Northeast France Research Articles

Long-term ACE Inhibitor/ARB Use Is Associated With Severe Renal Dysfunction and Acute Kidney Injury in Patients With Severe COVID-19: Results From a Referral Center Cohort in the Northeast of France.

BackgroundIn patients with severe coronavirus disease 2019 (COVID-19), data are scarce and conflicting regarding whether chronic use of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) influences disease outcomes. In patients with severe COVID-19, we assessed the association between chronic ACEI/ARB use and the occurrence of kidney, lung, heart, and liver dysfunctions and the severity of the inflammatory reaction as evaluated by biomarkers kinetics, and their association with disease outcomes.MethodsWe performed a retrospective longitudinal cohort study on consecutive patients with newly diagnosed severe COVID-19. Independent predictors were assessed through receiver operating characteristic analysis, time-series analysis, logistic regression analysis, and multilevel modeling for repeated measures.ResultsOn the 149 patients included in the study 30% (44/149) were treated with ACEI/ARB. ACEI/ARB use was independently associated with the following biochemical variations: phosphorus >40 mg/L (odds ratio [OR], 3.35, 95% confidence interval [CI], 1.83–6.14), creatinine >10.1 mg/L (OR, 3.22, 2.28–4.54), and urea nitrogen (UN) >0.52 g/L (OR, 2.65, 95% CI, 1.89–3.73). ACEI/ARB use was independently associated with acute kidney injury stage ≥1 (OR, 3.28, 95% CI, 2.17–4.94). The daily dose of ACEI/ARB was independently associated with altered kidney markers with an increased risk of +25 to +31% per each 10 mg increment of lisinopril-dose equivalent. In multivariable multilevel modeling, UN >0.52 g/L was independently associated with the risk of acute respiratory failure (OR, 3.54, 95% CI, 1.05–11.96).ConclusionsPatients chronically treated with ACEI/ARB who have severe COVID-19 are at increased risk of acute kidney injury. In these patients, the increase in UN associated with ACEI/ARB use could predict the development of acute respiratory failure.

Follow-Up of Multi-Organ Dysfunction and Inflammation Using Biomarker Kinetics in Patients with Severe COVID-19 Disease and Association with Disease Outcomes: Results from a Referral Center Cohort in the North East of France

BACKGROUND: COVID-19 disease can induce pulmonary and systemic inflammation and subsequent multi-organ dysfunction In patients with severe COVID-19 disease, no

Management of eosinophilic esophagitis in children according to atopic status: A retrospective cohort in northeast of France

IntroductionMost children with eosinophilic esophagitis (EoE) are atopic, but the impact of atopy on the remission and development of EoE is still unclear. The aim of our study was to determine the impact of atopy on remission of EoE and to describe allergy tests and the choice of treatment for a cohort of EoE children in France. MethodsAll children diagnosed with EoE between January 2013 and June 2018 in the five pediatric centers in the northeast of France were included. Children were divided into two groups according to personal atopic disorders. Histological remission was defined on the basis of an eosinophilic count below 15 eosinophils per high-power field. ResultsAmong the 49 children included, 38 (78%) were atopic. Allergy tests were performed for 45 children (92%). Rates of sensitization were similar in both groups: 64% had food sensitization and 64% had aeroallergen sensitization. The most commonly attempted first-line therapy was with proton pump inhibitors (63%), followed by swallowed topical steroids (STS) (18%). First-line therapy was not associated with atopic status (P=0.88). Atopic children had a nonsignificant tendency for a higher remission rate after STS (55% vs. 0%, P=0.24) and a higher global remission rate (54% vs. 33%, P=0.18) compared with non-atopic children. ConclusionAllergy testing is relevant in the majority of children with EoE whether or not they have atopic disorders. Atopy seems to be associated with better response to STS. Further studies are needed to determine whether atopic status determines histological response.

