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19 pages, 4 figures, 1 table, supplementary materials https://www.mdpi.com/article/10.3390/biology12060774/s1.-- Data Availability Statement: Data are available upon request to the primary author, Competitive interactions come in a variety of forms and may be modulated by the size and number of individuals involved, and/or the resources available. Here, intra- and interspecific competitive behaviours for food (i.e., foraging/food search and feeding/food ingestion) were experimentally characterized and quantified in four co-existing deep-sea benthic species. Three sea stars (Ceramaster granularis, Hippasteria phrygiana, and Henricia lisa) and one gastropod (Buccinum scalariforme) from the bathyal Northwest Atlantic were investigated using video trials in darkened laboratory conditions. A range of competitive or cooperative behaviours occurred, depending on species (conspecific or heterospecific), comparative body size, and the number of individuals involved. Contrary to expectations, small individuals (or smaller species) were not always outcompeted by larger individuals (or larger species) when foraging and feeding. Moreover, faster species did not always outcompete slower ones while scavenging. Overall, this study sheds new light on scavenging strategies of co-existing deep-sea benthic species in food-limited bathyal environments, based on complex behavioural inter- and intraspecific relationships, This work was supported in part by the Natural Sciences and Engineering Research Council of Canada (NSERC) via grants awarded to A.M. [...] J.A. is a member of the Tecnoterra Associated Research Unit (ICM-CSIC/UPC) and supported by the Spanish Government through the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2019-000928-S)

The aim was to define the risk factors for acute urinary retention (AUR) and urinary tract infections (UTIs) in colon or high rectum anastomosis patients based on the absence of a urinary catheter (UC) or the early removal of the UC (24 h).This is a multicentre, international retrospective analysis of a prospective database including all patients undergoing colon or high rectum anastomoses. Patients were part of the enhanced recovery programme audit, developed by the Francophone Group for Enhanced Recovery after Surgery, and were included if no UC was inserted or if a UC was inserted for24 h.In all, 9389 patients had colon or high rectum anastomoses using laparoscopy, open surgery or robotic surgery. Among these patients, 4048 were excluded because the UC was left in place24 h (43.1%) and 97 were excluded because the management of UC was unknown (1%). Among the 5244 colon or high rectum anastomoses patients included, AUR occurred in 5.2% and UTI occurred in 0.7%. UCs were in place for24 h in 2765 patients (52.7%) and 2479 did not have UCs in place (47.3%). Multivariate analysis showed that management of the UC was not significantly associated with the occurrence of AUR and that risk factors for AUR were male gender, ≥65 years old, having an American Society of Anesthesiologists score ≥3 and receiving epidural analgesia. Conversely, being of male gender was a protective factor of UTI, while being ≥65 years old, having open surgery and receiving epidural analgesia were risk factors for UTIs. The management of the UC was not significantly associated with the occurrence of UTIs but the occurrence of AUR was a more significant risk factor for UTIs.UCs in place for24 h did not reduce the occurrence of AUR or UTI compared to the absence of UCs.

MDS-RS patients are characterized by chronic anemia and a low risk of Acute Myeloid Leukemia (AML) progression and they generally become Red Blood Cell (RBC) transfusion dependent (TD).We performed a retrospective "real-life" observational study of 6 months in 100 MDS-RS TD patients, recruited in 12 French centers, to describe transfusion characteristics, and evaluate the frequency and causes of hospitalizations, health costs, and morbidity, associated with transfusion dependency, in a French population of RBC transfusion-dependent MDS-RS patients.79% of the patients had high transfusion burden (HTB) and 21% low transfusion burden (LTB). HTB patients had a longer disease duration (6 vs. 3.7 years, p = 0.0078), more frequent iron chelation (82% vs. 50%, p = 0.0052) and higher serum ferritin (p = 0.03). During the 6-month study period, 22% of the patients required inpatient hospitalization, 36% of them for symptomatic anemia requiring emergency RBC transfusion. The 6-month median transfusion costs, including the cost of the day care facility, transportation to and from the hospital, iron chelation, and lab tests, was 16,188€/patient.MDS-RS represents the archetypal type of chronically transfused lower-risk MDS. Most of those patients have a high transfusion burden and thus frequently need visits to the hospital's day care facility, and frequent hospitalizations, with an overall high median treatment cost. Those costs should be compared with costs of new treatments potentially able to avoid RBC transfusion dependence and to reduce the complications of chronic anemia in MDS-RS patients.

Our aim was to identify factors associated with shoulder dystocia following an attempted operative vaginal delivery (aOVD) in a prospective cohort study and to evaluate whether these factors can be used to accurately predict shoulder dystocia by building a score of shoulder dystocia risk. This was a planned secondary analysis of a prospective cohort study of deliveries with aOVD at term from 2008–2013. Cases were defined as women with shoulder dystocia following an aOVD defined as a delivery that requires additional obstetric maneuvers following failure of gentle downward traction on the fetal head to effect delivery of the shoulders. Multivariate logistic regression analyses were performed to determine risk factors for shoulder dystocia. Shoulder dystocia occurred in 57 (2.7%) of the 2118 women included. In the whole cohort, women with shoulder dystocia more often had a history of shoulder dystocia (3.5% vs. 0.2%, p = 0.01), and there was a significant interaction between aOVD and gestational age and the duration of the second stage of labor: women with shoulder dystocia more often had a gestational age > 40 weeks and a second stage of labor longer than 3 h specifically for midpelvic aOVD. In multivariable analysis, a history of shoulder dystocia was the only factor independently associated with shoulder dystocia following aOVD (aOR 27.00, 95% CI 4.10–178.00). The AUC for the receiver operating characteristic curve generated using a multivariate model with term interaction with head station was 0.70 (95% CI 0.62–0.77). The model failed to accurately predict shoulder dystocia.

Background Lung point-of-care ultrasonography (L-POCUS) is highly effective in detecting pulmonary peripheral patterns and may allow early identification of patients who are likely to develop an acute respiratory distress syndrome (ARDS). We hypothesized that L-POCUS performed within the first 48 hours of non-critical patients with suspected COVID-19 would identify those with a high-risk of worsening. Methods POCUSCO was a prospective, multicenter study. Non-critical adult patients who presented to the emergency department (ED) for suspected or confirmed COVID-19 were included and had L-POCUS performed within 48 hours following ED presentation. The lung damage severity was assessed using a previously developed score reflecting both the extension and the intensity of lung damage. The primary outcome was the rate of patients requiring intubation or who died within 14 days following inclusion. Results Among 296 patients, 8 (2.7%) met the primary outcome. The area under the curve (AUC) of L-POCUS was 0.80 [95%CI:0.60–0.94]. The score values which achieved a sensibility >95% in defining low-risk patients and a specificity >95% in defining high-risk patients were Conclusion L-POCUS performed within the first 48 hours following ED presentation allows risk-stratification of patients with non-severe COVID-19.

Members of the family Lamippidae are obligate endoparasitic copepods that typically associate with octocorals. In the present work, the association between Lamippe bouligandi and its bathyal sea pen host Anthoptilum grandiflorum was examined. A total of 1463 females and 23 males of L. bouligandi were collected from 195 colonies of A. grandiflorum. Details of the external morphology and digestive organs of the female copepod are used to refine our understanding of its feeding strategy and relationship with the host, and a preliminary overview of the male is provided for the first time. A combination of histology, scanning electron microscopy and laboratory monitoring of live sea pens hosting L. bouligandi were used to elucidate aspects of its life history, including the reproductive cycle, brooding strategy, and embryonic and larval development.

International audience

Gersemia rubiformis is a soft coral belonging to the family Nephtheidae, known to provide habitat for many organisms and to play an essential role in benthic ecosystems. The present study examined the relationship between G. rubiformis and the epibiotic amphipod Stenula nordmanni in the coastal waters of eastern Canada. The prevalence of the association was 100% with an average burden of 35 amphipods (mostly juveniles) per coral host. The sex ratio in the amphipods was female-biased and there was a distinct sexual dimorphism, males being significantly larger than females. In a single coral colony, about 38% of female amphipods were found to brood propagules at various stages of development up to juveniles. Upon release, juvenile amphipods were transparent and acquired the pink color characteristic of the adult by feeding on the coral tissues, thereby mimicking the coloration of the host. Ingestion of coral tissues was confirmed by the presence of host sclerites in the digestive tract of amphipods. In turn, amphipods were seen to protect their host by repulsing predatory nudibranchs approaching the coral colony. Together, findings suggest that the amphipods display a specific and obligate mutualistic association with their coral host, considering that they benefit from shelter and food, and the host benefits from active protection against potential predators. The apparent trophic relationship does not appear to generate any detriment to the host. In addition, some of the symbiotic amphipods examined were found to be hosts themselves, to chytrid fungi attached to their exoskeleton.

Late-term fetal demise including fetal death in utero, late miscarriage and late termination of pregnancy are relatively frequent occurrences. Post-traumatic stress disorder (PTSD) is a pathology that finds its roots in exposure to a life-threatening event or an event related to death. Exposure to fetal death during a late-term fetal demise is, therefore, a situation at risk of trauma. The objective of this study was to assess the prevalence of PTSD symptoms in the short term among patients faced with late fetal demise, and to identify potential risk factors. All women were assessed at 15 days, one month, and three months after late fetal demise using the Impact of Event Scale-Revised (IES-R) and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ). At 15 days, 44.2% of patients presented a pathological score on the IES-R (≥ 33). At one month and three months, this figure was 34.1% and 9.1% respectively. Factor associated with PTSD symptoms were: peritraumatic dissociation (p = 0.014), seeing the fetus during hospitalization (p = 0.035), holding the fetus in one’s arms (p = 0.046), and the organization of a funeral service (p = 0.025). Patients experiencing late fetal demise are at significant risk of trauma. Care providers should remain vigilant to identify high-risk situations to offer appropriate care.Clinical trials registration number: NCT03433989.

In claudication, the correlation between walking-induced biomarkers and indices of clinical severity (e.g., walking distance or ankle brachial index (ABI)), is fair. We hypothesized that a correlation would be observed between the clinical estimation of ischemia severity with exercise transcutaneous oximetry (Ex-TcpO2) and lactate increase. A prospective study was performed among 377 patients with arterial claudication. We recorded age, sex, ABI, body mass index (BMI), systolic arterial blood pressure (SBP), and glycemia. Capillary blood lactate was measured at rest and 3 min after a constant load treadmill test. We recorded maximum walking time (MWT), heart rate (HRmax), the sum of minimal decrease from oxygen values for buttocks, thighs and calves Ex-TcpO2 (DROPmin), as well as the amplitude of chest-TcpO2 decrease. A multilinear regression model was used to assess the variables associated with lactate increase. BMI, SBP, HRmax, the amplitude of decrease in chest-TcpO2 and DROPmin, but not age, sex, ABI, MWT, diabetes mellitus nor glycemia, were significantly associated to lactate increase in the model. Because it accounts for the severity and diffusion of lower-limb exercise-induced ischemia and detects exercise induced hypoxemia, TcpO2 may be preferable to ABI or MWT to estimate the metabolic consequences of walking in claudicants.

Holothuria scabra is one of the most intensively studied holothuroids, or sea cucumbers (Echinodermata: Holothuroidea), having been discussed in the literature since the early 19th century. The species is important for several reasons: (1) it is widely distributed and historically abundant in several shallow soft-bottom habitats throughout the Indo-Pacific, (2) it has a high commercial value on the Asian markets, where it is mainly sold as a dried product (beche-de-mer) and (3) it is the only tropical holothuroid species that can currently be mass-produced in hatcheries. Over 20 years have elapsed since the last comprehensive review on H. scabra published in 2001. Research on H. scabra has continued to accumulate, fuelled by intense commercial exploitation, and further declines in wild stocks over the entire distribution range. This review compiles data from over 950 publications pertaining to the biology, ecology, physiology, biochemical composition, aquaculture, fishery, processing and trade of H. scabra, presenting the most complete synthesis to date, including scientific papers and material published by local institutions and/or in foreign languages. The main goal of this project was to summarize and critically discuss the abundant literature on this species, making it more readily accessible to all stakeholders aiming to conduct fundamental and applied research on H. scabra, or wishing to develop aquaculture, stock enhancement and management programs across its geographic range.

Resume But de l’etude Le lien entre l’ileus postoperatoire, la duree de sejour et l’autonomie rapportee par le patient (ARP) n’est pas connu alors que cette ARP pourrait aider le chirurgien a adapter le jour de sortie du patient. Le but de cette etude etait d’evaluer l’evolution de l’ARP dans la periode postoperatoire, ainsi que les differents facteurs influencant cette evolution. Patients et methodes Cette etude retrospective sur une base de donnees prospective incluait les patients operes d’une chirurgie colorectale dans un seul centre sur une periode de 14 mois. L’ARP etait defini en utilisant la premiere partie du Groningen Activity Restriction Scale appele « activity of the daily life » (de 9 le meilleur) a 45 (le moins bon). Resultats Parmi les 101 patients operes, 80 % retrouvaient leur ARP preoperatoire (± 5 points) pendant 2 jours precedant la sortie. L’ARP etait significativement diminuee par la chirurgie (p 2 l’aggravait (p = 0,03). Les programmes de rehabilitation amelioree tendaient a ameliorer la recuperation de l’ARP (p = 0,09). Conclusion L’ARP pourrait etre utilisee pour optimiser le jour de sortie d’un patient apres chirurgie colorectale.

The demand and high market price for sea cucumber has led to the collapse of wild stocks for many traditional species in Asia and the Indo-Pacific. New species have therefore been introduced to the...

While so-called brown bodies were first defined in the 1950s as colorful aggregates of cells in the general cavity of echinoderms and other marine benthic taxa, their distribution and role have not yet been fully clarified. This work characterized free coelomocytes and corresponding aggregates ("bodies") in the hydrovascular system and perivisceral coelom, as well as those attached on the membranes of the viscera, in the holothuroid Cucumaria frondosa. Responses to the presence of foreign particles were investigated, providing novel insights on the immune system. A total of eight coelomocyte cell types was detected, while aggregates were formed of three to six types of coelomocytes. Only red-colored aggregates were found in the hydrovascular system, whereas brown aggregates were confined to the perivisceral coelom. The encapsulation mechanism of foreign particles injected in the hydrovascular system was monitored. Particles were first gathered by phagocytes and vibratile, crystal, and morula cells into a whitish aggregate that was then covered by hemocytes, imparting a red color to the aggregates. After their transfer to the perivisceral coelom, aggregates became brown and were ultimately expelled through the anus. Finally, a range of stressors (i.e., harvesting method, presence of a predator, and physical injury) was found to increase the abundance of aggregates, thus highlighting the role of these bodies in the immune response of C. frondosa.

Deep-sea nudibranchs (Mollusca: Gastropoda: Heterobranchia) have rarely been reported from eastern Canada. Here we describe range extensions for two species found in the northwest Atlantic Ocean. Tritonia newfoundlandica Valdés, Murillo, McCarthy & Yedinak, 2017 was originally collected on the Flemish Cap off Newfoundland, Canada, and Doridoxa ingolfiana Bergh, 1899 was originally found off western Greenland with further records in Iceland, northern Norway, and southeastern Canada. We extend the northern range of T. newfoundlandica 1067 km along the eastern coast of North America and add occurrences of D. ingolfiana in the Labrador Sea, bridging a 2044 km gap between previous records in Greenland and southern Newfoundland. The latter species thus exhibits a continuous distribution from Svalbard, the Faroe Islands, Greenland, down to the southern tip of the Grand Banks in eastern Canada. Tritonia newfoundlandica was collected in its known depth range, whereas the depth distribution of D. ingolfiana was extended by 30 m to a maximum depth of 1375 m. Both species were collected with numerous nephtheid corals, suggesting that there may be a functional relationship, where the nudibranchs find refuge or food on them.

Methods have been proposed to mitigate the environmental footprint of aquaculture, including co-culture of species occupying different trophic levels. In this study, sea cucumbers Cucumaria frondosa, either from production tanks fed with effluent water from land-based salmon culture over 4 yr or collected from the field, were compared using stable isotope, lipid and fatty acid (FA) signatures as indicators of waste assimilation, health and biochemical composition. Enrichment of δ13C in muscle bands and intestine and of δ15N in muscle bands, gonad and intestine was detected in captive individuals relative to wild individuals, suggesting the uptake and assimilation of waste from salmon culture. The higher levels of FA biomarkers typical of salmon feed (18:1ω9, 18:2ω6 and 20:1ω9) and lower ω3/ω6 ratio in the captive sea cucumbers were also in line with assimilation of the waste. However, male and female sea cucumbers from the co-culture became smaller with time, their organ indices were lower than those of wild individuals (e.g. poorly developed gonad), and their biochemical composition differed: triacylglycerol content was greater in wild individuals and phospholipid content was greater in captive individuals. Also, FA profiles of all tissues differed between the 2 groups, whereas total lipid in muscle bands and gonad remained similar. Overall, results support that co-culture with suspension-feeding sea cucumbers may help mitigate the salmon industry footprint. In turn, the biochemical composition of the sea cucumbers changed, and their reduced size and body indices suggest that this food source does not provide suitable nutrients to sustain growth and reproduction.

