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A novel testing policy was implemented in May in France to systematically screen potential COVID-19 infections and suppress local outbreaks while lifting lockdown restrictions. 20,777 virologically-confirmed cases were notified in mainland France from May 13, 2020 (week 20, end of lockdown) to June 28 (week 26). Accounting for missing data, positive tests before symptom onset, and the delay from symptom onset to test, this corresponds to 14,061 [95% CI 13,972-14,156] cases with symptom onset during this period, a likely underestimation of the real number. Using age-stratified transmission models parameterized to behavioral data and calibrated to regional hospital admissions, we estimated that 103,907 [95% CI 90,216-116,377] COVID-19 symptomatic cases occurred, suggesting that 9 out of 10 cases with symptoms were not ascertained. Median detection rate increased from 7% [6-8]% to 38% [35-44]% over time, with large regional variations. Healthcare-seeking behavior in COVID-19 suspect cases remained low (31%). Model projections for the incidence of symptomatic cases (6.7 [5.8, 7.4] per 100,000 in week 26) were compatible with estimates from participatory surveillance, provided that 80% of suspect cases consulted. Encouraging awareness and same-day healthcare-seeking behavior in suspect cases is critical to improve detection. The capacity of the system remained however insufficient even at the low levels of viral circulation achieved after lockdown, and was predicted to deteriorate rapidly for increasing epidemic activity. Substantially more aggressive, targeted, and efficient testing with easier access is required to act as a pandemic-fighting tool. These elements should be considered in light of the currently observed increase of cases in France and other European countries.

As countries in Europe gradually relaxed lockdown restrictions after the first wave, test-trace-isolate strategies became critical to maintain the incidence of coronavirus disease 2019 (COVID-19) at low levels

International audience; Purpose: Drug-drug interactions (DDIs) require monitoring in an aging population with increasing polypharmacy exposure. We aimed to estimate the prevalence of exposure to potential DDIs using the French healthcare insurance system database, for six DDIs with various clinical relevance: angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs (ARBs-ACEIs + NSAIDs), antiplatelet agents and NSAIDs (AAP + NSAIDs), serotonergic drugs and tramadol (SD + T), statins and macrolides (S + M), oral anticoagulant and NSAIDs (OAC + NSAIDs), and colchicine and macrolides (C + M).Methods: We used exhaustive healthcare data from a 1/97th random sample of the population covered by the French health insurance system (EGB) between 2006 and 2016. Exposure to a DDI was defined as overlapping exposure to two interacting drugs. The prevalence of exposure was estimated by year.Results: Prevalence of exposure in 2016 was estimated at 3.7% for ARBs-ACEIs + NSAIDs, 1.5% for AAP + NSAIDs, 0.76% for SD + T, 0.36% for S + M, 0.24% for AOC + NSAIDs, and 0.02% for C + M. In 26% to 58% of episodes of exposure, the two interacting drugs were prescribed by the same physician and dispensed by the same pharmacy the same day. Between 2006 and 2016, the yearly prevalence was increasing for SD + T and for DDIs involving NSAIDs, and it was decreasing for those involving macrolides.Conclusion: Exposures to potential DDIs in France are not uncommon with a high proportion resulting from a co-prescription by the same physician. Monitoring the prevalence of exposure to DDIs is needed to implement prevention measures. Administrative data enable this surveillance in large and representative cohorts.

Several French regions where coronavirus disease (COVID-19) has been reported currently show a renewed increase in ILI cases in the general practice-based Sentinelles network. We computed the number of excess cases by region from 24 February to 8 March 2020 and found a correlation with the number of reported COVID-19 cases so far. The data suggest larger circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the French population than apparent from confirmed cases.

The recent emergence of the SARS-CoV-2 in China has raised the spectre of a novel, potentially catastrophic pandemic in both scientific and lay communities throughout the world. In this particular context, people have been accused of being excessively pessimistic regarding the future consequences of this emerging health threat. However, consistent with previous research in social psychology, a large survey conducted in Europe in the early stage of the COVID-19 epidemic shows that the majority of respondents was actually overly optimistic about the risk of infection. https://psyarxiv.com/364qj/

Introduction: Horner's syndrome is an unusual side effect of epidural analgesia. We report an unusual symptom after epineural axis analgesia for labor, which happened three times in the same patient. Horner's syndrome occurrence following epidural catheterization should lead the anesthetic team to search for a subdural position of the catheter because of its potentially threatening complications. Patient's concern: Our patient, a 38 years old pregnant woman, was managed by the anesthetic team for the analgesia of her second labor. Anesthetic consultation pointed out that she had a history of Horner's syndrome after epidural analgesia attempt during her first pregnancy. During our anesthetic management of her second labor, she presented, on the left side of the body, with the same symptom as she had during her first labor a few years ago, associated with high unilateral sensory block after epidural catheterization. After the total regression of neurological signs, a second catheterization attempt was followed by a contralateral isolated Horner's syndrome with no sensory block. Diagnosis: A few minutes after the induction of analgesia, our patient presented left ptosis, meiosis, and enophthalmos associated with a high homolateral sensory block. The subdural catheter position was suspected, and the catheter was removed. Intervention: Because of this repeated unusual complication and because we would not have used the catheter for an emergency C section, we chose to remove it definitively. Outcome: Our patient had a total regression of the symptoms 1 h after the catheter withdrawal. Delivery was rapid, with no complications, and she was discharged from the hospital 3 days after. Conclusion: Our observations suggest the possibility of a potential anatomical particularity of the dural canal in this patient and question the safety of performing an epidural catheterization for further procedures.

