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Abstract Animal care committees remain ambiguous on the need for anesthetics during experimental procedures on invertebrate taxa due to long-standing questioning of their sentience and pain perception. When used, anesthetizing procedures for invertebrates have commonly been adapted from those developed for vertebrates, under the largely unverified assumption that they afford the same benefits. The present study formally tested the efficacy of four common anesthetics of aquatic invertebrates (ethanol, MgCl2, clove oil, MS-222) using behavioural (reaction to physical contact and presence of a predator), physiological (respiration rate), cellular (coelomocytes), and hormonal (cortisol) biomarkers in the holothuroid Cucumaria frondosa (Echinodermata). While subjects recovered from exposures to all anesthetics tested, their responses differed markedly. Ethanol did not immobilize the individuals and concurrently increased their respiration rate, and cellular and hormonal stress markers. MgCl2 and clove oil reduced the behavioural and physiological responses, and decreased the cellular markers, but increased the cortisol levels. Only MS-222 fully immobilized the treated individuals and decreased their respiration rate, both during exposure and throughout ulterior interactions with a predator, while keeping coelomocyte counts and cortisol concentrations at baseline levels. MS-222 thus appears to induce the loss of sensation, representing a promising anesthetic and sedative in soft-bodied aquatic invertebrates.

Abstract Background Urinary tract infections are common affections, especially for women. Difficult access to a general practitioner to obtain a prescription has led France to offer dispensing under protocol by community pharmacists. The primary objective of this study is to evaluate the effectiveness of a pharmacist care protocol provided to manage women with urinary tract infection symptoms. This objective will be assessed using the Acute Cystitis Symptom Score. Methods PharmaCyst’ is an open-label, multicenter, controlled, cluster-randomized study conducted in the Loire region, France. Women aged between 18 and 65 years presenting to a pharmacy complaining of at least one symptom of an uncomplicated urinary tract infection present over the last 3 days (including burning pain during micturition, dysuria, pollakiuria, urgent urination) will be considered for inclusion. All patients will be contacted on day 3, 10, and month 3. A total of 480 patients need to be recruited for the 24 clusters participating in the research. The quantitative data will be described using means and standard deviations and compared using Student’s t-test. The qualitative data will be described using numbers and percentages and compared using chi2 test (or Fisher’s exact test if necessary). The primary and secondary outcomes analyses will consider the intention-to-treat population. Discussion PharmaCyst’ is the first clinical trial conducted in France only by community pharmacists. Its results could lead to an extension of the protocol. Trial registration The protocol has been approved by the French ethics committee on 2022/12/02 and is registered under the number 49RC22_0240 on ClinicalTrials.gov.

A new species of holothuroid, Pseudothyone labradorensis sp. nov. (order Dendrochirotida and family Sclerodactylidae), was discovered off the coast of Labrador (eastern Canada) at a depth of 740–969 m. Two specimens were described based on morphological and genetic parameters. Distinctive characters included pinkish body colour, presence of tube feet on a ‘tail’, supporting rod-shaped ossicles in the tube feet, and rod-shaped ossicles in the tentacles. To investigate its phylogenetic relationships, partial sequences of COI were obtained for the new species as well as for the type species P. raphanus and another North Atlantic species P. serrifera. According to the phylogenetic analysis, P. labradorensis sp. nov. appeared in a well-supported clade with P. raphanus and P. serrifera. Molecular data also suggest polyphyly of the genus, showing the Northeast Pacific species Pseudothyone belli recovered outside of the clade containing the type species. Pseudothyone labradorensis sp. nov. is the first species of the genus from the Northwest Atlantic. A key to the North Atlantic Pseudothyone is provided.

Abstract Background The COVID-19 pandemic has had a significant impact on mental health, with evidence suggesting an enduring mental health crisis. Studies worldwide observed increased usage of antidepressants, anxiolytics, and hypnotics during the pandemic, notably among young people and women. However, few studies tracked consumption post-2021. Our study aimed to fill this gap by investigating whether the surge in the number psychotropic drug consumers in France persisted 2 years after the first lockdown, particularly focusing on age and gender differences. Methods We conducted a national retrospective observational study based on the French national insurance database. We retrieved all prescriptions of anxiolytics, hypnotics, and antidepressants dispensed in pharmacies in France for the period 2015–2022. We performed interrupted time series analyses based on Poisson models for five age classes (12–18; 19–25; 26–50; 51–75; 76 and more) to assess the trend before lockdown, the gap induced and the change in trend after. Results In the overall population, the number of consumers remained constant for antidepressants while it decreased for anxiolytics and hypnotics. Despite this global trend, a long-term increase was observed in the 12–18 and 19–25 groups for the three drug classes. Moreover, for these age classes, the increases were more pronounced for women than men, except for hypnotics where the trends were similar. Conclusions The number of people using antidepressants continues to increase more than 2 years after the first lockdown, showing a prolonged effect on mental health. This effect is particularly striking among adolescents and young adults confirming the devastating long-term impact of the pandemic on their mental health.

Research on ecologically and economically important sea cucumbers has been focused on temperate and tropical species, leaving those from higher latitudes, such as the Canadian Arctic, understudied. This study compared the phenotypic characters of the sea cucumber Cucumaria frondosa sampled from populations of the Arctic (Hudson Bay, Nunavut) and Northwest Atlantic (Newfoundland). Organ indices and external and internal tissue pigmentation, and various biochemical metrics (proximate composition, lipids, fatty acids, amino acids, lipid-soluble vitamins, carotenoids) were assessed. All sea cucumbers had similar total body weights, but those from Newfoundland had heavier gonads and body walls, while the tissue pigmentation of Nunavut individuals was distinctive (more red and yellow trivium, darker brown pigmentation). Moisture and ash contents of sea cucumbers were similar between locations; however, protein and lipid contents in Nunavut samples were 12 and 50% lower, respectively. Inversely, Nunavut samples contained more ω-3 fatty acids, a greater degree of lipid desaturation, double the concentration of proline and vitamin A, and more carbohydrates and astaxanthin than Northwest Atlantic samples. Examining phenotypic variability across latitudes and longitudes, including into the Arctic, highlights unique physical and biochemical features attributed to this specific environment and may support the sustainable development of sea cucumber fisheries.

Abstract Background Hip arthroplasty is a frequently performed procedure in orthopedic surgery, carried out in almost all health structures for two main issues: fracture and coxarthrosis. Even if volume–outcome relationship appeared associated in many surgeries recently, data provided are not sufficient to set surgical thresholds neither than closing down low-volumes centers. Question With this study, we wanted to identify surgical, health care-related and territorial factors influencing patient’ mortality and readmission after a HA for a femoral fracture in 2018 in France. Patients and methods Data were anonymously collected from French nationwide administrative databases. All patients who underwent a hip arthroplasty for a femoral fracture through 2018 were included. Patient outcome was 90-day mortality and 90-day readmission rate after surgery. Results Of the 36,252 patients that underwent a HA for fracture in France in 2018, 0.7% died within 90-day year and 1.2% were readmitted. Male and Charlson comorbidity index were associated with a higher 90-day mortality and readmission rate in multivariate analysis. High volume was associated with a lower mortality rate. Neither time of travel nor distance upon health facility were associated with mortality nor with readmission rate in the analysis. Conclusion Even if volume appears to be associated with lower mortality rate even for longer distance and time of travel, the persistence of exogenous factors not documented in the French databases suggests that regionalization of hip arthroplasty should be organized with caution. Clinical relevance As volume–outcome relationship must be interpreted with caution, policy makers should not regionalize such surgery without further investigation.

Abstract 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.

Abstract 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.

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.

ObjectiveTo study the impact of the true mean daily dose and the true mean number of injections per week on the yearly height gain in short children treated with recombinant human growth hormone (rhGH).Design and Methods220 children from the French Easypod™ Connect Observational Study (ECOS) used the Easypod™ electronic device to record rhGH injections. The mean daily rhGH dose (the sum of the doses truly received divided by the number of days) and mean number of injections per week (the number of injections truly performed divided by the number of weeks) were calculated. Linear mixed models were used to study the impact of short (3-month) and long (1-year) variations in rhGH administration on the yearly height change [as a standard deviation score (SDS)], with time on treatment as a covariate. For each patient, several periods of 3 or 12 months were considered and designated as poorly adherence or fully adherence. We studied the impact of each of period on the height change.ResultsAt treatment initiation, the mean ± SD age was 9.8 ± 3.7 years (females: 47%, prepubertal: 86%) and the mean height was -2.28 ± 0.92 SDS. The mean treatment duration was 3.2 ± 1.1 years (685.2 patient years). 122 patients were GH-deficient, 79 were small for gestational age, and 19 had Turner syndrome. When treatment was computed over 12-month periods, receiving a mean daily dose 5 injections/week), whereas maintaining a mean daily dose >0.03 mg/kg.d with5 injections/week). For 3-month periods, changes in the daily rhGH dose or the number of injections per week over such short period did not influence the yearly height gain SDS.ConclusionThe 12-month treatment model showed that when poor adherence leads to a low true daily GH dose, the yearly height gain is low. The 3-month treatment model showed that poor adherence for short periods (