Avoiding the use of nasogastric tubes (NGTs) is recommended after colorectal surgery but there is no consensus on intraoperative gastric decompression using NGTs during colorectal surgery. The objective was to assess the effect of avoiding insertion of NGTs during colorectal surgery for the recovery of gastrointestinal (GI) functions. 1561 patients undergoing colorectal surgery, for whom information on NGT use was available, were included in this retrospective analysis and propensity score analysis of the prospective GRACE Audit database. Patients who did and did not have an NGT during surgery were compared. Among the study population of 1561 patients, 696 patients were matched to correct baseline differences between groups. The no-NGT group significantly improved GI motility impairment (e.g., less postoperative nausea [OR = 0.59; CI 95%: 0.42–0.84] and a better tolerance of early feeding [OR = 2.07; CI 95%: 1.33–3.22]). Such an association was also highlighted for reduced postoperative morbidity [OR = 0.60; CI 95%: 0.43–0.83], and especially pulmonary complications [OR = 0.08; CI 95%: 0.01–0.59], or parietal complications [OR = 0.29; CI 95%: 0.09–0.87]. The risk of postoperative ileus was not significantly reduced in the no-NGT group [OR = 0.67; CI 95%: 0.43–1.06]. No NGT insertion during colorectal surgery is safe and could improve postoperative GI function recovery.

International audience; Objective To assess the relationship between anal incontinence (AI) 8 years after childbirth and the occurrence of obstetrical anal sphincter injuries (OASIS) and/or performance of an episiotomy during childbirth. Methods This is a nationwide database analysis performed on two national medico-administrative databases, including all the women aged 18 years or older who delivered infants in France in 2012. The main outcome measure was AI in the 8 years after delivery. Results Of the 163 443 perineal tears reported, 0.47% were grade 3 (n = 3173) and 0.08% were grade 4 (n = 579); 8938 women experienced AI (1.33%) and 261 women experienced severe AI (0.04%). Episiotomies performed in the absence of risk factors for OASIS were significantly associated with an increased risk of AI (odds ratio [OR] 1.59, 95% confidence interval [CI]1.49-1.69; P < 0.001). Grade 3 and 4 OASIS also significantly increased the risk of AI and severe AI. Mediolateral episiotomy was preventive of OASIS when performed in women at risk (OR 0.26, 95% CI 0.23-0.30; P < 0.001) but contributed to OASIS in the absence of risk (OR 2.18, 95% CI 1.98-2.40; P < 0.001). Conclusion OASIS present a risk factor for AI. Episiotomies could reduce the occurrence of OASIS, but they could also increase the risk of long-term AI in the absence of risk factors for OASIS.

To assess severe short-term maternal and neonatal morbidity and pelvic floor disorders at 6 months postpartum after attempted operative vaginal delivery according to the instrument used.We conducted a prospective study of women with live, singleton, term fetuses in vertex presentation. Patients attempted operative vaginal delivery in a French tertiary care university hospital from December 2008 through October 2013. We used multivariable logistic regression and propensity score methods to control for indication bias and compare outcomes associated with vacuum-assisted or forceps- or spatula-assisted delivery. Severe maternal and neonatal morbidity were composite primary endpoints. Symptoms of urinary incontinence (UI) and anal incontinence (AI) were assessed 6 months after delivery by validated self-administered questionnaires.Among 2,128 attempted operative vaginal deliveries, 30.7% (n=654) used vacuum and 69.3% (n=1,474) used forceps or spatulas. Severe maternal morbidity occurred in 5.4% (n=35; 95% CI 3.8-7.4) of vacuum attempts and 10.5% (n=154; 95% CI 8.3-12.1) of forceps or spatula attempts (P.001); severe neonatal morbidity occurred in 8.4% (n=55; 95% CI 6.4-10.8) and 10.2% (n=155; 95% CI 8.7-11.8), respectively (P=.2). Although attempted operative vaginal deliveries with forceps or spatula were significantly associated with more frequent severe maternal morbidity (adjusted odds ratio [aOR] 1.99 95% CI 1.27-3.10) in the multivariable logistic regression analysis, this association was no longer significant after propensity score matching (aOR 1.46 95% CI 0.72-2.95). Attempted operative vaginal deliveries with forceps or spatula were not significantly associated with more frequent severe neonatal morbidity after multivariable logistic regression or propensity score matching. Among the 934 women (43.9%) who responded to questionnaires at 6 months, the prevalence of symptoms of UI and AI were 22.7% and 22.0%, respectively, with no significant differences between the groups.In singleton term pregnancies, neither severe short-term maternal or neonatal morbidity nor UI or AI were more frequent after attempted operative vaginal delivery by forceps or spatulas than by vacuum after controlling for indication bias with a propensity score analysis.

The innate immunity of echinoderms has been a research focus since the early twentieth century, consistently providing ever deeper knowledge of its complexity and evolutionary aspects. At its core are coelomocytes, which are diverse cells collectively known to respond in a variety of ways, including via movement, phagocytosis, and aggregation. However, features of cellular immunity have never been compared in echinoderms from phylogenetic and distributional perspectives, to provide insight into ecological and evolutionary patterns. The present study catalyzed and characterized the formation of coelomocyte aggregates in members of all five extant classes of echinoderms. The morphological characteristics of these aggregates (including their colour, shape, texture, size) were assessed, as well as the major cells composing them. Coelomocyte diversity (both as free and aggregated forms) was determined to be maximum in class Holothuroidea, followed by Echinoidea, with the other classes showing similar levels of diversity. The colours of coelomocyte aggregates appeared to be more closely linked to phylogeny (classes, orders) rather than geographic range, or external colour of the species themselves. Asteroids and ophiuroids displayed primarily light-coloured aggregates, from transparent to green; while holothuroids, echinoids and crinoids demonstrated more vivid variants, from red to deep purple. The kinetics of aggregate formation and expulsion were monitored in selected species, showing immediate cellular response to foreign particulate matter in the form of encapsulation and various methods of expulsion, including through the dermal papillae of asteroids and the anus (cloaca) of holothuroids. The findings support that coelomocyte aggregate formation is a conserved immune response across all five extant classes of echinoderms with variations in their cell catalysts, complexity, shape, colour, and size.

Holothuroids (sea cucumbers) are one of the most ubiquitous groups of benthic animals found across diverse marine ecosystems. As echinoderms, they also occupy an important place in the evolutionary hierarchy, sitting close to vertebrates in the deuterostome clade, making them valuable multidisciplinary model organisms. Apart from being ecologically and phylogenetically important, many species are commercially exploited for luxury seafood markets. With the global rise of aquaculture and fisheries, management and protection of these valuable species relies on a better understanding of how their immune systems respond to environmental and anthropogenic stressors. Here, the cellular, hormonal and behavioral indicators of stress in the North Atlantic sea cucumberCucumaria frondosawere examined. The immediate and carry-over (post recovery) effects of a 1-hour exposure to low salinities or to emersion (at two temperatures) highlighted that morphoplasticity inC. frondosawas accompanied by shifts in all monitored indicators. From baseline levels measured in controls, densities of free coelomocytes increased, showing successions of specific cell types and subsequent coelomocyte aggregations, combined with a rise in cortisol levels. These responses mirrored increased fluctuations in cloacal opening rates, decreased force of attachment to the substrate, and enhanced movements and active buoyancy adjustment with increasingly severe stressors. The findings suggest that many systems of sea cucumbers are impacted by stresses that can be associated with harvesting and handling methods, with likely implications for the quality of the processed products. Gaining a deeper understanding of immune and hormonal responses of sea cucumbers is not only of broad ecological and evolutionary value, but also helpful for the development of sustainable fisheries and aquaculture practices, and conservation programs.

Velvet shell, Velutina velutina (Müller, 1776), is a specialist predator of ascidians, like other members of the gastropod family Velutinidae. Globally, invasive ascidians have become problematic, ecologically and economically, yet ecological knowledge of velutinids remains limited. This study outlines the life history and feeding ecology of V. velutina in eastern Canada based on laboratory work complemented by field observations. The life history of V. velutina is closely linked with ascidians, which serve as prey and protection for their egg capsules. Egg capsules were embedded within tunics of Aplidium glabrum (Verrill, 1871) and Ascidia callosa Stimpson, 1852, with a preference for the latter. Seasonal behavioural shifts were consistent annually and corresponded with seawater temperature cycles. Feeding dominated during the coldest months (January–May), growth occurred as water temperature increased to the annual maximum (June and July), transitioning to mating during the warmest period (July–August), and egg capsule deposition dominated as water temperature declined (November–January). Larvae hatched between January and July after 2–4 months of development. Velutina velutina preyed on all ascidian species presented during this study, including golden star tunicate, Botryllus schlosseri (Pallas, 1766), and vase tunicate, Ciona intestinalis (Linnaeus, 1767), two non-indigenous species, although solitary species were preferred.

Biochemical markers developed initially for food-web studies of terrestrial and shallow-water environments have only recently been applied to deep-sea ecosystems (i.e., in the early 2000s). For the first time since their implementation, this review took a close look at the existing literature in the field of deep-sea trophic ecology to synthesize current knowledge. Furthermore, it provided an opportunity for a preliminary analysis of global geographic (i.e., latitudinal, along a depth gradient) trends in the isotopic (δ15N, δ13C) and fatty acid composition of deep-sea macro- and megafauna from heterotrophic systems. Results revealed significant relationships along the latitudinal and bathymetric gradients. Deep-sea animals sampled at temperate and polar latitudes displayed lower isotopic ratios and greater proportions of essential ω3 long-chain polyunsaturated fatty acids (LC-PUFAs) than did tropical counterparts. Furthermore, δ15N and δ13C ratios as well as proportions of arachidonic acid increased with increasing depth. Since similar latitudinal trends in the isotopic and fatty acid composition were found in surface water phytoplankton and particulate organic matter, these results highlight the link across latitudes between surface primary production and deep-water communities. Because global climate change may affect quantity and quality (e.g., levels of essential ω3 PUFAs) of surface primary productivity, and by extension those of its downward flux, the dietary intake of deep-sea organisms may likely be altered. In addition, because essential ω3 PUFAs play a major role in the response to temperature variations, climate change may interfere with the ability of deep-sea species to cope with potential temperature shifts. Importantly, methodological disparities were highlighted that prevented in-depth analyses, indicating that further studies should be conducted using standardized methods in order to generate more reliable global predictions.

Purpose/background Quetiapine is a relatively new atypical antipsychotic with fewer adverse effects. It is increasingly prescribed to patients. The purpose of this study was to describe the cases of poisoning observed at the western France Poison Control Centre and identify potential risk factors that increase the severity of the cases. Methods This was a retrospective study of self-poisoning with quetiapine as reported by the western France Poison Control Centre between 2007 and 2017. Results There were 372 cases of quetiapine poisoning. Circumstances are known in 367 of 372 cases. There were 75 cases of null severity (grade 0), 133 cases of mild severity (grade 1), 85 cases of moderate severity (grade 2), and 79 cases of high severity (grade 3). Five deaths were listed in this series. The most commonly observed symptoms were neurological and cardiovascular in nature (drowsiness, coma, tachycardia, hypotension). Of these cases, 79.8% included voluntary ingestions. Among 302 cases with coagents, the most common coagents were benzodiazepines (56%), other psychotropic drugs (41%), and antidepressants (37%). An evaluated ingested dose 1500 mg or greater and 2 or more coagents increase the risk of severe poisoning. In particular, concomitant ingestion of benzodiazepines and antidepressants with quetiapine was associated with high severity (odds ratio, 2.478 [confidence interval, 1.3-4.723]; odds ratio, 1.820 [confidence interval, 1.010-3.316]). Conclusions Quetiapine may lead to severe poisoning for which there is currently no specific treatment. Patients and practitioners should be aware of this when quetiapine is prescribed, particularly when used in combination with other medications, and in order to deal with cases of poisoning.

