Grand Est Region Research Articles

MULTISENGE: A MULTIMODAL AND MULTITEMPORAL BENCHMARK DATASET FOR LAND USE/LAND COVER REMOTE SENSING APPLICATIONS

Abstract. This paper presents MultiSenGE that is a new large scale multimodal and multitemporal benchmark dataset covering one of the biggest administrative region located in the Eastern part of France. MultiSenGE contains 8,157 patches of 256 × 256 pixels for the Sentinel-2 L2A , Sentinel-1 GRD images in VV-VH polarization and a Regional large scale Land Use/Land Cover (LULC) topographic reference database. With MultiSenGE, we contribute to the recents developments towards shared data use and machine learning methods in the field of environmental science. The purpose of this dataset is to propose relevant and easy-access dataset to explore deep learning methods. We use MultiSenGE to evaluate the performance for urban areas using well-known deep learning techniques. These results serve as a baseline for future research on remote sensing applications using the multi-temporal and multimodal aspects of MultiSenGE. With all patches georeferenced at a 10 meters spatial resolution covering the whole Grand-Est Region, MultiSenGE provides an opportunity for environmental benchmark dataset will help to advance data-driven techniques for land use/land cover remote sensing applications.

U-Net feature fusion for multi-class semantic segmentation of urban fabrics from Sentinel-2 imagery: an application on Grand Est Region, France

ABSTRACT Urban areas are increasing since several years as a result of development of built-up areas, network infrastructure, industrial areas or other built-up areas. This urban sprawl has a considerable impact on natural areas by changing the functioning of ecosystems. Mapping and monitoring Urban Fabrics (UF) is therefore relevant for urban planning and management, risk analysis, human health or biodiversity. For this research, Sentinel-2 (level 2A) single-date images of the East of France, with a high spatial resolution (10 m), are used to assess two semantic segmentation networks (U-Net) that we combined using feature fusion between a from scratch network and a pre-trained network on ImageNet. Moreover three spectral or textural indices have been added to the both networks in order to improve the classification results. The results showed a performance gain for the fusion methods in classifying several UF. However, there is a difference in performance depending on the urbanization gradient; highly urbanized areas provide a better distinction of some UF’s classes than rural areas.

The mood disorder spectrum vs. schizophrenia decision tree: EDIPHAS research into the childhood and adolescence of 205 patients

BackgroundThe early detection of patients at risk of developing schizophrenia and bipolar disorder, and more broadly mood spectrum disorder, is a public health concern. The phenotypical overlap between the prodromes in these disorders calls for a simultaneous investigation into both illness trajectories.MethodThis is an epidemiological, retrospective, multicentre, descriptive study conducted in the Grand-Est region of France in order to describe and compare early symptoms in 205 patients: 123 of which were diagnosed with schizophrenia and 82 with bipolar disorder or mood spectrum disorder. Data corresponding to the pre-morbid and prodromal phases, including a timeline of their onset, were studied in child and adolescent psychiatric records via a data grid based on the literature review conducted from birth to 17 years of age.ResultsTwo distinct trajectories were highlighted. Patients with schizophrenia tended to present more difficulties at each developmental stage, with the emergence of negative and positive behavioural symptoms during adolescence. Patients with mood spectrum disorder, however, were more likely to exhibit anxiety and then mood-related symptoms. Overall, our results corroborate current literature findings and are consistent with the neurodevelopmental process. We succeeded in extracting a decision tree with good predictability based on variables relating to one diagnosis: 77.6% of patients received a well-indexed diagnosis. An atypical profile was observed in future mood spectrum disorder patients as some exhibited numerous positive symptoms alongside more conventional mood-related symptoms.ConclusionThe combination of all these data could help promote the early identification of high-risk patients thereby facilitating early prevention and appropriate intervention in order to improve outcomes.

