Effects of Climate Variability on Malaria Transmission in Southern Côte d'Ivoire, West Africa.

Malaria continues to be a major public health concern with a substantial burden in Africa. Even though it has been widely demonstrated that malaria transmission is climate-driven, there have been very few studies assessing the relationship between climate variables and malaria transmission in Côte d'Ivoire. We used the VECTRI model to predict malaria transmission in southern Côte d'Ivoire. First, we tested the suitability of VECTRI in modeling malaria transmission using ERA5 temperature data and ARC2 rainfall data. We then used the projected climatic data pertaining to 2030, 2050, and 2080 from a set of 14 simulations from the CORDEX-Africa database to compute VECTRI outputs. The entomological inoculation rate (EIR) from the VECTRI model was well correlated with the observed malaria cases from 2010 to 2019, including the peaks of malaria cases and the EIR. However, the correlation between the two parameters was not statistically significant. The VECTRI model predicted an increase in malaria transmissions in both scenarios (RCP8.5 and RCP4.5) for the time period 2030 to 2080. The monthly EIR for RCP8.5 was very high (1.74 to 1131.71 bites/person) compared to RCP4.5 (0.48 to 908 bites/person). These findings call for greater efforts to control malaria that take into account the impact of climatic factors.

Increasing load carriage and running speed differentially affect the magnitude, variability and coordination patterns of muscle forces.

The study aims to investigate the effects of different loads and speed during running on inter- and intra-individual muscle force amplitudes, variabilities and coordination patterns. Nine healthy participants ran on an instrumentalized treadmill with an empty weight vest at two velocities (2.6 m/s and 3.3 m/s) or while carrying three different loads (4.5, 9.1, 13.6 kg) at 2.6 m/s while kinematics and kinetics were synchronously recorded. The major lower limb muscle forces were estimated using a musculoskeletal model. Muscle force amplitudes and variability, as well as coordination patterns were compared at the group and at the individual level using respectively statistical parametric mapping and covariance matrices combined with multidimensional scaling. Increasing the speed or the load during running increased most of the muscle force amplitudes (p < 0.01). During the propulsion phase, increasing the load increased muscle force variabilities around the ankle joint (modification of standard deviation up to 5% of body weight (BW), p < 0.05) while increasing the speed decreased variability for almost all the muscle forces (up to 10% of BW, p < 0.05). Each runner has a specific muscle force coordination pattern signature regardless of the different experimental conditions (p < 0.05). Yet, this individual pattern was slightly adapted in response to a change of speed or load (p < 0.05). Our results suggest that adding load increases the amplitude and variability of muscle force, but an increase in running speed decreases the variability. These findings may help improve the design of military or trail running training programs and injury rehabilitation by progressively increasing the mechanical load on anatomical structures.

Malaria in Senegal: Recent and Future Changes Based on Bias-Corrected CMIP6 Simulations.

Malaria is a constant reminder of the climate change impacts on health. Many studies have investigated the influence of climatic parameters on aspects of malaria transmission. Climate conditions can modulate malaria transmission through increased temperature, which reduces the duration of the parasite's reproductive cycle inside the mosquito. The rainfall intensity and frequency modulate the mosquito population's development intensity. In this study, the Liverpool Malaria Model (LMM) was used to simulate the spatiotemporal variation of malaria incidence in Senegal. The simulations were based on the WATCH Forcing Data applied to ERA-Interim data (WFDEI) used as a point of reference, and the biased-corrected CMIP6 model data, separating historical simulations and future projections for three Shared Socio-economic Pathways scenarios (SSP126, SSP245, and SSP585). Our results highlight a strong increase in temperatures, especially within eastern Senegal under the SSP245 but more notably for the SSP585 scenario. The ability of the LMM model to simulate the seasonality of malaria incidence was assessed for the historical simulations. The model revealed a period of high malaria transmission between September and November with a maximum reached in October, and malaria results for historical and future trends revealed how malaria transmission will change. Results indicate a decrease in malaria incidence in certain regions of the country for the far future and the extreme scenario. This study is important for the planning, prioritization, and implementation of malaria control activities in Senegal.