The environmental control of reproductive processes is central to both fundamental and applied aspects of animal ecology. The present study experimentally assessed how environmental factors modulate gametogenesis and spawning and impact embryo development and survival in the holothuroid Cucumaria frondosa, a cold-water echinoderm with lecithotrophic development. Adults were exposed to three seawater temperatures, four photoperiod regimes, and two food concentrations during 120 days overlapping the natural gametogenic and spawning periods. Among all the treatments tested, exposure to ambient conditions of water temperature (−1 to 3 °C), photoperiod (8 to 13 h of light) and food concentration (3 × 103 ± 896 rotifers g−1 of sea cucumbers d−1) yielded the greatest reproductive output and embryo survival. At pre-spawning, males and females had the highest gonad index (~33%) and where filled with mature gametes. At spawning, females in ambient conditions released the highest number of oocytes (1.2 × 103 oocytes female−1) and yielded the highest embryo survival rates (21% at 20 days post fertilization). Individuals exposed to warmer water temperatures (6 and 12 °C) experienced delayed gametogenesis and did not spawn. Individuals under 24-h light, 24-h dark, and advanced (4 months) photoperiods showed delayed gametogenesis and low numbers of oocytes released; moreover, embryos died within 10 days post fertilization. Individuals fed with high food concentration (6 × 103 ± 982 rotifers g−1 of sea cucumbers d−1) showed similar results to ambient conditions, suggesting that increased food supply neither decreased nor enhanced reproductive output over the experimental period. This study sheds new light on the environmental drivers of reproductive success in C. frondosa, which is of value for developing conservation strategies and mariculture protocols in cold-water holothuroids with lecithotrophic development.

While the study of dispersal and connectivity in the ocean typically centres on pelagic species and planktonic larval stages of benthic species, the present work explores an overlooked locomotor means in post‐settlement benthic stages that redefines their dispersal potential.Members of the echinoderm class Holothuroidea colonize a diversity of marine environments world‐wide, where they play key ecological and economical roles, making their conservation a priority. Holothuroids are commonly called sea cucumbers or sea slugs to reflect their slow movements and are assumed to disperse chiefly through pelagic larvae.The present study documents and explores their unexpected ability to actively modify their buoyancy, leading them to tumble or float at speeds orders of magnitudes faster than through benthic crawling. Two focal species representing different taxonomic orders, geographic distributions and reproductive strategies were studied over several years.Active buoyancy adjustment (ABA) was achieved through a rapid increase in water‐to‐flesh ratio by up to 740%, leading to bloating, and simultaneously detachment from the substrate. It occurred as early as 6 months post settlement in juveniles and was recorded in wild adult populations. In experimental trials, ABA was triggered by high conspecific density, decreasing salinity and increasing water turbidity. Based on field video footage, ABA‐assisted movements generated speeds of up to 90 km/day.These findings imply that displacement during planktonic larval stages may not supersede the locomotor capacity of benthic stages, challenging the notion of sedentarity. Combining the present results and anecdotal reports, ABA emerges as a generalized means of dispersal among benthic animals, with critical implications for world‐wide management and conservation of commercially and ecologically significant species., This study documents the unexpected ability of so‐called sessile or sedentary benthic marine animals (e.g. sea cucumbers) to actively modify their buoyancy to tumble or float at speeds orders of magnitudes faster than anticipated. These findings redefine the locomotor capacity of benthic animals, challenging the notion of sedentarity, with critical implications for worldwide management and conservation of commercially and ecologically significant species.

The present study investigated methods to trigger spawning and artificially induce oocyte maturation in the commercial cold-water suspension-feeding sea cucumber Cucumaria frondosa. Spawning occurred after exposure to live phytoplankton, commercial phytoplankton paste, and conspecific sperm. Live phytoplankton at 1 × 105 cells ml−1 induced the highest proportion of females to spawn (mean of 56%); promoted the greatest oocyte release (mean of 19,200 oocytes female−1), best quality of eggs and highest survival of embryos (65%; 20 d post fertilization). More concentrated live phytoplankton (1 × 106 cells ml−1) triggered 43% of the females to release ~16,100 oocytes female−1 and survival rates 20 d post fertilization were lower (50%). Both phytoplankton paste treatments (1 × 105 and 1 × 106 cells ml−1) yielded intermediate results in terms of percent spawning females (26%), abundance of oocytes released (11,000 and 7300 oocytes female−1, respectively), quality of eggs, and survival of embryos (44 and 50%, respectively). Sperm from conspecific (2 and 10 × 106 spermatozoa ml−1) induced the lowest proportion of females to spawn (16%) with release of 3000 and 1700 oocytes female−1, respectively; furthermore, all embryos died within 10 d post fertilization. Results for males were slightly different: spawning was more frequent (63%) in the sperm treatment at 2 × 106 spermatozoa ml−1 followed by live phytoplankton at 1 × 106 and 1 × 105 cells ml−1 (43%), and phytoplankton paste at 1 × 105 cells ml−1 (46%); the lowest spawning success was observed for phytoplankton paste at 1 × 106 cells ml−1 and conspecific sperm at 10 × 106 spermatozoa ml−1 (26%). Thermal shock, desiccation, potassium chloride (injection or bath), and serotonin (injection) did not induce spawning in C. frondosa. When oocytes isolated from mature ovaries were exposed to three different concentrations of 1-Methyladenine (1-MA), Dithiothreitol (DTT), 2,3-Dimercapto-1-propanol (BAL), and L-cysteine (L-cyst), DTT at 10−1 M induced the highest proportion of oocytes (48%) to shed follicle cells (i.e. ovulate); whereas other treatments induced only 2–6% of ovulation, similar to the control (seawater). All oocytes that shed follicle cells remained unfertilizable. Overall, live phytoplankton emerged as the most suitable spawning trigger for C. frondosa, a Dendrochirotida that produces maternally-provisioned oocytes. In the context of expanding sea cucumber aquaculture, this finding provides a tool to maximize the availability of gametes in this cold-water species, with possible applicability to similar commercial dendrochitotids.

International audience; Mostly studied at the individual level, the analysis of immigrants’ health status at a populational level may provide a different perspective to investigate, including social determinants as part of the explanation of the relationship between them and health status in France. We analyzed freely accessible databases curated by French public bodies. The dependent variables were death rate and mean age at death. Immigrant rate and covariates associated with either of the outcomes were explored in univariate and multivariate models. Linear models were used to explain the mean age at death, whereas tobit models were used to explain the death rate. The immigrant rate varied markedly from one department to another, as did healthcare accessibility, population’s age profile, and economic covariates. Considering univariate models, almost all the studied covariates were significantly associated with comes. The immigrant rate was associated with a lower death rate and a lower age at death. In multivariate models, the immigrant rate was no longer associated with age at death but was still negatively associated with the death rate. In France, the departments with a higher proportion of immigrants were those with a lower death rate, possibly because immigrants are attracted to economically thriving areas.

International audience; Objectives: The impact of conventional treatment for acute myeloid leukemia (AML) on the nutritional, cognitive, and functional status of elderly patients is seldom studied. This assessment was performed in the context of the LAMSA 2007 trial.Methods: The trial enrolled 424 patients with de novo AML. Among them, 316 benefited from geriatric assessment (GA) including nutritional, cognitive, and functional status and were scored according to Eastern Cooperative Oncology Group (ECOG) and sorror for the prediction of treatment toxicity, morbidity, and mortality. Patients were investigated at diagnosis for three times during follow-up.Results: This study showed that AML and its treatment have no impact on cognitive (P = .554) nor functional status (P = .842 for Activity of Daily Living and P = .087 for Instrumental Activities of Daily Living). The nutritional status improved over time (P = .041). None of these three parameters at baseline, associated or not with ECOG and sorror scores, impacted survivals or toxicities.Conclusions: The cognitive, functional, and nutritional status had no impact in this cohort of fit elderly AML patients without unfavorable cytogenetics. The GA tools used provided no additional information compared with ECOG and sorror scores, to predict toxicity, morbidity, or mortality due to intensive chemotherapy.

International audience; In this randomized phase 3 study, the FILO group tested whether the addition of 6 mg/m(2) of gemtuzumab ozogamycin (GO) to standard chemotherapy could improve outcome of younger patients with de novo acute myeloid leukemia (AML) and intermediate-risk cytogenetics. GO arm was prematurely closed after 254 inclusions because of toxicity. A similar complete remission rate was observed in both arms. Neither event-free survival nor overall survival were improved by GO in younger AML patients (

Recent efforts have been devoted to the link between responses to non-physical stressors and immune states in animals, mostly using human and other vertebrate models. Despite evolutionary relevance, comparatively limited work on the appraisal of predation risk and aspects of cognitive ecology and ecoimmunology has been carried out in non-chordate animals. The present study explored the capacity of holothuroid echinoderms to display an immune response to both reactive and anticipatory predatory stressors. Experimental trials and a mix of behavioural, cellular and hormonal markers were used, with a focus on coelomocytes (analogues of mammalian leukocytes), which are the main components of the echinoderm innate immunity. Findings suggest that holothuroids can not only appraise threatening cues (i.e. scent of a predator or alarm signals from injured conspecifics) but prepare themselves immunologically, presumably to cope more efficiently with potential future injuries. The responses share features with recently defined central emotional states and wane after prolonged stress in a manner akin to habituation, which are traits that have rarely been shown in non-vertebrates, and never in echinoderms. Because echinoderms sit alongside chordates in the deuterostome clade, such findings offer unique insights into the adaptive value and evolution of stress responses in animals.

IntroductionIn the context of the COVID-19 pandemic, early identification of patients who are likely to get worse is a major concern. Severity mainly depends on the development of acute respiratory distress syndrome (ARDS) with a predominance of subpleural lesions. Lung point-of-care ultrasonography (L-POCUS) is highly effective in detecting pulmonary peripheral patterns and may be appropriate for examining patients with COVID-19. We suggest that L-POCUS performed during the initial examination may identify patients with COVID-19 who are at a high risk of complicated treatment or unfavourable evolution.Methods and analysisPoint-of-care ultrasonography for risk stratification of non-critical COVID-19 patients on admission is a prospective, multicentre study. Adult patients visiting the emergency department (ED) of participating centres for suspected or confirmed COVID-19 are assessed for inclusion. Included patients have L-POCUS performed within 48 hours following ED admission. The severity of lung damage is assessed using the L-POCUS score based on 36 points for ARDS. Apart from the L-POCUS score assessment, patients are treated as recommended by the WHO. For hospitalised patients, a second L-POCUS is performed at day 5±3. A follow-up is carried out on day 14, and the patient’s status according to the Ordinal Scale for Clinical Improvement for COVID-19 from the WHO is recorded.The primary outcome is the rate of patients requiring intubation or who are dead from any cause during the 14 days following inclusion. We will determine the area under the ROC curve of L-POCUS.Ethics and disseminationThe protocol has been approved by the French and Belgian Ethics Committees and is carried out in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. The study is funding by a grant from the French Health Ministry, and its findings will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04338100.