The effects of living and learning conditions on the health-related quality of life of children and adolescents during the COVID-19 lockdown in the French Grand Est region

IntroductionCOVID-19 lockdown measures resulted in children and adolescents staying and learning at home. This study investigated health-related quality of life (HRQoL) and its associated factors among youth during the first lockdown.MethodsA cross-sectional study was conducted among 8- to 18-year-olds from the French Grand Est region. Sociodemographic data and information on living and learning conditions were collected using an online survey. HRQoL was assessed using the KIDSCREEN-27. Multiple regression analysis was performed to explore factors related to low HRQoL in each dimension.ResultsIn total, 471 children from 341 households were included. Difficulties isolating at home were associated with low HRQoL in the psychological well-being (OR = 2.2, 95% CI: 1.2–4.0) and parent relations and autonomy (OR = 2.1, 95% CI: 1.2–3.8) dimensions. Conflicts with dwelling occupants were related to increased ORs in the psychological well-being (OR = 2.9, 95% CI: 1.9–4.6), parent relations and autonomy (OR = 2.2, 95% CI: 1.4–3.4) and school environment (OR = 2.4, 95% CI: 1.5–3.7) dimensions. Living in an apartment (OR = 1.8, 95% CI: 1.1–3.1), never leaving home (OR = 2.6, 95% CI: 1.2–5.9), having indoor noise at home (OR = 2.3, 95% CI: 1.2–4.6), and having a parent with high anxiety (OR = 1.8, 95% CI: 1.1–3.1) were associated with low HRQoL in the social support and peers dimension. Children working less than 1 h/day on schoolwork had an increased OR of 3.5 (95% CI: 1.4–9.0) in the school environment dimension.ConclusionLiving and learning conditions were associated with low HRQoL among children and adolescents during the COVID-19 lockdown. Prevention and intervention programs are needed to support youth by facilitating their interactions and improving their coping and to prepare for future waves.

History of a vaccination of proximity

The Grand-Est region was one of the first affected by the severe acute respiratory syndrome coronavirus 2 in March 2020. The liberal nurses were in the first line to bring their competences to the service of the patients. Motivated and involved, they took the initiative to open a vaccination center in January2021 and demonstrated the added value of working together. Sharing of experience by a private nurse in this region.

Violences éducatives ordinaires et accompagnement à la parentalité : enjeux actuels, dispositifs existants et perspectives

On 10 July 2019, France became the fifty-sixth country to officially ban ordinary educational violence (OEV). This type of method was previously tolerated by a jurisprudence that recognized the possessors of parental authority as having a customary “right of punishment”. The term OEV implies that violence could have an educational virtue and be presented as ordinary, banal, without generating harmful consequences for children. Even though their use is strongly favored by French parents, and this so-called “anti-spanking” law has been presented in the media as a societal debate, the theoretical and scientific literature, in particular the conclusions of five recent meta-analyses, provide fairly clear answers as to the consequences of these OEVs. The American Psychological Association and the American Academy of Pediatrics have recognized the educational ineffectiveness of these methods, while declaring that there is now sufficient scientific evidence to attest to their harmful effects in the short term (cognitive and attentional difficulties, externalized disorders) as well as in the long term (mental disorders). While this ban is strong on a symbolic level, the challenge is now to shift educational concepts towards more positive parenting practices. It is up to the entire early childhood sector to be an actor and bearer of this change. Many parenting support schemes are already in place, whether they are aimed at all families or at more targeted populations, when vulnerabilities are identified. The first module of the programme triple P, which has been successfully tested in the Grand-Est region and is now available free of charge to all French parents, is an example of an effective and affordable innovative scheme.

Global Warming and Human Health Effects of Wood Heating Life Cycle in the Grand-Est Region in France

Global Warming and Human Health Effects of Wood Heating Life Cycle in the Grand-Est Region in France

Global Warming and Human Health Effects of Wood Heating Life Cycle in the Grand-Est Region in France

Global Warming and Human Health Effects of Wood Heating Life Cycle in the Grand-Est Region in France

Effect of the COVID-19 outbreak and lockdown on mental health among post-secondary students in the Grand Est region of France: results of the PIMS-CoV19 study

