Interseasonal RSV infections in Switzerland - rapid establishment of a clinician-led national reporting system (RSV EpiCH).

In anticipation of an interseasonal respiratory syncytial virus (RSV) epidemic, a clinician-led reporting system was rapidly established to capture RSV infections in Swiss hospitals, starting in January 2021. Here, we present details of the reporting system and first results to June 2021. An unusual epidemiology was observed with an interseasonal surge of RSV infections associated with COVID-19-related non-pharmacological interventions. These data allowed real-time adjustment of RSV prophylaxis guidelines and consequently underscore the need for and continuation of systematic nationwide RSV surveillance.

The characterization of key physiological traits of medicinal cannabis (Cannabis sativa L.) as a tool for precision breeding.

BACKGROUND: For millennia, drug-type cannabis strains were extensively used for various medicinal, ritual, and inebriant applications. However, cannabis prohibition during the last century led to cultivation and breeding activities being conducted under clandestine conditions, while scientific development of the crop ceased. Recently, the potential of medicinal cannabis has been reacknowledged and the now expanding industry requires optimal and scientifically characterized varieties. However, scientific knowledge that can propel this advancement is sorely lacking. To address this issue, the current study aims to provide a better understanding of key physiological and phenological traits that can facilitate the breeding of advanced cultivars. RESULTS: A diverse population of 121 genotypes of high-THC or balanced THC-CBD ratio was cultivated under a controlled environment facility and 13 plant parameters were measured. No physiological association across genotypes attributed to the same vernacular classification was observed. Floral bud dry weight was found to be positively associated with plant height and stem diameter but not with days to maturation. Furthermore, the heritability of both plant height and days to maturation was relatively high, but for plant height it decreased during the vegetative growth phase. To advance breeding efficacy, a prediction equation for forecasting floral bud dry weight was generated, driven by parameters that can be detected during the vegetative growth phase solely. CONCLUSIONS: Our findings suggest that selection for taller and fast-growing genotypes is likely to lead to an increase in floral bud productivity. It was also found that the final plant height and stem diameter are determined by 5 independent factors that can be used to maximize productivity through cultivation adjustments. The proposed prediction equation can facilitate the selection of prolific genotypes without the completion of a full cultivation cycle. Future studies that will associate genome-wide variation with plants morphological traits and cannabinoid profile will enable precise and accelerated breeding through genomic selection approaches.

[Characteristics of patients admitted from emergency units in 18 internal medicine departments and organisation of these departments: A cross sectional study from SNFMI (SiFMI study group) in 2015]. / Caractéristiques des patients admis en médecine interne dans 18 hôpitaux français en aval des urgences et organisation de ces services : enquête transversale de la SNFMI (groupe d'étude SiFMI) en 2015.

INTRODUCTION: Patients admitted from emergency units represent a large portion of the population in internal medicine departments. The aim of this study is to identify characteristics of patients and organization of these departments. METHODS: Between June 29th and July 26th 2015, voluntary internal medicine departments from the SiFMI group prospectively filled anonymized internet forms to collect data of each patients admitted in their ward from emergency units, during seven consecutive days. RESULTS: Three hundred and sixty-five patients from emergency departments were admitted in 18 internal medicine inpatients departments, totalling 1100 beds and 33,530 annual stays, 56% of them for emergency units inpatients. Mean age was 68 years, 54% were women, mean Charlson score was 2.6 and 44% of the patients took at least three drugs. Main causes of hospitalization were infectious (29%) and neurological (17%) diseases. Mean length of stay was 9.2 days. The medical team was composed by a median value of 4,5 [2,75-6,25] senior full-time equivalents, 86% were internists. Each department except one received residents, two third of them were from general medicine. CONCLUSION: This study highlights a high organizational variability among internal medicine departments and patients, and sets internal medicine as a specialty with a great capacity to achieve an integrative/comprehensive management of patients and to offer a comprehensive basis for physicians in training.

The marine geological imprint of Antarctic ice shelves.

