Epilepsy care delivery during COVID-19 in resource limited countries: A survey in collaboration with International Epilepsy Equity Group

Background: The impact of the pandemic has had worse effects in countries with already stretched healthcare resources. The study aim was to explore changes in epilepsy care delivery in resource-limited countries during and since the acute phase of the COVID-19 pandemic. Method: A cross-sectional survey was conducted in 22 countries among health care providers (HCPs) caring for persons with epilepsy (PWE), in collaboration with newly formed global collaborators, the International Epilepsy Equity Group. Findings were compared based on World Bank Ranking (WBR) and HCPs’ practice type. Data were analyzed using Chi-square tests (α= 0.05) and pairwise multiple comparisons with α= 0.017 (Bonferroni adjustment). Open-ended responses were analyzed using thematic analysis. Findings: A total of 241 HCPs participated in the study. Of these, 8.30%, 65.98%, and 21.99% were from high-income (HIC), upper-middle-income (UMIC), and lower-middle-income countries (LMICs), respectively. Among HCPs, 31.12% were adult specialists, and 43.98% were pediatric specialists. During the acute phase of the pandemic, HCPs reported that the major barrier for PWE was difficulty reaching physicians/healthcare providers. Except for difficulty reaching physicians/healthcare providers (WBR P=0.01 HIC<LMIC), no other significant differences in barriers during the acute phase were observed. Since the acute phase of the pandemic, the major concern for PWE was fear of getting infected with the SARS CoV-2 virus. Significant differences in concerns since the acute phase included lockdowns (WBR: P= 0.03 UMIC<LMIC), fiscal difficulties (WBR: P<0.001 UMICs<LMICs, UMICs<HIC; practice type: P= 0.006 adult<others, pediatrics < others), clinic closure (WBR: P=0.003 UMIC<HIC; practice type: P= <0.001 adult<others, pediatric<others), and long waiting times (WBR: P=0.005, LMIC<UMIC, LMIC<HIC; practice type: P=0.006 pediatric<adults). Diagnostic services, including EEG, MRI, CT (practice type: P<0.001, adult<others; pediatric<others), and lab work (WBR: P=0.01 UMIC<HIC), were restricted. The telephone was the most reported teleconsultation method used. Except for SMS/texting (WBR P= 0.02 UMIC<LMIC), there were no significant differences in teleconsultation methods used. Discussion: There is a high probability that the initial wave and consequent reduction of in-person care, restriction of health services, and fiscal difficulties affecting all involved in care deliver, led to disruption of epilepsy care. Additional supports are needed in resource-limited countries to cope with future pandemics

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Testing a global standard for quantifying species recovery and assessing conservation impact.

Recognizing the imperative to evaluate species recovery and conservation impact, in 2012 the International Union for Conservation of Nature (IUCN) called for development of a "Green List of Species" (now the IUCN Green Status of Species). A draft Green Status framework for assessing species' progress toward recovery, published in 2018, proposed 2 separate but interlinked components: a standardized method (i.e., measurement against benchmarks of species' viability, functionality, and preimpact distribution) to determine current species recovery status (herein species recovery score) and application of that method to estimate past and potential future impacts of conservation based on 4 metrics (conservation legacy, conservation dependence, conservation gain, and recovery potential). We tested the framework with 181 species representing diverse taxa, life histories, biomes, and IUCN Red List categories (extinction risk). Based on the observed distribution of species' recovery scores, we propose the following species recovery categories: fully recovered, slightly depleted, moderately depleted, largely depleted, critically depleted, extinct in the wild, and indeterminate. Fifty-nine percent of tested species were considered largely or critically depleted. Although there was a negative relationship between extinction risk and species recovery score, variation was considerable. Some species in lower risk categories were assessed as farther from recovery than those at higher risk. This emphasizes that species recovery is conceptually different from extinction risk and reinforces the utility of the IUCN Green Status of Species to more fully understand species conservation status. Although extinction risk did not predict conservation legacy, conservation dependence, or conservation gain, it was positively correlated with recovery potential. Only 1.7% of tested species were categorized as zero across all 4 of these conservation impact metrics, indicating that conservation has, or will, play a role in improving or maintaining species status for the vast majority of these species. Based on our results, we devised an updated assessment framework that introduces the option of using a dynamic baseline to assess future impacts of conservation over the short term to avoid misleading results which were generated in a small number of cases, and redefines short term as 10 years to better align with conservation planning. These changes are reflected in the IUCN Green Status of Species Standard

Evolution des teneurs en cuivre des huîtres du Bassin d'Arcachon: influence de la législation sur les peintures antisalissures

The ban of tributyltin compounds in antifouling paints induced a strong decrease in the level of tin in Arcachon bay. At the same time, copper inputs have increased tenfold since 1982 owing to the widespread use of paints containing cuprous oxide. In spite of this large input, the statistical analysis of monitoring data (1979-1985) show a relative stability in the copper levels in Arcachon bay oysters.L'interdiction de l'utilisation des peintures antisalissures à base de tributylétain a entraîné une diminution importante de la contamination en étain du bassin d'Arcachon. Parallèlement, les apports de cuivre ont décuplé à partir de 1982, du fait de l'emploi massif de peintures à base d'oxyde de cuivre. Malgré l'importance de ces apports, l'analyse statistique des données de surveillance de 1979 à 1985 met en évidence une relative stabilité des teneurs en cuivre des huîtres du bassin d'Arcachon

Copper levels evolution in Arcachon bay oysters : role of the regulation on antifouling paints

The ban of tributyltin compounds in antifouling paints induced a strong decrease in the level of tin in Arcachon bay. At the same time, copper inputs have increased tenfold since 1982 owing to the widespread use of paints containing cuprous oxide. In spite of this large input, the statistical analysis of monitoring data (1979-1985) show a relative stability in the copper levels in Arcachon bay oysters.L'interdiction de l'utilisation des peintures antisalissures à base de tributylétain a entraîné une diminution importante de la contamination en étain du bassin d'Arcachon. Parallèlement, les apports de cuivre ont décuplé à partir de 1982, du fait de l'emploi massif de peintures à base d'oxyde de cuivre. Malgré l'importance de ces apports, l'analyse statistique des données de surveillance de 1979 à 1985 met en évidence une relative stabilité des teneurs en cuivre des huîtres du bassin d'Arcacho

Sublethal and histopathological effects of trace levels of tributyltin fluoride on adult oysters

Shell malformations and histological effects of environmental concentrations of TBTF (2, 13.1 and 64.8 ng/l) were assessed on adult oysters Crassostrea gigas during a 1-month experiment, including both an exposure and a depuration phase. The results showed that the digestive gland is the primary target organ. Recoverable modifications were observed at the lowest concentration. Limited necrosis was observed at the highest concentration and a longer exposure could have led to extensive and irreversible tissue lesions. Shell malformations (chambering) were observed during the depuration phase. Finally the authors suggest that safe TBT levels in mariculture waters should be lower than 2 ng/1

Efficacy of selective PDE4D negative allosteric modulators in the object retrieval task in female cynomolgus monkeys (Macaca fascicularis).

Cyclic adenosine monophosphate (cAMP) signalling plays an important role in synaptic plasticity and information processing in the hippocampal and basal ganglia systems. The augmentation of cAMP signalling through the selective inhibition of phosphodiesterases represents a viable strategy to treat disorders associated with dysfunction of these circuits. The phosphodiesterase (PDE) type 4 inhibitor rolipram has shown significant pro-cognitive effects in neurological disease models, both in rodents and primates. However, competitive non-isoform selective PDE4 inhibitors have a low therapeutic index which has stalled their clinical development. Here, we demonstrate the pro-cognitive effects of selective negative allosteric modulators (NAMs) of PDE4D, D159687 and D159797 in female Cynomolgous macaques, in the object retrieval detour task. The efficacy displayed by these NAMs in a primate cognitive task which engages the corticostriatal circuitry, together with their suitable pharmacokinetic properties and safety profiles, suggests that clinical development of these allosteric modulators should be considered for the treatment of a variety of brain disorders associated with cognitive decline

Dosage automatique du mercure total dans les organismes marins par fluorescence atomique

SIGLEAvailable at INIST (FR), Document Supply Service, under shelf-number : RP 12592 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc