Estimating economic benefits of biological control of Ambrosia artemisiifolia by Ophraella communa in southeastern France

The North American common ragweed, Ambrosia artemisiifolia, which produces highly allergenic pollen, is invasive in different parts of the world, including Europe. In 2013, common ragweed in northern Italy was found attacked by another accidentally introduced species, the North American leaf beetle Ophraella communa, which is used for biological control of common ragweed in China. Since the establishment of O. communa, ragweed pollen concentrations in northern Italy have significantly dropped. Here we set out to estimate the potential economic benefits of establishment of O. communa in the Rhône-Alpes region in south-eastern France, where detailed data on the economic impact of common ragweed are available. Extrapolating from the change in airborne ragweed pollen concentrations in the Milan area, we estimated that establishment of O. communa in the Rhône-Alpes region will reduce the number of days with ragweed pollen concentrations at which sensitive people express symptoms by 50% and the medical costs due to common ragweed by 5.2–6.8 M € annually. Our findings suggest that investments of public funds are justified to conduct a complete assessment of the potential risks and benefits associated with the accidental establishment of O. communa in Europe

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Entre montagnes et vallées : essai de localisation du centre de gravité démographique des populations savoyardes aux XVI-XVIIIe siècles.

International audienceThe aim of this article is to quantify and map the distribution by altitude of the inhabitants of the “Pays de Savoie” region using information obtained from statistical comparative analysis of the 1561 salt tax and those of 1758 and 1776. The evolution according to the period and geographical situation has been evaluated as well as the importance of the displacement of the population between the mountains and the valleys. It can be quite clearly seen that the high level of inhabitants living in mountainous areas in the mid-sixteenth century was never repeated after that period, even if almost everywhere during the second half of the eighteenth century there was a very noticeable increase in population (+ 18,5 % on average between 1758 and 1776). Even if the population of a few towns such as Chambéry greatly increased as more and more people were living in the valleys, most of the population continued to live in the mountains. The church registers of the Beaufortain parish show that the population growth in mountain villages progressed more than the increase in the number of people leaving the villages. Even though mountain villages never reached the high levels of population seen in 1561 again, and at the same time continued to provide the valleys and the surrounding areas with a migrant population, they resisted depopulation and often the number of inhabitants even increased. The demographic history of the Alps should not therefore be considered as a long, continuous decline. + MAPS + STAT.« Comment, sur le plan social et économique les rapports entre montagnes et plats pays évoluèrent-ils? ». Un certain nombre de sources permettent assurément de répondre à cette question. On le sait, pendant une grande partie de la période moderne, les montagnes furent de véritables « châteaux d’eau » démographiques, irriguant les vallées et avant-pays parfois lointains. Mais dans quelle mesure les déclarations des contemporains, les évocations littéraires ou les constructions historiographiques n’ont-elles pas en partie mythifié ces représentations convenues ? A quelles altitudes se situait, en réalité, le centre de gravité démographique des diverses provinces du duché de Savoie, que ce soit en 1561 ou en 1776 ? A quel moment a-t-il vraiment basculé entre le « haut » et le « bas » ? Il s’agirait ici de reprendre des études, souvent nombreuses mais dispersées, et d’en faire la synthèse et la cartographie statistique, afin d’analyser de façon précise les mutations démographiques en les confrontant aux écrits des intendants, des autorités ecclésiastiques ou des voyageurs. Il conviendra également d’essayer de comprendre dans quelle mesure ces mouvements sont la cause, ou la conséquence, de mutations économiques et sociales profondes.+ CARTES + TABLEAUX STATISTIQUE

Atlas historique et statistique de la Savoie au XVIIIe siècle

cartes, arbres généalogiques, graphiquesCet ouvrage compte 100 chapitres, composés chacun d'une double page (textes d'un côté, cartes et graphiques de l'autre), répartis en quatre grandes parties : aspects politiques, administratifs et judiciaires, aspects démographiques, aspects religieux et culturels, aspects économiques et sociaux. Il aborde donc toutes les facettes de l'Histoire des Pays de Savoie, depuis l'occupation française de 1703-1713 jusqu'à l'arrivée des troupes révolutionnaires en 1792. Chaque page recèle des surprises, tant les sujets abordés sont variés. Comme tout atlas, on doit pouvoir le feuilleter en tout sens et il ne nécessite pas forcément une lecture continue. Un système de renvois (corrélats) permet de retrouver facilement les sujets connexes. La cartographie ancre solidement chaque phénomène dans un cadre géographique précis. Elle confirme le rôle fondamental, quel que soit le sujet étudié, des vallées et des principales voies de passage. Les courbes et diagrammes illustrent la place acquise durant les dernières décennies par l'histoire quantitative et sérielle, ainsi que les multiples possibilités offertes désormais par les traitements informatiques, lesquels démultiplient les recherches et ouvrent la voie à de nouvelles problématiques