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Some micronutrients have key roles in immune defence, including mucosal defence mechanisms and immunoglobulin production. Altered micronutrient status has been linked with COVID-19 infection and disease severity. We assessed the associations of selected circulating micronutrients with anti-SARS-CoV-2 IgG and IgA seropositivity in the Swiss community using early pandemic data. Case-control study comparing the first PCR-confirmed COVID-19 symptomatic cases in the Vaud Canton (May to June 2020, n = 199) and controls (random population sample, n = 447), seronegative for IgG and IgA. The replication analysis included seropositive (n = 134) and seronegative (n = 152) close contacts from confirmed COVID-19 cases. Anti-SARS-CoV-2 IgG and IgA levels against the native trimeric spike protein were measured using the Luminex immunoassay. We measured plasma Zn, Se and Cu concentrations by ICP-MS, and 25-hydroxy-vitamin D 3 (25(OH)D 3) with LC-MS/MS and explored associations using multiple logistic regression. The 932 participants (54.1% women) were aged 48.6 ± 20.2 years (±SD), BMI 25.0 ± 4.7 kg/m2 with median C-Reactive Protein 1 mg/l. In logistic regressions, log 2 (Zn) plasma levels were negatively associated with IgG seropositivity (OR [95% CI]: 0.196 [0.0831; 0.465], P < 0.001; replication analyses: 0.294 [0.0893; 0.968], P < 0.05). Results were similar for IgA. We found no association of Cu, Se, and 25(OH)D 3 with anti-SARS-CoV-2 IgG or IgA seropositivity. Low plasma Zn levels were associated with higher anti-SARS-CoV-2 IgG and IgA seropositivity in a Swiss population when the initial viral variant was circulating, and no vaccination available. These results suggest that adequate Zn status may play an important role in protecting the general population against SARS-CoV-2 infection. ISRCTN18181860. [ABSTRACT FROM AUTHOR]

Cardiovascular (CV) diseases (CVD) are the leading cause of mortality worldwide and their impact will increase due to the gradual aging of population. Vascular calcification, which is defined as a formation of hydroxyapatite crystals in the vascular wall, is a serious pathological condition often accompanying CVD and it is a strong predictor of CV events and mortality. Vascular smooth muscle cells (VSMCs) are one of the main type of cells defining development and progression of CVD and vascular calcification. Copper (Cu) is an essential microelement for humans, and it is involved in a plethora of processes affecting CV health. However, copper significance in pathophysiology of VSMCs is critically understudied. The aim was to investigate Cu role in relevant physiological responses of VSMCs. The work was carried out on human aortic primary VSMCs. We utilised standard biochemical, molecular and cell biology approaches as well as transcriptome sequencing to assess roles of Cu in VSMCs calcification and migration by means of Cu supplementation and chelation. Physiological levels of Cu (10 uM) inhibited calcification of VSMCs, stimulated their metabolic activity and protein synthesis as well as promoted migration. Cu chelation reversed the observed effects and at higher doses was lethal for VSMCs. On the other hand, excessive doses of Cu (up to 150 uM) were also detrimental for VSMCs indicating narrow range of beneficial concentrations. Low micromolar concentrations of Cu inhibited alkaline phosphatase activity both associated with cells and in cell-conditioned media. According to the transcriptomics data, further confirmed by quantitative PCR, physiological amount of Cu during calcification inhibited osteogenic transdifferentiation of VSMCs, reduced cellular immunity-related reactions and promoted synthesis of extracellular matrix (ECM) structural proteins at the initiation stage of the calcification process. Summarising, physiological concentration of Cu inhibited in vitro calcification of VSMCs due to prevention of their osteogenic differentiation and stabilisation of ECM. Taken together, our results underline importance of Cu homeostasis for CV health and suggest targeting Cu metabolism in development of new preventive and therapeutical approaches for CVD. IK, JHB and IO were part-funded by the European Union's Horizon 2020 programme (H2020-RISE 2016-734931, MILEAGE Project) and IO was also supported by a Vernadski PhD scholarship from the French government. [ABSTRACT FROM AUTHOR]

