De la Covid-19 vers une métropole résiliente : l’exemple du Grand Nancy

Cette étude concerne les enjeux sociaux et spatiaux de la gestion de la pandémie, et notamment la préparation à la sortie du confinement sur le territoire de la Métropole du Grand Nancy. Face aux risques sanitaires liés à la Covid-19, la Métropole a mis en place des mesures afin de doter l’ensemble de ses 20 communes de ressources pour préparer au mieux cette sortie du confinement, ainsi que la convalescence de la société grâce à une approche globale de la résilience. L’objectif visé est l’accompagnement des citoyens de manière complémentaire au cadre fixé par l’État. La Métropole a sollicité ses partenaires afin de constituer une cellule de réflexion. Cette cellule pluridisciplinaire de réflexion avant sortie de confinement continue d’aider les représentants des communes à gérer cette situation inédite grâce à un système de communication visant à apporter des réponses concrètes aux problématiques rencontrées. L’ensemble de ces travaux s’est concrétisé sous la forme d’un plan de résilience métropolitaine, à vocation très opérationnelle

From Covid-19 to a resilient metropolis: the example of the Great Nancy

Health promotion is a major focus of the metropolitan project of Grand Nancy. The city’s second-generation local health contract has identified a network of local actors. This paper focuses on social and spatial issues of pandemic management and post containment. In response to the health risks associated with Covid-19, the metropolis has implemented measures to provide all its 20 communes with resources to prepare as best as possible for the ending stay-at-home restrictions in compliance wit..

Advances in archaeomagnetic dating in Britain: New data, new approaches and a new calibration curve

yesArchaeomagnetic dating offers a valuable chronological tool for archaeological investigations, particularly for dating fired material. The method depends on the establishment of a dated record of secular variation of the Earth's magnetic field and this paper presents new and updated archaeomagnetic directional data from the UK and geomagnetic secular variation curves arising from them. The data are taken from publications from the 1950's to the present day; 422 dated entries derived from existing archaeo and geomagnetic databases are re-evaluated and 487 new directions added, resulting in 909 entries with corresponding dates, the largest collection of dated archaeomagnetic directions from a single country. An approach to improving the largest source of uncertainty, the independent dating, is proposed and applied to the British Iron Age, resulting in 145 directions from currently available databases being updated with revised ages and/or uncertainties, and a large scale reassessment of age assignments prior to inclusion into the Magnetic Moments of the Past and GEOMAGIA50 databases. From the significantly improved dataset a new archaeomagnetic dating curve for the UK is derived through the development of a temporally continuous geomagnetic field model, and is compared with previous UK archaeomagnetic dating curves and global field models. The new model, ARCH-UK.1 allows model predictions for any location in the UK with associated uncertainties. It is shown to improve precision and accuracy in archaeomagnetic dating, and to provide new insight into past geomagnetic field changes.Arts and Humanities Research Counci

Levels of acid sphingomyelinase (ASM) in Caenorhabditis elegans in microgravity

Both Amyotrophic Lateral Sclerosis (ALS) patients and astronauts in spaceflight suffer from muscle atrophy. Previous research suggests that the enzyme acid sphingomyelinase (ASM) may be involved in the pathogenesis of ALS, but it is not known if ASM influences muscle atrophy in microgravity. In this study, C. elegans were exposed to microgravity conditions on the International Space Station (ISS) within the confines of a Fluid Mixing Enclosure (FME). Return of the FME yielded 72,050 live nematodes, the first demonstration of C. elegans survival of space travel in an FME. After the nematodes returned to Earth, in much larger numbers than seen in previous FME experiments, the size and ASM expression levels in experimental worms were compared to control Earth-bound worms. C. elegans that returned from the ISS were larger in both length and cross-sectional area than the control worms, and they exhibited decreased expression of ASM-1 and ASM-2 proteins. Further research must be conducted to elucidate the role of ASM in muscle atrophy, as there were many limitations to this study. Understanding the role of ASM in muscle atrophy may lead to the discovery of novel targets for treatment of both ALS and muscle atrophy in microgravity. This study was a student led initiative and undertaken as a project within the Student Spaceflight Experiment Program (SSEP), under the auspices of the National Center for Earth and Space Science Education and the Arthur C Clarke Institute for Space Education

The inositol phosphatase MTMR4 is a novel target of the ubiquitin ligase Nedd4

The inositol phosphatase, MTMR4 (myotubularin-related protein 4), was identified as a novel interactor of the ubiquitin ligase Nedd4 (neural-precursor-cell-expressed developmentally down-regulated 4). hMTMR4 (human MTMR4) and Nedd4 co-immunoprecipitated and co-localized to late endosomes. The PY (Pro-Tyr) motif of hMTMR4 binds to WW (Trp-Trp) domains of hNedd4. MTMR4 expression was decreased in atrophying muscle, whereas Nedd4 expression was increased and hMTMR4 was ubiquitinated by hNedd4, suggesting that this novel interaction may underlie the biological process of muscle breakdown