Understanding the likely future impacts of biological invasions is crucial yet highly challenging given the multiple relevant environmental, socio‐economic and societal contexts and drivers. In the absence of quantitative models, methods based on expert knowledge are the best option for assessing future invasion trajectories. Here, we present an expert assessment of the drivers of potential alien species impacts under contrasting scenarios and socioecological contexts through the mid‐21st century. Based on responses from 36 experts in biological invasions, moderate (20%–30%) increases in invasions, compared to the current conditions, are expected to cause major impacts on biodiversity in most socioecological contexts. Three main drivers of biological invasions—transport, climate change and socio‐economic change—were predicted to significantly affect future impacts of alien species on biodiversity even under a best‐case scenario. Other drivers (e.g. human demography and migration in tropical and subtropical regions) were also of high importance in specific global contexts (e.g. for individual taxonomic groups or biomes). We show that some best‐case scenarios can substantially reduce potential future impacts of biological invasions. However, rapid and comprehensive actions are necessary to use this potential and achieve the goals of the Post‐2020 Framework of the Convention on Biological Diversity., Distribution of uncertainty if 15 major drivers of biological invasions will exhibit major impacts on the environment by 2050 under a best‐ and worst‐case scenario.

Highlights: • From 1960 to 2020 reported costs of US biological invasions were at least $1.22 tril. • Annual invasion costs increased from $2 bil in 1960–69 to $21 bil in 2010–20. • Most costs were damages ($896 bil), with lower management investments ($47 bil). • Agriculture sector ($510 bil) and terrestrial habitat ($644 bil) were impacted most. • Knowledge gaps in reporting make these monetary costs severely underestimated. Abstract: The United States has thousands of invasive species, representing a sizable, but unknown burden to the national economy. Given the potential economic repercussions of invasive species, quantifying these costs is of paramount importance both for national economies and invasion management. Here, we used a novel global database of invasion costs (InvaCost) to quantify the overall costs of invasive species in the United States across spatiotemporal, taxonomic, and socioeconomic scales. From 1960 to 2020, reported invasion costs totaled $4.52 trillion (USD 2017). Considering only observed, highly reliable costs, this total cost reached $1.22 trillion with an average annual cost of $19.94 billion/year. These costs increased from $2.00 billion annually between 1960 and 1969 to $21.08 billion annually between 2010 and 2020. Most costs (73%) were related to resource damages and losses ($896.22 billion), as opposed to management expenditures ($46.54 billion). Moreover, the majority of costs were reported from invaders from terrestrial habitats ($643.51 billion, 53%) and agriculture was the most impacted sector ($509.55 billion). From a taxonomic perspective, mammals ($234.71 billion) and insects ($126.42 billion) were the taxonomic groups responsible for the greatest costs. Considering the apparent rising costs of invasions, coupled with increasing numbers of invasive species and the current lack of cost information for most known invaders, our findings provide critical information for policymakers and managers.

International audience; Objectives: We aimed to identify patients' clinical characteristics associated with respiratory viruses identified among patients presenting with influenza-like illness (ILI).Methods: A sample of patients of all ages presenting with ILI was included by physicians of the French Sentinelles network during two seasons (2015/16 and 2016/17). Nasopharyngeal samples were tested for the presence of influenza virus (IV), respiratory syncytial virus (RSV), human rhinovirus (HRV) and human metapneumovirus (HMPV). Patients' characteristics associated with each of the four virus classes were studied using multivariate logistic regressions.Results: A total of 5859 individuals were included in the study: 48.0% tested positive for IV, 7.9% for HRV, 7.5% for RSV and 4.1% for HMPV. Cough was associated with IV (OR 2.14, 95% CI 1.81–2.52) RSV (OR 2.52, 95% CI 1.75–3.74) and HMPV detection (OR 2.15, 95% CI 1.40–3.45). Rhinorrhoea was associated mainly with HRV detection (OR 1.75, 95% CI 1.34–2.32). Headache was associated with IV detection (OR 1.75, 95% CI 1.34–2.32), whereas absence of headache was associated with RSV and HMPV detection. Dyspnoea was associated with RSV detection (OR 2.33, 95% CI 1.73–3.12) and absence of dyspnoea with IV detection. Conjunctivitis was associated with IV detection (OR 1.27, 95% CI 1.08–1.50). Some associations were observed only in children: dyspnoea and cough with RSV detection (age