Suicides in the Vorontsov Сorps in France 1815—1818: Examples and Causes

The article considers the problem of soldier suicides in the Russian occupation corps under the command of the Count Mikhail Vorontsov, which was a part of the Occupation Coalition Army, located in the north-east of France in 1815—1818 according the terms of the Paris Peace Treaty concluded at November 20, 1815. The author basing on the reports of the investigative commissions that studied the details of such incidents and also on the eyewitness accounts, tryed to analyze the main motives that pushed the soldiers to take their own lives, as well as modes of suicides and the reaction of the command to this phenomenon.

Continuous atmospheric CO<sub>2</sub>, CH<sub>4</sub> and CO measurements at the Observatoire Pérenne de l'Environnement (OPE) station in France from 2011 to 2018

Abstract. Located in north-east France, the Observatoire Pérenne de l'Environnement (OPE) station was built during the Integrated Carbon Observation System (ICOS) Demonstration Experiment to monitor the greenhouse gases mole fraction. Its continental rural background setting fills the gaps between oceanic or mountain stations and urban stations within the ICOS network. Continuous measurements of several greenhouse gases using high-precision spectrometers started in 2011 on a tall tower with three sampling inlets at 10, 50 and 120 m above ground level (a.g.l.). Measurement quality is regularly assessed using several complementary approaches based on reference high-pressure cylinders, audits using travelling instruments and sets of travelling cylinders (“cucumber” intercomparison programme). Thanks to the quality assurance strategy recommended by ICOS, measurement uncertainties are within the World Meteorological Organisation compatibility goals for carbon dioxide (CO2), methane (CH4) and carbon monoxide (CO). The time series of mixing ratios from 2011 to the end of 2018 are used to analyse trends and diurnal and seasonal cycles. The CO2 and CH4 annual growth rates are 2.4 ppm yr−1 and 8.8 ppb yr−1 respectively for measurements at 120 m a.g.l. over the investigated period. However, no significant trend has been recorded for CO mixing ratios. The afternoon mean residuals (defined as the differences between midday observations and a smooth fitted curve) of these three compounds are significantly stronger during the cold period when inter-species correlations are high, compared to the warm period. The variabilities of residuals show a close link with air mass back-trajectories.

Closed loop supply chain network for local and distributed plastic recycling for 3D printing: a MILP-based optimization approach

Recent research and initiatives increasingly propose a new approach, based on distributed plastic recycling for open-source (OS) 3D printing technologies, as a way to deal with the issue of plastic waste and to support the development of the circular economy (CE). Distributed recycling can be thought of as a sort of “smart grid”, composed of small and coordinated recycling units. However, the operational complexity of this distributed approach limits its application. Furthermore, the environmental and economic advantages have yet to be demonstrated. This article therefore explores the economic and environmental feasibility of this distributed plastic recycling approach from a logistics perspective, as a step towards its validation. To achieve this, an optimization mixed integer linear programming (MILP) model was used as an evaluation tool, representing a local closed loop supply chain (CLSC) network. The proposed model is illustrated using a case study of a university seeking to implement a distributed recycling demonstrator in order to recover 3D printing wastes from secondary schools in the northeast of France. Following this step, a sensitivity analysis was carried out considering the market variations (price of virgin plastic filament) and the amount of available plastic waste derived from the schools. The results obtained show positive economic and environmental benefits of carrying out this new method of plastic recycling. This work serves as a basis for continuing to explore the feasibility and replication of the distributed plastic recycling network in other contexts.

Distribution of soil properties along forest-grassland interfaces: Influence of permanent environmental factors or land-use after-effects?