Reductions in the thickness and extent of Antarctic ice shelves are triggering increased discharge of marine-terminating glaciers. While the impacts of recent changes are well documented, their role in modulating past ice-sheet dynamics remains poorly constrained. This reflects two persistent issues; first, the effective discrimination of sediments and landforms solely attributable to sub-ice-shelf deposition, and second, challenges in dating these records. Recent progress in deciphering the geological imprint of Antarctic ice shelves is summarised, including advances in dating methods and proxies to reconstruct drivers of change. Finally, we identify several challenges to overcome to fully exploit the paleo record.

Diagnostic value of 18-F fluorodeoxyglucose PET/CT and bone scan in Schnitzler syndrome.

Introduction: Schnitzler syndrome is an auto-inflammatory disease defined by chronic urticarial eruption and monoclonal gammopathy. 18F fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is often performed, but its utility in Schnitzler syndrome has not been specifically investigated. The aim of this study was to determine whether PET/CT is informative in the diagnosis and follow-up of Schnitzler syndrome relative to other imaging techniques, including bone scans.Patients and methods: Patients of this study were selected from the French cohort established by Néel et al. All patients with a diagnosis of Schnitzler syndrome (according to Strasbourg's and Lipsker's criteria) who had at least one PET/CT were included. Data were collected from medical records. PET/CT scans were all reviewed by a nuclear physician blinded to the clinical and imaging data.Results: Ten patients underwent at least one PET/CT scan and all had at least one 99mTechnetium bone scan during their follow-up. The most frequent PET/CT abnormalities were diffuse bone-marrow and/or increased femoral fluorodeoxyglucose uptake, but they did not correlate with disease activity. Conversely, bone-scan abnormalities, including mainly increased radiotracer uptake in long bones, appeared to strongly correlate with Schnitzler syndrome activity.Discussion: PET/CT does not appear to be useful for the diagnosis and follow-up of Schnitzler syndrome. However, bone scans appear to be more sensitive for diagnosis and may correlate with clinical activity. Bone scans may be well positioned to distinguish Schnitzler syndrome relapse from other aetiologies of bone, joint, or muscle pain.Conclusion: Bone scans may be favoured over PET/CT in Schnitzler syndrome.

A Simple Target Interception Task as Test for Activities of Daily Life Performance in Older Adults.

Previous research showed that a simple target interception task reveals differences between younger adults (YA) and older adults (OA) on a large screen under laboratory conditions. Participants intercept downward moving objects while a horizontally moving background creates an illusion of the object moving in the opposite direction of the background. OA are more influenced by this illusory motion than YA. OA seem to be less able to ignore irrelevant sensory information than YA. Since sensory integration relates to the ability to perform Activities of Daily Living (ADL), this interception task can potentially signal ADL issues. Here we investigated whether the results of the target interception task could be replicated using a more portable setup, i.e., a tablet instead of a large touch screen. For YA from the same, homogeneous population, the main effects were replicated although the task was more difficult in the tablet set-up. After establishing the tablet's validity, we analyzed the response patterns of OA that were less fit than the OA in previous research. We identified three different illusion patterns: a (large) illusion effect (indicating over integration), a reverse illusion effect, and no illusion effect. These different patterns are much more nuanced than previously reported for fit OA who only show over integration. We propose that the patterns are caused by differences in the samples of OA (OA in the current sample were older and had lower ADL scores), possibly modulated by increased task difficulty in the tablet setup. We discuss the effects of illusory background motion as a function of ADL scores using a transitional model. The first pattern commences when sensory integration capability starts to decrease, leading to a pattern of over-integration (illusion effect). The second pattern commences when compensatory mechanisms are not sufficient to counteract the effect of the background motion, leading to direction errors in the same direction as the background motion (reverse illusion). The third pattern commences when the task requirements are too high, leading OA to implement a probabilistic strategy by tapping toward the center of the screen.

[Use of a medical discharge sheet for medication reconciliation in an internal medicine department: Assessment of general practitioners' opinion]. / Conciliation médicamenteuse avec remise d'une fiche de conciliation de sortie dans un service de Médecine Interne : évaluation de la perception des médecins généralistes.