International audience; The statistics of concentration data, measured during unknown atmospheric dispersion events, are not fully understood although they are required in modeling, assessment, uncertainty analysis, and information fusion. The concentrations measured over a field of monitoring network is regarded as a vector which contains both magnitude and direction. Traditional statistics (mean, standard deviations, etc.) based on magnitude of concentration data summarize data properties but are limited in characterizing variations in data and their modeling quality. Comparatively, directions are efficient in providing valuable information to address these issues. Here we propose a statistical framework which transforms concentration measurements into directions projected on a hypersphere and analyzes their orientation and distribution. The directional data measured in identical conditions are expected to be rotationally symmetric around its principal axis and follow Watson distribution. The clustering parameter of Watson distribution measures tightness of directional data and, thus, can measure indirectly variations in observed data. It is shown that the clustering parameter is able to summarize an overall variation in data and modeling quality of data in a dispersion trial. The study analyzes real data taken from continuous release experiments, called “Fusion Field Trials,” conducted at Dugway Proving Ground, Utah, United States.

Recent studies have highlighted cities as prime locations for the introduction, establishment, and spread of non-native and invasive species. As the hydrological arteries of cities, urban river corridors have an important role to play in influencing species invasions. This overview examines existing literature to consider (a) how the landscape functions of urban river corridors (habitat, conduit, barrier/filter, sink, and source) relate to species invasions; (b) the organismal and geographical foci of research into non-native species invasions along urban rivers; and (c) the need to more fully consider the roles that non-native species may play in the recombinant communities of novel urban river ecosystems. The review ends with an identification of research priorities at the intersection of urban river corridor function and invasion biology.

Background Vaccination policy in France was previously characterised by the coexistence of eight recommended and three mandatory vaccinations for children younger than 2 years old. These 11 vaccines are now mandatory for all children born after 1 January 2018. Aim To study the French population’s opinion about this new policy and to assess factors associated with a positive opinion during this changing phase. Methods A cross-sectional survey about vaccination was conducted from 16 November–19 December 2017 among the GrippeNet.fr cohort. Data were weighted for age, sex and education according to the French population. Univariate and multivariate analyses were performed to identify factors associated with a favourable opinion on mandatory vaccines’ extension and defined in the ‘3Cs’ model by the World Health Organization Strategic Advisory Group of Experts working group on vaccine hesitancy. Results Of the 3,222 participants (response rate 50.5%) and after adjustment, 64.5% agreed with the extension of mandatory vaccines. It was considered a necessary step by 68.7% of the study population, while 33.8% considered it unsafe for children and 56.9% saw it as authoritarian. Factors associated with a positive opinion about the extension of mandatory vaccines were components of the confidence, complacency and convenience dimensions of the ‘3Cs’ model. Conclusions In our sample, two thirds of the French population was in favour of the extension of mandatory vaccines for children. Perception of vaccine safety and benefits were major predictors for positive and negative opinions about this new policy.

International audience; In case of a release of a hazardous material (e.g., a chemical or a biological agent) in the atmosphere, estimation of the source from concentration observations (provided by a network of sensors) is a challenging inverse problem known as the atmospheric source term estimation (STE) problem. This study emphasizes a method, known in the literature as the renormalization inversion technique, for addressing this problem. This method provides a solution that has been interpreted as a weighted minimal norm solution and can be computed in terms of a generalized inverse of the sensitivity matrix of the sensors. This inverse is constructed by using an appropriate diagonal weight matrix whose components fulfill the so-called renormalizing conditions. The main contribution of this paper is that it proposes a new compact algorithm (it requires less than 15 lines of MATLAB code) to obtain, in a fast and efficient way, those optimal weights. To show that the algorithm, based on the properties of the resolution matrix, matches the requirements of emergency situations, analysis of the computational complexity and memory requirements is included. Some numerical experiments are also reported to show the efficiency of the algorithm.; En cas de rejet de matières dangereuses (p. ex. un produit chimique ou un agent biologique) dans l'atmosphère, la caractérisation de la source d’émission à partir de mesures de concentration (fournies par un réseau de capteurs) nécessite la résolution d’un problème inverse, connu sous le nom de problème d'Estimation du Terme Source (STE). Cette étude se concentre sur une des méthodes de résolution de ce problème, connue dans la littérature sous le nom de « méthode de renormalisation ». Cette dernière fournit une solution de norme minimale pondérée qui peut être obtenue après avoir calculé un inverse généralisé de la matrice de sensibilité des capteurs. Cet inverse fait intervenir une matrice de pondération diagonale dont les composants doivent vérifier les conditions dites de renormalisation. La principale contribution de cet article est qu'il propose un nouvel algorithme, rapide, efficace et particulièrement compact (il comporte moins de 15 lignes de code MATLAB), qui permet d’obtenir cette matrice. Pour montrer que l'algorithme, basé sur la notion de matrice de résolution, est performant et peut être utilisé en situation opérationnelle, sa complexité informatique globale est étudiée. Enfin, son utilisation est illustrée sur des cas réels.