Soil properties vary spatially according to land use; both because land users have selected specific soil properties for specific land uses, and land uses modify the soil properties. However, permanent environment factors and land-use effects are unlikely to display the exact same spatial patterns. Study of the spatial and historical patterns of distribution of soil properties could help to separate between these two causes. In this aim, we studied 22 forest-grassland interfaces with controlled historical configurations in northeast France. In each land use (forest and grassland), three distances to the edge (edge, periphery and core) and two land-use histories (ancient and recent) were studied.Along forest-grassland interfaces, forests were usually located slightly upslope of grasslands, and mainly because this non-random topographic position the topsoil texture was significantly more silty in forests, and clayey in grasslands. After statistically controlling for the effects of topography and soil texture, we observed two main gradients of variation in soil properties according to the distance-to-edge (acidity in forest and nutrient content in grassland). In forest, pH and Ca dropped from the edges to the peripheries (15 m distance), while in grassland, C, N, P and Na sharply increased from the edges to the cores (25 m distance). These results demonstrate, through the edge effect, the strong influence of the land use on a part of soil properties. Furthermore, less than two centuries after grassland afforestation or deforestation, we observed that soil properties in recent forests and recent grasslands were respectively closer to their current land use than to their former land use. These results demonstrate a rapid change in soil properties after land-use change. However, recent forests and recent grasslands kept a legacy of soil texture from their former land use, respectively. Recent grasslands also kept a lower soil density, N and Na content compared to ancient grasslands.Hence, this study of forest-grassland interfaces show strong and short-scale relationships between land use and soil properties and suggest that they express both original choices of land users for specific soil properties and land-use after-effects. The non-random topographic position of the forest-grassland interfaces indicates a conscious choice of this positioning by the land users, for agronomic reasons. Beyond that, land use, through vegetation composition and management practices, also has a strong impact on soil properties. The fact that land-use changes affect most soil properties after only a few decades confirms the existence of land-use effects over time.

Detection of old scattered windthrow using low cost resources. The case of Storm Xynthia in the Vosges Mountains, 28 February 2010

Abstract Unlike the contiguous windthrows, the scattered windthrows occurring as a result of wind gusts of lower speed (100-140 km/h) than in the first case (>140 km/h) are much more difficult to detect due to their much smaller areas and due to their very large number (several hundred in the wooded Vosges Mountains). The objective of this research is to present a rapid procedure for the detection of the scattered windthrows based on low cost, Landsat type images, knowing that certain sensors cannot be accessed without significant investments. Our application is based on the study of effects caused by the Storm Xynthia in the Vosges Mountains in the North-East of France, on 28 February 2010. Thus, based on two sets of Landsat satellite images, we used the “dark object” approach and the Disturbance Index, as well as the image classification before and after the storm, resulting in a map of changes. Following the detection process, 257 scattered polygons were detected, totalling 229 ha. For validation purposes, high-resolution images and orthophotoplans taken before and after storm were used. The error matrix was calculated, achieving an overall accuracy of 86%, which confirmed the quality of our analysis and supported this procedure for detecting scattered windthrow based on low cost resources.

Comparison of the removal of 21 micropollutants at actual concentration from river water using photocatalysis and photo-Fenton

The development of technologies capable of eliminating a wide spectrum of micropollutants of diverse nature from waters becomes essential. Advanced oxidation processes (AOPs) seem to be the most promising technologies but the most appropriate AOP to remove the micropollutants is still under debate. In this study, for the first time, the comparison of the efficiency of TiO2 heterogeneous photocatalysis and iron-impregnated faujasite heterogeneous photo-Fenton process is conducted towards the removal of a mixture of 21 micropollutants from a real river at low concentrations. The sampling area is situated on the Meurthe River, downstream the wastewater treatment plant of the city of Nancy in the northeast of France. To assess the impact of the micropollutants concentration and the matrix composition, two sampling campaigns have been performed at different periods of the year. Among the targeted micropollutants, 14 pharmaceuticals, 1 personal care product, 4 endocrine disruptors and 2 perfluorinated molecules are specifically followed. Their concentrations range from few ng L−1 to hundreds ng L−1. The adsorption of all the micropollutants is higher onto the iron-impregnated faujasite compared to that onto TiO2 due to the larger surface area of the iron-impregnated faujasite. The iron-impregnated faujasite offers superior photo-Fenton oxidation efficiency towards the degradation of the micropollutants over the TiO2 photocatalysis system. For almost all the micropollutants, the contaminants are totally removed after 30 min by photo-Fenton while a longer period is necessary by photocatalysis. A relationship between the removal efficiencies and the octanol–water partition coefficient (log Kow) of each micropollutant has been extracted from the data. A further economic evaluation confirms that the photo-Fenton process is also the better in terms of cost.

