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Objectives Even in an ‘optimal’ health system, patients’ characteristics may have an impact on their care. We investigated whether age, gender and place of birth have an impact in the HIV care continuum in France, a country with a universal free healthcare system. Methods We estimated differences in the 5 year restricted mean percentage of person-time spent (i) in care, (ii) receiving ART and (iii) on ART and virally suppressed among 2432 (30.2%) women, 3925 MSM (48.7%) and 1709 men who have sex with women (MSW; 21.2%) entering care in the Dat’AIDS French prospective cohort between 1 January 2013 and 31 December 2017. Trial registration: Clinicaltrials.gov reference NCT02898987. Results Men and women spent 85.6% and 82.8% of person-time on ART and 69.9% and 65% suppressed, respectively. MSM, MSW and women spent 86.9%, 82.6% and 82.8% of person-time on ART and 72.5%, 63.7% and 65% suppressed, respectively. Patients born in France (47%) and patients born abroad spent 87.9% and 81.9% of person-time on ART and 74.6% and 62.9% suppressed, respectively. Young men born abroad were found to spend the smallest person-time with non-detectable viral load (53% for MSW and 58.1% for MSM). Conclusions Despite free access to care and universal ART in France, disparities remain in the HIV continuum care across age, country of birth and way of HIV acquisition. Clinical and public health interventions targeting specific patients’ conditions are needed.

There has been much concern in recent years about the welfare of elephants in zoos across North America and Europe. While some previous studies have assessed captive elephant welfare at a particular point in time, there has been little work to develop methods which could be used for regular, routine welfare assessment. Such assessment is important in order to track changes in welfare over time. A welfare assessment tool should be rapid, reliable, and simple to complete, without requiring specialist training and facilities; welfare assessments based on behavioural observations are well suited to this purpose. This report describes the development of a new elephant behavioural welfare assessment tool designed for routine use by elephant keepers. Tool development involved: (i) identification of behavioural indicators of welfare from the literature and from focus groups with relevant stakeholders; (ii) development of a prototype tool; (iii) testing of the tool at five UK zoological institutions, involving 29 elephants (representing 46% of the total UK captive elephant population of 63 animals); (iv) assessment of feasibility and reliability of aspects of the prototype tool; (v) assessment of the validity of each element of the tool to reflect the relevant behaviour by comparing detailed behavioural observations with data from the prototype tool; (vi) assessment of known-groups criterion validity by comparing prototype tool scores in individuals with demographics associated with better or worse welfare; (vii) development of a finalised tool which incorporated all elements of the tool which met the criteria set for validity and reliability. Elements of the tool requiring further consideration are discussed, as are considerations for appropriate application and interpretation of scores. This novel behavioural welfare assessment tool can be used by elephant-holding facilities for routine behavioural welfare monitoring, which can inform adjustments to individual welfare plans for each elephant in their collection, to help facilities further assess and improve captive elephant welfare. This study provides an example of how an evidence-based behavioural welfare assessment tool for use by animal caretakers can be developed within the constraints of zoo-based research, which could be applied to a range of captive species.

The severity of psychopathology has a strong negative impact on quality of life (QoL) among older adults with schizophrenia spectrum disorder. However, because these subjects generally experience multiple psychiatric symptoms, it remains unclear whether decreased QoL in this population is due to specific symptoms (e.g., hallucinations), specific dimensions of psychopathology (e.g., negative symptoms), a general psychopathology dimension representing the shared effect across all psychiatric symptoms, or a combination of these explanations. Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large (N = 353) multicenter sample of older adults with schizophrenia spectrum disorder recruited from French public-sector psychiatric departments. We used structural equation modeling to examine the shared and specific effects of psychiatric symptoms on QoL, while adjusting for sociodemographic characteristics, general medical conditions, global cognitive functioning and psychotropic medications. Psychiatric symptoms and QoL were assessed face-to-face by psychiatrists using the Brief Psychiatric Rating Scale (BPRS) and the Quality of Life Scale (QLS). Among older adults with schizophrenia spectrum disorder, effects of psychiatric symptoms on QoL were exerted mostly through a general psychopathology dimension (β = − 0.43, p

The objectives of this work were (i) geographical analysis of the 2012-2014 outbreak of rabies in Greece using GIS and (ii) comparative analysis of animal cases with data of potential human exposure to rabies together with environmental data, in order to provide information for risk assessment, effective monitoring and control. Most animal cases (40/48) involved red foxes, while domestic animals were also diagnosed with rabies. Overall, 80% of the cases were diagnosed in central northern Greece; 75% of the cases were diagnosed in low altitudes (< 343.5 m), within a distance of 1 km from human settlements. Median distance from livestock farms was 201.25 m. Most people potentially exposed to rabies (889/1060) presented with dog bite injuries. Maximum entropy analysis revealed that distance from farms contributed the highest percentage in defining environmental niche profiles for rabid foxes. Oral vaccination programmes were implemented in 24 administrative units of the country during 2013 and 2014, covering a total surface area of similar to 60 000 km(2). Rabies re-occurrence in Greece emphasizes the need for ongoing surveillance in cross-border areas and in areas with intense human activity.

West Nile Virus (WNV) is the causative agent of a vector-borne, zoonotic disease with a worldwide distribution. Recent expansion and introduction of WNV into new areas, including southern Europe, has been associated with severe disease in humans and equids, and has increased concerns regarding the need to prevent and control future WNV outbreaks. Since 2010, 524 confirmed human cases of the disease have been reported in Greece with greater than 10% mortality. Infected mosquitoes, wild birds, equids, and chickens have been detected and associated with human disease. The aim of our study was to establish a monitoring system with wild birds and reported human cases data using Geographical Information System (GIS). Potential distribution of WNV was modelled by combining wild bird serological surveillance data with environmental factors (e.g. elevation, slope, land use, vegetation density, temperature, precipitation indices, and population density). Local factors including areas of low altitude and proximity to water were important predictors of appearance of both human and wild bird cases (Odds Ratio = 1,001 95%CI = 0,723-1,386). Using GIS analysis, the identified risk factors were applied across Greece identifying the northern part of Greece (Macedonia, Thrace) western Greece and a number of Greek islands as being at highest risk of future outbreaks. The results of the analysis were evaluated and confirmed using the 161 reported human cases of the 2012 outbreak predicting correctly (Odds = 130/31 = 4,194 95%CI = 2,841-6,189) and more areas were identified for potential dispersion in the following years. Our approach verified that WNV risk can be modelled in a fast cost-effective way indicating high risk areas where prevention measures should be implemented in order to reduce the disease incidence. © 2014 Valiakos et al.

International audience; An increase in circulating catecholamine levels represents one of the mechanisms whereby organisms cope with stress. In the periphery, catecholamines mainly originate from the sympathoadrenal system. As we reported, in addition to the central control through cholin-ergic innervation, a local gap junction-delineated route between adrenal chromaffin cells contributes to catecholamine exocytosis. Here, we investigated whether this intercellular communication is modified when the hormonal demand is increased as observed during cold stress. Our results show that in cold exposed rats, gap-junctional communication undergoes a functional plasticity, as evidenced by an increased number of dye-coupled cells. Of a physiological interest is that this upregulation of gap-junctional coupling results in the appearance of a robust electrical coupling between chromaffin cells that allows the transmission of action potentials between coupled cells. This enhancement of gap-junctional communication parallels an increase in expression levels of connexin36 (Cx36) and con-nexin43 (Cx43) proteins. Both transcriptional and posttranslational mechanisms are involved because Cx36 transcripts are increased in stressed rats and the expression of the scaffolding protein zonula occludens-1, known to interact with both Cx36 and Cx43, is also upregulated. Consistent with an upregulated coupling extent in stressed rats, the cytosolic Ca 2ϩ concentration rises triggered in a single cell by an iontophoretic application of nicotine occur simultaneously in several neighboring cells. These results describe for the first time a functional plasticity of junctional coupling between adult chromaffin cells that should be crucial for adaptation to stress or sensitization to subsequent stressors.

National audience

International audience; Pituitary adenylate cyclase-activating polypeptide (PACAP) is a 38-amino acid peptide that was first isolated from ovine hypothalamic extracts on the basis of its ability to stimulate cAMP formation in anterior pituitary cells. PACAP belongs to the vasoactive intestinal polypeptide (VIP)-glucagon-growth hormone releasing factor-secretin superfamily. The sequence of PACAP has been remarkably well conserved during the evolution from protochordate to mammals, suggesting that PACAP is involved in the regulation of important biological functions. PACAP is widely distributed in the brain and peripheral organs, notably in the endocrine pancreas, gonads, and respiratory and urogenital tracts. Characterization of the PACAP precursor has revealed the existence of a PACAP-related peptide whose activity remains unknown. Two types of PACAP binding sites have been characterized. Type I binding sites exhibit a high affinity for PACAP and a much lower affinity for VIP whereas type II binding sites have similar affinity for PACAP and VIP. Molecular cloning of PACAP receptors has shown the existence of three distinct receptor subtypes, the PACAP-specific PAC1 receptor, which is coupled to several transduction systems, and the two PACAP/VIP-indifferent VPAC1 and VPAC2 receptors, which are primarily coupled to adenylyl cyclase. PAC1 receptors are particularly abundant in the brain and pituitary and adrenal glands whereas VPAC receptors are expressed mainly in the lung, liver, and testis. The wide distribution of PACAP and PACAP receptors has led to an explosion of studies aimed at determining the pharmacological effects and biological functions of the peptide. This report reviews the current knowledge concerning the multiple actions of PACAP in the central nervous system and in various peripheral organs including the endocrine glands, the airways, and the cardiovascular and immune systems, as well as the different effects of PACAP on a number of tumor cell types.

International audience; I t is well known that the secretion of catecholamine by adrenal medullary cells is under the regulation of neurotransmitters, mainly acetylcholine. During the last years, the localization of peptides and peptidergic receptors in the adrenal medulla has raised the possibility of a peptidergic regulation of catecholamine secretion by adrenal chromaffin cells. For example, we have recently shown that neuropeptide Y can increase mRNA levels of tyrosine hydroxylase (TH), the enzyme that catalyzes the first step in the biosynthe-sis of catecholamines in the rat adrenal medulla. 1 Adenylate cyclase-activating polypeptide (PACAP), a 38 amino acid polypeptide isolated from the ovine hypothalamus on the basis of its stimulatory effect on cAMP production by pituitary cells, 2 has been found in the brain and peripheral organs, particularly the gastrointestinal tract, testis, and adrenal medulla. 3-5 The occurrence of PACAP receptors (type 1) in the rat adrenal medulla 6 and the stimulating influence of PACAP on the release of catecholamines from cultured porcine adrenal chromaffin cells 7 strongly suggest that this peptide might play a role in the control of catecholamine secretion by the adrenal medulla. In order to study the possible involvement of PACAP in the regulation of catecholamine biosynthesis by the adrenal gland, we have studied the effects of intravenous injections of PACAP and its potent antagonist PACAP(6-38) 8 on the genetic expression of TH in the adrenal medulla of the adult intact male rat. To determine the site of action of PACAP, we performed bilateral adrena-lectomy and homologous implantation of the adrenals under the kidney capsules. Those animals with implanted adrenals were injected with the same peptides. In all the experiments, eight animals per group were used. The levels of TH mRNA levels were measured by quantitative in situ hybridization. The hybridization technique was performed as previously described. 1 The hybridized sections were exposed to Kodak X-Omat