Effectiveness and cost-effectiveness of four different strategies for SARS-CoV-2 surveillance in the general population (CoV-Surv Study): study protocol for a two-factorial randomized controlled multi-arm trial with cluster sampling

Background: To achieve higher effectiveness in population-based SARS-CoV-2 surveillance and to reliably predict the course of an outbreak, screening, and monitoring of infected individuals without major symptoms (about 40% of the population) will be necessary. While current testing capacities are also used to identify such asymptomatic cases, this rather passive approach is not suitable in generating reliable population-based estimates of the prevalence of asymptomatic carriers to allow any dependable predictions on the course of the pandemic. Methods: This trial implements a two-factorial, randomized, controlled, multi-arm, prospective, interventional, single-blinded design with cluster sampling and four study arms, each representing a different SARS-CoV-2 testing and surveillance strategy based on individuals' self-collection of saliva samples which are then sent to and analyzed by a laboratory. The targeted sample size for the trial is 10,000 saliva samples equally allocated to the four study arms (2500 participants per arm). Strategies differ with respect to tested population groups (individuals vs. all household members) and testing approach (without vs. with pre-screening survey). The trial is complemented by an economic evaluation and qualitative assessment of user experiences. Primary outcomes include costs per completely screened person, costs per positive case, positive detection rate, and precision of positive detection rate. Discussion: Systems for active surveillance of the general population will gain more importance in the context of pandemics and related disease prevention efforts. The pandemic parameters derived from such active surveillance with routine population monitoring therefore not only enable a prospective assessment of the short-term course of a pandemic, but also a more targeted and thus more effective use of local and short-term countermeasures. Trial registration: ClinicalTrials.gov DRKS00023271. Registered November 30, 2020, with the German Clinical Trials Register (Deutsches Register Klinischer Studien

Typical features of Parkinson disease and diagnostic challenges with microdeletion 22q11.2

Objective: To delineate the natural history, diagnosis, and treatment response of Parkinson disease (PD) in individuals with 22q11.2 deletion syndrome (22q11.2DS), and to determine if these patients differ from those with idiopathic PD. Methods: In this international observational study, we characterized the clinical and neuroimaging features of 45 individuals with 22q11.2DS and PD (mean follow-up 7.5 ± 4.1 years). Results: 22q11.2DS PD had a typical male excess (32 male, 71.1%), presentation and progression of hallmark motor symptoms, reduced striatal dopamine transporter binding with molecular imaging, and initial positive response to levodopa (93.3%). Mean age at motor symptom onset was relatively young (39.5 ± 8.5 years); 71.4% of cases had early-onset PD (<45 years). Despite having a similar age at onset, the diagnosis of PD was delayed in patients with a history of antipsychotic treatment compared with antipsychotic-naive patients (median 5 vs 1 year, p = 0.001). Preexisting psychotic disorders (24.5%) and mood or anxiety disorders (31.1%) were common, as were early dystonia (19.4%) and a history of seizures (33.3%). Conclusions: Major clinical characteristics and response to standard treatments appear comparable in 22q11.2DS-associated PD to those in idiopathic PD, although the average age at onset is earlier. Importantly, treatment of preexisting psychotic illness may delay diagnosis of PD in 22q11.DS patients. An index of suspicion and vigilance for complex comorbidity may assist in identifying patients to prioritize for genetic testing

Les éventrations diaphragmatiques congénitales de l'enfant.

STRASBOURG-Medecine (674822101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

MSI detection and its pitfalls in CMMRD syndrome in a family with a bi-allelic MLH1 mutation

International audienc

Fatigue and Thermal Cracking of Hot and Warm Bituminous Mixtures with Different RAP Contents

This paper presents results of laboratory tests on hot and warm bituminous mixtures produced with Reclaimed Asphalt Pavement (RAP). Additives were used to produce warm bituminous mixtures. Fatigue behaviour and thermomechanical behaviour at low temperature were investigated. Fatigue was studied by analysing the tension/compression fatigue test results. Four different failure criteria were used in order to evaluate fatigue life. The low temperature behaviour of the materials was characterized using the Thermal Stress Restrained Specimen Test (TSRST). For each material, three replicates were performed. The experimental device was improved so that radial strains in two directions could be measured during the tests. Tri-dimensional behaviour could thus be investigated. The results of both tests were analysed and the influence of the void content, RAP content, type of additives and manufacturing process was evaluated. The results show that RAP addition and warm bituminous mixtures could be combined to obtain mixtures with performances comparable to classical hot mixtures

Analysis and modeling of 3D complex modulus tests on hot and warm bituminous mixtures

International audienc

Reclaimed asphalt pavement and additives’ influence on 3D linear behaviour of warm mix asphalts

International audienc

Phytoavailability of Cd, Cr, Cu, Hg, Mn, Mo, Ni, Pb, Tl and Zn in Arable Crop Systems Amended for 13 to 15 Years with Organic Waste Products

Repeated applications of organic waste products (OWP) are a source of trace elements (TE) inputs to agricultural topsoils. The present study aimed at (i) assessing the effects of repeated OWP inputs on the chemical properties of topsoils in two long-term field experiments (13 and 15 years; calcareous and non-calcareous soils), (ii) evaluating TE phytoavailability and their transfer to grain (winter wheat and maize) and (iii) identifying the underlying factors causing alterations of TE phytoavailability. In both field experiments, receiving compliant or slightly high doses of OWP in compliance with regulations, OWP and soil physicochemical properties and TE concentrations in soils and grains were determined. In situ phytoavailability of TE was assessed at two juvenile crop growth stages by analyzing TE concentrations in shoot plantlets. Depending on the OWP input amount, results showed that compared to the soil receiving no organic amendment, repeated OWP inputs significantly increased soil organic carbon content, pH, cation exchange capacity, total soil Cu, Mo and Zn concentration and the phytoavailability of Mo, while the phytoavailability of Cd, Mn, Ni and Tl was significantly reduced. No notable effect was observed for Cr, Cu, Hg, Pb and Zn phytoavailability. Statistical approaches suggested that due to the repeated OWP applications, increased soil organic carbon content and pH, were likely responsible for decreased TE phytoavailability (e.g., Cd)