Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Littérature et champ symbolique (essai pour une théorie de l'écriture actuelle en Afrique francophone)

L'objet premier de cette étude est de tenter "un essai pour une théorie de l'écriture littéraire actuelle en Afrique francophone". Accessoirement, il devait servir à redéfinir à travers une " autre " lecture du fait littéraire africain francophone, la nature et la fonction des littératures des pays dominés.Dans une perspective historiciste, il est apparu que la littérature africaine francophone dans son ensemble a pu se constituer depuis les années 1930 en un monde social " autonome " dont les propriétés générales reposent principalement sur les catégories culturelles dites " orales " et " traditionnelles ". D'un point de vue pratique, l'oralité et la tradition orale africaine loin d'être invariablement le prolongement de la proclamation d'une " âme nègre " demeurent essentiellement la " règle du jeu littéraire africain ". Objets d'enjeux et lieux de tension, l'oralité et la tradition orale servent aux écrivains du champ africain dans leur besoin de positionnement structural: aux pionniers (Césaire/Senghor) pour le maintien de leur statut de "dominants", aux prétendants (Pacéré/Zadi) pour leur prétention à la " classicité ". Stratégiquement porteurs et symboliquement riches en ressources, les items oraux et traditionnels subissent toutes sortes d'amplications, de grossissement et d'extrapolation (discours identitaires, manipulation de la racine et de la pureté, argument du sacré et du secret). En tout état de cause, l'acte littéraire en Afrique ou en francophonie , comme l'acte politique ou économique est un " acte calculé " dont la rationalité pour être saisie nécessite la parfaite connaissance de ce qu'il est convenu d'appeler suivant la terminologie bourdieusienne un " champ symbolique " et/ou le " champ littéraire africain "The first step of this study is to try an essay of a theory for the present litérary writing in the french-speaking communities of Africa . secondarily, the purpsose was to give another definition, through another reading of the african french-speaking literary fact, the nature and the function of the dominated contries literatures.In a historicity perspective, it appeared that the african french speaking literature, in its all, has been set-up since 1930 in an autonomous social word, which general copyrights are principally based on the cultural catégories, knows as the oral and traditional ones.On a pratical point of view, the oral way and the african oral tradition, far to invariably be the extension of the proclamation of a negro soul , are essentially the rule of the african literary game .Subjects of stakes and places of tensions, the oral way and the oral tradition are used by writers of the african field, in their need of structural setting up: the pioneers (Césaire/Senghor) for the maintaining of their dominant status ; the pretenders (Pacéré/Zadi) for their pretentiousness for the classicism . Strategically beneficial and symbolically rich of resources, the oral and the traditional items suffer from all kind of amplifications, of magnifications and extrapolations (speechs relating to the identity, manipulation of the roots and the purity, arguments of the sacred and secret ).In all case , the literary act in Africa or in the french-speaking communities, like the political or economical act is a calculated act that the rationality to be hold , needs a perfect knowledge of what has been agreed to call, following the Bourdieu's terminology a symbolic field and/or the african literary field .CERGY PONTOISE-BU Les Cerclades (951272104) / SudocSudocFranceF

MACVIA Clinical Decision Algorithm in Allergic Rhinitis in adolescents and adults

International audienceThe selection of pharmacotherapy for patients with allergic rhinitis depends on several factors, including age, prominent symptoms, symptom severity, control of allergic rhinitis, patient preferences and cost. Allergen exposure and resulting symptoms vary and treatment adjustment is required. Clinical decision support systems (CDSS) may be beneficial for the assessment of disease control. Clinical decision support systems should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine the treatment and its step-up or step-down strategy depending on AR control. MACVIA-LR (Fighting chronic diseases for active and healthy ageing) one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (MASK: MACVIA-ARIA Sentinel networK). A clinical decision support system is currently being developed to optimize allergic rhinitis control. An algorithm developed by consensus is presented in this paper. This algorithm should be confirmed by appropriate trials