Usseau – Le Bourg

Identifiant de l'opération archéologique : 204718 Date de l'opération : 2008 (SD) L’opération de surveillance archéologique a été réalisée lors des travaux d’enfouissement de réseaux d’eau et d’électricité commandités par la Commune d’Usseau.  Ces travaux ont eu lieu dans le centre du Bourg d’Usseau, à l’emplacement des actuels réseaux de voirie. L’opération a consisté à observer et enregistrer les vestiges archéologiques rencontrés lors des phases d’ouverture des tranchées.  Les dimensions ..

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

Background: We previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15–20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in ~ 80% of cases. Methods: We report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded. Results: No gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5–528.7, P = 1.1 × 10−4) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR = 3.70[95%CI 1.3–8.2], P = 2.1 × 10−4). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR = 19.65[95%CI 2.1–2635.4], P = 3.4 × 10−3), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR = 4.40[9%CI 2.3–8.4], P = 7.7 × 10−8). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD] = 43.3 [20.3] years) than the other patients (56.0 [17.3] years; P = 1.68 × 10−5). Conclusions: Rare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old

Recommendations for malaria prevention in moderate to low risk areas : travellers' choice and risk perception

The considerable malaria decline in several countries challenges the strategy of chemoprophylaxis for travellers visiting moderate- to low-risk areas. An international consensus on the best strategy is lacking. It is essential to include travellers' opinions in the decision process. The preference of travellers regarding malaria prevention for moderate- to low-risk areas, related to their risk perception, as well as the reasons for their choices were investigated.; Prior to pre-travel consultation in the Travel Clinic, a self-administered questionnaire was given to travellers visiting moderate- to low-risk malaria areas. Four preventive options were proposed to the traveller, i.e., bite prevention only, chemoprophylaxis, stand-by emergency treatment alone, and stand-by emergency treatment with rapid diagnostic test. The information was accompanied by a risk scale for incidence of malaria, anti-malarial adverse drug reactions and other travel-related risks, inspired by Paling palettes from the Risk Communication Institute.; A total of 391 travellers were included from December 2012 to December 2013. Fifty-nine (15%) opted for chemoprophylaxis, 116 (30%) for stand-by emergency treatment, 112 (29%) for stand-by emergency treatment with rapid diagnostic test, 100 (26%) for bite prevention only, and four (1%) for other choices. Travellers choosing chemoprophylaxis justified their choice for security reasons (42%), better preventive action (29%), higher efficacy (15%) and easiness (15%). The reasons for choosing stand-by treatment or bite prevention only were less medication consumed (29%), less adverse drug reactions (23%) and lower price (9%). Those who chose chemoprophylaxis were more likely to have used it in the past (OR = 3.0 (CI 1.7-5.44)), but were not different in terms of demographic, travel characteristics or risk behaviour.; When travelling to moderate- to low-risk malaria areas, 85% of interviewees chose not to take chemoprophylaxis as malaria prevention, although most guidelines recommend it. They had coherent reasons for their choice. New recommendations should include shared decision-making to take into account travellers' preferences

Comparaison des systèmes de soins primaires français et catalan à travers la prise en charge d'une pathologie chronique (l'hypertension artérielle)

Le but de l'étude est de faire découvrir la pratique quotidienne des médecins généralistes français et catalan à travers la prise en charge d'une pathologie chronique telle que l'hypertension.La description puis l'analyse de ses deux exercices est dans les deux cas replacée dans leur contexte théorique permet de mettre en exergue les aspects positifs et négatifs de chacun des systèmes de soins.Cette étude desciptive a été menée à partir d'une expérience d'interne de médecine générale ambulatoire en France puis en catalogne.Les principales différences mises en évidence sont:-En espagne,la santé est entièrement décentralisée aux communautées autonomes.La prise en chargedu patient est multidisciplinaire et gratuite.En effet,la pratique de la médecine générale publique est majoritairement organisée autour de centres de santé où la prise en charge de la patientèle se fait en binôme avec une infirmière,où la présence de travailleurs sociaux est quotidien,où le personnel administratif est en grand nombre ,où la formation continue,les staffs,la recherche sont intégrés à la vie quotidienne des médecins.Le logiciel informatique est unique pour l'ensemble de la communauté autonome.Cependant les médecins catalans salariés ont un rythme de consultation très rapide,dans les villes ils ne font pas de pédiatrie ni de gynécologie,le réseau de soins est prédéterminé et le salaire des médecins est peu élevé.-la médecine générale française est classiquement libérale.Les avantages de cette organisation sont la liberté d'installation avec un libre choix des horaires,de la durée des consultations,de son réseau de professionnels consultants,restreinte au respects des conventions passées avec l'assurance maladie .La contrepartie est une charge administrative plus lourde,un travail plus solidaire,une rémunération à l'acte ne favorisant pas les actions de prévention et d'éducation thérapeutique.Le dépistage de masse est plus étendu qu'en catalogne mais la formation continue et surtout la recherche sont bien moins présents dans la pratique quotidienne des médecins généralistes.La pratique actuelle de la médecine générale voit se développer le salariat et un exercice beaucoup plus multidisciplinaire.MONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Les poissons et les oiseaux du Taillis des Coteaux (Antigny, Vienne), niveaux magdaléniens: origine naturelle ou culturel

International audienceNumerous fish and bird bones have been discovered in the Lower and Middle Magdalenians levels (IIIa and IIe) of the Taillis des Coteaux's cave (Antigny, Vienne, France). Before interpreting them as witnesses of fishing methods and bird hunting, one has to explore the question of accumulation agents. The taphonomic analysis takes into consideration density and spatial distribution of several kinds of remains: fish; birds; small vertebrates (essentially rodents); and, artifacts. This approach is enriched by combining observations on fauna remains: bone surfaces, age and sizes estimations. The analysis of spatial distribution indicates a clear concentration of small mammals, fish and birds located under the cave's porch. This spatial pattern shows that the small vertebrates of this concentration probably share a common taphonomic history. This hypothesis is reinforced by the fact that hunters and gatherers' artifacts are displaying a different distribution. By comparing ethological data with a combination of criteria (i.e.: fauna spectrum, percentage of species' representation, age and size of species), one can stipulate that this accumulation reflects the activity of a large nocturnal raptor. One also observes the involvement of a small carnivorous in the cave, as well as Magdalenian hunters depositing some bird remains and large salmonid bones. The findings therefore demonstrate a mixed accumulation to which participated big nocturnal raptors, carnivorous and humans.Les niveaux attribués au Magdalénien inférieur (IIIa) et moyen (IIe) de la grotte du Taillis des Coteaux (Antigny, Vienne) ont livré de nombreux restes de poissons et d'oiseaux. Avant de les interpréter comme des témoins de pratiques de pêche ou de chasse aux oiseaux, la question de(s) (l')agent(s) accumulateur(s) se pose. L'analyse taphonomique mise en oeuvre est fondée essentiellement sur la densité et la répartition spatiale de diverses catégories de vestiges: les poissons, les oiseaux, les petits vertébrés - rongeurs pour l'essentiel- ainsi que les vestiges anthropogènes. Cette approche est complétée par de premières observations concernant les surfaces osseuses, les estimations des âges et tailles des individus. L'analyse de la répartition spatiale indique une nette concentration, sous le porche de la grotte, de micromammifères mêlés à des poissons et des oiseaux. Cette disposition indique que les petits vertébrés de cette concentration partagent vraisemblablement une histoire taphonomique commune. Cette hypothèse est renforcée par le fait que cette localisation contraste avec la répartition spatiale des vestiges accumulés assurément par les chasseurs-cueilleurs. En mettant en parallèle les données éthologiques avec une combinaison de critères, incluant spectre faunique, pourcentage de représentation des espèces, âges et tailles des espèces, il apparaît que cette accumulation pourrait être le reflet de l'activité d'un grand rapace nocturne. On note par ailleurs l'intervention d'un petit carnivore dans la grotte, ainsi que la participation des chasseurs magdaléniens dans l'introduction de certains restes d'oiseaux et de Salmonidés de grande taille. Cette approche conclut donc à une origine mixte de l'accumulation à laquelle ont contribué grands rapaces nocturnes, carnivores et Hommes

Résultats préliminaires d'une thérapie cognitive basée sur la pleine conscience (MBCT) appliquée à un groupe de patients phobiques sociaux

International audienceObjectives The aim of this exploratory study is twofold: one the one hand present a Mindfulness-Based Cognitive group Therapy intervention, built on model of Segal and adapted to social phobic patients. One the other hand, provide short-term results from a first group of patients who benefited from this therapy. Patients The study involves 9 participants (2 men) aged 27-55 years. Participants are social phobic outpatients who followed a Mindfulness-Based Cognitive group Therapy proposed in a health center. The goals of the therapy were: learn to better manage emotions, reduce anxiety, improve self-esteem, learn to know themselves better, to live in the moment and not to fear the judgment of the other. Before participation, all subjects were informed of the assessment procedure and gave their free and informed consent. Patients completed questionnaires before the start of treatment and after the treatment. The questionnaires administered assessed the depressive and anxious symptomatology assertiveness, self-esteem, strategies of emotional regulation, thoughts in social interaction, the tendency to perfectionism, positive and negative affectivity, and mindfulness skills. Psychotherapy was held over 8 sessions of 2 hours per week and exercises between sessions. It was led by a psychologist trained in behavioral and cognitive therapies, and mindfulness, an occupational therapist also trained in behavioral and cognitive therapies, more two interns psychologists. Sessions focused on methods of learning the centering of attention on the present moment, body awareness and the use of cognitive tools. To evaluate the short-term effects of the treatment, we compared the questionnaires' scores of patients to two stroke of the evaluation. Results The first results are suggesting an improvement after surgery for several dimensions evaluated: anxiety, depression, assertiveness, ruminations, non-adaptive emotion regulation strategies, and mindfulness capacity of non-judgment. However, the results are less conclusive as regards mindfulness capabilities. We present and discuss the initial results in relation to the already published studies and in taking account the limitations of the study: small staff, no control group, sex ratio. Conclusions The first results are encouraging. They suggest to replicate the study with other social phobic patients to verify the effectiveness of MBCT on social phobia

Data from: Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation

Objectives: Extracorporeal membrane oxygenation support is indicated in severe and refractory respiratory or circulatory failures. Neurological complications are typically represented by acute ischemic or hemorrhagic lesions, which induce higher morbidity and mortality. The primary goal of this study was to assess the prognostic value of cerebral tissue oxygen saturation (StcO2) on mortality in neonates and young infants treated with ECMO. A secondary objective was to evaluate the association between StcO2 and the occurrence of cerebral lesions. Study Design: This was a prospective study in infants < 3 months of age admitted to a pediatric intensive care unit and requiring ECMO support. Measurements: The assessment of cerebral perfusion was made by continuous StcO2 monitoring using near-infrared spectroscopy (NIRS) sensors placed on the two temporo-parietal regions. Neurological lesions were identified by MRI or transfontanellar echography. Results: Thirty-four infants <3 months of age were included in the study over a period of 18 months. The ECMO duration was 10±7 days. The survival rate was 50% (17/34 patients), and the proportion of brain injuries was 20% (7/34 patients). The mean StcO2 during ECMO in the non-survivors was reduced in both hemispheres (p = 0.0008 right, p = 0.03 left) compared to the survivors. StcO2 was also reduced in deceased or brain-injured patients compared to the survivors without brain injury (p = 0.002). Conclusion: StcO2 appears to be a strong prognostic factor of survival and of the presence of cerebral lesions in young infants during ECMO

Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation.

Extracorporeal membrane oxygenation support is indicated in severe and refractory respiratory or circulatory failures. Neurological complications are typically represented by acute ischemic or hemorrhagic lesions, which induce higher morbidity and mortality. The primary goal of this study was to assess the prognostic value of cerebral tissue oxygen saturation (StcO2) on mortality in neonates and young infants treated with ECMO. A secondary objective was to evaluate the association between StcO2 and the occurrence of cerebral lesions.This was a prospective study in infants < 3 months of age admitted to a pediatric intensive care unit and requiring ECMO support.The assessment of cerebral perfusion was made by continuous StcO2 monitoring using near-infrared spectroscopy (NIRS) sensors placed on the two temporo-parietal regions. Neurological lesions were identified by MRI or transfontanellar echography.Thirty-four infants <3 months of age were included in the study over a period of 18 months. The ECMO duration was 10±7 days. The survival rate was 50% (17/34 patients), and the proportion of brain injuries was 20% (7/34 patients). The mean StcO2 during ECMO in the non-survivors was reduced in both hemispheres (p = 0.0008 right, p = 0.03 left) compared to the survivors. StcO2 was also reduced in deceased or brain-injured patients compared to the survivors without brain injury (p = 0.002).StcO2 appears to be a strong prognostic factor of survival and of the presence of cerebral lesions in young infants during ECMO