BackgroundThe COVID-19 epidemic has sent students around the world in to lockdown. This study sought to assess the prevalence of impaired self-perceived mental health and identify associated factors among French post-secondary students during the lockdown.MethodsA cross-sectional study was conducted among French students living in the Grand Est area in France from May 7 to 17, 2020 during the first lockdown. An online survey was used to collect sociodemographic data, learning and teaching conditions, living conditions, and exposure to COVID-19, and self-perceived mental health was assessed with mental composite score (MCS) of the SF-12.ResultsOverall, 4018 were analyzed. Most participants were female (70.7%), and the mean age was 21.7 years (SD 4.0). The mean MCS score was 44.5 (SD 17.3). Impaired mental health, defined by a MCS < 1st Quartile, was mainly associated with female sex; decreased time for learning; not having access to the outside with a garden, a terrace or a balcony; difficulties with the living situation and having someone in the home affected by the SARS-COV2 requiring hospitalization or not.ConclusionsThis study showed that living conditions during lockdown had a clear impact on the mental health of French post-secondary students. There is a need to improve prevention and to access distance education as well as an urgent need for measures to develop healthy coping strategies for students. This is significant challenge and will assist in moderating the risk for the development of further distress and mental health concerns.

A generic information framework for decision-making in a forest-based bio-economy

Key message We present a methodological framework that both scientists and supply chain actors can mobilise to organise information at different scales of observation, and further make informed decisions regarding the supply and extraction of bio-molecules from forest biomass. We demonstrate its usefulness for extracting bio-molecules contained in silver fir growing in France. Context Numerous bio-active molecules can be extracted from trees at an industrial scale. Supply chain actors play a central role in this emerging bio-economy. However, they do not have enough information and tools to make informed decisions with respect to species, growing locations, or identities of potential suppliers of relevant wood biomass. Aims We explore and demonstrate an information chain and methodological framework that can help make three critical decisions regarding the selection of (1) the species containing the desired bio-molecules, (2) the locations where the resource is collected, and (3) the supply chain partners and types of industrial wood by-products necessary to obtain sufficient biomass for industrial extraction. Methods The methodological framework provides detailed guidelines and references to select the right combination of sampling protocol, allometric models, chemical analyses, GIS tools, and forest growth and supply chain models in order to produce information for the three decision steps within various regional contexts. Results We apply the framework within the context of supply chain actors who are interested in estimating the quantity and diversity of bio-molecules contained in silver fir (Abies alba Mill.) growing in the Grand Est region of France. We show how conflicting environmental, legal and economic constraints can affect the results. We discuss future challenges that need to be tackled to improve the methodological framework. Conclusion This study represents a highly detailed overview of the potential bio-molecules contained in a tree species, from its natural habitat or plantation to the end of the regional supply chain. It also represents a step towards the development of a generic knowledge infrastructure and methodology that is necessary to solve various decision-making problems regarding the industrial supply and extraction of high-value bio-molecules.

Deepening the territorial Life Cycle Assessment approach with partial equilibrium modelling: First insights from an application to a wood energy incentive in a French region

An innovative modelling framework and metrics are developed to assess the economic and environmental performances of regional incentives in the wood energy sector. Our approach is based on the coupling between a partial equilibrium economic model of the forest sector with Life Cycle Assessment (LCA). Its originality relies on the computation of regional eco-efficiency ratios while taking account of diverse direct and indirect spatial and market interactions. Several adaptations were implemented to ensure consistency between the two modelling approaches in terms of process yields and flow balances. These adaptations make it possible to produce both economic and environmental indicators with a consistent perimeter. Finally, we used two kinds of eco-efficiency indicators to compare bioenergy policies. On the one hand, Partial Eco-Efficiency (PEE) combines the economic surplus induced by an incentive on the energy wood sector with its potential environmental impacts. On the other hand, Full Eco-Efficiency (FEE) adds the environmental impacts avoided by substitution between wood-energy and fossil fuels, compared to a business-as-usual (BAU) scenario. The proposed adaptations were applied to a case study in the French Grand Est region that compared the eco-efficiency of scenarios with or without a subsidy to wood energy consumption. Results show that subsidy increases the eco-efficiency of the forest-based sector using both PEE and FEE while keeping competition with the other regions to a minimum. However, most benefits come from the consideration of avoided impacts, with FEE far exceeding PEE. Using FEE, the scenario with the subsidy is 5% to 50% more eco-efficient than the BAU despite an increased consumption of wood products, due to economic gains and avoided impacts. These outcomes show the importance of considering potential trade-offs when assessing the economic and environmental performance of regional policies in favour of the bioeconomy.