Heat waves and health risks in the northern part of Senegal: analysing the distribution of temperature-related diseases and associated risk factors.

The Sahelian zone of Senegal experienced heat waves in the previous decades, such as 2013, 2016 and 2018 that were characterised by temperatures exceeding 45°C for up to 3 successive days. The health impacts of these heat waves are not yet analysed in Senegal although their negative effects have been shown in many countries. This study analyses the health impacts of observed extreme temperatures in the Sahelian zone of the country, focusing on morbidity and mortality by combining data from station observation, climate model projections, and household survey to investigate heat wave detection, occurrence of climate-sensitive diseases and risk factors for exposure. To do this, a set of climatic (temperatures) and health (morbidity, mortality) data were collected for the months of April, May and June from 2009 to 2019. These data have been completed with 1246 households' surveys on risk factor exposure. Statistical methods were used to carry out univariate and bivariate analyses while cartographic techniques allowed mapping of the main climatic and health indicators. The results show an increase in temperatures compared to seasonal normal for the 1971-2000 reference period with threshold exceedances of the 90th percentiles (42°C) for the maxima and (27°C) the minima and higher temperatures during the months of May and June. From health perspective, it was noted an increase in cases of consultation in health facilities as well as a rise in declared morbidity by households especially in the departments of Kanel (17.7%), Ranérou (16.1 %), Matam (13.7%) and Bakel (13.7%). The heat waves of May 2013 were also associated with cases of death with a reported mortality (observed by medical staff) of 12.4% unequally distributed according to the departments with a higher number of deaths in Matam (25, 2%) and in Bakel (23.5%) than in Podor (8.4%) and Kanel (0.8%). The morbidity and mortality distribution according to gender shows that women (57%) were more affected than men (43%). These health risks have been associated with a number of factors including age, access to drinkable water, type of fuel, type of housing and construction materials, existence of fan and an air conditioner, and health history.The heat wave recurrence has led to a frequency in certain diseases sensitive to rising temperatures, which is increasingly a public health issue in the Sahelian zone of Senegal.

Inter-strides variability affects internal foot tissue loadings during running.

Running overuse injuries result from an imbalance between repetitive loadings on the anatomical structures and their ability to adapt to these loadings. Unfortunately, the measure of these in-vivo loadings is not easily accessible. An optimal amount of movement variability is thought to decrease the running overuse injury risk, but the influence of movement variability on local tissue loading is still not known. A 3D dynamic finite element foot model driven by extrinsic muscle forces was developed to estimate the stress undergone by the different internal foot structures during the stance phase. The boundary conditions of different trials with similar running speed were used as input. Variability in bone stress (10%) and cartilage pressure (16%) can be expected while keeping the overall running speed constant. Bone and cartilage stress were mainly influenced by the muscle force profiles rather than by ground reaction force. These findings suggest, first, that the analysis of a single trial only is not representative of the internal tissue loadings distribution in the foot and second, that muscle forces must be considered when estimating bone and cartilage loadings at the foot level. This model could be applied to an optimal clinical management of the overuse injury.

Obesidade como fator agravante da COVID-19 em adultos hospitalizados: revisão integrativa / Obesidad como factor agravante de COVID-19 en adultos hospitalizados: revisión integradora / Obesity as an aggravating factor of COVID-19 in hospitalized adults: an integrative review

