Determinants of COVID-19 vaccine hesitancy in French hospitals.

OBJECTIVES: COVID-19 vaccines have become the new hope for stemming the pandemic. We aimed to assess pre-launch vaccine acceptance among hospital workers in the Auvergne-Rhône-Alpes Administrative Region of France. METHODS: We performed a cross sectional study involving all hospital workers in 11 Auvergne-Rhône-Alpes hospitals in December 2020. Univariate and multivariate analyses were performed to identify factors associated with vaccine hesitancy. RESULTS: We analyzed completed questionnaires from 1,964 respondents (78% women, mean age 42 years, 21.5% physicians, 41% private care centers). A total of 1,048 (53%) hospital workers were in favor of COVID-19 vaccination. Vaccine hesitancy was associated with: female gender; young age; paramedical, technical, and administrative professions (i.e., all non-medical professions); no prior flu vaccination; and employment in the private medical care sector (p<0.05). Distrust of health authorities and pharmaceutical lobbying were the main obstacles to vaccination. Inversely, creating herd immunity and protecting patients and household members were the most frequently cited reasons in favor of vaccination. More than two-thirds of participants feared that the clinical and biological research was too rapid and worried about serious adverse effects. Most participants were interested in written information on the available vaccines, but the most vaccine-hesitant categories preferred oral information. Only 35% supported mandatory vaccination. CONCLUSIONS: Targeted written and oral information campaigns will be necessary to improve vaccination coverage among hospital workers who show a surprisingly high hesitancy rate. Imposing mandatory vaccination could be counterproductive.

Gastrointestinal nematode infection and performance of weaned stocker calves in response to anthelmintic control strategies.

Gastrointestinal nematode (GIN) parasite control recommendations are in a state of flux because of the increase in anthelmintic resistant cattle parasites, such as Cooperia spp. In addition, Cooperia spp. infection is typically high in warm-season grass pastures and can affect growth performance of grazing stocker calves in the Gulf Coast Region. This study evaluated the effects of moxidectin pour-on, oxfendazole oral suspension, or a combination of the two given at separate times on infection and performance of weaned beef calves grazing summer forages. Steers (n=42) and heifers (n=31) were stratified by sex, d-11 fecal egg count (FEC), and d-1 shrunk body weight (BW) to one of 10 pastures with four anthelmintic treatments and one control. Treatments included: (1) oxfendazole given on d 0 and moxidectin on d 73 (O+M), (2) moxidectin given on d 0 and oxfendazole on d 73 (M+O), (3) moxidectin given on d 0 (M), (4) oxfendazole given on d 0 (O) and (5) no anthelmintic given (CON). Calves grazed for d-110 beginning May 27th. Response variables were FEC (collected on d-11, 14, 31, 45, 59, 73, 87 and 108), coprocultures (evaluated for d 87 and 108), final shrunk BW, shrunk BW gain, average daily gain (ADG), and full BW gain (collected on d 31, 59, 73, 87, and 108). Calves treated with either oxfendazole (O+M and O) or moxidectin (M+O and M) on d 0 had significantly lower (P<0.001) FEC than the CON calves on d 14, 31 and 45. However, the M+O treated calves had significantly higher (P<0.001) FEC than both oxfendazole treated groups. In addition, calves treated with a second dewormer on d 73 (O+M and M+O) had significantly lower (P<0.001) FEC by d 87 than the CON or M treated calves. Shrunk BW gain and ADG were significantly greater (P=0.005) for the O+M compared to the M treated and CON calves, but comparable with the M+O and O treated calves, respectively. Coprocultures sampled on d 87 and 108 for calves not receiving a second dewormer were predominantly Cooperia spp. and Ostertagia spp. On d 87, no larvae were recovered from the M+O treated calves, whereas the O+M treated calves had 94% Cooperia spp. and 3% Ostertagia spp. recovered. Providing a benzimidazole with a macrocyclic lactone given at two different periods may provide better GIN parasite control and improve animal gains for stocker calves grazing warm-season grass pastures.

Normal calves produced after transfer of in vitro fertilized embryos cultured with an antiviral compound.