Quantifying intra-annual dynamics of carbon sequestration in the forming wood: a novel histologic approach

This study presents a novel histologic approach to quantify the intra-annual dynamics of carbon sequestration in forming wood. This innovative approach, based on repeated measurements of xylem apparent density, is more direct, and more accurate than the previously published cellular-based approach. Moreover, this new approach, which was tested here on softwoods, is also applicable to hardwoods without any modification. Forest ecosystems are key players of the terrestrial carbon cycle. Indeed, wood represents the principal carbon pool of terrestrial biomass, accumulated in trees through cambial activity. Here, we present a novel, simple, and fast approach to accurately estimate the intra-annual dynamics of aboveground woody biomass production based on image analysis of forming xylem sections. During the 2015 growing season, we weekly collected wood samples (microcores) containing the forming xylem on seven Norway spruces (Picea abies (L.) Karst), grown in Hesse forest (North-East France). The microcores were prepared to allow the observation of the forming tissues with an optical microscope. Xylem apparent density and radial increment were then measured directly on images of the histological sections. In order to compare our “histologic approach” with the previously published “cellular approach,” we also counted the number of tracheids in each differentiation zones, and measured the tracheid dimensions all along the last-formed tree ring. The two approaches yielded comparable meaningful results, describing xylem size increase and aboveground woody biomass production as bell-shaped curves culminating in May and June respectively. However, the histologic approach provided a shorter time lag between xylem size increase and biomass production than the cellular one. Better quantification of the shift between stem growth in size and in biomass will require addressing the knowledge gap regarding lignin deposition kinetics. Nevertheless, our novel histologic approach is simpler and more direct than the cellular one, and may open the way to a first quantification of intra-annual dynamics of woody biomass production in angiosperms, where the cellular approach is hardly applicable.

Early evaluation of impacts of cold waves and floods during winter 2018 in France

ObjectiveThe presentation describes the results of the daily monitoring of health indicators conducted by the French public health agency during the major floods and the cold wave that occurred in January 2018 in France, in order to early identify potential impact of those climatic events on the population.IntroductionThe Seine River rises at the north-East of France and flows through Paris before emptying into the English Channel. On January 2018 (from 22th January to 11th February, Weeks 4 to 6), major floods occurred in the Basin of Seine River, after an important rainy period. This period was also marked by the occurrence on the same area of a first cold wave on Week 6 (from 5th to 7th February), including heavy snowfall and ice conditions from 9th to 10th February. A second similar cold wave occured from 28th February and 1st March.Floods of all magnitude are known to have potential health impacts on population [1], both at short, medium and long term both on physical (injuries, diarrhoeal disease, Carbon Monoxyde poisoning, vector-borne disease) and mental health. Extreme cold weather have also the potential to further impact on human health through direct exposure to lower temperatures, and associated adverse conditions, such as snow and ice [2]. Such situations may be particularly associated to direct impact like hypothermia, frostbite and selected bone/joint injuries).MethodsSince 2004, the French Public Health Agency (Santé publique France) set up a national syndromic surveillance system SurSaUD, enabling to ensure morbidity and mortality surveillance [3]. In 2018, morbidity data were daily collected from a network involving about 700 emergency departments (ED) and 58 emergency general practitioners’ associations SOS Médecins. 92% of the national ED attendances and 95% of national SOS Médecins visits are caught by the system.Both demographic (age and gender), administrative (date and location of consultation, transport) and medical information (chief complaint, medical diagnosis using ICD10 codes in ED and specific thesauri in SOS Médecins associations, severity, hospitalization after discharge) are recorded for each patient.The daily and weekly evolution of the number of all-cause ED attendances and SOS Médecins consultations during the flooding period were compared to the evolution on the two previous years. The number of hospitalisations after ED discharge was also monitored. The immediate health impact of floods and cold waves was assessed by monitoring eight syndromic indicators: gastroenteritis, carbon monoxide poisoning, burnt, stress, faintness, drowning, injuries and hypothermia.Analyses were performed by age group (<15 years, 15-64 years, more than 65 years) and at different geographical levels (national, Paris region and districts located in the Basin of Seine River).ResultsIn 2018, syndromic surveillance did not show any major impact on all-cause ED attendances and SOS Médecins consultations from week 4 to week 6, neither in Paris area nor in other areas along the Seine River. The recorded numbers were comparable to the two precedent years in all age groups.A decrease of the all-cause ED attendances was observed during the 1st day with ice conditions in Normandy and Paris, mainly in children and adults aged 15-64 years.During week 6 in Paris area, an increase of ED attendances was observed for injuries (+4% compared to the past weeks – figure 1) and to a lesser extent for hypothermia and frostbite (16 attendances compared to less than 9 for the past weeks). Similar increase in injuries were observed in Normandy during the second cold wave (Figure 1).ConclusionsDuring the flood episode, the rising water level was slow with foreseeable evolution, compared to other sudden flood events occurring in south of France in 2010 due to violent thunderstorms. This progressive evolution allows French authority to deploy wide specific organization in order to mitigate impact on concerned populations. That may explain the absence impact observed in ED at regional and national levels during the flood disaster. The evolution of injuries during 2018 episode is attributable to the cold wave that occurred simultaneously.As the French syndromic surveillance system is implemented on the whole territory and collects emergency data routinely since several years, it constitutes a reactive tool to assess the potential public health impact of both sudden and predictable disasters. It can either contribute to adapt management action or reassure decision makers if no major impact is observed.

Effects of Statins to Reduce All-Cause Mortality in Heart Failure Patients: Findings from the EPICAL2 Cohort Study.

The addition of statins to standard care in heart failure (HF) patients remains controversial in clinical practice. Large-scale clinical trials failed to show mortality benefits, but uncertainty persists in real-world settings. We evaluated whether the prescription of statins at hospital discharge is associated with a reduction in all-cause mortality at up to 1year of follow-up in HF patients. We analyzed data from Epidémiologie et Pronostic de l'Insuffisance Cardiaque Aiguë en Lorraine(EPICAL2) cohort study of 2254 hospitalized acute HF patients who were admitted to 21 hospitals located in northeast France for acute HF between October 2011 and October 2012 and who received statins at discharge compared with patients who did not. We used propensity score matching and instrumental variable analyses to estimate the treatment effects of statins, and a multivariable Cox proportional-hazards model to examine survival with statin use, adjusting for patient demographics, HF characteristics, medical history, comorbidities, drug treatment and other known potential confounders. We plotted Kaplan-Meier survivor curves, and used log-rank test to determine the equality of survivor functions. We included 2032 patients in this investigation: 919 (45%) in the statin-treated group and 1113 (55%) in the control group. The estimated average statin-treatment effects for all-cause mortality in HF failed to demonstrate a significant effect on mortality [Z = - 1.73, 95% confidence interval (CI) - 0.11 to 0.007, pvalue = 0.083, and Z = - 0.95, 95% CI - 1.34 to 0.46, pvalue = 0.34] for propensity score matching and instrumental variable analyses, respectively. Moreover, the Cox proportional-hazards model showed that statin prescription was not significantly associated with the rate of death (hazard ratio = 0.85, 95% CI 0.66-1.11, p value = 0.26), adjusted for all confounders. In patients with HF (and reduced or preserved ejection fraction), the prescription of statins did not appear to be associated with better survival after 1year of follow-up in the EPICAL2 cohort. We cannot exclude that a subpopulation of HF patients may have some benefits compared with the whole HF population or that there might be a lack of power to show such effect. NCT02880358.

On the Predictability of Radiation Fog Formation in a Mesoscale Model: A Case Study in Heterogeneous Terrain

This study evaluates the predictability of the formation phase of a radiation fog event observed during the night of 31 October 2015 to 01 November 2015 in the north-east of France at three sites managed by OPE (Observatoire Pérenne de l’Environnement). The fog layer shows significantly different behaviors at the three areas, which are located only a few kilometers apart. Three fog life cycles were observed: the formation of a dense adiabatic fog, the formation of a thin patchy fog, or no fog formation despite favorable conditions. This event was studied with the Meso-NH numerical mesoscale model at two horizontal resolutions, 500 m and 50 m. Simulations at 50 m allow estimation of the spread of the predicted parameters over the heterogeneous terrain studied. These numerical simulations strongly suggest that this event involved numerous interactions and complex circulations. The wind above the nocturnal boundary layer greatly affects the transition of shallow patchy fog into thick adiabatic fog. These numerical simulations also show that the occurrence and type of fog could be very different over a small but heterogeneous area. It is also interesting to note that the spread of the simulated parameters was very high during the transition from shallow fog to a deep fog layer. The spread was concentrated during the regime transition between the fog formation and its maturity. This appeared to be the result of the complex interplay of processes at numerous ranges of scale. A new concept called “pseudo-process diagram” is presented. These pseudo-process diagrams are very good tools to analyze fog, and allow a good illustration of the spread of fog during this chaotic phase. This kind of concept seems a promising tool to analyze fog predictability in depth.

Genome sequencing and traits analysis of Burkholderia strains reveal a promising biocontrol effect against grey mould disease in grapevine (Vitis vinifera L.).

Grey mould caused by Botrytis cinerea is among the most important disease affecting the production of grapevine worldwide. The high economical loss each year has led producers to become more dependent on chemical pesticides for protection. However, environmental impacts of the pesticides overuse have sparked crescent interest in developing alternative biocontrol methods. The use of plant-associated bacteria has, thus, received many attentions as a promising strategy for sustainable agriculture. Three strains, isolated from the rhizosphere of crops cultivated in the northeast of France, were evaluated for their antagonistic effect. They were found to exhibit an antagonistic effect against a set of phytopathogenic fungi. Phenotypic and molecular characterization showed that isolates belong to the genus Burkholderia. The genome sequencing and analysis of isolated strains revealed the presence of gene clusters coding for secondary metabolites potentially involved in the biocontrol. When the grapevine plantlets were infected with B. cinerea, all plants associated with isolated strains showed a significant protection against B. cinerea compared to non-inoculated plants. To understand the mechanisms contributing to the biocontrol effect of selected isolates, the production of reactive oxygen species (ROS) and the expression of several defense genes were investigated. The maximum accumulation of H2O2 was detected in the inoculated cell suspension medium 30min after the challenge with B. cinerea. After pathogen challenge, results showed that grapevine cell culture inoculated with isolated strains exhibited significant over expression of defense markers genes PR5, PR10, and chit4c, in response to B. cinerea, confirming their priming effect.

Performance of an instrumented embankment constructed with lime-treated silty clay during four-years in the Northeast of France

Abstract The soil-atmosphere interaction is investigated in a densely monitored large-scale embankment constructed with compacted lime treated soils in the Northeast of France. The field instrumentation covered spatial and temporal changes of the soil suction and moisture at predefined locations within the embankment, as well as meteorological data. This paper focuses on the field performance of a compacted lime-treated silty clay in the embankment system subjected to the natural variations of the environmental conditions, including temperature changes and wetting-drying cycles, in a continental climate. The used sensors provide continuous soil moisture measurements in good agreement with the soil suction measurements over a four-year monitoring period for the investigated embankment. Soil suction and corresponding soil moisture variations follow consistently a systematic annual and seasonal fluctuation at different depths. Monitoring and evaluation of the investigated embankment indicate stability of the lime-treated silty clay in relation to the weather conditions. As expected, maximum changes in suction occur at the interface between soil and atmosphere, near the ground surface. Even at the location of −0.75 m from the soil-slope face the soil-atmosphere interaction is noticeable in terms of daily soil suction and moisture measurements.

Quantification of human adenovirus and norovirus in river water in the north-east of France.