Resumo Objetivo: Identificar, na literatura científica, a relação da obesidade como fator de risco agravante para a morbidade por COVID-19. Métodos: Trata-se de um estudo bibliográfico, tipo revisão integrativa de literatura, nos idiomas português, inglês e espanhol, por meio da estratégia PICo, em cinco bases de dados,PubMed, Scopus, Web of Science, Embasee BVS, realizada de maio a junho de 2020. Os critérios de inclusão adotados foram: artigos primários realizados com adultos; disponíveis na íntegra; publicados durante o período de 2019 a 2020; nos idiomas português, inglês e espanhol. Os critérios de exclusão foram: relato de casos; casos clínicos; dissertações; teses; os já selecionados na busca em outra base de dados e que não respondessem à questão da pesquisa. Resultados: A seleção resultou em noveestudos, sendo que quatro estudos - 44,4% (E3, E5, E6 e E7) - apresentaram a prevalência de obesidade em adultos hospitalizados por COVID-19, dois estudos - 22,2% (E6, E9) - associaram a obesidade ao desenvolvimento da COVID-19 grave, três estudos - 33,3% (E1, E4 e E7) - associaram a obesidade à necessidade de ventilação mecânica e três estudos - 33,3% (E2, E4 e E8) - associaram a obesidade à mortalidade por COVID-19. Conclusão: A obesidade trata-se de uma doença crônica não transmissível, sendo um fator de risco considerado importante para o agravamento da doença COVID-19, no entanto, é passível de prevenção, pois hábitos saudáveis de vida podem reduzir o quadro grave de infecção por COVID-19.

Resumen Objetivo: Identificar en la literatura científica la relación de la obesidad como factor de riesgo agravante para la morbilidad por COVID-19. Métodos: Se trata de un estudio bibliográfico, tipo revisión integradora de literatura, en idioma portugués, inglés y español, por medio de la estrategia PICO, en cinco bases de datos: PubMed, Scopus, Web of Science, Embase y BVS, realizada de mayo a junio de 2020. Los criterios de inclusión adoptados fueron: artículos primarios realizados con adultos, con texto completo disponible, publicados durante el período de 2019 a 2020, en idioma portugués, inglés y español. Los criterios de exclusión fueron: relato de casos, casos clínicos, tesis de maestría y doctorado, los artículos ya seleccionados en la búsqueda en otra base de datos y los que no respondieran la pregunta de investigación. Resultados: La selección tuvo como resultado nueve estudios, de los cuales cuatro — 44,4% (E3, E5, E6 y E7) — presentaron prevalencia de obesidad en adultos hospitalizados por COVID-19; en dos estudios — 22,2% (E6, E9) — se relacionó la obesidad con el desarrollo de COVID-19 grave; en tres estudios — 33,3% (E1, E4 y E7) — se relacionó la obesidad con la necesidad de ventilación mecánica; y en tres estudios — 33,3% (E2, E4 y E8) — se relacionó la obesidad con la mortalidad por COVID-19. Conclusión: La obesidad se trata de una enfermedad crónica no transmisible y es considerada un factor de riesgo importante para el agravamiento de la enfermedad COVID-19. Sin embargo, la prevención es posible, ya que los hábitos de vida saludables pueden reducir el cuadro grave de infección por COVID-19.

Abstract Objective: To identify, in scientific literature, the relationship of obesity as an aggravating risk factor for morbidity by COVID-19. Methods: This is a bibliographic and integrative literature review study, in Brazilian Portuguese, English and Spanish languages, through PICo strategy, in the PubMed, Scopus, Web of Science, Embase and VHL databases, held from May to June 2020. Primary articles conducted with adults, available in full, published during the period 2019 to 2020, in Brazilian Portuguese, English and Spanish were included. Case reports, clinical cases, dissertations, theses, the already selected in the search in another database and that did not answer the question of the search were excluded. Results: The selection resulted in nine studies. Four studies - 44.4% (E3, E5, E6 and E7) - presented the prevalence of obesity in adults hospitalized by COVID-19. Two studies - 22.2% (E6, E9) - associated obesity with the development of severe COVID-19. Three studies - 33.3% (E1, E4 and E7) - associated obesity with the need for mechanical ventilation. Three studies - 33.3% (E2, E4 and E8) - associated obesity with mortality due to COVID-19. Conclusion: Obesity is a chronic non-communicable disease, being a risk factor considered important for the worsening of COVID-19 disease, however, it is preventable, because healthy lifestyle habits can reduce the severe picture of COVID-19 infection.

COVID-19 mortality risk for older men and women.

BACKGROUND: Case-fatality from COVID-19 has been reported to be relatively high in patients age 65 years or older. We sought to determine the age-specific rates of COVID-19 mortality at the population level. METHODS: We obtained information regarding the total number of COVID-19 reported deaths for six consecutive weeks beginning at the 50th recorded death, among 16 countries that reported a relatively high number of COVID-19 cases as of April 12, 2020. We performed an ecological study to model COVID-19 mortality rates per week by age group (54 years or younger, 55-64 years, and 65 years or older) and sex using a Poisson mixed effects regression model. RESULTS: Over the six-week period of data, there were 178,568 COVID-19 deaths from a total population of approximately 2.4 billion people. Age and sex were associated with COVID-19 mortality. Compared with individuals ages 54 years or younger, the incident rate ratio (IRR) was 8.1, indicating that the mortality rate of COVID-19 was 8.1 times higher (95%CI = 7.7, 8.5) among those 55 to 64 years, and more than 62 times higher (IRR = 62.1; 95%CI = 59.7, 64.7) among those ages 65 or older. Mortality rates from COVID-19 were 77% higher in men than in women (IRR = 1.77, 95%CI = 1.74, 1.79). CONCLUSIONS: In the 16 countries examined, persons age 65 years or older had strikingly higher COVID-19 mortality rates compared to younger individuals, and men had a higher risk of COVID-19 death than women.

Climate Variability and Malaria over West Africa.

Malaria is a major public health problem in West Africa. Previous studies have shown that climate variability significantly affects malaria transmission. The lack of continuous observed weather station data and the absence of surveillance data for malaria over long periods have led to the use of reanalysis data to drive malaria models. In this study, we use the Liverpool Malaria Model (LMM) to simulate spatiotemporal variability of malaria in West Africa using daily rainfall and temperature from the following: Twentieth Century Reanalysis (20th CR), National Center for Environmental Prediction (NCEP), European Centre for Medium-Range Weather Forecasts (ECMWF) Atmospheric Reanalysis of the Twentieth Century (ERA20C), and interim ECMWF Re-Analysis (ERA-Interim). Malaria case data from the national surveillance program in Senegal are used for model validation between 2001 and 2016. The warm temperatures found over the Sahelian fringe of West Africa can lead to high malaria transmission during wet years. The rainfall season peaks in July to September over West Africa and Senegal, and the malaria season lasts from September to November, about 1-2 months after the rainfall peak. The long-term trends exhibit interannual and decadal variabilities. The LMM shows acceptable performance in simulating the spatial distribution of malaria incidence. However, some discrepancies are found. These results are useful for decision-makers who plan public health and control measures in affected West African countries. The study would have substantial implications for directing malaria surveillance activities and health policy. In addition, this malaria modeling framework could lead to the development of an early warning system for malaria in West Africa.

Early Effect Markers and Exposure Determinants of Metalworking Fluids Among Metal Industry Workers: Protocol for a Field Study.

BACKGROUND: Exposure to aerosols from metalworking fluids (MWF) has previously been related to a series of adverse health outcomes (eg, cancer, respiratory diseases). Our present epidemiological study focuses on occupational exposures to MWF and a panel of exposure and effect biomarkers. We hypothesize that these health outcomes are caused by particle exposure that generates oxidative stress, leading to airway inflammation and ultimately to chronic respiratory diseases. We aimed to assess whether MWF exposure, in particular as characterized by its oxidative potential, is associated with biomarkers of oxidative stress and inflammation as well as genotoxic effects. OBJECTIVE: The ultimate goal is to develop exposure reduction strategies based on exposure determinants that best predict MWF-related health outcomes. The following relationships will be explored: (1) exposure determinants and measured exposure; (2) occupational exposure and preclinical and clinical effect markers; (3) exposure biomarkers and biomarkers of effect in both exhaled breath condensate and urine; and (4) biomarkers of effect, genotoxic effects and respiratory symptoms. METHODS: At least 90 workers from France and Switzerland (30 controls, 30 exposed to straight MWF and 30 to aqueous MWF) were followed over three consecutive days after a nonexposed period of at least two days. The exposure assessment is based on MWF, metal, aldehyde, and ultrafine particle number concentrations, as well as the intrinsic oxidative potential of aerosols. Furthermore, exposure biomarkers such as metals, metabolites of polycyclic aromatic hydrocarbons and nitrosamine are measured in exhaled breath condensate and urine. Oxidative stress biomarkers (malondialdehyde, 8-isoprostane, 8-hydroxy-2'-deoxyguanosine, nitrates, and nitrites) and exhaled nitric oxide, an airway inflammation marker, are repeatedly measured in exhaled breath condensate and urine. Genotoxic effects are assessed using the buccal micronucleus cytome assay. The statistical analyses will include modelling exposure as a function of exposure determinants, modelling the evolution of the biomarkers of exposure and effect as a function of the measured exposure, and modelling respiratory symptoms and genotoxic effects as a function of the assessed long-term exposure. RESULTS: Data collection, which occurred from January 2018 until June 2019, included 20 companies. At the date of writing, the study included 100 subjects and 29 nonoccupationally exposed controls. CONCLUSIONS: This study is unique as it comprises human biological samples, questionnaires, and MWF exposure measurement. The biomarkers collected in our study are all noninvasive and are useful in monitoring MWF exposed workers. The aim is to develop preventative strategies based on exposure determinants related to health outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13744.

Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents.

OBJECTIVE: Specific inhalation challenge (SIC) as the reference diagnostic test for occupational asthma (OA) is not widely available worldwide. We aimed to develop non-SIC-based models for OA. METHODS: Of 427 workers who were exposed to high-molecular-weight agents and referred to OA clinic at Montréal Sacré-Cœur Hospital between 1983 and 2016, we analysed 160 workers who completed non-specific bronchial hyper-responsiveness (NSBHR) tests and still worked 1 month before SIC. OA was defined as positive SIC. Logistic regression models were developed. The accuracy of the models was quantified using calibration and discrimination measures. Their internal validity was evaluated with bootstrapping procedures. The final models were translated into clinical scores and stratified into probability groups. RESULTS: The final model, which included age ≤40 years, rhinoconjunctivitis, inhaled corticosteroid use, agent type, NSBHR, and work-specific sensitisation had a reasonable internal validity. The area under the receiver operating characteristics curve (AUC) was 0.91 (95% CI 0.86 to 0.95), statistically significantly higher than the combination of positive NSBHR and work-specific sensitisation (AUC=0.84). The top 70% of the clinical scores (ie, the high probability group) showed a significantly higher sensitivity (96.4%vs86.9%) and negative predictive value (93.6%vs84.1%) than the combination of positive NSBHR and work-specific sensitisation (p value <0.001). CONCLUSIONS: We developed novel scores for OA induced by high-molecular-weight agents with excellent discrimination. It could be helpful for secondary-care physicians who have access to pulmonary function test and allergy testing in identifying subjects at a high risk of having OA and in deciding on appropriate referral to a tertiary centre.

Declines in Malaria Burden and All-Cause Child Mortality following Increases in Control Interventions in Senegal, 2005-2010.

Malaria is endemic in Senegal. The national malaria control strategy focuses on achieving universal coverage for major interventions, with a goal of reaching preelimination status by 2018. Senegal began distribution of insecticide-treated nets (ITNs) and introduced artemisinin-based combination therapy in 2006, then introduced rapid diagnostic tests in 2007. We evaluated the impact of these efforts using a plausibility design based on malaria's contribution to all-cause under-five mortality (ACCM) and considering other contextual factors which may influence ACCM. Between 2005 and 2010, household ownership of ITNs increased from 20% to 63%, and the proportion of people sleeping under an ITN the night prior to the survey increased from 6% to 29%. Malaria parasite prevalence declined from 6% to 3% from 2008 to 2010 among children under five. Some nonmalaria indicators of child health improved, for example, increase of complete vaccination coverage from 58% to 64%; however, nutritional indicators deteriorated, with an increase in stunting from 16% to 26%. Although economic indicators improved, environmental conditions favored an increase in malaria transmission. ACCM decreased 40% between 2005 and 2010, from 121 (95% confidence interval [CI] 113-129) to 72 (95% CI 66-77) per 1,000, and declines were greater among age groups, epidemiologic zones, and wealth quintiles most at risk for malaria. After considering coverage of malaria interventions, trends in malaria morbidity, effects of contextual factors, and trends in ACCM, it is plausible that malaria control interventions contributed to a reduction in malaria mortality and to the impressive gains in child survival in Senegal.