Anxiety is common in hospitalized patients and can worsen pain or lead to unsuccessful pain relief. The purpose of this study was to evaluate the usefulness of measuring anxiety with a visual analog scale (VAS) in the hospitalized patient experiencing pain. We conducted a multiple-center cross-sectional study. Adult inpatients experiencing moderate to severe pain defined by a pain VAS score ≥40 of 100 were included. Pain and anxiety data were collected using the following instruments: pain VAS, anxiety VAS, State Anxiety Scale of the Spielberger State-Trait Anxiety Inventory (STAI-YA) and Anxiety Subscale of the Hospital Anxiety and Depression Scale (HAD-A). Data were collected from 394 patients. Of those patients, 43.6% (171 of 392) and 36.6% (143 of 391) had significant anxiety according to STAI-Ya and HAD-A, respectively. Correlation was good between anxiety-VAS and STAI-YA (ρ = 0.67 [95% confidence interval 0.61-0.72]) and moderate between anxiety VAS and HAD-D (ρ = 0.48 [0.39-0.56]). The main factor predictive of situational anxiety was history of anxiety-depression symptoms (odds ratio = 2.95 [1.93-4.56]). For anxiety VAS score ≥ 40 of 100, the sensitivity for detecting anxiety was 81% with 70% specificity. This study confirmed the high prevalence of anxiety among inpatients experiencing pain, demonstrated the capacity of a VAS to assess this anxiety, determined an anxiety VAS cutoff level to screen for significant anxiety, and identified risk factors of anxiety in this population. Anxiety VAS has been found to be an easy-to-use method familiar to caregivers, with all the advantages needed for an effective screening instrument. An anxiety VAS score ≥40 of 100 would thus warrant particular attention to adapt care to the patient's anxiety-related pain and initiate specific therapeutic interventions. [ABSTRACT FROM AUTHOR]

Purpose: Radiation-induced (RI) plexopathy is a rare peripheral nerve injury after radiation therapy for cancer. No treatment has been shown to slow its progression. A pentoxifylline-vitamin E combination significantly reduced RI fibrosis, and its association with clodronate (PENTOCLO) allowed healing of osteoradionecrosis and reduction of neurologic symptoms in phase 2 trials.Methods and Materials: A placebo-controlled, double-blind trial conducted in adults with RI limb plexopathy without cancer recurrence, randomized in 2 arms to PENTOCLO (pentoxifylline 800 mg, tocopherol 1000 mg, clodronate 1600 mg 5 days per week) or triple placebo. The primary outcome measure after 18 months of treatment was the neurologic Subjective Objective Management Analytic (SOMA) score evaluating pain, paresthesia, and motor disability.Results: Between 2011 and 2015, 59 patients were included: 1 false inclusion (neoplastic plexopathy), 29 treated with placebo (group P), and 29 treated with the active drugs (group A); 46 patients presented an upper-limb and 12 a lower-limb plexopathy. The mean delay after irradiation was 26 ± 8 years, for patients with neurologic symptoms for 5 ± 5 years. The median global SOMA scores in the P and A groups, respectively, were 9 (range, 6-11) versus 9 (range, 8-11) at M0 and 9 (range, 5-12) versus 10 (range, 6-11) at M18 without any significant difference. Analysis of the secondary outcomes showed that SOMA score subdomains for pain and paresthesia were more affected in group A (not significant). The frequency of adverse events was similar in the 2 groups (81% of patients): slight expected vascular-gastrointestinal symptoms in A, but a large excess of RI complications (arterial stenosis).Conclusions: This first randomized drug trial in RI plexopathy failed to show a beneficial effect. More studies are needed in patients with less advanced disease and fewer confounding comorbidities and with a more sensitive measure to detect a therapeutic effect. [ABSTRACT FROM AUTHOR]