The objective was to develop a radiological score obtained from multi-detector computed tomography (MDCT) to differentiate between single band adhesion (SBA) and matted adhesions (MA) as the etiology of small bowel obstruction (SBO). All consecutive patients who underwent surgery from January 2013 to June 2018 for adhesion-induced SBO were retrospectively included. Among the 193 patients having surgery for SBO, 119 (61.6%) had SBA and 74 (38.4%) had MA surgically proven. In multivariate analysis, the presence of a beak sign (OR = 3.47, CI [1.26; 9.53], p = 0.02), a closed loop (OR = 11.37, CI [1.84; 70.39], p = 0.009), focal mesenteric haziness (OR = 3.71, CI [1.33; 10.34], p = 0.01) and focal and diffuse peritoneal fluid (OR = 4.30, CI [1.45; 12.73], p = 0.009 and OR = 6.34, CI [1.77; 22.59], p = 0.004, respectively) were significantly associated with SBA. Conversely, the presence of diffuse mesenteric fluid without focal fluid (OR = 0.23, CI [0.06; 0.92], p = 0.04) and an increase of the diameter of the most dilated loop (OR = 0.94, CI [0.90; 0.99], p = 0.02) were inversely associated with SBA. Using the significant predictive factors of SBA, we built a composite score to radiologically predict the etiology of SBO. The area under the receiver operating characteristic (ROC) curve of the score was 0.8274. For a cut-off score of -0.523, sensitivity, specificity and the percentage of patients correctly classified were 78.4%, 84.6% and 80%, respectively. If the score is ≥ 7, the probability that the mechanism of SBO is not SBA was 100%. The present score, validated in a different population, could be a significant tool in the decision for surgical management.

Additional file 1. Proxy’s questionnaire for patient’s initial assessment at ICU admission.

International audience

Background Students’ choice of medical specialties has evolved throughout year, with a growing interest in quality of life and in technological specialties. We investigated the repartition of such choices in the world and its influencing factors with a focus on the gender's influence, for helping policy-makers to deal with medical shortage and territorial to specialty disconnect. Methods A systematic search was conducted on MEDLINE and Scopus from January 2010 to January 2020. Data extraction and analysis followed JBI and PRISMA recommendations. The selected articles had to focus on medical students, detail their choice of specialty, and look for factors influencing their choice. Articles were excluded if they only assessed the attractiveness of a specialty, or evaluated a public policy. This review was registered on PROSPERO, CRD 42020169227. Findings 751 studies were screened, and fifty-four were included. Surgery and internal medicine were the most wanted specialties, both in occidental and non-occidental countries. The main factors influencing the choice of specialty were lifestyle, work-life balance and discipline interest, with variation across different countries. Gender clearly affected this choice with 63.7% of men willing radiology and 14.7% of men in obstetrics and gynecology. Interpretation Influential factors vary with specialty and are affected by the country of residence. Gender has a great impact in students’ willingness to work in specific specialties. Policymakers should adapt their appealing strategies according to the country and the medical discipline concerned. Funding The authors have no support or funding to report.

While so-called brown bodies were first defined in the 1950s as colorful aggregates of cells in the general cavity of echinoderms and other marine benthic taxa, their distribution and role have not yet been fully clarified. This work characterized free coelomocytes and corresponding aggregates ("bodies") in the hydrovascular system and perivisceral coelom, as well as those attached on the membranes of the viscera, in the holothuroid

International audience; Background: Arterial pressure lability is common during the process of replacing syringes used for norepinephrine infusions in critically ill patients. It is unclear if there is an optimal approach to minimise arterial pressure instability during this procedures. We investigated whether 'double pumping' changeover (DPC) or automated changeover (AC) reduced blood pressure lability in critically ill adults compared with quick syringe changeover (QC).Methods: Patients requiring a norepinephrine infusion syringe change were randomised in a non-blinded trial undertaken in six ICUs. Randomisation was minimised by norepinephrine flow rate at inclusion and centre. The primary outcome was the frequency of increased/decreased mean arterial pressure (defined by 15 mm Hg from baseline measurements) within 15 min of switching the syringe compared with QC.Results: Patients (mean age: 64 (range:18-88)) yr were randomly assigned to QC (n=95), DPC (n=95), or AC (n=96). Increased MAP was the commonest consequence of syringe changeovers. MAP variability was most frequent after DPC (89/224 changeovers; 39.7%) compared with 57/223 (25.6%) changeovers after quick syringe switch and 46/181 (25.4%) in patients randomised to receive automated changeover (P=0.001). Fewer events occurred with QC compared with DPC (P=0.002). Sensitivity analysis based on mixed models showed that performing several changeovers on a single patient had no impact. Both type of changeover and norepinephrine dose before syringe changeover were independently associated with MAP variations >15 mm Hg.Conclusions: Quick changeover of norepinephrine syringes was associated with less blood pressure lability compared with DPC. The prevalence of MAP variations was the same between AC and QC.Clinical trial registration: NCT02304939.

Background Improving outcomes of older patients admitted into intensive care units (ICU) is a raising concern. This study aimed at determining which geriatric and ICU parameters were associated with in-hospital and long-term mortality in this population. Methods We conducted a prospective multicentric observational cohort study, including patients aged 75 years and older requiring mechanical ventilation, admitted between September 2012 and December 2013 into ICU of 13 French hospitals. Comprehensive geriatric assessment at ICU admission and ICU usual parameters were registered in a standardized manner. Survival was recorded and comprehensive geriatric assessment was updated after 1 year during a dedicated home visit. Results 501 patients were analyzed. 108 patients (21.6%) died during the hospital stay. One-year survival rate was 53.8% (IC 95% [49.2%; 58.2%]). Factors associated with increased in-hospital mortality were higher acute illness severity score, resuscitated cardiac arrest as primary ICU diagnosis, perception of anxiety and low quality of life by the proxy, and living in a chronic care facility before ICU admission. Among patients alive at hospital discharge, factors associated with increased 1-year mortality in multivariate analysis were longer duration of mechanical ventilation, all primary ICU diagnoses other than septic shock, a Katz-activities of daily living (ADL) score below 5 and living in a chronic care facility before ICU admission. Among the 163 survivors at 1 year who received a second comprehensive geriatric assessment, the ADL score (functional abilities) showed a significant but moderate decline over time, whereas the Mini-Zarit score (family burden) improved. No significant change in patients’ place of life was observed after 1 year, and quality of life was reported as happy-to-very-happy in 88% of survivors. Conclusions The mortality rate remains high among older ICU patients requiring mechanical ventilation. Factors associated with short- and long-term mortality combined geriatric and ICU criteria, which should be jointly evaluated in routine care. Clinical trial registration NCT01679171