BACKGROUND: Medication reconciliation (MR) is a systematic and comprehensive review of all medication a patient is taking. In this study, a discharge medication sheet (DMS) is given to patients upon discharge: it contains discharge prescription and any changes made to admission prescription with justifications. The aim of this study is to explore general practitioners' (GP) perceptions of this DMS in order to suggest improvements. METHODS: In this prospective observational study, individual semi-directed interviews were conducted with GPs who received a DMS following the hospitalization of one of their patients. Answers were grouped by topic and subjected to descriptive analysis. RESULTS: Between October 2015 and July 2016, 33 DMS were completed. Among the 33 GPs, 16 had seen their patients with their DMS and agreed to be interviewed. The DMS was very appreciated and improved care pathway. However, this study highlights transmission difficulties for this sheet, attributed in particular to a lack of information of practitioners and patients and to the paper format, which appears to be inadequate. The main suggested improvement is real-time transmission of the DMS via email. CONCLUSION: Practitioners' opinion is in favor of the use of a DMS. Certain specific points need to be improved, such as better information of practitioners and patients, and transmission of the DMS via a secure email system.

Aging and Sensitivity to Illusory Target Motion With or Without Secondary Tasks.

Older individuals seem to find it more difficult to ignore inaccurate sensory cues than younger individuals. We examined whether this could be quantified using an interception task. Twenty healthy young adults (age 18-34) and twenty-four healthy older adults (age 60-82) were asked to tap on discs that were moving downwards on a screen with their finger. Moving the background to the left made the discs appear to move more to the right. Moving the background to the right made them appear to move more to the left. The discs disappeared before the finger reached the screen, so participants had to anticipate how the target would continue to move. We examined how misjudging the disc's motion when the background moves influenced tapping. Participants received veridical feedback about their performance, so their sensitivity to the illusory motion indicates to what extent they could ignore the task-irrelevant visual information. We expected older adults to be more sensitive to the illusion than younger adults. To investigate whether sensorimotor or cognitive load would increase this sensitivity, we also asked participants to do the task while standing on foam or counting tones. Background motion influenced older adults more than younger adults. The secondary tasks did not increase the background's influence. Older adults might be more sensitive to the moving background because they find it more difficult to ignore irrelevant sensory information in general, but they may rely more on vision because they have less reliable proprioceptive and vestibular information.

Effects of Aging in Multisensory Integration: A Systematic Review.

Multisensory integration (MSI) is the integration by the brain of environmental information acquired through more than one sense. Accurate MSI has been shown to be a key component of successful aging and to be crucial for processes underlying activities of daily living (ADLs). Problems in MSI could prevent older adults (OA) to age in place and live independently. However, there is a need to know how to assess changes in MSI in individuals. This systematic review provides an overview of tests assessing the effect of age on MSI in the healthy elderly population (aged 60 years and older). A literature search was done in Scopus. Articles from the earliest records available to January 20, 2016, were eligible for inclusion if assessing effects of aging on MSI in the healthy elderly population compared to younger adults (YA). These articles were rated for risk of bias with the Newcastle-Ottawa quality assessment. Out of 307 identified research articles, 49 articles were included for final review, describing 69 tests. The review indicated that OA maximize the use of multiple sources of information in comparison to YA (20 studies). In tasks that require more cognitive function, or when participants need to adapt rapidly to a situation, or when a dual task is added to the experiment, OA have problems selecting and integrating information properly as compared to YA (19 studies). Additionally, irrelevant or wrong information (i.e., distractors) has a greater impact on OA than on YA (21 studies). OA failing to weigh sensory information properly, has not been described in previous reviews. Anatomical changes (i.e., reduction of brain volume and differences of brain areas' recruitment) and information processing changes (i.e., general cognitive slowing, inverse effectiveness, larger time window of integration, deficits in attentional control and increased noise at baseline) can only partly explain the differences between OA and YA regarding MSI. Since we have an interest in successful aging and early detection of MSI issues in the elderly population, the identified tests form a good starting point to develop a clinically useful toolkit to assess MSI in healthy OA.

Preoperative estimation of seizure control after resective surgery for the treatment of epilepsy.

