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Emergence and spread of the SARS-CoV-2 omicron (BA.1) variant across Africa: an observational study
No full textInternational audienceBackground: In mid-November, 2021, the SARS-CoV-2 omicron variant (B.1.1.529; BA.1 sublineage) was detected in southern Africa, prompting international travel restrictions. We aimed to investigate the spread of omicron BA.1 in Africa.Methods: In this observational study, samples from patients infected with SARS-CoV-2 from 27 laboratories in 24 African countries, collected between June 1, 2021 and April 14, 2022, were tested for omicron BA.1 and delta (B.1.617.2) variants using real-time RT-PCR. Samples that tested positive for BA.1 by RT-PCR and were collected before estimated BA.1 emergence according to epidemiological properties were excluded from downstream analyses. The diagnostic precision of the assays was evaluated by high-throughput sequencing of samples from four countries. The observed spread of BA.1 was compared with mobility-based mathematical simulations and entries for SARS-CoV-2 in the Global Initiative on Sharing All Influenza Data (GISAID) genomic database. We estimated the effective reproduction number (Rt) at the country level considering the BA.1 fraction and the reported numbers of infections. Phylogeographical analyses were done in a Bayesian framework.Findings: Through testing of 13 294 samples from patients infected with SARS-CoV-2, we established that, by November-December, 2021, omicron BA.1 had replaced the delta variant of SARS-CoV-2 in all African subregions, following a south-north gradient, with a median Rt of 2·60 (95% CI 2·46-2·71). This south-north spread, established on the basis of PCR data, was substantiated by phylogeographical reconstructions, ancestral state reconstructions, and GISAID data. PCR-based reconstructions of country-level BA.1 predominance and the availability of BA.1 genomic sequences in GISAID correlated significantly in time (p=0·0002, r=0·78). The first detections of BA.1 in high-income settings beyond Africa were predicted accurately in time by mobility-based mathematical simulations (p<0·0001). Comparing PCR-based reconstructions with mobility-based mathematical simulations suggested that SARS-CoV-2 infections in Africa were under-reported by approximately ten times. Inbound travellers infected with BA.1, departing from five continents, were identified in six African countries by early December, 2021.Interpretation: Omicron BA.1 was widespread in Africa when travel bans were implemented, limiting their effectiveness. Combined with genomic surveillance and mobility-based mathematical modelling, PCR-based strategies can inform Rt and the geographical spread of emerging pathogens in a cost-effective and timely manner, and can guide evidence-based, non-pharmaceutical interventions such as travel restrictions or physical distancing
The Role of Multimodality Imaging in Multiple Valvular Heart Diseases. A Clinical Consensus Statement of the European Association of Cardiovascular Imaging (EACVI) of the ESC
No full textInternational audienceWith this document, the European Association of Cardiovascular Imaging provides an Expert Consensus on the role of multi-modality imaging (MMI) in the management of patients with multiple valvular heart disease (MVD). Emphasis is given to the use of MMI to unravel the diagnostic challenges that characterize these patients and to improve risk stratification. Complementing the last European Society of Cardiology and European Association of Cardio-Thoracic Surgery guidelines on valvular heart disease, this Expert Consensus document also outlines how MMI assessment should form an integral part of the multi-disciplinary heart team discussion for patients with MVD to help with complex decision-making regarding the choice and timing of treatment
Prérequis et organisation du parcours de soins en vue de l’utilisation d’une thérapie cellulaire ou génique par cellules stromales mésenchymateuses (CSM) ou par cellules T porteuses d’un récepteur antigénique chimérique (CAR-T cells) chez les patients avec maladies auto-immunes systémiques
No full textInternational audienceFirst-line treatments of autoimmune systemic diseases (ARD) are based on the use of various types of immunosuppressive or immunomodulatory drugs, either alone or in association, according to standardized reference protocols. Prolonged use of these drugs in severe or refractory ARD is associated with high morbidity and increased mortality. Innovative cell therapies represent a new promising approach for patients with ARDs, with the recent clinical use of: a) mesenchymal stromal cells (MSCs), based on their immunomodulatory, antifibrotic and pro-angiogenic properties and b) Chimeric Antigen Receptors (CAR) T cell therapies T lymphocytes, where genetically modified expression of a chimeric antigen receptor (CAR-T cells). Therapeutic use of MSC or CAR-T cells, remains indications of exception in patients with severe ARDs resistant to prior standard therapies with new prerequisite and organisation of health-care pathways as compared to traditional drugs, not only for the Cell and Gene Therapy (CGT) product definition and delivery process, but also for the patient clinical management before and after administration of the CGT product. The aim of this workshop under the auspices of the French Speaking Society of Bone Marrow and Cell transplantation (SFGM-TC) working group on autoimmune diseases (MATHEC) is to describe: a) the prerequisite for French hospitals to set-up the specific health-care pathways for MSC or CART therapy in ARDs patients, in accordance with regulatory and safety needs to perform academic or industry sponsored clinical trials, and b) the care-pathway for ARD patients treated with CGT, highlighting the importance of working in tandem between the ARD and the CAR-T cell specialist all along the indication, procedures and follow-up of ARDs. Patient safety considerations are central to guidance on patient selection to be validated collectively at the multidisciplinary team meeting (MDTM) based on recent (less than 3 months) thorough patient evaluation. MSC and CAR-T procedural aspects and follow-up are then carried out within appropriately experienced and SFGM-TC accredited centres in close collaboration with the ADs specialist
Modern health worries and exposure perceptions of individuals reporting varying levels of sensitivity to electromagnetic fields: results of two successive surveys
No full textInternational audienceIntroduction Individuals who claim to be affected by idiopathic environmental intolerance attributed to electromagnetic fields (EMFs) report symptoms linked to EMF exposure. Uncertainties about the causes of these symptoms often leave them seeking their own care solutions. In our connected societies, they may limit their exposure, leading to a spiral of avoidance that negatively impacts overall health. Our objective is to gain insights into the characteristics of people who report sensitivity to EMFs in an attempt to provide care guidance. This study focuses on modern health worries (MHW), behaviours, and exposure perceptions of people reporting various sensitivity levels to EMFs during the COVID-19 lockdowns, which altered habits and increased telecommunication device use. Methods We conducted two surveys during relaxed lockdown periods in Belgium (June/July 2020 and February/March 2021). A total of 97 and 285 participants, respectively, answered a questionnaire on sensitivity to EMFs, MHW, exposure perception, and strategies to limit EMF exposure. We applied nonparametric descriptive and multivariate statistical analyses. Results Higher sensitivity to EMFs correlates with greater MHW regarding EMF sources and more strategies to limit EMF exposure. However, these strategies were inconclusive, as many still felt highly exposed to EMFs. Discussion Given the high distress, social isolation, and professional difficulties faced by some EMF sensitive individuals, the relevance of exposure avoidance strategies is questionable. People who perceive high sensitivity to EMFs report worries and avoidance behaviors, yet still feel highly exposed. The findings suggest exploring new care avenues
Cryptic circulation of chikungunya virus in Cote d'Ivoire revealed by sentinel travellers, 2023-2024
No full textInternational audienceChikungunya virus (CHIKV) is known to circulate in Africa, but there is little evidence of CHIKV transmission in Côte d’Ivoire. Using genomic data, we linked CHIKV cases imported in France from Côte d’Ivoire to a lineage from the West African genotype, likely been circulating in the country since July 2021
Evaluating script concordance tests (SCTs) through the lens of Bayesian reasoning: Enhancing assessment in medical education.