Psychiatry to support the Covid-19 vaccination campaign

Health professionals have been mobilised to contribute to the emergency vaccination campaign deployed since theend of 2020 to combat the Covid-19 pandemic. In a mental health institution of theGrand-Est region, a vaccination centre has been implemented in emergency to contribute to the collective public health effort. Feedback from a hospital health executive.

Care and management of adults with autism spectrum disorder in family practice: difficulties experienced by general practitioners.

Few studies exist regarding the management and support of adults with autism spectrum disorder (ASD) in family practice. Most of them concern the management of children. As a primary care professional however, the general practitioner (GP) has a role to play at every step of the autistic adult's care pathway. With this study, we sought to identify GPs' experienced difficulties in caring for and managing their adult patients with ASD. We conducted a qualitative study of 11 French GPs caring for adults with ASD via semistructured interviews and a thematic content analysis. GPs were recruited from 5 counties of the Grand Est Region (Marne, Haute-Marne, Meurthe-et-Moselle, Meuse and Vosges). All of the GPs described difficulties with the diagnostic process and the lack of initial training. Most of the respondents expressed difficulties with medical consultations of patients presenting an intellectual disability (ID) and with the lack of communication between GPs and mental health specialists during the patient care process. More than half of the GPs described difficulties with referral pathways for diagnosis due to lengthy delays and patient reluctance to seek psychiatric care. More than half of the respondents also experienced difficulties with providing proper social care, and with responding to patient distress due to their healthcare experiences. Improving awareness and training about ASD in adults, as well as harmonizing the diagnostic process and referral pathways, might reduce GPs' experienced difficulties in caring for this population.

Effect of Anti-COVID-19 Measures on Atmospheric Pollutants Correlated with the Economies of Medium-sized Cities in 10 Urban Areas of Grand Est Region, France

Using Sentinel-5P data, this study investigated the magnitude of change in the concentration of air pollutants (NO2, HCHO, SO2, O3, CO, and aerosol index) in the air of ten cities and urban areas of the French region of Grand Est as a result of the first lockdown imposed between March 17, 2020 and May 11, 2020. The results showed that the air quality in the urban environments of Grand Est improved significantly compared to the same period in 2019 without lockdown. NO2, O3, aerosol index and CO were the pollutants that exhibited maximum reductions by an average of -33.98%, -5.94%, -26.82% and -0.66%, respectively (the observed maximum decreases were -54.7%, -7.7%, -13.1%, and -5.3%, respectively). The largest decrease occurred in the Public Establishments of Inter-municipal Cooperation (EPCI, in French: Établissement public de coopération intercommunale) areas of Eurométropole de Strasbourg, CA Colmar, and CA Mulhouse Alsace. The maximum decrease in air pollution first occurred in land cover classes close to cities, followed by built-up urban areas. In this study, a global depollution index known as the atmospheric clearance index (ACI) was developed, which involved several air pollution parameters, and quantitatively analyzed the decrease in contamination levels of the atmosphere in this region. In addition, the correlation between the novel ACI and other population and economic development indices was studied. The results indicated that there was a negative and statistically significant correlation between ACI and population density, gross domestic product, gross value added (GVA) at basic prices, number of employees, and active enterprises.

Antibiotic stewardship in French nursing homes: a 2019 regional survey.

BackgroundAntibiotic resistance is a growing issue in nursing homes (NHs). Antibiotic stewardship (ABS) programmes can reduce antibiotic use in NHs, but few studies have assessed to what extent they are implemented in NHs.ObjectivesTo describe ABS current practices and describe the opinion of NH stakeholders regarding ABS and opportunities for improvement in one French region.MethodsWe invited by e-mail the medical and nurse coordinators of all NHs of the Grand Est region, France, to participate in our survey in 2019. The online questionnaire included 35 questions covering four topics: NH characteristics, current ABS practices, attitudes towards ABS and opinions on strategies to promote ABS. A score evaluating implementation of core ABS elements was calculated using the current ABS practice responses.ResultsOut of 417 NHs, 75 (18%) participated in our survey. The three most implemented ABS activities were antibiotic consumption monitoring (65%), antibiotic plan documentation (56%) and antibiotic prescription guide distribution (54%). Audit and feedback, training sessions or identification of a local ABS leader ranged from 13% to 29%. Participants positively perceived ABS and most suggestions to improve ABS programmes in NH, with maximal interest in training, audit and feedback interventions. The median score for implementation of core ABS elements was 3.3 (IQR = 2.3–5.4; theoretical range 0–11), and the score distribution was not associated with any NH characteristic.ConclusionsWhile there is still room for improvement, NHs had a positive attitude towards ABS strategies. Some regional and national initiatives to promote ABS in NHs exist and should be actively promoted.