PURPOSE: Predicting seizure control after epilepsy surgery is difficult. The objectives of this work are: (a) to estimate the value of surgical procedure, presence of neuroimaging abnormalities, need for intracranial recordings, resection lobe, pathology, durations of epilepsy and follow-up period to predict postsurgical seizure control after epilepsy surgery and (b) to provide empirical estimates of successful outcome after different combinations of the above factors in order to aid clinicians in advising patients presurgically about the likelihood of success under their patients' individual circumstances. METHODS: We report postsurgical seizure control from all 243 patients who underwent resective surgery for epilepsy at King's College Hospital between 1999 and 2011. Among the 243 patients, 233 had lobar or sub-lobar resections, 8 had multilobar resections and 2 had excision of a hypothalamic hamartoma. We examined the relation between postsurgical seizure control and type of surgical procedure, presence of neuroimaging abnormalities, pathology, resection lobe and the need of intra-cranial electrodes to identify seizure onset. RESULTS: Among the 243 patients, 126 (52%) enjoyed outcome grade I, 40 (16%) had grade II, 51 (21%) had grade III and 26 (11%) had grade IV (mean follow-up 41.1 months). Normal neuroimaging or need for intracranial recordings was not associated with poorer outcome. Patients undergoing temporal resections showed better outcome than those with frontal resections, due to the poor outcome seen in frontal patients with normal neuroimaging. Among temporal resections, there was no difference in outcome between patients with and without neuroimaging abnormalities. Among patients with lesions on imaging, temporal and frontal resections showed similar outcomes. Likelihood of favourable outcome under the patient's individual circumstances was estimated by the tables provided. There was an 8-9% decrease in the percentage of grade I between follow-up at 12 and >36 months. CONCLUSION: Overall, nearly 70% of patients undergoing resective surgery enjoy favourable post-surgical seizure control. Normal neuroimaging should not discourage surgery in temporal patients but is a negative prognostic sign in normal MRI frontal patients. There were no statistical differences in outcome between patients with neuroimaging lesions in frontal or temporal lobes.

Histopathologic improvement with lymphedema management, Léogâne, Haiti.

In countries where bancroftian filariasis is endemic, lymphedema of the leg is a public health problem, particularly for women, who are disproportionately affected. We investigated the effect of basic lymphedema management (hygiene, skin care, and lower limb movement and elevation) on the histologic features of lymphedema. A total of 118 skin-punch biopsy specimens were collected from the legs of 91 patients enrolled in a lymphedema treatment clinic in Léogâne, Haiti. Follow-up biopsy specimens were collected from 27 patients succeeds, equals 12 months later. Keratinocyte hyperproliferation, condensed dermal collagen, and mononuclear perivascular infiltrate increased with lymphedema stage, which suggested progressive chronic inflammation and fibrosis. Follow-up biopsies showed reductions in perivascular mononuclear infiltrate in the superficial dermis (41% decrease in prevalence), perivascular fibrosis in the deep dermis (58% decrease), and periadnexal mononuclear infiltrate (53% decrease). These data suggest that the clinical improvement commonly observed with basic lymphedema management has a histologic basis.

Eficácia do aconselhamento para doenças sexualmente transmissíveis em unidades de referência da cidade de Fortaleza, CE, Brasil / Efficacy of couselling in STD reference health units in the city of Fortaleza, CE, Brazil

Avalia a eficácia do aconselhamento para DST seguindo a recomendação nacional. O estudo foi realizado em pacientes com DST atendidos em quatro unidades públicas de saúde de referência de Fortaleza, nordeste do Brasil

[Nosocomial infection in psychiatry: myth or reality...?]. / L'infection nosocomiale en psychiatrie: mythe ou réalité...?

The absence of nosocomial infections control in the hospital Henri-Laborit, specialized in mental medicine, has brought ourselves to answer the question: is the nosocomial infection in psychiatric hospital a myth or a reality? A retrospective study of global nosocomial infections incidence has been realized from ten years of microbiology laboratory data. During this time, 716 patients have contracted one or several nosocomial infections. The incidence rate is 3%, the incidence density rate 0.3/1000. The urinary infections represent half of the infections, followed by the septic wounds. Some infections like septicaemia implicate the patient vital prognosis.