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

Présence et évasion : l’hypnothérapie en milieu carcéral

Un psychologue clinicien au sein d’un établissement pénitentiaire exerce dans un contexte bien loin de celui du soin, ce qui nécessite des aménagements thérapeutiques. L’introduction de l’hypnose dans notre pratique carcérale nous a permis d’ouvrir des espaces pour le patient comme pour le thérapeute. Pourtant il n’est pas si simple de faire de l’hypnose avec les détenus, la relation à autrui étant en effet problématique pour beaucoup. La rencontre avec Léo, un jeune homme d’une vingtaine d’années, diagnostiqué psychopathe et incarcéré pour assassinat a permis l’émergence de ce travail de recherche et de construire notre posture de clinicien-chercheur. Au fil de cette rencontre ancrée dans la réalité carcérale, nous avons pensé un dispositif innovant : la transe musicale. C’est au travers de cette authentique expérience clinique que nous avons élaboré une méthodologie afin d’évaluer cette prise en charge créative auprès de patients psychopathes incarcérés

Neurological and physiological disorders in Artemia harboring manipulative cestodes.

5 pagesInternational audienceThere are many impressive examples of host manipulation by parasites, but mechanisms underlying these ethological changes, as well as their physiological consequences, are not well characterized. Here, we analyzed part of the cerebral proteome of brine shrimp Artemia infected by manipulative cestodes, using for the first time the ProteinChip Surface-Enhanced Laser Desorption Ionization and Time of Fly Mass Spectrometry (SELDI-TOF MS) system, which has been proposed as an excellent way to analyze the host genome during the host-parasite interaction processes. We found 2 peptides downregulated in individuals infected by the dilepidid, Anomotaenia tringae (4.5 kDa), and by the 2 hymenolepidids, Flamingolepis liguloides and Confluaria podicipina (3.9 kDa), which are potential candidates for involvement with the manipulation process. The identification of 2 head peptides (4.1 and 4.2 kDa) overexpressed in all the categories in brine shrimp living at the surface (both infected individuals and uninfected controls) suggests its association with the different environmental conditions experienced at the water surface. In parallel, brine shrimp infected by C. podicipina showed significant values of triglycerides, potentially augmenting their profitability and attractiveness for the predaceous definitive host (grebes). We discuss our findings in relationship with current ideas on the complexity of parasitically modified organisms

Extubation of patients undergoing extracorporeal life support. A retrospective study

IF 1.147International audienceIntroduction:The use of extracorporeal life support (ECLS) is increasing worldwide, in particular for the management of refractory cardiac arrest, cardiogenic shock and post cardiopulmonary bypass ventricular failure. Extubation of patients under extracorporeal membrane oxygenation (ECMO) for respiratory failure is a growing practice for adult and pediatric patients, especially for lung transplantation candidates. Because of potential complications and, specifically, accidental arterial decannulation, extubation of patients under ECLS is not standard practice. Our goal was to evaluate the interest in patient extubation under ECLS.Materials and methods:We performed a monocentric, retrospective study of all ECLS cases between January 2014 and January 2016. We excluded patients who died within the first 48 hours of ECLS.Results:We analyzed 57 of the initial 109 patients included in the study. The initial SOFA score was higher in the non-extubated group under ECLS, without significant difference (8.6 ± 2.8 vs 7.2 ± 2.1, p=0.065). Patients who were not extubated had a higher rate of acquired ventilator pneumonia (61.9% vs 26.7%, p=0.03). Moreover, patients who were extubated under ECLS had better 30-day survival rates (73.3% vs 40.5%, p=0.04). In multivariate analyses, the independent factors associated with mortality were age, duration of ECLS and the lack of extubation under ECLS.Conclusion:Extubation of patients under ECLS is safe and feasible. Furthermore, in extubated patients, we observed fewer cases of ventilator-associated pneumonia and better 30-day survival rates

Species identification of fish shoals using coupled split-beam and multibeam echosounders and two scuba-diving observational methods

Species identification remains crucial for interpreting acoustic backscatter delivered by active acoustic meth-odologies. The study took place in a Marine Protected Area where highly restricted areas were present such as no take zones. We used an innovative methodology coupling split-beam and multibeam echosounders to detect and classify monospecific fish shoals (i.e. schools or aggregations). Species identifications were realised by under-water visual censuses made by scientific divers. Two experimental protocols, where the divers gave the identi-fications instantaneously thanks to a communication wireframe, were tested: three roving scuba divers locating the shoals or a towed scuba diver directly behind the vessel. Energy responses, 3-D morphological, shape indexes and spatial descriptive variables of multiple independent samples of 4 observed fish species shoals (Atherina sp., Boops boops, Chromis chromis and Spicara maena) were calculated from the acoustic data. According to their behaviour and feeding strategy, significant differences in the acoustic variables were found between species. The combined use of acoustic data from both echosounders significantly improved the fish species classification. They were well discriminated using a Linear Discriminant Analysis (LDA), including for B. boops, C. chromis and S. maena, which were all observed in aggregations. Finally, we used this LDA model to allocate species to un-known shoals monitored by acoustics methods in the studied site, highlighting the interest of our methodology to predict bentho-pelagic and pelagic fish distributions in shallow waters. We suggest that these acoustic methods to discriminate fish species could provide valuable insights for marine management and decision-making

First resolved observations of a highly asymmetric debris disc around HD 160305 with VLT/SPHERE★★★

International audienceContext. Direct imaging of debris discs gives important information about their nature, their global morphology, and allows us to identify specific structures possibly in connection with the presence of gravitational perturbers. It is the most straightforward technique to observe planetary systems as a whole.Aims. We present the first resolved images of the debris disc around the young F-type star HD 160305, detected in scattered light using the VLT/SPHERE instrument in the near infrared.Methods. We used a post-processing method based on angular differential imaging and synthetic images of debris discs produced with a disc modelling code (GRaTer) to constrain the main characteristics of the disc around HD 160305. All of the point sources in the field of the IRDIS camera were analysed with an astrometric tool to determine whether they are bound objects or background stars.Results. We detect a very inclined (~82°) ring-like debris disc located at a stellocentric distance of about 86 au (deprojected width ~27 au). The disc displays a brightness asymmetry between the two sides of the major axis, as can be expected from scattering properties of dust grains. We derive an anisotropic scattering factor g > 0.5. A second right-left asymmetry is also observed with respect to the minor axis. We measure a surface brightness ratio of 0.73 ± 0.18 between the bright and the faint sides. Because of the low signal-to-noise ratio (S/N) of the images we cannot easily discriminate between several possible explanations for this left-right asymmetry, such as perturbations by an unseen planet, the aftermath of the breakup of a massive planetesimal, or the pericenter glow effect due to an eccentric ring. Two epochs of observations allow us to reject the companionship hypothesis for the 15 point sources present in the field

Antitumor immunity induced by antibody-based natural killer cell engager therapeutics armed with not-alpha IL-2 variant

International audienceHarnessing innate immunity is emerging as a promising therapeutic approach in cancer. We report here the design of tetraspecific molecules engaging natural killer (NK) cell-activating receptors NKp46 and CD16a, the β-chain of the interleukin-2 receptor (IL-2R), and a tumor-associated antigen (TAA). In vitro, these tetraspecific antibody-based natural killer cell engager therapeutics (ANKETs) induce a preferential activation and proliferation of NK cells, and the binding to the targeted TAA triggers NK cell cytotoxicity and cytokine and chemokine production. In vivo, tetraspecific ANKETs induce NK cell proliferation and their accumulation at the tumor bed, as well as the control of local and disseminated tumors. Treatment of non-human primates with CD20-directed tetraspecific ANKET leads to CD20+ circulating B cell depletion, with minimal systemic cytokine release and no sign of toxicity. Tetraspecific ANKETs, thus, constitute a technological platform for harnessing NK cells as next-generation cancer immunotherapies