Bovine viral diarrhea virus (BVDV) replicates in embryo co-culture systems and remains associated with developing IVF bovine embryos, despite washing and trypsin treatment. Previous research demonstrated that 2-(4-[2-imidazolinyl]phenyl)-5-(4-methoxyphenyl)furan (DB606) inhibits replication of BVDV in cultured cells. The objective of this study was to evaluate the capability of IVF embryos to develop into normal, weaned calves after exposure to antiviral concentrations of DB606 during IVC. Oocytes were obtained from cows via transvaginal, ultrasound-guided follicular aspiration. Presumptive zygotes (n = 849) that resulted from fertilization of these oocytes were cultured for 7 d in medium supplemented with 0.4 microM DB606 or medium lacking antiviral agent. All blastocysts (n = 110) were transferred individually into the uterus of a synchronized recipient. The pregnancy status of recipients was determined using transrectal ultrasonography at 21-23 d after embryo transfer. Additional pregnancies as controls (n = 21) were initiated by natural breeding. Developing fetuses and resulting calves were evaluated every 27-34 d. Blastocyst development, pregnancies per transferred embryo, pregnancies maintained per pregnancies established, gestation length, gender ratio, birth weights, viability of neonates, complete blood counts, and serum chemistry profiles at 3 mo of age and adjusted 205 d weaning weights were compared for research treatments. Development to weaning after exposure to DB606 did not differ significantly from controls. In conclusion, bovine embryo cultures can be safely supplemented with antiviral concentrations of DB606; addition of DB606 agent might prevent viral transmission if BVDV were inadvertently introduced into the embryo culture system.

Pharmacokinetics of ceftiofur in llamas and alpacas.

Pharmacokinetic studies of antibiotics in South American camelids are uncommon, therefore drugs are often administered to llamas and alpacas based on dosages established in other domestic species. The disposition of ceftiofur sodium was studied in llamas following intramuscular administration and in alpacas following intravenous and intramuscular administration. Eleven adult llamas were given ceftiofur sodium by intramuscular injection. Each animal received either a standard dose of 2.2 mg/kg or an allometrically scaled dose ranging from 2.62 to 2.99 mg/kg in a crossover design. Ten adult alpacas were given ceftiofur sodium by intravenous and intramuscular injections. Each animal received a standard dosage of 1 mg/kg or an allometrically scaled dose ranging from 1.27 to 1.44 mg/kg i.v., and 1.31-1.51 mg/kg i.m. Blood samples were collected at 0, 0.25, 0.5, 1, 2, 4, 8, 12, 24, 36, 48, and 72 h after administration of the ceftiofur. Pharmacokinetic parameters of ceftiofur in llamas and alpacas were similar following i.m. dosing at both dose levels. The only differences noted were in the total AUC between dose levels, but the AUC/dose values were not different. A sequence effect was noted in the alpaca data, which resulted in lower AUCs for the second dose when the i.v. dose was given first, and with higher AUCs for the second dose when the i.m. dose was given first. Overall, ceftiofur pharmacokinetics in llamas and alpacas are similar, and also very similar to reported parameters for sheep and goats.

Internal parasite control strategies.

To maintain the general health of small ruminants, owners, managers, and clinicians should be familiar with the body condition-scoring [table: see text] methods, general health, and overall appearance of the animals in their care. Any changes in the overall health of individual animals or the flock should be noted immediately, the cause determined, and immediate measures should be taken to correct any problems. Parasite management in small ruminants is a difficult and arduous task. When a program that reduces parasite infestation is discovered, it should be carefully implemented, maintained with vigilance, and constantly "tweaked" to maximize its effectiveness.

A comparison of physical examination and clinicopathologic parameters between sheared and nonsheared alpacas (Lama pacos).

The purpose of this study was to determine the physiological changes associated with chronic heat stress in sheared versus nonsheared alpacas. Fourteen intact male adult alpacas were randomly assigned to one of the two groups: Group S alpacas were sheared to within 2cm of their skin; Group NS alpacas were not sheared. These animals were maintained from June through August in east central Alabama. Data collected in the morning, every two weeks, included vital signs, body weight, body condition score, complete blood counts, serum chemistries and electrolytes, whole blood selenium, and plasma cortisol. S and NS groups were contrasted using the repeated measures analysis of variance, and pertinent correlations with weather parameters were calculated. Clinical heat stress was not evident in any animals during the study. Significant differences between treatment groups were seen in rectal temperature (P=0.0095), sodium concentration (P=0.0219), and blood urea nitrogen (BUN) (P=0.0189). The mean rectal temperature of the NS group was above the normal range on five sampling times compared to only once for the S group. However, mean sodium and serum urea nitrogen levels were within normal limits in both groups at all sampling times. Rectal temperature of only the S group was positively correlated to weather parameters. Sodium of both S and NS groups and BUN of the NS group were negatively correlated with weather parameters. This study indicates that there are differences between sheared and nonsheared alpacas in physical examination and clinicopathologic parameters that can be correlated with changes in ambient conditions. These differences suggest that nonsheared alpacas are less heat tolerant than sheared alpacas. Therefore, shearing is recommended for animals exposed to similar conditions.

A comparison of surface and rectal temperatures between sheared and non-sheared alpacas (Lama pacos).

The objective of this research was to determine if whole-body shearing would effect gross thermoregulation in alpacas. Eight mature, intact male alpacas were randomly assigned to one of two groups and maintained in outdoor pastures with adequate artificial shade from June through August (summer climate) in east central Alabama, USA. Group one animals (N=4) were sheared to remove all fiber to within 2cm of their skin. Group 2 animals (N=4) were left non-sheared. Sheared alpacas tended to have lower rectal temperatures during high ambient temperatures than did non-sheared alpacas (P=0.06). Thermographic studies of the scrotum revealed cooler surface temperatures in sheared versus non-sheared alpacas (P=0.05). Temperatures in the right medial thigh of sheared animals were 0.9 degrees C cooler than the thigh region of non-sheared animals in the morning (P<0.03). Right medial thigh temperatures were 1.6 degrees C cooler in sheared alpacas in the afternoon (P<0.01). Significant positive correlations were found in non-sheared animals between ambient temperature and rectal temperature in the morning (r=0.612, P=0.014). In sheared animals during the morning significant positive correlations were established between the Heat Stress Index (HSI) and the right medial thigh surface temperatures (r=0.648, P=0.003), the HSI and rectal temperature (r=0.729, P=0.0003), the ambient temperature and right medial thigh surface temperature (r=0.485, P=0.04), and the ambient temperature and the rectal temperature (r=0.823, P<0.0001). In the afternoon a significant positive correlation was found in the sheared alpacas between the HSI and the right medial thigh surface temperature, rectal temperature and surface scrotal temperature (r=0.538, P=0.02, r=0.543, P=0.019 and r=0.522, P=0.045), respectively. These data indicate that whole-body shearing of alpacas could have a beneficial effect on thermoregulation when used as a preventative measure against heat stress. Shearing may assist heat dissipation resulting in a cooler surface body temperature and rectal temperature in alpacas when challenged by the heat and humidity experienced in the summer months in the southeastern United States.

Membrane hyperpolarization and salt sensitivity induced by deletion of PMP3, a highly conserved small protein of yeast plasma membrane.

Yeast plasma membranes contain a small 55 amino acid hydrophobic polypeptide, Pmp3p, which has high sequence similarity to a novel family of plant polypeptides that are overexpressed under high salt concentration or low temperature treatment. The PMP3 gene is not essential under normal growth conditions. However, its deletion increases the plasma membrane potential and confers sensitivity to cytotoxic cations, such as Na(+) and hygromycin B. Interestingly, the disruption of PMP3 exacerbates the NaCl sensitivity phenotype of a mutant strain lacking the Pmr2p/Enap Na(+)-ATPases and the Nha1p Na(+)/H(+) antiporter, and suppresses the potassium dependency of a strain lacking the K(+) transporters, Trk1p and Trk2p. All these phenotypes could be reversed by the addition of high Ca(2+) concentration to the medium. These genetic interactions indicate that the major effect of the PMP3 deletion is a hyperpolarization of the plasma membrane potential that probably promotes a non-specific influx of monovalent cations. Expression of plant RCI2A in yeast could substitute for the loss of Pmp3p, indicating a common role for Pmp3p and the plant homologue.

Differentiation of gastrointestinal diseases of calves.

With a complete history, careful physical examination, and targeted diagnostics, the practitioner can differentiate the causes of gastrointestinal diseases in calves. The authors hope that this article helps the practitioner in this regard. Armed with a diagnosis, he or she can then proceed with proper treatment and prevention, which is the ultimate goal.

Differentiation of gastrointestinal diseases in adult cattle.

Many of the common gastrointestinal disorders of adult cattle may be diagnosed by a careful physical examination, whereas other disturbances require the use of diagnostic testing. It is important to differentiate the causes of gastrointestinal disturbances to make better treatment decisions and have a clearer prognosis for the specific animal or herd of cattle.

[Patients in a state of agitation at the admission service of a Rouen hospital emergency department]. / Les patients agités au service d'accueil et d'urgence du CHU de Rouen.