[Teachers' assessment practices in context of nursing clinical education : a qualitative descriptive study.] / Les pratiques évaluatives d'enseignants en soins infirmiers lors des stages : une étude descriptive qualitative.

Since no study has yet been able to assess the Quebec portrait of teachers' evaluation practices in the context of clinical education in nursing. Considering the importance of clinical teaching and evaluation in the education of nursing students, this study is justified. This article presents the results of a study that aimed to describe and understand the experience of teachers in the ongoing assessment of nursing students' learning during clinical education. It aimed to describe the evaluation practices of teachers during the learning of students in clinical education and achievement context, and to identify factors influencing these practices. In the context of descriptive qualitative research, the data collection was mainly based on the description of practices reported and collected during interviews realized with 10 nursing teachers of a college of the region of Saguenay-Lac-Saint-Jean (SLSJ, Quebec, Canada). The results allowed, for instance, to identify and to describe the evaluation practices led in this specific context of the study : the direct and indirect observation ; the questions asked to the sudent and to the group of sutdents and individual and group feed-back. They also allowed to enumerate and to categorize factors which can influence these practices, that is facilitates factors, barriers and faiths.

Comparison of Malaria Simulations Driven by Meteorological Observations and Reanalysis Products in Senegal.

The analysis of the spatial and temporal variability of climate parameters is crucial to study the impact of climate-sensitive vector-borne diseases such as malaria. The use of malaria models is an alternative way of producing potential malaria historical data for Senegal due to the lack of reliable observations for malaria outbreaks over a long time period. Consequently, here we use the Liverpool Malaria Model (LMM), driven by different climatic datasets, in order to study and validate simulated malaria parameters over Senegal. The findings confirm that the risk of malaria transmission is mainly linked to climate variables such as rainfall and temperature as well as specific landscape characteristics. For the whole of Senegal, a lag of two months is generally observed between the peak of rainfall in August and the maximum number of reported malaria cases in October. The malaria transmission season usually takes place from September to November, corresponding to the second peak of temperature occurring in October. Observed malaria data from the Programme National de Lutte contre le Paludisme (PNLP, National Malaria control Programme in Senegal) and outputs from the meteorological data used in this study were compared. The malaria model outputs present some consistencies with observed malaria dynamics over Senegal, and further allow the exploration of simulations performed with reanalysis data sets over a longer time period. The simulated malaria risk significantly decreased during the 1970s and 1980s over Senegal. This result is consistent with the observed decrease of malaria vectors and malaria cases reported by field entomologists and clinicians in the literature. The main differences between model outputs and observations regard amplitude, but can be related not only to reanalysis deficiencies but also to other environmental and socio-economic factors that are not included in this mechanistic malaria model framework. The present study can be considered as a validation of the reliability of reanalysis to be used as inputs for the calculation of malaria parameters in the Sahel using dynamical malaria models.

Responsiveness of a simple tool for assessing change in behavioral intention after continuing professional development activities.

BACKGROUND: Continuing professional development (CPD) activities are one way that new knowledge can be translated into changes in practice. However, few tools are available for evaluating the extent to which these activities change health professionals' behavior. We developed a questionnaire called CPD-Reaction for assessing the impact of CPD activities on health professionals' clinical behavioral intentions. We evaluated its responsiveness to change in behavioral intention and verified its acceptability among stakeholders. METHODS AND FINDINGS: We enrolled 376 health professionals who completed CPD-Reaction before and immediately after attending a CPD activity. We contacted them three months later and asked them to self-report on any behavior change. We compared the mean rankings on each CPD-Reaction construct before and immediately after CPD activities. To estimate its predictive validity, we compared the median behavioral intention score (post-activity) of health professionals reporting a behavior change three months later with the median behavioral intention score of physicians who reported no change. We explored stakeholders' views on CPD-Reaction in semi-structured interviews. Participants were mostly family physicians (62.2%), with an average of 19 years of clinical practice. Post-activity, we observed an increase in intention-related scores for all constructs (P < 0.001) with the most appreciable for the construct beliefs about capabilities. A total of 313 participants agreed to be contacted at follow up, and of these only 69 (22%) reported back. Of these, 43 (62%) self-reported a behavior change. We observed no statistically significant difference in intention between health professionals who later reported a behavior change and those who reported no change (P = 0.30). Overall, CPD stakeholders found the CPD-Reaction questionnaire of interest and suggested potential solutions to perceived barriers to its implementation. CONCLUSION: The CPD-Reaction questionnaire seems responsive to change in behavioral intention. Although CPD stakeholders found it interesting, future implementation will require addressing barriers they identified.