Determinants of Depressive Symptoms at 1 Year Following ICU Discharge in Survivors of $ 7 Days of Mechanical Ventilation : Results From the RECOVER Program, a Secondary Analysis of a Prospective Multicenter Cohort Study

Abstract : Background: Moderate to severe depressive symptoms occur in up to one-third of patients at 1 year following ICU discharge, negatively affecting patient outcomes. This study evaluated patient and caregiver factors associated with the development of these symptoms. Methods: This study used the Rehabilitation and Recovery in Patients after Critical Illness and Their Family Caregivers (RECOVER) Program (Phase 1) cohort of 391 patients from 10 medical/surgical university-affiliated ICUs across Canada. We determined the association between patient depressive symptoms (captured by using the Beck Depression Inventory II [BDI-II]), patient characteristics (age, sex, socioeconomic status, Charlson score, and ICU length of stay [LOS]), functional independence measure (FIM) motor subscale score, and caregiver characteristics (Caregiver Assistance Scale and Center for Epidemiologic Studies-Depression Scale) by using linear mixed models at time points 3, 6, and 12 months. Results: BDI-II data were available for 246 patients. Median age at ICU admission was 56 years (interquartile range, 45-65 years), 143 (58%) were male, and median ICU LOS was 19 days (interquartile range, 13-32 days). During the 12-month follow-up, 67 of 246 (27.2%) patients had a BDI-II score ≥ 20, indicating moderate to severe depressive symptoms. Mixed models showed worse depressive symptoms in patients with lower FIM motor subscale scores (1.1 BDI-II points per 10 FIM points), lower income status (by 3.7 BDI-II points; P = .007), and incomplete secondary education (by 3.8 BDI-II points; P = .009); a curvilinear relation with age (P = .001) was also reported, with highest BDI-II at ages 45 to 50 years. No associations were found between patient BDI-II and comorbidities (P = .92), sex (P = .25), ICU LOS (P = .51), or caregiver variables (Caregiver Assistance Scale [P = .28] and Center for Epidemiologic Studies Depression Scale [P = .74]). Conclusions: Increased functional dependence, lower income, and lower education are associated with increased severity of post-ICU depressive symptoms, whereas age has a curvilinear relation with symptom severity. Knowledge of risk factors may inform surveillance and targeted mental health follow-up. Early mobilization and rehabilitation aiming to improve function may serve to modify mood disorders

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Change in the Prevalence of Testing for Latent Tuberculosis Infection in the United States: 1999–2012

Purpose. There is no information on the change in prevalence of latent tuberculosis infection (LTBI) testing in the United States (US) following the introduction of the interferon gamma release assay (IGRA), a new and alternative diagnostic method for LTBI. The purpose of this study was to evaluate potential changes in the prevalence of LTBI testing in the US following the introduction of IGRA. Methods. This was a multiyear cross-sectional study using nationally representative data from the 1999-2000 and 2011-2012 US National Health and Nutrition Examination Surveys. Self-reported prevalence of LTBI testing was estimated among groups known to have increased LTBI risk. Descriptive statistics were used. Results. Compared to 1999-2000, significantly fewer individuals self-reported being tested for LTBI in 2011-2012 among Hispanic Americans (68.0% versus 60.7%, ) and among those with comorbidities (74.7% versus 72.0%, ). There were also nonsignificant trends towards less self-reported LTBI testing in 2011-2012 versus 1999-2000 among household contacts of active TB cases, foreign-born individuals, and African Americans. Conclusions. Despite the introduction of IGRA, LTBI testing occurs less frequently in the US among vulnerable groups. Possibly inadequate targeted LTBI testing could result in increased active TB in the US in the future.Peer Reviewe

Change in the Prevalence of Testing for Latent Tuberculosis Infection in the United States: 1999–2012

Purpose. There is no information on the change in prevalence of latent tuberculosis infection (LTBI) testing in the United States (US) following the introduction of the interferon gamma release assay (IGRA), a new and alternative diagnostic method for LTBI. The purpose of this study was to evaluate potential changes in the prevalence of LTBI testing in the US following the introduction of IGRA. Methods. This was a multiyear cross-sectional study using nationally representative data from the 1999-2000 and 2011-2012 US National Health and Nutrition Examination Surveys. Self-reported prevalence of LTBI testing was estimated among groups known to have increased LTBI risk. Descriptive statistics were used. Results. Compared to 1999-2000, significantly fewer individuals self-reported being tested for LTBI in 2011-2012 among Hispanic Americans (68.0% versus 60.7%, p<0.0001) and among those with comorbidities (74.7% versus 72.0%, p=0.02). There were also nonsignificant trends towards less self-reported LTBI testing in 2011-2012 versus 1999-2000 among household contacts of active TB cases, foreign-born individuals, and African Americans. Conclusions. Despite the introduction of IGRA, LTBI testing occurs less frequently in the US among vulnerable groups. Possibly inadequate targeted LTBI testing could result in increased active TB in the US in the future