Medical kit for single-handed offshore yacht races

Background: The medical kit is the basis of medical support in maritime environment; it is defined by international or national regulations and guidelines. For offshore races, rules and recommendations are proposed by national or international sailing federations. Sailing and racing offshore alone presents specificities that sometimes make it difficult to apply the usual recommendations. The epidemiology of single-handed offshore race is dominated by traumatic risks. Medical events are relatively rare because competitors are high-level athletes, generally young and subject to complete medical assessments. The scarcity of available scientific data makes it necessary to choose appropriate methods for developing recommendations. The purpose of this work is to propose a medical kit adapted and applicable to these situations. Materials and methods: The method used was that of “Professional recommendations by formal consensus of experts” derived from the Rand/UCLA method. After a critical analysis of the literature, a panel of 19 experts having expertise in medicine in maritime environment was gathered from various medical specialties (cardiologist, internist, intensivist and emergency physician, ear-nose-throat physician and general practitioner) and from varied medical activities. They had not declared any direct conflict of interest. Results: A medical kit proposal has been developed. The choice of drugs was based on the analysis of the epidemiology of medical events observed during the last offshore races. The experts’ choice was to reduce the quantity of medication and medical devices in order to limit the risk of confusion of medicines and dosages. Drugs with significant side effects or requiring third party monitoring have been removed. Medical devices designed to do an intervention impossible to perform on oneself have also been eliminated. Conclusions: Solo sailing remains a marginal maritime activity with specific risks. The development of single-handed races requires an adaptation of medical support through the development of a specific medical kit and adapted training. The formalised consensus of experts seems to be an appropriate method for developing recommendations in the field of maritime medicine

A new theta-type thermosensitive replicon from Lactoccocus lactis as an integration vector for Enterococcus faecalis

We isolated a replication thermosensitive mutant of the theta-type lactococcal pUCL22 replicon. An improved version of this thermosensitive replicon was obtained by fusioning the replication repA gene with the downstream repB gene. The resulting plasmid was named pUCB3522Ts. It is highly instable at 42°C in Enterococcus faecalis. Integration into the chromosome via homologous recombination was monitored using the npr gene of E. faecalis JH2-2 as a target. A 513 bp PCR amplification product from an internal region of this npr gene was cloned into pUCB3522Ts. Integration of this construction into the JH2-2 npr gene was selected by shift temperature, from 30°C to 42°C. 85% of the analysed clones showed integration into the npr gene, demonstrating the practicality of this thermosensitive replicon as a genetic integrative tool for E. faecali

Origins of house mice in ecological niches created by settled hunter-gatherers in the Levant 15,000 y ago

International audienceReductions in hunter-gatherer mobility during the Late Pleistoceneinfluenced settlement ecologies, altered human relations withanimal communities, and played a pivotal role in domestication.The influence of variability in human mobility on selection dynamicsand ecological interactions in human settlements has not beenextensively explored, however. This study of mice in modern Africanvillages and changingmicemolar shapes in a 200,000-y-long sequencefrom the Levant demonstrates competitive advantages for commensalmice in long-term settlements. Mice from African pastoralhouseholds provide a referential model for habitat partitioningamong mice taxa in settlements of varying durations. The datareveal the earliest known commensal niche for house mice in longtermforager settlements 15,000 y ago. Competitive dynamics andthe presence and abundance of mice continued to fluctuate withhuman mobility through the terminal Pleistocene. At the Natufiansite of Ain Mallaha, house mice displaced less commensal wild miceduring periods of heavy occupational pressure but were outcompetedwhen mobility increased. Changing food webs and ecologicaldynamics in long-term settlements allowed house mice to establishdurable commensal populations that expanded with human societies.This study demonstrates the changing magnitude of cultural nicheconstruction with varying human mobility and the extent of environmentalinfluence before the advent of farming

Preparation and medical follow-up for a single-handed transatlantic rowing race

Background: A single-handed transatlantic rowing race was organised between Senegal and French Guyana (2600 nautical miles). During the race, rowers adjust their lifestyle to maintain an optimal level of performance. Nutrition, circadian rhythm disturbance, psychological state, pain and other medical problems impact on physical abilities and increase the occurrence of accidents. We surveyed the prevalence of medical complications during this race and the preparation that we could suggest for this kind of activity. Materials and methods: This is a descriptive, retrospective case series study. Follow-up consisted of sending out a questionnaire and performing individual interviews. Results: A total of 23 participants including 1 woman and 22 men; mean age of 46.5 years (range: 35–59) entered the race. The race lasted for 39 to 52 days with participants rowing between 10 and 12 h/day. Nine participants dropped out. Energy intake was 4500 to 6000 kcal/day and fluid intake was 4 to 5.5 L/day. Mean weight loss was 13.3 kg. The resting period was 6 ± 1 h/24 h divided into 1.5 to 2 h periods essentially during darkness. A total of 92% of the racers required medical care for dermatological problems; other conditions requiring medical care were: tendinitis in 10 cases, diarrhoea in 4, moderate to severe seasickness in 4, hallucinations in 3, panic attacks in 2, burns in 2, and disembarkation syndrome (“land sickness”) lasting from 45 min to 6 h in 13. Conclusions: Physiological and psychological impact of this type of event is still unclear. The most common medical problems are dermatological, rheumatological complications and minor trauma. Medical and psychological preparation should be offered to candidates for these competitions.