Abstract Purpose We present a concise description of an in-house decision aid software called "C entral 3D" that allows a quick and robust lung tumor classification between central and peripheral as defined by the Radiation Therapy Oncology Group (RTOG) 0813. Methods and materials Twenty cases of lung tumors were selected for this study and four radiation oncologists blindly classified them as peripheral versus central without assistance of our software. All discordant cases were reviewed using C entral 3D and prompt consensus was obtained. Results Many authors have stressed the importance of adopting risk adaptive fractionation schedule with lower biological equivalent dose when treating centrally-located high risks lesions. C entral 3D addresses the limitation of current treatment planning systems to represent image data in fixed planes and can help radiation oncologists to fully characterize these pulmonary lesions. [ABSTRACT FROM AUTHOR]

Many older patients and patients with Parkinson’s disease (PD) do not respect medication prescriptions. Non-adherence is caused by several factors among which three play an important role: Treatment complexity, cognitive decline, and patient-provider communication. This article presents an ongoing multidisciplinary project, the CONSIGNELA project, which adopts a patient-centered approach for improving medication adherence in these patients. The first objective of the project is to identify the best way to communicate medication prescriptions with tablets and touch-screen devices. The second objective is to improve medication adherence by creating a collaborative application (app) designed both for older and PD patients and for healthcare professionals in charge of them. Two solutions are combined: A cognitive and a technological solutions. The cognitive solution consists in studying in real time older and PD patients while consulting and executing prescriptions presented in different formats to select the most efficient one. The technological solution aims to improve collaboration between health professionals and patients by developing System of Systems (SoS). The research model used in the project includes three phases. Only the results of phase 1 are presented in the article. A research app, CONSIGNELA-Appli-R was programmed to analyze patient cognitive processes while consulting a prescription on a tablet. A pilot study was carried out with young adults to test it. It confirmed a facilitating effect of table format. In parallel, the prototype of a second app, CONSIGNELA-Appli-P, for patients and healthcare providers was developed. It is based on an SoS architecture connecting a virtual pillbox, a Multi-Agent System (MAS) and a knowledge platform. The virtual pillbox is used by patients and providers to improve mutual understanding of medication prescriptions. The MAS provides agents that extract and analyze indicators, actions and information resulting from the interaction between patients and virtual pillboxes. All the information is capitalized and stored in the knowledge platform. Providers can receive charts and dashboards showing information about the following of the medication regimen, for instance, if patients are following it correctly or not. [ABSTRACT FROM AUTHOR]

Since 1992, two instruments – the Food Neophobia Scale (FNS) and the Varseek-scale – are used to measure food neophobia and variety seeking tendency, two personality traits that are at the heart of the management of the omnivore’s paradox. This article highlights their conceptual difference, and empirical indistinctness. In-depth analyzes are carried out regarding their content and construct validity. FNS has weaknesses regarding its construct validity (dimensionality, convergent validity). Discriminant validity cannot be established, due to too strong similarities between their items, which hamper the content validity of Varseek-scale. This scale has good predictive validity for willingness to try new or unfamiliar foods. However, it does not reflect the desire for alternation among familiar foods, for which a new operationalization seems necessary. [ABSTRACT FROM AUTHOR]

• Analytical Hierarchy Process proves a flexible method to assess vulnerability and risk. • Risk experience, wildland-urban interface and tree traits drive vulnerability. • Considering socio-economic drivers and several assets broadens the analysis. • Stakeholders confirmed the relevance of participative assessments using MCDA. • We identify vulnerable locations not yet subject to hazard. The Mediterranean region is routinely affected by forest fires, with adverse consequences on ecological, infrastructural, and socioeconomic assets. In a context of climate change, it is crucial for fire prevention and suppression to be able to identify locations where assets are most at risk, due to environmental, physical or socio-economic reasons. Besides, this knowledge needs to be developed together with operational services and field experts to ensure their application. So far, fire risk research has largely focused on fire behavior, effects, and model simulation. In this article, we show how the concept of vulnerability can provide a flexible and relevant framework for assessing fire risk and be evaluated using a spatial multicriteria decision analysis method (MCDA) - the Analytical Hierarchy Process (AHP)- based on both quantitative data and expert judgment gathered through a participative approach. We focus on South-Eastern France, a region characterized by high economic and environmental stakes and heavily affected by wildfires. We develop a series of spatialized indicators using ecological, land-use and sociodemographic data which we aggregate to produce vulnerability maps for three categories of assets: population, ecosystems and infrastructures. An ex-post workshop was organized with field experts to put both the approach and results into discussion. Results reveal significant differences in indicators' perceived contributions to risk and vulnerability and enable appraising the contribution of sociodemographic factors, often overlooked in the literature. We also reveal differences in spatial patterns across both vulnerability subcomponents and exposed assets, helping identify primary and secondary vulnerability hotspots and underlying drivers. Consideration of multiple subcomponents of risk and vulnerability may help local decision makers prioritize how and where measures should be implemented, while the use of MCDA favors experience and knowledge sharing and among stakeholders while providing a basis of discussion. [ABSTRACT FROM AUTHOR]