Impact of environmental factors on the culturability and viability of Listeria monocytogenes under conditions encountered in food processing plants.

The ability of Listeria monocytogenes to adhere to and persist on surfaces for months or even years may be responsible for its transmission from contaminated surfaces to food products. Hence the necessity to find effective means to prevent the establishment of L. monocytogenes in food processing environments. The aim of this study was to assess, through a fractional experimental design, the environmental factors that could affect the survival of L. monocytogenes cells on surfaces to thereby prevent the persistence of this pathogen in conditions mimicking those encountered in food processing plants: culture with smoked salmon juice or meat exudate, use of two materials with different hygiene status, biofilm of L. monocytogenes in pure-culture or dual-culture with a Pseudomonas fluorescens strain, application of a drying step after cleaning and disinfection (C&D) and comparison of two strains of L. monocytogenes. Bacterial survival was assessed by culture, qPCR to quantify total cells, and propidium monoazide coupled with qPCR to quantify viable cells and highlight viable but non-culturable (VBNC) cells. Our results showed that failure to apply C&D causes cell persistence on surfaces. Moreover, the sanitation procedure leads only to a loss of culturability and appearance of VBNC populations. However, an additional daily drying step after C&D optimises the effectiveness of these procedures to reduce culturable populations. Our results reinforce the importance to use molecular tools to monitor viable pathogens in food processing plants to avoid underestimating the amounts of cells using only methods based on cell culture.

Modelling hotspots of the two dominant Rift Valley fever vectors (Aedes vexans and Culex poicilipes) in Barkédji, Sénégal.

BACKGROUND: Climatic and environmental variables were used successfully by using models to predict Rift Valley fever (RVF) virus outbreaks in East Africa. However, these models are not replicable in the West African context due to a likely difference of the dynamic of the virus emergence. For these reasons specific models mainly oriented to the risk mapping have been developed. Hence, the areas of high vector pressure or virus activity are commonly predicted. However, the factors impacting their occurrence are poorly investigated and still unknown. In this study, we examine the impact of climate and environmental factors on the likelihood of occurrence of the two main vectors of RVF in West Africa (Aedes vexans and Culex poicilipes) hotspots. METHODS: We used generalized linear mixed models taking into account spatial autocorrelation, in order to overcome the default threshold for areas with high mosquito abundance identified by these models. Getis' Gi*(d) index was used to define local adult mosquito abundance clusters (hotspot). RESULTS: For Culex poicilipes, a decrease of the minimum temperature promotes the occurrence of hotspots, whereas, for Aedes vexans, the likelihood of hotspot occurrence is negatively correlated with relative humidity, maximum and minimum temperatures. However, for the two vectors, proximity to ponds would increase the risk of being in an hotspot area. CONCLUSIONS: These results may be useful in the improvement of RVF monitoring and vector control management in the Barkedji area.

[Occupational asthma]. / Asthme professionnel.

Occupational asthma is the most common occupational respiratory disease. It mainly affects young workers with significant socio-economic consequences. Early recognition improves its prognosis. A rigorous investigative approach while the worker is still exposed at work and appropriate medical care require a multi-disciplinary collaboration. Prevention is the key element in the management of professional asthma.

L'asthme professionnel est la plus fréquente des maladies respiratoires professionnelles. Il touche surtout les travailleurs jeunes et a des conséquences socio-économiques importantes. Le reconnaître précocement permet d'améliorer le pronostic. Une investigation rigoureuse, pendant que le travailleur est encore exposé sur son lieu de travail, et un suivi médical approprié nécessitent une collaboration pluridisciplinaire. La prévention reste l'élément essentiel dans la prise en charge de cette maladie.

Clinical validation of LTMS-S: A wearable system for vital signs monitoring.

LTMS-S is a new wearable system for the monitoring of several physiological signals--including a two-lead electrocardiogram (ECG)--and parameters, such as the heart rate, the breathing rate, the peripheral oxygen saturation (SpO2), the core body temperature (CBT), and the physical activity. All signals are measured using only three sensors embedded within a vest. The sensors are standalone with their own rechargeable battery, memory, wireless communication and with an autonomy exceeding 24 hours. This paper presents the results of the clinical validation of the LTMS-S system.

The majority of accredited continuing professional development activities do not target clinical behavior change.

PURPOSE: Continually improving patient outcomes requires that physicians start new behaviors, stop old behaviors, or adjust how they practice medicine. Continuing professional development (CPD) is the method most commonly used by physicians to improve their knowledge and skills. However, despite regular physician attendance at these activities, change in clinical behavior is rarely observed. The authors sought to identify which of Bloom's domains (cognitive, affective, or psychomotor) are targeted by the learning objectives of CPD activities offered by medical associations, regulatory bodies, and academic institutions in the province of Quebec, Canada. METHOD: The authors evaluated the objectives of 110 accredited CPD activities offered to physicians and other health professionals from November 2012 to March 2013. The objectives of each activity were extracted and classified into learning domains using Bloom's taxonomy. RESULTS: Ninety-six percent of the learning objectives analyzed targeted the cognitive domain, which consists of six levels of increasing complexity: knowledge, comprehension, application, analysis, synthesis, and evaluation. Half (47%) targeted knowledge and comprehension, whereas only 26% aimed to improve skills in analysis, synthesis, and evaluation. CONCLUSIONS: Most accredited CPD activities within this sample were generally not designed to promote clinical behavior change because the focus of these activities was on remembering and understanding information instead of preparing physicians to put knowledge into practice by analyzing information, evaluating new evidence, and planning operations that lead to behavior change. Educators and CPD providers should take advantage of well-established theories of health professional behavior change, such as sociocognitive theories, to develop their activities.

Statistical modeling of the abundance of vectors of West African Rift Valley fever in Barkédji, Senegal.

Rift Valley fever is an emerging mosquito-borne disease that represents a threat to human and animal health. The exophilic and exophagic behavior of the two main vector in West Africa (Aedes vexans and Culex poicilipes), adverse events post-vaccination, and lack of treatment, render ineffective the disease control. Therefore it is essential to develop an information system that facilitates decision-making and the implementation of adaptation strategies. In East Africa, RVF outbreaks are linked with abnormally high rainfall, and can be predicted up to 5 months in advance by modeling approaches using climatic and environmental parameters. However, the application of these models in West Africa remains unsatisfactory due to a lack of data for animal and human cases and differences in the dynamics of the disease emergence and the vector species involved in transmission. Models have been proposed for West Africa but they were restricted to rainfall impact analysis without a spatial dimension. In this study, we developed a mixed Bayesian statistical model to evaluate the effects of climatic and ecological determinants on the spatiotemporal dynamics of the two main vectors. Adult mosquito abundance data were generated from July to December every fortnight in 2005-2006 at 79 sites, including temporary ponds, bare soils, shrubby savannah, wooded savannah, steppes, and villages in the Barkédji area. The results demonstrate the importance of environmental factors and weather conditions for predicting mosquito abundance. The rainfall and minimum temperature were positively correlated with the abundance of Cx. poicilipes, whereas the maximum temperature had negative effects. The rainfall was negatively correlated with the abundance of Ae. vexans. After combining land cover classes, weather conditions, and vector abundance, our model was used to predict the areas and periods with the highest risks of vector pressure. This information could support decision-making to improve RVF surveillance activities and to implement better intervention strategies.