OBJECTIVE: To determine the incidence and causes of agitation states in patients presenting at the Rouen University Hospital emergency room and to analyze the management scheme. PATIENTS AND METHOD: A prospective study was conducted over a 9 month period in 100 consecutive patients presenting a state of agitation assessed using the Overt Aggression Scale. A pre-planned management protocol was applied. RESULTS: The incidence of states of agitation was 0.56%. There were 43 women and 57 men, mean age 33 years. Most of the agitated patients were admitted between 6 p.m. and 4 a.m. (69%). Over the 9 month period, 2 patients were admitted twice for agitation and 2 absconded. Low glucose level was the cause of agitation in 4 cases. Alcohol and/or drug use concerned 73% of the agitated patients and was the most frequently observed triggering factor (17%). Only 6% of the patients had a regular employment. Physical restraining measures and sedation were required in 86% and 84% of the cases respectively. Among 67 patients given loxapine for sedation, 2 developed acute dyskinesia and 9 low blood pressure. One out of 4 patients were referred to a psychiatric unit. CONCLUSION: Patients in a state of agitation are young, often female, and in a difficult socio-economic situation. Hypoglycemia is the main differential diagnosis. A triggering factor can often be identified. A state of agitation is not a repetitive condition but occurs as a short-lived episode in the patientís history. Such patients need rapid care to avoid further aggravation and disruption of the emergency room activity, and to prevent the patient from fleeing. Loxapine provides effective sedation but requires regular monitoring of blood pressure and can provoke acute dyskinesia in young subjects.

Influence of pH and temperature on kinetics of ceftiofur degradation in aqueous solutions.

The objective of this study was to evaluate the stability of ceftiofur (1 mg mL(-1)) in aqueous solutions at various pH (1, 3, 5, 7.4 and 10) and temperature (0, 8, 25, 37 and 60 degrees C) conditions. The ionic strength of all these solutions was maintained at 0.5 M. Ceftiofur solutions at pH 5 and 7.4 and in distilled water (pH = 6.8) were tested at all the above temperatures. All other solutions were tested at 60 degrees C. Over a period of 84 h, the stability was evaluated by quantifying ceftiofur and its degradation product, desfuroylceftiofur, in the incubation solutions. HPLC was used to analyse these compounds. At 60 degrees C, the rate of degradation was significantly higher at pH 7.4 compared with pH 1, 3, 5 and distilled water. At both 60 degrees C and 25 degrees C, degradation in pH 10 buffer was rapid, with no detectable ceftiofur levels present at the end of 10 min incubation. Degradation rate constants of ceftiofur were 0.79+/-0.21, 0.61+/-0.03, 0.44+/-0.05, 1.27+/-0.04 and 0.39+/-0.01 day(-1) at pH 1, 3, 5, 74 and in distilled water, respectively. Formation of desfuroylceftiofur was the highest (65%) at pH 10. The rate of degradation increased in all aqueous solutions with an increase in the incubation temperature. At pH 7.4 the degradation rate constants were 0.06+/-0.01, 0.06+/-0.01, 0.65+/-0.17, and 1.27+/-0.05 day(-1) at 0, 8, 25, 37 and 67 degrees C, respectively. The energy of activation for ceftiofur degradation was 25, 42 and 28 kcal mol(-1) at pH 5, 7.4 and in distilled water, respectively. Desfurylceftiofur formation was the greatest at alkaline pH compared with acidic pH. Ceftiofur degradation accelerated the most at pH 7.4 and was most rapid at pH 10. The results of this study are consistent with rapid clearance of ceftiofur at physiological pH.

Ceftiofur distribution in plasma and joint fluid following regional limb injection in cattle.

The objective of this study was to evaluate the efficacy of regional intravenous (i.v.) injection of ceftiofur in delivery of this drug to joint fluid and plasma in a limb distal to a tourniquet in five, healthy, adult, mixed breed beef cattle. A tourniquet was positioned in the mid-metacarpal region, and 500 mg of ceftiofur was administered through a catheter in the dorsal common digital vein (DCDV). Plasma samples were collected from the catheter at 15, 30 and 45 min postinjection, and from the abaxial proper palmar vein (APPV) at 15 min postinjection. Synovial fluid was collected from the metacarpal phalangeal joint at 45 min postinjection. Ceftiofur concentrations were estimated in plasma and synovial fluid using high-pressure liquid chromatography (HPLC) and a microbiological assay utilizing Pasteurella haemolytica as the test organism. Both assays indicated highest plasma concentrations of ceftiofur at 15 min, with the concentrations declining with time. Concentrations of ceftiofur in plasma obtained from the DCDV were not significantly different from APPV levels, indicating rapid distribution of ceftiofur within the limb. Microbiological assay always demonstrated higher concentrations of ceftiofur compared with HPLC assay, because the former probably also detected the active metabolites of ceftiofur as well as the parent compound. At 45 min, ceftiofur concentrations determined by HPLC were 251+/-97 and 15+/-5 microg/mL in plasma and synovial fluid, respectively. Regional intravenous injection appears to be a feasible technique to produce rapid distribution of ceftiofur within the limb well above therapeutic concentrations.