Part of the French timber transformation industry suffers from difficulties to adapt to recent changes on global markets. This translates into net exports of raw wood and imports of transformed products, detrimental to both the trade balance and the local creation of wealth. At the same time, no consistent and homogeneous accounts for wood product production and consumption exist at this time. This article first aims at objectifying this situation by undertaking the first material flow analysis of the French forest-wood supply chain. We then evaluate the potential consequences of various scenarios of raw wood exports reduction policies, namely subsidies for consumption or transformation and taxation of exports, on both economic outcomes for the different actors and material flows. We thus provide an example of coupling material flow analysis with economic modeling in an attempt to move from the diagnostic phase to the assessment of possible actions within a decision-making perspective. [ABSTRACT FROM AUTHOR]

Résumé Introduction Ces dernières années, le lambeau de grand dorsal a vu ses indications se réduire au profit de sa version préservant le muscle : le lambeau perforant thoracodorsal (TDAP). La dissection intramusculaire de la perforante permet de diminuer les séquelles au niveau du site donneur mais permet également un allongement du pédicule par rapport au pédicule du lambeau musculocutané de grand dorsal. Le but de cette étude était de quantifier de manière objective l’allongement du pédicule thoracodorsal lorsque la perforante est disséquée au travers des fibres musculaires et au sein du tissus adipeux sous-cutané. Matériels et méthodes Seize TDAP ont été disséqués sur cadavre frais. Nous avons défini 4 portions de pédicule : (1) hypoderme ; (2) tissu adipeux sous-cutané ; (3) tissu intramusculaire ; (4) pédicule « classique ». La longueur de chaque portion et la longueur totale du pédicule ont été mesurées. Résultats La dissection intramusculaire de la perforante permet d’obtenir un allongement du pédicule théorique de 5,25 cm, voire de 9,19 cm si l’on poursuit la dissection dans le tissu sous-cutané. La longueur totale potentiellement exploitable est de 20,66 cm. Conclusion La dissection de la perforante du lambeau thoracodorsal permet d’obtenir un allongement du pédicule d’environ 5 cm, voire de 9 cm si l’on pousse la dissection dans le tissu sous-cutané. Un long pédicule présente un intérêt en chirurgie reconstructrice des membres et en reconstruction faciale lorsque la microchirurgie n’est pas réalisable. Summary Purpose In recent years, the indications of latissimus dorsi myocutaneous flap decreased in favor of its version preserving muscle: the thoracodorsal artery perforator flap (TDAP). The intramuscular dissection reduce donor site morbidity but also allows an extension of the pedicle compared to conventional latissimus dorsi flap pedicle. The purpose of this study was to quantify objectively elongation of the pedicle when the perforator is dissected through the muscle. Method Sixteen TDAP flap were dissected in 9 cadavers. The pedicle was divided into 4 distinct parts: (1) hypodermis, (2) subcutaneous fat, (3) intramuscular, (4) conventional pedicle. Results The length of the pedicle is significantly increased when the pedicle is dissected through the muscle. This extends the theoretical length from 5.25 cm up to 9.19 cm if the dissection is extended to the deep fat. Indeed, this results in a potentially exploitable TDAP pedicle length of 20.66 cm. Conclusion The dissection of the perforator allows an extension of the pedicle of about 5 or 9 cm if we continue the dissection in the subcutaneous fat. A long pedicle may be interesting in lower limb reconstructive surgery and facial reconstruction where microsurgery is not feasible. [ABSTRACT FROM AUTHOR]

Background The African continent has the greatest burden of surgical disability-adjusted life years, yet the least is known about operative care here. This analysis describes the surgical patients admitted to 7 hospitals supported by the Médécins Sans Frontières (MSF) over 3 years in 3 conflict-affected countries—Eastern Democratic Republic of Congo, Central African Republic, and South Sudan. Methods A standardized operative data collection tool was used for routine collection of operative inpatient data between 2011 and 2013 at 7 MSF surgical facilities. Surgical records of 14,482 patients were analyzed to describe surgical epidemiology, major procedures, and perioperative mortality. The perioperative mortality rate (POMR) was calculated within 2 days of admission (POMR2) and within 30 days from admission (POMR30). The POMR is used as a marker of quality of operative care. Results Caesarean delivery was the most common major procedure performed and had a POMR30 of 5.28 per 1,000 admissions. The overall inpatient mortality was 19.67 per 1,000 admissions. Children had greater POMR than adults for the same procedure types (47.97 vs 15.89 deaths per 1,000 admissions, P < .001); 85.1% of all major procedures were emergency procedures and between 3 and 30% of admissions were related to violence. After adjustment, perioperative death was associated with emergency surgery, violence, and age younger than 15 years. Conclusion POMRs varied by age group and type of major procedure performed. Collecting surgical data is achievable and can inform future planning and support for national surgical programs. More information is needed on operative outcomes in adults and children in low-resource settings to improve quality and access to care. [ABSTRACT FROM AUTHOR]

The ability of pharmacological agents to target both “classical” risk factors and inflammation may be key for successful outcomes in the prevention and treatment of atherogenesis. Among the promising drugs interfering with cholesterol metabolism, we investigated whether methyl beta-cyclodextrin (KLEPTOSE® CRYSMEB) could positively impact on atherogenesis, lipid profile and atherosclerotic plaque inflammation in ApoE −/− mice. Eleven-week old ApoE −/− mice were fed either a normal diet (N.D.) or a high-cholesterol diet (H.D.), resulting in different levels of hypercholesterolemia. KLEPTOSE® CRYSMEB (40 mg/kg) or vehicle was intraperitoneally administrated 3 times per week in the last 16 weeks before euthanasia in mice under N.D. and in the last 11 weeks under H.D. Treatment with KLEPTOSE® CRYSMEB reduced triglyceride serum levels in both atherogenesis mouse models. In H.D. mice, treatment with KLEPTOSE® CRYSMEB increased HDL-cholesterol levels and reduced free fatty acids and spleen weight. In both mouse models, treatment with KLEPTOSE® CRYSMEB reduced atherosclerotic plaque size in thoraco-abdominal aortas and intraplaque T lymphocyte content, but did not induce relevant improvements in other histological parameters of vulnerability (macrophage, neutrophil, MMP-9 and collagen content). Conversely and more markedly in H.D. mice, treatment with KLEPTOSE® CRYSMEB was associated with a reduction in genetic markers of Th1-mediated immune response. In vitro, KLEPTOSE® CRYSMEB dose-dependently abrogated Th1 proliferation and IFNγ release. In conclusion, treatment with KLEPTOSE® CRYSMEB reduced atherosclerotic plaque size by improving triglyceride serum levels and Th1-mediated response. These results indicate this drug as a potential tool for blocking atheroprogression associated with different severity degrees of hypercholesterolemia. [ABSTRACT FROM AUTHOR]

Given the plethora of terroir products, local food companies could find an advantage in specifying their positioning by taking into account what the terroir represents for consumers. This research contributes to identifying specific attributes of a terroir in tune with consumer expectations, and tests their capacity to ameliorate consumer hedonic assessments and judgments for these products. Results show the potential of a positioning based on the environment, which is respected by the practices of terroir producers, and which also guarantees the quality of the product. [ABSTRACT FROM AUTHOR]

Between 2009 and September 2012, locally acquired cases of P. vivax infection were reported in Greece, mostly from the agricultural area of Evrotas, Lakonia (n Z 48), but also sporadically from five other regions (n Z14), suggesting that conditions in these areas are favourable for local transmission of malaria. The risk of re-establishment of malaria in Greece will depend on whether the receptivity for disease transmission (presence of the mosquito vector and adequate ecological and climatic factors) and the vulnerability (importation of the parasite in human reservoirs or presence of infected mosquito vectors) continue to be present in the country. The continuous implementation of the integrated preparedness and response plan for malaria that covers all aspects from surveillance and laboratory diagnosis to vector control and the reorganization of public health infrastructures are necessary to prevent transmission and control the disease in the long term. However, the impact of the severe economic crisis on current health-care, public health infrastructures and vector control constitute a great challenge for the future. The current threat of renewed sustained local malaria transmission in Greece (and thus in continental Europe) merits an international response, including financial and technical support, from European and international stakeholders. [ABSTRACT FROM AUTHOR]

Since beta-2 microglobulin (B2M) is a surrogate marker for middle molecular weight uremic toxins and the major protein component in dialysis-related amyloidosis, it has been frequently studied in dialysis patients. It is not known, however, whether B2M has an impact in patients with chronic kidney disease (CKD) not yet on dialysis. Here we studied the relationship of plasma B2M levels to clinical and cardiovascular outcomes in 142 patients (mean age of 67 years) at different stages of CKD. B2M levels increased with CKD stage and thus were highest in hemodialysis patients. Baseline B2M levels were associated with vascular calcification but not with arterial stiffness or bone density. During a mean follow-up of 969 days, 44 patients died and 49 suffered a cardiovascular event. Higher B2M levels were independently associated with overall and cardiovascular mortality and cardiovascular events in the whole cohort and with cardiovascular events in the predialysis cohort. Moreover, B2M appeared to be a better predictor than well-established factors associated with outcomes in this population, such as estimated glomerular filtration rate ((eGFR), only for predialysis patients), inflammation biomarkers, and other factors included in a propensity score. Thus, we confirm the strong relationship between B2M levels and eGFR and confirm the power of B2M to predict overall and cardiovascular mortality and cardiovascular events in patients at different stages of CKD. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents a coupled thermo-hydro-mechanical (THM) model enriched with a buckling-type criterion for progressive spalling. In the first part of the paper, a general fully coupled multi-phase THM model describing the behaviour of concrete at moderate and high temperatures is presented. Then the spalling criterion and its numerical implementation in the framework of the finite element method are presented. Finally, a simple 1D numerical example will illustrate the effectiveness of the implemented numerical approach. [Copyright &y& Elsevier]

Abstract: Benzo[c]phenanthrolines and benzo[c]phenanthrolinones substituted by dialkylaminoalkyl side chains at position N5 and C6, respectively, were synthesised and their biological activity evaluated. They displayed interessant cytotoxicity associated with some DNA interactions. However, the low topoisomerase 1 affinity suggests that other cellular targets are responsible for the antiproliferative activity. [Copyright &y& Elsevier]

Abstract: A series of copolymers were prepared by ring-opening polymerization of ɛ-caprolactone and dl-lactide, using zinc lactate as catalyst. The resulting PCL/PLA copolymers were characterized by various analytical techniques such as NMR, SEC, DSC and X-ray diffraction. The [CL]/[LA] ratios of the copolymers are very close to those in the feed, indicating a good conversion of monomers. The copolymers with CL contents higher than 50% appear semi-crystalline, the crystalline structure being of the PCL-type. Compression moulded polymer films were allowed to degrade in a pH = 7.6 phosphate buffer containing Pseudomonas lipase. Data show that copolymers with CL contents lower than 25% are not degradable and the degradation rate increases with CL content for CL-rich copolymers. Various soluble degradation products are detected in the degradation medium, including CL1 to CL3 and LA1 to LA4 homo-oligomers, and CL2LA1 co-oligomer. The presence of LA homo-oligomers and CL2LA1 co-oligomer suggests that Pseudomonas lipase can not only degrade PCL but also LA short blocks along PCL/PLA copolymer chains. On the other hand, little changes of composition are detected during degradation, in agreement with a surface erosion mechanism as shown by ESEM. [Copyright &y& Elsevier]