No full textInternational audienceBackground: Script Concordance Tests (SCTs) represent an innovative assessment method which have been introduced in the 2024 French National Ranking Examinations (EDN). These tests compare a student's clinical reasoning with that of a panel of experts under conditions of uncertainty. Typically, the question involves the impact of new information on an initially proposed hypothesis, with answers given on a Likert scale.Main findings: This article aims to didactically illustrate how SCTs are consistent with probabilistic reasoning as modeled by Bayes' theorem. In addition, by comparing SCT writing guidelines with Bayesian reasoning concepts, several ambiguities were identified: (1) What stage of clinical reasoning do SCTs evaluate? (2) What are the appropriate labels for Likert scale responses? (3) Does the expert panel provide a relevant reference for SCTs?Conclusions: Currently, many of these questions remain unanswered in the literature, with recent data suggesting that experienced physicians' responses to SCTs are often biased. Beyond their use as an assessment tool in the EDN, SCTs offer a valuable opportunity to develop and deepen the teaching of probabilistic reasoning in medical education and serve as a potential area of research to improve clinical practice
Updated checklist with new records and molecular data for the mosquitoes (Diptera: Culicidae) of Hong Kong
No full textInternational audienceAn extensive mosquito survey was carried out in Hong Kong from September to October 2022, employing a variety of collection methods. Specimens were identified using a combination of morphology and mitochondrial cytochrome C oxidase subunit 1 (COI) barcode sequences. Twenty-nine species, including three new records, i.e., Culex bicornutus (Theobald), Culex cinctellus Edwards, and Lutzia chiangmaiensis Somboon & Harbach, were collected. Phylogenetic analysis of COI sequences of Culex annulus Theobald and Culex vishnui Theobald collected in Hong Kong and elsewhere revealed that the sequences of the two nominal species are genetically very similar and are included in the same clade. Consequently, the synonymy of Cx. annulus with Cx. vishnui is reinstated. Lutzia halifaxii (Theobald) is removed from the list of species in Hong Kong and is replaced with Lutzia vorax Edwards, the identification of which is confirmed in the present study. The record of Culex spiculothorax Bram recorded in Hong Kong is replaced with the senior synonym Culex sasai Kano, Nitahara & Awaya. The occurrence of Anopheles fluviatilis James and Aedes aegypti (Linnaeus) is discussed. Finally, an updated checklist of the mosquitoes of Hong Kong, which now includes 76 species representing 14 genera, is provided, with notation of those species that vector pathogens of human diseases
Les composés dicarbonylés dans les aliments et le corps humain
No full textPublication de l'Académie d'Agriculture de France, Encyclopédie, grand thème 8 : alimentation & santé humaineFiche consultable sur le site internet www.academie-agriculture.fr onglet "Publications" puis "Table des matières des documents de l'Encyclopédie". Reproduction autorisée sous réserve d'en citer la provenance Encyclopédie : Question sur Les erreurs passent, il n'y a que le vrai qui reste (Diderot) Les composés dicarbonylés dans les aliments et le corps humainFiche QUESTIONS SUR… n° 08.04.Q16 février 2025 Mots clés : composés dicarbonylés, méthylglyoxal, 3-désoxyglucosone, glycation Les composés dicarbonylés sont présents dans des aliments aussi variés que le vin, le miel ou le pain, mais aussi dans nos cellules et notre sang. Ils sont généralement chimiquement très réactifs, et donc impliqués dans de nombreuses réactions. Ils ne sont pas toujours simples à quantifier, mais un intérêt croissant est porté à leurs devenir métabolique et à leurs effets sur la santé. Certains scientifiques, qui observent leur abondance dans plusieurs pathologies, n'hésitent pas à parler de stress dicarbonylé ! 1 Un autre 1,2-dicarbonyle asymétrique très étudié est le méthylglyoxal (Figure 1-b) aussi appelé 2oxoaldéhyde 3 ; c'est un céto-aldéhyde dérivé de l'acide pyruvique, largement décrit pour sa réactivité chimique 1 Rabbani et al., 2021. 2 Une fonction carbonyle est constituée d'un atome de carbone lié par une double liaison à un atome d'oxygène. 3 Préfixe oxo : présence d'un atome d'oxygène doublement lié à un autre atome ; les cétones, par exemple sont des composés oxo.</div
Plague in Small Mammals From an Endemic Focus of the Malagasy Central Highlands: A Longitudinal Survey With a Special Reference on Black Rats ( Rattus rattus )