Analysis of first gastric compartment fluid collected via percutaneous paracentesis from healthy llamas.

OBJECTIVE: To evaluate the safety and efficacy of percutaneous paracentesis for fluid collection from the first gastric compartment of healthy llamas and to describe characteristics of that fluid. DESIGN: Prospective study. ANIMALS: 10 healthy adult llamas. PROCEDURE: Physical examinations were performed prior to sample collection and for 14 days afterwards. A CBC was performed prior to sample collection and 5 days later. A 16-gauge, 7.5-cm stainless steel needle, positioned approximately 20 cm caudal to the costochondral junction of the last rib, was pointed in a dorsocraniomedial direction and pushed through the abdominal wall into the lumen of the first gastric compartment. Fluid was aspirated and analyzed immediately for color, odor, consistency, pH, methylene blue reduction (MBR) time, protozoa, and bacteria. RESULTS: Fluid samples were obtained from 9 of 10 llamas. Mean volume was 4.1 ml, mean pH was 6.67, and mean MBR time was 173 seconds. Odor was slightly acidic, color was light brown-green to light yellow-green, and consistency was moderate. Small protozoa with variable iodine staining and gram-negative bacteria were commonly detected. With few exceptions, results of physical examinations and CBC remained within reference ranges. CLINICAL IMPLICATIONS: Fluid samples from the first gastric compartment can be successfully obtained by percutaneous paracentesis. Fluid characteristics were similar to those of fluid collected via orogastric tube in llamas and cattle.

[Diagnosis and management of anxiety in victims of psychological trauma]. / Diagnostic et prise en charge de l'anxiété chez les victimes de psychotraumatismes.

Management of psychic injury has been developing in France recently. Community catastrophies like wars or natural events, individual's stress are more and more related. Physicians are qualified for the treatment of their psychic consequences. Family doctors know people and local geographic situations and are often the first medical managers on the scene of the disaster.

1H- and 2H-NMR studies of a fragment of PMP1, a regulatory subunit associated with the yeast plasma membrane H(+)-ATPase. Conformational properties and lipid-peptide interactions.

PMP1 is a 38-residue polypeptide associated with the yeast plasma membrane H(+)-ATPase, found to regulate the enzyme activity. To investigate the molecular basis of the PMP1 biological function, the conformational properties of a synthetic PMP1 fragment, A18-F38, comprising the predicted C-terminal cytoplasmic domain and a part of the transmembrane anchor have been studied by 1H- and 2H-NMR spectroscopies. High resolution 1H-NMR experiments showed that, in deuterated DPC micelles, the A18-G34 segment adopts a well defined helix conformation. Our data suggest that the whole PMP1 molecule forms a unique helix whose axis might be slightly tilted with respect to the bilayer normal. Protonated DPC, DMPC and DMPS were incorporated in deuterated micelles containing the PMP1 fragment for studying lipid-peptide interactions. Unusually strong and selective intermolecular NOEs between lipid chain and peptide side chain protons, especially those of the unique Trp residue, were observed. Solid state 2H-NMR experiments performed on pure deuterated POPC and mixed deuterated POPC:POPS (5:1) bilayers revealed that the PMP1 fragment specifically interacts with negatively charged PS lipids.

[Anxiety and medicine: what is the role of the psychiatrist?]. / Anxiété et médecine: quelle place pour le psychiatre?

The relationship between medicine and psychiatry is complex and sometimes a little difficult. Anxiety is frequently met in somatic medicine units and particularly in General Hospital where psychiatrists are often required for crisis situations. So, anxiety disorder becomes a link between physicians and psychiatrists looking after same inpatients. Epidemiological high comorbidity too is demonstrated between anxiety and somatic disorders. More and more frequently, psychiatrists are engaged for care of post traumatic stress disorders. In fact, in modern medicine, the psychiatrist is collecting medical, psychosocial and humanist points of view. His missions of clinician, teacher, and researcher seem really important for the future evolution of medicine.