Participative design of conservation agriculture cropping systems in organic agriculture

This paper compares to co-design processes aiming at defining innovative cropping systems that combine conservation agriculture and organic farming

Co-designing innovative cropping systems to improve soil functioning in organic farming

Organic agriculture is called upon to raise production to meet growing demand all the while ensuring the respect of the environment. In this context, improving the soil biological activity is crucial. Farmers are taking great interest in agroecological practices, such as conservation tillage associated with soil cover crops. The inclusion of these practices into current organic crop management systems calls for profound changes in the whole system.In this paper, we present aeight steps method to help farmers designing innovative prototypes of cropping systems. The method involves three design workshops, starting with a given decontextualized situation, before progressively integrating farmers‟ constraints. The method was run with two groups of six and seven farmers respectively in two different regions of France.Of the 28 completed prototypes designed, we present here only the seven most detailed. They differ greatly from current cropping systems in their increased use of cover crops (four times more frequent) and greatly decreased reliance on deep soil tillage (mouldboard plowing was eight times less frequent). Farmers initiated the adoption of these innovations by anticipating technical and pedoclimatic constraints. The method, involving researchers and farmers, produced conditions thatencouraged the famers to act creatively. Further studies in the form of ex post trials are necessary to accurately assess the consequences of such innovative cropping systems on soil functioning and crop performance

Vaccine breakthrough hypoxemic COVID-19 pneumonia in patients with auto-Abs neutralizing type I IFNs

Life-threatening `breakthrough' cases of critical COVID-19 are attributed to poor or waning antibody response to the SARS- CoV-2 vaccine in individuals already at risk. Pre-existing autoantibodies (auto-Abs) neutralizing type I IFNs underlie at least 15% of critical COVID-19 pneumonia cases in unvaccinated individuals; however, their contribution to hypoxemic breakthrough cases in vaccinated people remains unknown. Here, we studied a cohort of 48 individuals ( age 20-86 years) who received 2 doses of an mRNA vaccine and developed a breakthrough infection with hypoxemic COVID-19 pneumonia 2 weeks to 4 months later. Antibody levels to the vaccine, neutralization of the virus, and auto- Abs to type I IFNs were measured in the plasma. Forty-two individuals had no known deficiency of B cell immunity and a normal antibody response to the vaccine. Among them, ten (24%) had auto-Abs neutralizing type I IFNs (aged 43-86 years). Eight of these ten patients had auto-Abs neutralizing both IFN-a2 and IFN-., while two neutralized IFN-omega only. No patient neutralized IFN-ss. Seven neutralized 10 ng/mL of type I IFNs, and three 100 pg/mL only. Seven patients neutralized SARS-CoV-2 D614G and the Delta variant (B.1.617.2) efficiently, while one patient neutralized Delta slightly less efficiently. Two of the three patients neutralizing only 100 pg/mL of type I IFNs neutralized both D61G and Delta less efficiently. Despite two mRNA vaccine inoculations and the presence of circulating antibodies capable of neutralizing SARS-CoV-2, auto-Abs neutralizing type I IFNs may underlie a significant proportion of hypoxemic COVID-19 pneumonia cases, highlighting the importance of this particularly vulnerable population

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

Co-infection VIH et Histoplasma capsulatum variant capsulatum en France métropolitaine à l'ère des multithérapies anti-rétrovirales

L histoplasmose à Histoplasma capsulatum var. capsulatum est une mycose d importation en France métropolitaine. C est une infection opportuniste au cours de l infection à VIH définissant le SIDA dans sa forme extra-pulmonaire. Peu de données sont disponibles sur l histoplasmose au cours du SIDA dans les zones non endémiques ainsi que sur son pronostic et son évolution. Ce travail est une étude rétrospective recensant tous les cas de co-infection histoplasmose-VIH diagnostiqués en France métropolitaine entre 1997 et 2006. Soixante-quatre patients ont été identifiés. Les principales informations issues de l analyse de ces observations sont que l histoplasmose est une pathologie d importation pouvant survenir jusqu à 15 ans après le retour de zone d endémie, qu elle est fréquemment (42% des cas) révélatrice de l infection par le VIH et qu elle survient dans un contexte d immunodépression profonde (taux moyen de CD4 28/ L). Certains tableaux sont particulièrement évocateurs : atteinte cutanéo-muqueuse (45%), syndrome d activation macrophagique (14%). La mortalité élevée (23%) et précoce rend nécessaire un diagnostic rapide. Les moyens diagnostiques à privilégier sont les examens directs et les cultures (dont hémoculture). La sérologie a un faible intérêt et la place de la détection du galactomannane reste à établir. L incidence du syndrome inflammatoire de reconstitution immunitaire est remarquablement élevée (13%).Histoplasma capsulatum var. capsulatum histoplasmosis is not endemic in metropolitan France. Extra-pulmonary histoplasmosis is an AIDS-defining opportunistic infection. Few data are available about AIDS-related histoplasmosis in non-endemic areas. All (i.e. 64) AIDS-related histoplasmosis cases diagnosed in metropolitan France between 1997 and 2006 have been included in the retrospective study. Analysis of these cases indicated that histoplasmosis can occur more than 15 years after the last travel in an endemic area, that histoplasmosis is frequently (42%) the first HIV-infection manifestation and that patients with histoplasmosis are deeply immucompromised (mean CD4 count 28/ L). Muco-cutaneous lesions (45%) and hemophagocytic syndrome (14%) are suggestive of histoplasmosis. High early mortlaty rate (23%) is a plea for an ealier diagnosis. Direct examination and fungal cultures are the most useful diagnosis tools. Anti-histoplasma antibodies detection sensitvity is very low. The usefulness of galactomannan remains to be evaluated. Interestingly, immune restoration inflammatory syndrome is frequent (13%).ST QUENTIN EN YVELINES-BU (782972101) / SudocSudocFranceF

Farmers and agronomists design new biological agricultural practices for organic cropping systems in France

New organic cropping systems are needed to keep pace with the growing demand for organic food. Those systems should ideally give more yield and safe for the environment. Current innovations such as non-inversion tillage with cover crops are promising, but investigations usually do not take farmers view into account. Therefore, research work should include farmer participation to maximize success. We present here a method to help farmers in designing innovative cropping systems. This method involves several design workshops with farmers. The first steps of the method foster creativity by changing ways in which farmers thought and worked. The final steps of the method facilitated learning. Participatory tools are used to exchange views and knowledge. System prototypes were developed. The method was applied using groups of six and seven farmers from two French regions. The farmers generated 14 system prototypes. We found that system prototypes differed radically from current practices because prototypes are based on biological rather than mechanical methods. Indeed, cover crop use was almost four times more frequent in prototypes than in current systems. Moldboard plowing and mechanical weeding frequencies were, respectively, two and eight times lower. The main benefits of our method are (1) the involvement of volunteer farmers in the design process, (2) the combination of farmer knowledge and scientific knowledge, and (3) the use of various methodological supports

Soil fertility after 10 years of conservation tillage in organic farming

It has become commonplace to consider ploughing as an agricultural practice that destroys soil fertility. Organic farmers have traditionally used the plough to till their soil and control weeds. However, there is a growing interest in adopting tillage practices without ploughing to preserve long-term soil fertility and in the hope, subsequently, of increasing crop yields. The aim of this paper is to assess if conservation tillage treatments in organic farming did in fact improve long-term soil fertility, wheat rooting and yield in a long term field experiment (2004–2015). We compared the effects of conservation tillage treatments (superficial tillage – ST- with chisel at 15 cm depth and very superficial tillage – VST- at 5–7 cm depth) and conventional tillage treatments (traditional mouldboard ploughing- MP at 30 cm depth and shallow mouldboard ploughing – SMP- at 18 cm depth without skim coulter) during 10 years on a sandy loam soil in France. To assess soil fertility, physical (soil penetration resistance, visual soil profile observation), chemical (organic carbon – Corg, total nitrogen – Ntot and available phosphorus – OlsenP) and biotic (earthworms biomass, density and diversity) soil properties were measured in 2004-5 and 2015. The effect of soil fertility on wheat roots and crop growth was also measured in 2015. VST, and to a lesser extent ST, increased Corg, Ntot and OlsenP in the upper soil layer (from 0 to 15 cm) compared to ploughing treatments. On the contrary, soil compaction increased using conservation tillage treatments (VST and ST) during the 10 years of experiment, especially in the layers between 15 and 30 cm depth in comparison with ploughing treatments. This effect is not offset by an increase in earthworm abundance and activities in conservation treatments. Earthworm biomass and endogeic abundance were even higher in SMP compared to ST. Soil compaction limits roots, with less roots in depth with VST (from 12 to 30 cm and 48 to 70 cm) and ST (from 24 to 30 cm) compared to ploughing treatments. Conservation tillage treatments had positive effects on soil chemical components in the upper soil layer and contributed to the increase of wheat biomass until tillering stage. However, no wheat yield difference was found between treatments. Physical and biotic soil properties had not significantly improved after 10 years of conservation tillage. This could be due either to the insufficient duration of the experiment to foster a positive earthworm effect on soil porosity, or to the sandy soil, too sensitive to soil compaction in this organic cropping system (intensive mechanical weeding) and unfavourable for the development of the earthworm population

Imported acquired immunodeficiency syndrome-related histoplasmosis in metropolitan France: a comparison of pre-highly active anti-retroviral therapy and highly active anti-retroviral therapy eras.

