Large-scale genome sampling reveals unique immunity and metabolic adaptations in bats

SCV was supported by a Max Planck Research Group awarded by the Max Planck Gesellschaft, a Human Frontiers Science Program Grant (RGP0058/2016) and a UKRI Future Leaders Fellowship (MR/T021985/1).Comprising more than 1,400 species, bats possess adaptations unique among mammals including powered flight, unexpected longevity, and extraordinary immunity. Some of the molecular mechanisms underlying these unique adaptations includes DNA repair, metabolism and immunity. However, analyses have been limited to a few divergent lineages, reducing the scope of inferences on gene family evolution across the Order Chiroptera. We conducted an exhaustive comparative genomic study of 37 bat species, one generated in this study, encompassing a large number of lineages, with a particular emphasis on multi-gene family evolution across immune and metabolic genes. In agreement with previous analyses, we found lineage-specific expansions of the APOBEC3 and MHC-I gene families, and loss of the proinflammatory PYHIN gene family. We inferred more than 1,000 gene losses unique to bats, including genes involved in the regulation of inflammasome pathways such as epithelial defence receptors, the natural killer gene complex and the interferon-gamma induced pathway. Gene set enrichment analyses revealed genes lost in bats are involved in defence response against pathogen-associated molecular patterns and damage-associated molecular patterns. Gene family evolution and selection analyses indicate bats have evolved fundamental functional differences compared to other mammals in both innate and adaptive immune system, with the potential to enhance antiviral immune response while dampening inflammatory signalling. In addition, metabolic genes have experienced repeated expansions related to convergent shifts to plant-based diets. Our analyses support the hypothesis that, in tandem with flight, ancestral bats had evolved a unique set of immune adaptations whose functional implications remain to be explored.PostprintPeer reviewe

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Place de la cricothyrotomie dans le cadre de l'accès aux voies aériennes en médecine de guerre

LYON1-BU Santé (693882101) / SudocPARIS-Bib. Serv.Santé Armées (751055204) / SudocSudocFranceF

Saint-Maurice-Navacelles : Saint-Vincent de Soulages

National audienc

Saint-Maurice-Navacelles : Saint-Vincent de Soulages

National audienc

Saint-Maurice-Navacelles : Eglise Saint-Vincent de Soulages

National audienc

Comportamiento de bajo peso al nacer en el municipio Imías de Guantánamo

A study is done at the Policlinic "Ciro Frías Cabrera" Imías Township, Guantanamo province, from January 2010 to December 2012 with the aim of characterizing the behavior of low birth weight. The studied group consists of 957 low births, which is selected a sample of 59 Children. The information and data are entered manually processed and summarized in quantitative and qualitative variables, very important to the proposed objectives. The rate of low birth weight has a tendency to increase in the years of study, preterm births were predominated, with more than 2 000 g, average weight whose mothers mostly had at the time of birth: the following main results were obtained delivery, with age between 20 and 35 years, prevailing low birth weight children, whose women had vaginal sepsis during pregnancy.Se realizó un estudio en el Policlínico Universitario "Ciro Frías Cabrera", del municipio Imías, provincia Guantánamo, durante el periodo enero 2010 a diciembre 2012, con el objetivo de caracterizar el comportamiento de bajo peso al nacer. El universo de estudio estuvo constituido por 957 nacidos vivos, de los cuales se selecciona una muestra de 59 niños. Una vez obtenida la información los datos fueron introducidos y procesados de forma manual, resumiéndose en variables estudiadas cuantitativas y cualitativas, que le dieron salida a los objetivos propuestos. Como principales resultados se obtuvieron los siguientes: el índice de bajo peso al nacer tuvo una tendencia a incrementarse en los años de estudio, predominaron los partos pretérminos, con un peso promedio superior a los 2 000 g, cuyas madres en su mayoría, al momento del parto, tenían edades entre los 20 y los 35 años. Prevalecieron los niños bajo peso al nacer, cuyas mujeres tuvieron durante el embarazo sepsis vaginal

Prioritisation of ICU treatments for critically ill patients in a COVID-19 pandemic with scarce resources

International audienc

St Martin de Castries (Hérault), de l’habitat rural à l’ensemble ecclésial (VIIIe-XVIIIe siècles)

International audienceLa fouille programmée du site de Saint-Martin-de-Castries (La Vacqueire et Saint- Martin de Castries, Hérault), située sur le plateau du Larzac, a mis en évidence l’existence d’un habitat rural du haut Moyen Âge (VIIIe-IXe siècles) auquel succède un ensemble ecclésial. Le premier sanctuaire est élevé sur une initiative privée. Il est rapidement rattaché à l’abbaye de Gellone. Ce rattachement conditionne l’évolution de l’ensemble ecclésial jusqu’à son abandon au XVIIIe siècle. Les constructions sont organisées autour d'une église et d'une annexe qui feront lobjet de plusieurs phases de construction

St Martin de Castries (Hérault), de l’habitat rural à l’ensemble ecclésial (VIIIe-XVIIIe siècles)

International audienceLa fouille programmée du site de Saint-Martin-de-Castries (La Vacqueire et Saint- Martin de Castries, Hérault), située sur le plateau du Larzac, a mis en évidence l’existence d’un habitat rural du haut Moyen Âge (VIIIe-IXe siècles) auquel succède un ensemble ecclésial. Le premier sanctuaire est élevé sur une initiative privée. Il est rapidement rattaché à l’abbaye de Gellone. Ce rattachement conditionne l’évolution de l’ensemble ecclésial jusqu’à son abandon au XVIIIe siècle. Les constructions sont organisées autour d'une église et d'une annexe qui feront lobjet de plusieurs phases de construction