Human adenoviruses (HAdVs) are a major cause of infection and have been proposed as viral indicators of water quality. Human noroviruses (NoV) are the main cause of viral acute gastroenteritis. Quantitative data on the environmental prevalence of both viruses are needed. The genomes of HAdVs enteric adenovirus type 41 (HAdV41) and noroviruses of genogroups I and II (NoV GGI and GGII) were quantified over a 6-month period in a river located in north-eastern France. The samples were collected downstream from the discharge of a wastewater treatment plant. The viruses were concentrated using a glass wool method and the viral genomes were quantified using digital droplet PCR (ddPCR). All river water samples (15/15) were positive for the genomes of HAdVs, HAdV41, NoV GGI and NoV GGII. Concentrations of HAdVs, HAdV41 and NoV GII genomes were similar and HAdV41 represented ~ 80% of HAdVs. Infectious HAdVs were quantified in these samples using an integrated cell culture-quantitative PCR method (ICC-qPCR); they were detected in 93% (14/15) and quantified in 53% (8/15) of the samples. Thus, infectious HAdVs represented 0.3 to 12.2% of total HAdV particles detected by ddPCR. Infectious HAdV41 particles were found in 73% (11/15) of the samples. This common presence of pathogenic enteric viruses underlines the impact of wastewater discharge on quality of surface waters and may constitute a threat for human health. The relative abundance of genome of HAdV41 underlines the need for studies focusing on the specific detection of its infectious forms along water cycle.

Investigating the kinship between individuals deposited in exceptional Merovingian multiple burials through aDNA analysis: The case of Hérange burial 41 (Northeast France)

In funerary studies, “multiple burials” that have received several individuals in the same grave at the same time naturally raise questions concerning both the relationship linking the deceased and the cause of their simultaneous death. During the Merovingian period in Northeast France, multiple burials were revealed as highly rare and were consequently considered special burials linked to exceptional dramatic events. To help document the status of the deceased recovered from such special burials, we conducted ancient DNA analyses (mitochondrial and nuclear markers) to investigate the possible maternal kinship between a woman and three immature individuals simultaneously deposited in burial 41 at the Hérange site (Lorraine, France). The genetic data obtained (i) strongly supported a maternal (genetic) kinship between the woman centrally deposited in the burial and the two immatures deposited right beside her but (ii) permitted the exclusion of a genetic link between the woman and the teenager deposited along her legs. Thus, these data support the view that survivors had intimate knowledge of the deceased relationship and buried these individuals in a manner to illustrate their biological connections. As a consequence, if a common cause of death was the presupposition for the special treatment of the deceased recovered from Hérange burial 41, then interpersonal relationship was likely the deciding factor for setting this multiple burial.

Early assessment of public health impacts of major floods in France in June 2016 and winter 2018

Introduction The Seine River rises at the northeast of France and flows through Paris before emptying into the English Channel. On June 2016 (week 22) and January 2018 (weeks 4 to 6), major floods occurred in the Basin of Seine River, after important rainy periods. The second period was also marked by the occurrence on the same area of a cold wave including heavy snowfall and ice conditions on week 6. Floods are known to have potential health impacts on population living in those regions, both at short-, medium- and long-term both on physical and mental health. The objective of the study is to present the results of the daily monitoring of health indicators conducted by the French public health agency (SpFrance) during the two major floods, in order to early identify potential impact of those disasters on the population. Methods Since 2004, SpFrance set up a national syndromic surveillance system SurSaUD, enabling to ensure morbidity and mortality surveillance. Morbidity data are daily collected from a network involving emergency departments (ED) and emergency general practitioners’ associations SOS Medecins. Both administrative (age, gender, date and location of consultation) and medical information (medical diagnosis using ICD10 codes in ED and specific thesauri in SOS Medecins associations) are recorded for each patient. The daily and weekly evolution of the number of all-cause ED attendances and SOS Medecins consultations during the flood periods were compared to the evolution on the two previous years. The number of hospitalisations after ED discharge was also monitored. The immediate health impact of floods was assessed by monitoring eight syndromic indicators related to flood exposure: gastroenteritis, carbon monoxide poisoning, burnt, stress, faintness, drowning, injuries and hypothermia. Analyses were performed by age group and at different geographical levels (national, Paris region and districts located in the Basin of Seine River). Results During week 22-2016, a decrease of total number of ED attendances all ages and more specifically for children aged less than 15 years old was observed in region Centre (−15% compared with weeks 21 and 23) and to a lesser extent in Paris area (−4% and −12% respectively compared with week 21 and week 23). Locally, in the most impacted cities, an increase of total ED attendances was also observed for people aged 65 years and more. At the opposite, the number of all-cause SOS Medecins consultations remained stable in all age groups. Analysis by syndromic indicator did not show unusual variations during the first flood period. In 2018, syndromic surveillance did not show any major impact on all-cause ED attendances and SOS Medecins consultations from week 4 to week 6, neither in Paris area nor in other areas along the Seine River. The numbers were comparable to the two precedent years in all age groups. During week 6 in Paris area, an increase of ED attendances was observed for injuries (+4% compared to the past weeks) and to a lesser extent for hypothermia (16 attendances compared to less than 9 for the past weeks). Conclusion For both flood episodes the rising water level was slow with foreseeable evolution, compared to other sudden flood events occurring in south of France in 2010 due to violent thunderstorms. This progressive evolution allows French authority to deploy wide specific organization in order to mitigate impact on concerned populations. That may explain the limited impact observed during the two flood disasters. The evolution of injuries during 2018 episode is attributable to the cold wave that occurred simultaneously. As the French syndromic surveillance system is implemented on the whole territory and collects emergency data routinely since several years, it constitutes a reactive tool to assess the potential public health impact of both sudden and predictable disasters. It can either contribute to adapt management action or reassure decision makers if no major impact is observed.