The Extracytoplasmic Function Sigma Factor SigV Plays a Key Role in the Original Model of Lysozyme Resistance and Virulence of Enterococcus faecalis

Background: Enterococcus faecalis is one of the leading agents of nosocomial infections. To cause diseases, pathogens or opportunistic bacteria have to adapt and survive to the defense systems encountered in the host. One of the most important compounds of the host innate defense response against invading microorganisms is lysozyme. It is found in a wide variety of body fluids, as well as in cells of the innate immune system. Lysozyme could act either as a muramidase and/ or as a cationic antimicrobial peptide. Like Staphylococcus aureus, E. faecalis is one of the few bacteria that are completely lysozyme resistant. Results: This study revealed that oatA (O-acetyl transferase) and dlt (D-Alanylation of lipoteicoic acids) genes contribute only partly to the lysozyme resistance of E. faecalis and that a specific transcriptional regulator, the extracytoplasmic function SigV sigma factor plays a key role in this event. Indeed, the sigV single mutant is as sensitive as the oatA/dltA double mutant, and the sigV/oatA/dltA triple mutant displays the highest level of lysozyme sensitivity suggesting synergistic effects of these genes. In S. aureus, mutation of both oatA and dlt genes abolishes completely the lysozyme resistance, whereas this is not the case in E. faecalis. Interestingly SigV does not control neither oatA nor dlt genes. Moreover, the sigV mutants clearly showed a reduced capacity to colonize host tissues, as they are significantly less recovered than the parental JH2-2 strain from organs of mice subjected to intravenous or urinary tract infections

Tracking the Near Eastern origins and European dispersal of the western house mouse

Abstract: The house mouse (Mus musculus) represents the extreme of globalization of invasive mammals. However, the timing and basis of its origin and early phases of dispersal remain poorly documented. To track its synanthropisation and subsequent invasive spread during the develoment of complex human societies, we analyzed 829 Mus specimens from 43 archaeological contexts in Southwestern Asia and Southeastern Europe, between 40,000 and 3,000 cal. BP, combining geometric morphometrics numerical taxonomy, ancient mitochondrial DNA and direct radiocarbon dating. We found that large late hunter-gatherer sedentary settlements in the Levant, c. 14,500 cal. BP, promoted the commensal behaviour of the house mouse, which probably led the commensal pathway to cat domestication. House mouse invasive spread was then fostered through the emergence of agriculture throughout the Near East 12,000 years ago. Stowaway transport of house mice to Cyprus can be inferred as early as 10,800 years ago. However, the house mouse invasion of Europe did not happen until the development of proto urbanism and exchange networks — 6,500 years ago in Eastern Europe and 4000 years ago in Southern Europe — which in turn may have driven the first human mediated dispersal of cats in Europe

Systems medicine and integrated care to combat chronic noncommunicable diseases

We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century. This proposed holistic strategy involves comprehensive patient-centered integrated care and multi-scale, multi-modal and multi-level systems approaches to tackle NCDs as a common group of diseases. Rather than studying each disease individually, it will take into account their intertwined gene-environment, socio-economic interactions and co-morbidities that lead to individual-specific complex phenotypes. It will implement a road map for predictive, preventive, personalized and participatory (P4) medicine based on a robust and extensive knowledge management infrastructure that contains individual patient information. It will be supported by strategic partnerships involving all stakeholders, including general practitioners associated with patient-centered care. This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems

Energy Resolution Performance of the CMS Electromagnetic Calorimeter

The energy resolution performance of the CMS lead tungstate crystal electromagnetic calorimeter is presented. Measurements were made with an electron beam using a fully equipped supermodule of the calorimeter barrel. Results are given both for electrons incident on the centre of crystals and for electrons distributed uniformly over the calorimeter surface. The electron energy is reconstructed in matrices of 3 times 3 or 5 times 5 crystals centred on the crystal containing the maximum energy. Corrections for variations in the shower containment are applied in the case of uniform incidence. The resolution measured is consistent with the design goals

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio