Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030: a modelling study.

BACKGROUND: The past two decades have seen expansion of childhood vaccination programmes in low-income and middle-income countries (LMICs). We quantify the health impact of these programmes by estimating the deaths and disability-adjusted life-years (DALYs) averted by vaccination against ten pathogens in 98 LMICs between 2000 and 2030. METHODS: 16 independent research groups provided model-based disease burden estimates under a range of vaccination coverage scenarios for ten pathogens: hepatitis B virus, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, Streptococcus pneumoniae, rotavirus, rubella, and yellow fever. Using standardised demographic data and vaccine coverage, the impact of vaccination programmes was determined by comparing model estimates from a no-vaccination counterfactual scenario with those from a reported and projected vaccination scenario. We present deaths and DALYs averted between 2000 and 2030 by calendar year and by annual birth cohort. FINDINGS: We estimate that vaccination of the ten selected pathogens will have averted 69 million (95% credible interval 52-88) deaths between 2000 and 2030, of which 37 million (30-48) were averted between 2000 and 2019. From 2000 to 2019, this represents a 45% (36-58) reduction in deaths compared with the counterfactual scenario of no vaccination. Most of this impact is concentrated in a reduction in mortality among children younger than 5 years (57% reduction [52-66]), most notably from measles. Over the lifetime of birth cohorts born between 2000 and 2030, we predict that 120 million (93-150) deaths will be averted by vaccination, of which 58 million (39-76) are due to measles vaccination and 38 million (25-52) are due to hepatitis B vaccination. We estimate that increases in vaccine coverage and introductions of additional vaccines will result in a 72% (59-81) reduction in lifetime mortality in the 2019 birth cohort. INTERPRETATION: Increases in vaccine coverage and the introduction of new vaccines into LMICs have had a major impact in reducing mortality. These public health gains are predicted to increase in coming decades if progress in increasing coverage is sustained. FUNDING: Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation

Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030: a modelling study.

BACKGROUND: The past two decades have seen expansion of childhood vaccination programmes in low-income and middle-income countries (LMICs). We quantify the health impact of these programmes by estimating the deaths and disability-adjusted life-years (DALYs) averted by vaccination against ten pathogens in 98 LMICs between 2000 and 2030. METHODS: 16 independent research groups provided model-based disease burden estimates under a range of vaccination coverage scenarios for ten pathogens: hepatitis B virus, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, Streptococcus pneumoniae, rotavirus, rubella, and yellow fever. Using standardised demographic data and vaccine coverage, the impact of vaccination programmes was determined by comparing model estimates from a no-vaccination counterfactual scenario with those from a reported and projected vaccination scenario. We present deaths and DALYs averted between 2000 and 2030 by calendar year and by annual birth cohort. FINDINGS: We estimate that vaccination of the ten selected pathogens will have averted 69 million (95% credible interval 52-88) deaths between 2000 and 2030, of which 37 million (30-48) were averted between 2000 and 2019. From 2000 to 2019, this represents a 45% (36-58) reduction in deaths compared with the counterfactual scenario of no vaccination. Most of this impact is concentrated in a reduction in mortality among children younger than 5 years (57% reduction [52-66]), most notably from measles. Over the lifetime of birth cohorts born between 2000 and 2030, we predict that 120 million (93-150) deaths will be averted by vaccination, of which 58 million (39-76) are due to measles vaccination and 38 million (25-52) are due to hepatitis B vaccination. We estimate that increases in vaccine coverage and introductions of additional vaccines will result in a 72% (59-81) reduction in lifetime mortality in the 2019 birth cohort. INTERPRETATION: Increases in vaccine coverage and the introduction of new vaccines into LMICs have had a major impact in reducing mortality. These public health gains are predicted to increase in coming decades if progress in increasing coverage is sustained. FUNDING: Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation

On shear layer atomization within closed channels: Numerical simulations of a cough-replicating experiment

Aerosol generation during coughing and sneezing has gained major relevance due to the current COVID pandemic. The atomization involved in this process takes place in the complex context of the respiratory system and develops very rapidly. In order to get further insights on the early spray generation, we introduce a simplified model of physiological coughing or sneezing, in the form of a thin liquid layer subject to a rapid (30 m/s) air stream. The setup is simulated using the Volume-Of-Fluid method with octree mesh adaptation, the latter allowing grid sizes small enough to capture the Kolmogorov length scale. The results confirm the trend to an intermediate distribution between a Log-Normal and a Pareto distribution P(d)∝d−3.3 for the distribution of droplet sizes in agreement with a previous re-analysis of experimental results by one of the authors. The mechanism of atomization does not differ qualitatively from the multiphase mixing layer experiments and simulations. No mechanism for a bimodal distribution, also sometimes observed, is evidenced in these simulations.Fil: Pairetti, César Ignacio. Université Pierre et Marie Curie; Francia. Universidad Nacional de Rosario; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones en Métodos Computacionales. Universidad Nacional del Litoral. Centro de Investigaciones en Métodos Computacionales; ArgentinaFil: Villiers, Raphaël. Université Pierre et Marie Curie; FranciaFil: Zaleski, Stéphane. Université Pierre et Marie Curie; Franci

Guidelines on the use of ultrasound guidance for vascular access

Insertion of vascular access is a common procedure with potential for iatrogenic events, some of which can be serious. The spread of ultrasound scanners in operating rooms, intensive care units and emergency departments has made ultrasound-guided catheterisation possible. The first guidelines were published a decade ago but are not always followed in France. The French Society of Anaesthesia and Intensive Care has decided to adopt a position on this issue through its Guidelines Committee in order to propose a limited number of simple guidelines. The method used was the GRADE(®) method using the most recently published meta-analyses as the source of references. The level of evidence found ranged from low to high and all the positive aspects associated with ultrasound guidance, i.e. fewer traumatic complications at puncture, probably or definitely outweigh the potential adverse consequences regardless of whether an adult or child is involved and regardless of the site of insertion

Time to and differential time to blood culture positivity for assessing catheter‐related yeast fungaemia: A longitudinal, 7‐year study in a single university hospital

International audienceTime to positivity (TTP) and differential time to positivity (DTTP) between central and peripheral blood cultures are commonly used for bacteraemia to evaluate the likelihood of central venous catheter (CVC)-related bloodstream infection. Few studies have addressed these approaches to yeast fungaemia

La construction du militaire, Volume 3

Troisième volet du programme de recherche intitulé « la construction du militaire », cet ouvrage revient sur les pratiques discursives et langagières qui accompagnent la formation d’une société militaire en Europe. Prismes par lesquels les individus pensent et disent le monde qui les entoure, les formes du langage et leurs usages sociaux portent en effet les systèmes de représentation sur lesquels se construisent les identités individuelles et collectives. Lieu de la mise en scène de soi, pratique de distinction et facteur d’intégration, les usages de la langue contribuent activement à l’affirmation des sociétés et des identités militaires. En ce sens, elles sont un puissant vecteur de la cohésion au sein des armées en général, et des différents corps qui la composent en particulier. Elles sont encore un important médiateur du jeu social et des relations avec le reste du corps politique, mais également un enjeu de pouvoir. Les contributions de ce volume proposent ainsi une réflexion sur la façon dont les mots et les discours ont pris part à la construction d’une identité militaire durant une longue époque moderne courant de la fin du XVe siècle au XIXe siècle. Elles reviennent sur les enjeux politiques, institutionnels et sociaux de la désignation du militaire. Des côtes atlantiques à la grande plaine hongroise, des dernières guerres médiévales aux guerres de la révolution et de l’Empire, elles invitent à réfléchir sur ce long processus qui, de la formation d’une armée permanente à l’aube de la guerre industrielle, a transformé le guerrier en combattant de troupes régulières, et sur la manière dont l’État, la société et les militaires eux-mêmes ont façonné une condition militaire, soigneusement séparée de la condition civile

La traversée France-Angleterre du Moyen Âge à nos jours

La septième édition du colloque européen du Calaisis, fondé en 1993 sous l’égide de nombreux mécènes, dont la ville de Calais, se devait de mettre à l’honneur, sous la présidence du Professeur Jean-Philippe Genet, le célèbre exploit de Louis Blériot en choisissant le thème de la traversée du détroit, du Moyen Âge à nos jours. Une vingtaine de contributions de spécialistes universitaires, suivies par un public toujours plus nombreux, sont ici rassemblées : elles abordent ce thème pris dans son acception la plus large, étudiant à la fois ses aspects humains, économiques, politiques et culturels. Si les premières conférences abordent les échanges religieux et scolaires, le Moyen Âge tardif met en valeur la guerre, la diplomatie et de facto annonce la période moderne. Plus variées demeurent les interventions contemporaines. L’horizon s’élargit, le détroit est privilégié sur le plan sportif et dans le domaine économique : sur ce point, la géographie s’impose à l’historien. Une référence au général De Gaulle, qui a épousé une Calaisienne, mérite une mention particulière, introduisant au prochain colloque : « De Gaulle, Vendroux et la Résistance »

Défense et colonies dans le mode atlantique

La découverte puis l'exploitation de l'Afrique, de l'Asie et de l'Amérique par les Européens dès le XVe siècle ont conduit à une progressive militarisation de ces espaces, tant terrestres que maritimes. S'imposant aux pouvoirs politiques locaux ou faisant face aux convoitises étrangères, cette mise en défense par les différentes puissances européennes a contraint à un déploiement logistique spécifique et une adaptation aux différents terrains coloniaux. Construction de fortifications outre-mer, établissement de stations et de bases navales, recrutement et formation des milices ou encore élaboration de tactiques militaires deviennent des préoccupations permanentes même si toutes ces réalisations connaissent des évolutions heurtées en fonction des conjonctures, des disponibilités financières de chacun des États, des possibilités techniques et parfois de l'intelligibilité stratégique des décideurs. En outre, loin de suivre des trajectoires uniquement nationales, ce déploiement est également intelligible à l'aune de la circulation de l'information militaire, des modèles défensifs et par l'interprétation et la pondération des différents transferts techniques entre les espaces coloniaux. Les contributions de ce volume, qui ont été présentées à l'occasion de deux journées d'études organisées en 2012 et 2013 par le Centre de Recherches en Histoire Internationale et Atlantique (CRHIA) de l'université de Nantes, réfléchissent à ces différents aspects en montrant l'évolution de la mise en défense coloniale des débuts de l'époque moderne à l'âge atomique. Partant d'études de cas ou analysant plus globalement cette projection militaire, les auteurs apportent des éléments pour penser l'émergence d'un « système de défense atlantique »

Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030: a modelling study.

BACKGROUND: The past two decades have seen expansion of childhood vaccination programmes in low-income and middle-income countries (LMICs). We quantify the health impact of these programmes by estimating the deaths and disability-adjusted life-years (DALYs) averted by vaccination against ten pathogens in 98 LMICs between 2000 and 2030. METHODS: 16 independent research groups provided model-based disease burden estimates under a range of vaccination coverage scenarios for ten pathogens: hepatitis B virus, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, Streptococcus pneumoniae, rotavirus, rubella, and yellow fever. Using standardised demographic data and vaccine coverage, the impact of vaccination programmes was determined by comparing model estimates from a no-vaccination counterfactual scenario with those from a reported and projected vaccination scenario. We present deaths and DALYs averted between 2000 and 2030 by calendar year and by annual birth cohort. FINDINGS: We estimate that vaccination of the ten selected pathogens will have averted 69 million (95% credible interval 52-88) deaths between 2000 and 2030, of which 37 million (30-48) were averted between 2000 and 2019. From 2000 to 2019, this represents a 45% (36-58) reduction in deaths compared with the counterfactual scenario of no vaccination. Most of this impact is concentrated in a reduction in mortality among children younger than 5 years (57% reduction [52-66]), most notably from measles. Over the lifetime of birth cohorts born between 2000 and 2030, we predict that 120 million (93-150) deaths will be averted by vaccination, of which 58 million (39-76) are due to measles vaccination and 38 million (25-52) are due to hepatitis B vaccination. We estimate that increases in vaccine coverage and introductions of additional vaccines will result in a 72% (59-81) reduction in lifetime mortality in the 2019 birth cohort. INTERPRETATION: Increases in vaccine coverage and the introduction of new vaccines into LMICs have had a major impact in reducing mortality. These public health gains are predicted to increase in coming decades if progress in increasing coverage is sustained. FUNDING: Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation