median length of hospital stay (8 d in both groups; adjusted difference, 2.5 [95% CI, -0.9 to 5.8]), and kidney impairment (1% in both groups).Conclusions and Relevance: Among older patients with acute heart failure, use of a guideline-based comprehensive care bundle in the ED compared with usual care did not result in a statistically significant difference in the number of days alive and out of the hospital at 30 days. Further research is needed to identify effective treatments for acute heart failure in older patients.Trial Registration: ClinicalTrials.gov Identifier: NCT03683212. [ABSTRACT FROM AUTHOR]

Background: Drowning is still a major cause of accidental death worldwide. In 1997, Szpilman proposed a classification of drowning that has become the reference. As considerable efforts have been made to improve prevention and care, it seemed appropriate to reassess the prognosis and clinical presentation of drowning patients more than 20 years after this first publication. The aim of this study is to provide a reappraisal of patients who need advanced health care and a precise description of their respective neurologic, respiratory, and hemodynamic profiles.Methods: This retrospective study was conducted over four consecutive summer periods between 2014 and 2017 in ICUs located in France, French Polynesia, and the French Antilles. Patients were classified according to the drowning classification system proposed by Szpilman.Results: During the study period, 312 drowning patients were admitted with severe clinical presentation (grades 2-6). All patients benefited from rapid extraction from the water (< 10 min for all) and specialized care (emergency medical services), starting from the prehospital period. Although the global hospital mortality was similar to that previously reported (18.5%), great differences existed among the severity grades. Respective grade mortalities were low for grades 2 through 5 (grade 2, 0%; grade 3, 3%; grade 4, 0%; grade 5, 2%), and the mortality for grade 6 remained similar to that previously reported (54%). These results confirmed that the occurrence of cardiac arrest after drowning is still bad prognosis. Conversely, for other grades, this study strengthens the importance of specialized intervention to interrupt the drowning process.Conclusions: On the basis of these results, drowning-related cardiac arrest is still the prognosis cornerstone. For other victims, the prognosis was better than previously expected, which strengthens the importance of specialized intervention to interrupt the drowning process. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer screening is effective in reducing mortality due to uterine cervical cancer (UCC). However, inequalities in participation in UCC screening exist, especially according to age and social status. Considering the current situation in France regarding the ongoing organized UCC screening campaign, we aimed to assess general practitioners' (GPs) and gynaecologists' preferences for actions designed to reduce screening inequalities.Methods: French physicians' preferences to UCC screening modalities was assessed using a discrete choice experiment. A national cross-sectional questionnaire was sent between September and October 2014 to 500 randomly selected physicians, and numerically to all targeted physicians working in the French region Midi-Pyrénées. Practitioners were offered 11 binary choices of organized screening scenarios in order to reduce inequalities in UCC screening participation. Each scenario was based on five attributes corresponding to five ways to enhance participation in UCC screening while reducing screening inequalities.Results: Among the 123 respondents included, practitioners voted for additional interventions targeting non-screened women overall (p <  0.05), including centralized invitations sent from a central authority and involving the mentioned attending physician, or providing attending physicians with the lists of unscreened women among their patients. However, they rejected the specific targeting of women over 50 years old (p <  0.01) or living in deprived areas (p <  0.05). Only GPs were in favour of allowing nurses to perform Pap smears, but both GPs and gynaecologists rejected self-collected oncogenic papillomavirus testing.Conclusions: French practitioners tended to value the traditional principle of universalism. As well as rejecting self-collected oncogenic papillomavirus testing, their reluctance to support the principle of proportionate universalism relying on additional interventions addressing differences in socioeconomic status needs further evaluation. As these two concepts have already been recommended as secondary development leads for the French national organized screening campaign currently being implemented, the adherence of practitioners and the adaptation of these concepts are necessary conditions for reducing inequalities in health care. [ABSTRACT FROM AUTHOR]

Secondary spontaneous pneumothorax (SSP) occurs in the context of underlying pulmonary disease. Our objectives were to estimate the relationship between SSP and short term air pollution exposure with nitrogen dioxide (NO2), ozone (O3) and particulate matter with a diameter ≤ 10 μm (PM10). Patients with SSP were included between June 1, 2009 and May 31, 2013, in 14 Emergency Departments in France. In this case–crossover design study, PM10, NO2, and O3 data were collected hourly from monitoring stations. Quantitative values, fast increase in air pollutant concentration, and air quality threshold exceedance were retained. These assessments were calculated for each of the 4 days prior to the event (Lag 1–Lag 4) for all case and control period, and for the entire exposure period. A total of 135 patients with SSP were included, with a mean age of 55.56 (SD 18.54) years. For short term exposure of PM10, NO2 and O3, no differences were observed between case and control periods in terms of quantitative values of air pollutant exposure (P > 0.68), fast increase in concentration (P > 0.12) or air quality threshold exceedance (P > 0.68). An association between O3 exposures cannot be ruled out, especially when considering the Lag 2 prior to the event and in warm seasons. [ABSTRACT FROM AUTHOR]

Canine hip dysplasia (HD) is a complex developmental disease of the coxo-femoral joint and is one of the most common orthopedic conditions in dogs. Due to the genetic contribution, most of the programs fighting against HD recommend selective breeding that excludes affected dogs. Using the best-scoring dogs for breeding may reduce the prevalence of HD. In France, the phenotypic screening of coxo-femoral joint conformation remains a strategy for breeders to establish selection decisions. The HD prevalence was evaluated in 10 breeds, based on the assessment of 27,710 dogs, during the 1997–2017 screening period, which was divided into 3 homogeneous cohorts for analysis. The global HD prevalence varied widely among breeds from 5% (Siberian Husky) to 51.9% (Cane Corso). It decreased over time in 6 breeds, among which 4 (Cane Corso, Gordon Setter, Rottweiler and White Swiss Shepherd) showed a significant decrease. A statistically significant increase in HD prevalence was noted for the Siberian Husky. Although the efficacy of phenotype-based breeding programs remains controversial, our results are in accordance with several recent studies showing that long-term selection policies are valuable, as they may help decreasing the HD prevalence in some breeds. The complementary use of more recent tools such as estimated breeding values and genomics would probably help breeders achieve more substantive results. [ABSTRACT FROM AUTHOR]

This article examines the extent to which short supply chains affect the structuration of agri‐food sectors economically and politically. To do so, it first presents a theoretical framework drawing on regulationist economics and constructivist political science which guides research to examine the entire range of actors, processes, institutions and power relations which structure agri‐food sectors. It then applies this framework to the case of foie gras in South‐West France to target the relationship between 'short' and 'long' supply chains. Based on thirty interviews with farmers and public officials, it finds that a commonly heard discourse that both chains 'complement each other' masks the political domination of 'the long' over 'the short'. Through tracing this domination across two policy issues, namely product labelling and 'biosecurity' hygiene measures, and the way actors have worked politically to deal with them, the article demonstrates that this power asymmetry has been the principal cause of policy outcomes and, therefore, institutional reproduction. [ABSTRACT FROM AUTHOR]

The Bay of Marseille (BoM, France) is impacted by the urbanized and industrialized Aix-Marseille Metropolis, which is subject to significant increases in anthropogenic emissions of CO2. A carbonate chemistry balance module has been implemented into a biogeochemical model of the planktonic food web. The resulting model, named Eco3M-CarbOx includes 22 states variables that are dispatched into 5 compartments: phytoplankton, heterotrophic bacteria, detritus, dissolved organic and inorganic matter. The model suggests that the variability of the dissolved inorganic carbon system is mainly driven by the seawater temperature dynamics. A seasonal trend is identified by the model and it shows that, during the mixed water column period, the BoM is a sink for atmospheric CO2 and a net autotroph ecosystem, while during stratified water column period, the BoM is a source of CO2 to the atmosphere and a net heterotroph ecosystem. External forcings have an important impact on the carbonate equilibrium. Wind events change seawater temperature quickly, as during upwelling, for which the BoM waters change within a few days from a source of CO2 to the atmosphere to a sink into the ocean. Moreover, the higher the wind speed is, the higher the air-sea CO2 gas exchange fluxes are. The river intrusions with nitrate and alkalinity supplies lead to a decrease in the pCO2 value, favoring the conditions of a sink of atmospheric CO2 into the BoM. The nearby highly urbanized environment of the Aix-Marseille metropolis produces strong atmospheric values of CO2, also favoring the conditions of a sink of atmospheric CO2 into the waters of the BoM. [ABSTRACT FROM AUTHOR]

This paper presents the potential of nonlinear and linear versions of an observation operator for simulating polarimetric variables observed by weather radars. These variables, deduced from the horizontally and vertically polarized backscattered radiations, give information about the shape, the phase and the distributions of hydrometeors. Different studies in observation space are presented as a first step toward their inclusion in a variational data assimilation context, which is not treated here. Input variables are prognostic variables forecasted by the AROME-France numerical weather prediction (NWP) model at convective scale, including liquid and solid hydrometeor contents. A nonlinear observation operator, based on the T-matrix method, allows us to simulate the horizontal and the vertical reflectivities (ZHH and ZVV), the differential reflectivity ZDR , the specific differential phase KDP and the co-polar correlation coefficient ρHV. To assess the uncertainty of such simulations, perturbations have been applied to input parameters of the operator, such as dielectric constant, shape and orientation of the scatterers. Statistics of innovations, defined by the difference between simulated and observed values, are then performed. After some specific filtering procedures, shapes close to a Gaussian distribution have been found for both reflectivities and for ZDR , contrary to KDP and ρHV. A linearized version of this observation operator has been obtained by its Jacobian matrix estimated with the finite difference method. This step allows us to study the sensitivity of polarimetric variables to hydrometeor content perturbations, in the model geometry as well as in the radar one. The polarimetric variables ZHH and ZDR appear to be good candidates for hydrometeor initialization, while KDP seems to be useful only for rain contents. Due to the weak sensitivity of ρHV , its use in data assimilation is expected to be very challenging. [ABSTRACT FROM AUTHOR]