Feelings and experiences of emergency trained caregivers during the COVID-19 pandemic

Many nurses and healthcare students have undergone emergency training to reinforce the resuscitation teams faced with a massive influx of patients affected by the severe acute respiratory syndrome coronavirus 2. Trainers from the Grand-Est region have assessed, during the training course and then remotely, the feelings and experiences of the professionals involved.

Reinforcement in a COVID resuscitation unit in the Grand-Est region

Available and voluntary, with ten years' experience in the intensive care unit, a nurse testifies to the reinforcement she brought to the Grand-Est region last April, when her nursing colleagues from the hospitals were facing the surge of patients struck by serious forms of COVID-19. A memorable experience.

Unveiling the unknown: knowledge and risk perception about the planting of pesticide-treated seed among French arable farmers

An accurate data collection on the planting of pesticide-treated seeds (PTSs) is key to facilitate benefit vs. risk assessment of this practice. Only little is known on the awareness level of French arable farmers with regard to this practice. We carried out a questionnaire survey among French arable farmers practicing conventional farming in the Grand-Est region. A total of 153 answers were obtained. We found that, almost all (88%) respondents planted PTSs and that only 24% performed seed treatment by themselves. Over 70% of farmers experienced crop emergence losses but only 34% thought that it was due to biotic stresses. Most farmers (71%) were aware about the type of pesticides used on their seed but only 19% had a good knowledge about the active ingredients used for seed treatment. Solely 59% of the respondents systematically used protective equipments while treating seeds or handling PTSs. Only 50% of farmers thought that the planting of PTSs improves the crop establishment quality and yield. The awareness level of French farmers should be further improved, in terms of real risks vs. benefits of seed treatment and the planting of PTSs.

The Role of Macrolide Antibiotics in the Prevention of Severe COVID-19 Disease Progression Via the Disruption of Bacteria/virus Co-Operation

Research on the COVID-19 vaccine and antiviral drugs is essential to stop the continuous spread of the COVID-19 pandemic. Repositioning the available drugs to control the disease could help relieve hospitals and maintain the healthcare systems worldwide. Therefore, the use of Azithromycin (ATM) to prevent the adverse effects of the COVID-19 represents a potential avenue for further research. This article reviewed the clinical evidence and specialised molecular research to describe the dual antiviral and antibacterial role of ATM, and the potential co-operation between mycoplasmas and SARS-CoV-2. Non-published data obtained from family practitioners of the Grand Est region of France who prescribed ATM and observed noteworthy results were also analysed herein. Here, we proposed to better understand the role of bacteria as a cofactor in viral amplification. Specifically, we discussed the importance of Mycoplasma pneumoniae, often hidden in the pulmonary microbiota, which escalates the disease from a viral infection in patients with mild or moderate symptoms to a "cytokine storm", as described by many authors, with potential autoimmune consequences. Such bacteria, which are generally quiescent, can participate in the development of local immune disorders leading to superinfection. Finally, we identified a few potential actions that can be taken to prevent unfavourable COVID-19 disease progression, using ATM through a family practitioner-based approach and called for further research in this area.

SARS-CoV-2: the experience of the Legouest armed forces teaching hospital

The Legouest military training hospital is one of the eight hospitals of the armed forces health service. Situated in the Grand-Est region, one of the regions most affected by the COVID-19 epidemic in spring, it had to reorganise itself within a few days with its regional and national partners. While continuing to support forces sent abroad, to overseas territories or located in the East of France, the armed forces hospital had three major missions: the support of other military hospital facilities, the continued care of non-COVID patients and the care of patients affected by COVID-19 requiring non-intensive hospital care.