No full textInternational audiencePlague, a zoonotic disease caused by Yersinia pestis , remains a major public health threat in several parts of the world, including Madagascar. Factors underlying long‐term persistence and emergence of the pathogen remain poorly understood. We implemented a longitudinal survey to provide insights into plague reservoir ecology within an endemic focus. Six trapping sessions (TS) were conducted in six different localities of the Ankazobe district from 2018 to 2020 in order to monitor small mammal communities. A total of 2762 individuals composed of six species ( Rattus rattus , Rattus norvegicus , Mus musculus , Setifer setosus , Suncus murinus and Tenrec ecaudatus ) were caught over the six successive TS. R. rattus represented 88% of all captures, with the highest relative abundances observed during the dry season (June to August 2019). None of the micromammals tested positive for the presence of Y. pestis , neither with qPCR nor bacterial culture. However, 11 seropositive individuals (6 R. rattus , 2 M. musculus and 3 S. murinus ) were retrieved following ELISA, thus leading to a global seroprevalence of 0.4%. Our study highlighted the significant influence of climatic data on the seasonal variations of R. rattus abundance and suggest that black rat control should be conducted before the dry season, that is, during high reproduction period of rats, in order to reduce the number of reproducing animals and prevent subsequent increase in abundance. As three S. murinus and two M. musculus plague seropositive were identified in the present study, their potential role in plague eco‐epidemiology in Madagascar should be explored further
Exérèse du jabot chez le pigeon mondain : une approche chirurgicale innovante
No full textInternational audienceProblem: Crop ptosis is a common condition in pigeons. It is due to chronic colibacillosis or ingluvial indigestion. This is also a characteristic of Iberian pigeons: gorguero and gaditano. This important development of the crop can be managed surgically at the risk of fatal perforation.Objective: This study describes an innovative surgical technique for carrying out surgical excision of the crop in pigeons suffering from chronic colibacillosis at the “Maison des éleveurs” practice in Niamey, Niger.Methodology: The stages of this operation are: preparation of the operating field by defeathering the intervention area, cleaning-disinfection with povidone-iodine of the site and restraining the bird. No local or general anesthesia is necessary because birds cannot tolerate opioid derivatives such as lurocaïne or xylocaine. Two coprostasis forceps are then placed to demarcate the affected part. An excision of the lower part of the crop or the perforated part is carried out using a pair of scissors. A synthesis in two plans will be carried out: a simple overlock with an absorbable catgut on the membrane of the crop and simple stitches separated on the skin using a non-absorbable thread. The operation ends with a medicated dressing of the surgical wound.Main results: This surgery is an intervention with a very high septic risk. The success rate is 90%. Remission occurs within a week and the stitches are removed.Conclusion: Crop excision is an innovative surgical technique, easy to perform, which saves pigeons, which brings in a substantial income and which will quickly find a place of choice in the services offered by veterinarians.Problématique : La ptose du jabot est une affection fréquente chez le pigeon. Elle est due à une colibacillose chronique ou une indigestion ingluviale. C’est aussi une caractéristique chez les pigeons ibériques : gorguero et gaditano. Cet important développement du jabot peut être pris en charge chirurgicalement au risque d’une perforation mortelle. Objectif : Cette étude décrit une technique chirurgicale innovante pour réaliser une exérèse chirurgicale du jabot chez le pigeon souffrant d’une colibacillose chronique au cabinet « la maison des éleveurs » à Niamey au Niger.Méthodologie : Les étapes de cette opération sont : la préparation du champ opératoire par déplumage de la zone d’intervention, un nettoyage-désinfection à la polyvidone iodée du site et une contention de l’oiseau. Aucune anesthésie locale ou générale n’est nécessaire car les oiseaux ne supportent pas les dérivés morphiniques comme la lurocaïne ou la xylocaïne. Deux pinces à coprostase sont ensuite posées pour délimiter à partie atteinte. Une exérèse de la partie inférieure du jabot ou de la partie perforée est réalisée à l’aide d’une paire de ciseau. Une synthèse en deux plans sera réalisée : un surjet simple avec un catgut résorbable sur la membrane du jabot et des points simples séparés sur la peau au moyen d’un fil non résorbable. L’opération se termine par un pansement médicamenteux de la plaie chirurgicale.Principaux résultats : Cette chirurgie est une intervention à très haut risque septique. Le taux de succès est 90%. La rémission se fait en une semaine et on retire les points de sutures.Conclusion : L’exérèse du jabot est une technique chirurgicale innovante, facile à réaliser, qui sauve des pigeons, qui rapporte un revenu substantiel et qui trouvera rapidement une place de choix dans les services proposés par les vétérinaires