The consumption of locally-produced foodstuff: an important parameter of the radiological exposure for population living in the vicinity of French nuclear facilities

Either in normal or post-accidental situations, the ingestion of locally-produced foodstuffs, potentially contaminated, is one of the main exposures to the population living in the vicinity of nuclear facilities. For this reason, the French Institute for Radioprotection and Nuclear Safety has developed a specific methodology and has carried out surveys on dietary habits of some populations concerned. This study presents the methodology used for local food surveys, the amount consumed and how much food is produced locally. The results from the 6 surveys already done show that food surveys even if conducted with a specific aim as impact assessments provide further in-depth understanding of the food habits of local residents. There are still local specific population groups that have a high level of “home-consumption” for products more sensitive to contamination. For leafy vegetables and milk (products highly sensitive to contamination), home-consumption rates vary widely from one region to another from 76 to more than 90% and from 1 to 17% respectively. Specifically for the Andra survey carried out in a rural area in the North-East of France, self-sufficiency had reached 100% for a few products (game meat for example).

Do Plantago lanceolata Skin Prick Test-Positive Patients Display IgE to Genuine Plantain Pollen Allergens? Investigation of Pollen Allergic Patients from the North-East of France

Background: English plantain (Plantago lanceolata) is an important weed pollen allergen source triggering allergic symptoms during summer. To elucidate genuine versus cross-reactive sensitization, we investigated IgE reactivity patterns and inhibition capacities of plantain-sensitized patients. Methods: Sera of 35 rhinoconjunctivitis patients from the north-east of France with positive skin prick tests (SPT) to Plantago lanceolata pollen were tested with clinically relevant allergen sources using ELISA, ImmunoCAP, and immunoblot inhibition. Results: The patients were multisensitized with additional reactivity to grass (94.3%), ash (74.3%), birch (71.4%), and mugwort (55.2%) pollen in SPT. Sensitization prevalence to allergen molecules was 34.3% (Pla l 1), 94.3% (Phl p 1/5), 60.0% (Ole e 1), 65.7% (Bet v 1), 37.1% (profilin), and 40.0% (CCD). In immunoblot, IgE reactivity to plantain pollen was inhibited with relevant pollen extracts and purified rPla l 1. Two sera did not reveal any IgE cross-reactivity, while reactivity to plantain was efficiently inhibited by grass pollen in the sera of 10 patients. The sera from 17 different patients could be inhibited by grass, birch, or ash pollen to varying degrees. Thus, only 37.1% of our patients demonstrated true plantain pollen sensitization, while 62.9% were solely positive due to IgE cross-reactive molecules from other clinically relevant pollen. Conclusions: Plantain pollen-sensitized patients are multi-reactors demonstrating varying and complex IgE-reactivity profiles. In vivo and in vitro tests using extracts are typically blurred due to the presence of homologous allergens or CCD in grass, birch, or ash pollen. So far, Pla l 1 represents the only indicative marker allergen for the diagnosis of genuine plantain pollen sensitization.