International audienceHistoplasma capsulatum var. capsulatum infection is rare outside disease-endemic areas. Clinical presentation and outcome of acquired immunodeficiency syndrome-related histoplasmosis are unknown in non-endemic areas with wide access to highly active anti-retroviral therapy (HAART). Retrospective analysis of cases recorded at the French National Reference Center for Mycoses and Antifungals during two decades: pre-HAART (1985-1994) and HAART (1997-2006). Clinical features and outcome of all adults with proven acquired immunodeficiency syndrome-related histoplasmosis were compared between the two periods. One hundred four patients were included (40 during the pre-HAART era and 64 during the HAART era). Diagnosis was established a mean of 62 days after onset of symptoms. One-year overall mortality rates decreased from 53% (pre-HAART era) to 22% (HAART era). Diagnosis during the pre-HAART era and an older age were the only independent factors associated with death. Histoplasmosis is a rare invasive fungal infection outside disease-endemic areas. Its prognosis improved significantly during the HAART era

Outcomes of Patients Treated with Prehospital Noninvasive Ventilation: Observational Retrospective Multicenter Study in the Northern French Alps

International audienceNoninvasive ventilation (NIV) improves the outcome of acute cardiogenic pulmonary edema (AcPE) and acute exacerbation of chronic obstructive pulmonary disease (aeCOPD) but is not recommended in pneumonia. The aim of this study was to assess the appropriateness of the use of NIV in a prehospital setting, where etiological diagnostics rely mainly on clinical examination. This observational multicenter retrospective study included all the patients treated with NIV by three mobile medical emergency teams in 2015. Prehospital diagnoses and hospital diagnoses were extracted from the medical charts. The appropriateness of NIV was determined by matching the hospital diagnosis to the current guidelines. Among the 14,067 patients screened, 172 (1.2%) were treated with NIV. The more frequent prehospital diagnoses were AcPE (n = 102, 59%), acute respiratory failure of undetermined cause (n = 46, 28%) and aeCOPD (n = 17, 10%). An accurate prehospital diagnosis was more frequent for AcPE (83/88, 94%) than for aeCOPD (14/32, 44%; p < 0.01). Only two of the 25 (8%) pneumonia cases were diagnosed during prehospital management. Prehospital NIV was inappropriate for 32 (21%) patients. Patients with inappropriate NIV had a higher rate of in-hospital intubation than patients with appropriate NIV (38% vs. 8%; p < 0.001). This high frequency of inappropriate NIV could be reduced by an improvement in the prehospital detection of aeCOPD and pneumonia

Continued survival gains in recent years among critically ill myeloma patients.

International audienceOBJECTIVE: Therapeutic advances have improved survival in patients with myeloma (MM) over the past decade. We investigated whether survival has also improved in critically ill myeloma patients. DESIGN: Retrospective study. SETTING: Intensive care unit. PATIENT: Consecutive myeloma patients admitted to a teaching hospital ICU between 1990 and 2006. We compared three year-of-admission groups (1990-1995, 1996-2001, and 2002-2006) that matched changes in myeloma treatment (chemotherapy only, stem cell transplantation, and new molecules, respectively). INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: We included 196 patients. Reasons for ICU admission and patient characteristics were similar across groups; however, less use of conventional chemotherapy and radiotherapy and greater use of steroids were noted in the more recent periods. Over time, vasopressors and invasive mechanical ventilation were used decreasingly, and noninvasive ventilation increasingly, to treat acute respiratory failure. Hospital mortality decreased from 75% in 1990-1995 to 49% in 1996-2001 and 40% in 2002-2006 (P = 0.0007). Mortality was associated with poor performance status [OR 2.27, 95% CI (1.04-4.99)], need for mechanical ventilation [OR 4.33, 95% CI (1.86-10.10)], need for vasopressors [OR 2.57, 95% CI (1.12-5.86)], and admission for an event related to myeloma progression [OR 2.77, 95% CI (1.13-6.79)]. ICU admission within 48 h after hospital admission was associated with lower mortality [OR 0.28, 95% CI (0.19-0.89)]. CONCLUSION: Hospital mortality decreased significantly over the last 15 years in myeloma patients admitted to the ICU. Risk factors for death were organ failure and poor chronic health status. Early ICU admission was associated with lower mortality, suggesting opportunities for further improving survival