BACKGROUND & AIMS: :This paper reviews the climatological influences on major past storm events in the North-east Atlantic. Analyses are based on a millenary record of sedimentological and historical impacts affecting coastal societies. The effects of 20 past storms have been found from sedimentary deposits from the last 1,000 years. Historical archives confirmed these events. This paper highlights five major storms that have markedly impacted coastal populations. They date back to 1351-1352, 1469, 1645, 1711 and 1751 AD. The 1351-1352 AD event is defined as a millennium storm that was "likely apocalyptical", provoking serious damage and long lasting floods on much of the European coast. Major storm impacts have mostly been recorded during positive North Atlantic Oscillation phases. Four decreasing temperature phases are concomitant with 1300-1355, 1420-1470, 1560-1590 and 1690-1715 AD periods, during which much of the northern Atlantic coast of France underwent severe storm damages.

背景与目标： ：本文回顾了气候变化对东北大西洋过去重大风暴事件的影响。分析基于影响沿海社会的千年沉积学和历史影响的记录。从过去的1000年的沉积物中发现了20次过去的风暴的影响。历史档案馆证实了这些事件。本文重点介绍了五个严重影响沿海人口的大风暴。他们的历史可以追溯到公元1351-1352、1469、1645、1711和1751年。公元1351-1352年的事件被定义为“可能是世界末日”的千年风暴，在欧洲大部分地区造成了严重的破坏和长期的洪灾。在北大西洋涛动的积极阶段，主要记录了主要的风暴影响。四个温度下降阶段与公元1300-1355年，142​​0-1470年，1560-1590年和1690-1715年相伴，在此期间，法国北部大西洋沿岸的大部分地区遭受了严重的风暴破坏。

BACKGROUND & AIMS: :To better define the overall characteristics and risk factors for dying of adult pneumococcal endocarditis (PE) focusing on the echocardiographic diagnosis, the impact of surgery, and emergence of penicillin resistance, the medical and microbiologic charts of adult PE cases observed between 1991 and 1998 in university and general hospitals were reviewed through a nationwide retrospective study in France. Thirty cases of PE (22 men, 8 women; median age, 53 yr; range, 27-87 yr) were collected and validated. Twenty patients (66.7%) had no known predisposing cardiopathy; 4 had a bioprosthetic valve. The primary focus of infection was pneumonia in 10 (33.3%), and meningitis was noted in 12 (40.0%). Half the patients suffered from chronic alcoholism. Echocardiography detected vegetation(s) in 29 cases (96.7%), valvular perforation in 6 (20.0%), and/or valve ring abscess in 4 (13.3%). The most frequent complications were congestive heart failure (n = 19), large arterial emboli (n = 8), and focal abscesses (n = 7). Five strains were penicillin-resistant. Twenty (66.7%) patients underwent valve replacement, 12 of them during the first month. The overall mortality rate was 24.1%. According to a multivariate analysis, the risk factors independently associated with dying were age > or = 65 yr and septic shock, while cardiac surgery was protective (p < 0.01). In conclusion, PE is usually fulminant and causes severe valve damage and embolic complications; its short-term prognosis might be improved by early valve replacement.

背景与目标： ：为更好地定义成人肺炎球菌性心内膜炎（PE）的总体特征和死亡因素，重点在于超声心动图诊断，手术的影响以及青霉素耐药性的出现，我们在1991年至1998年间观察了成人PE病例的医学和微生物学图表在法国，通过一项全国性回顾性研究对大学和综合医院的住院医师进行了回顾。收集并验证了30例PE（22例男性，8例女性；中位年龄53岁；范围27-87岁）。 20例患者（66.7％）没有已知的诱发性心脏病。 4个有生物修复瓣膜。感染的主要焦点是肺炎10例（33.3％），注意到脑膜炎的12例（40.0％）。一半的患者患有慢性酒精中毒。超声心动图检查发现29例（96.7％）的植被，6例（20.0％）的瓣膜穿孔和/或4例（13.3％）的瓣膜脓肿。最常见的并发症是充血性心力衰竭（n = 19），大动脉栓塞（n = 8）和局灶性脓肿（n = 7）。五株对青霉素具有抗性。二十例（66.7％）患者接受了瓣膜置换术，其中第一个月有12例。总死亡率为24.1％。根据多变量分析，与死亡相关的独立危险因素为年龄≥65岁和败血性休克，而心脏手术是保护性的（p <0.01）。总之，PE通常是暴发性的，会导致严重的瓣膜损伤和栓塞并发症。早期更换瓣膜可改善其短期预后。

BACKGROUND & AIMS: The anaesthetic management of handicapped young adults is often difficult. However, few examples were found in the literature that attempted to specifically measure the frequency of general anaesthesia in the dental treatment of this group of patients. This paper focuses on the management of mentally or physically handicapped young patients undergoing extractions at a specialist dental service in Southern France. A survey of 184 young patients treated during a 39-month period, either under general (34 cases) or local (150 cases) anaesthesia was carried out. A minimum one-year follow-up period was used for each patient. The main characteristics of the patients who received general or local anaesthesia were compared and the factors which indicated the choice of general rather than local anaesthesia were assessed. This study attempts to define precise selection criteria, including dental and non-dental factors. Limited past treatment history was found to be a strong indicator of the need for general anaesthesia. The results of this study suggest that non-dental background factors were also important. The need for general anaesthesia was markedly increased in the groups with severe behavioural disturbances or low levels of contact with the general dental practitioner. If provision of regular dental services for disabled young patients can significantly reduce the need for general anaesthesia, care will have to be taken in developing the relationships between the hospital and general dental practitioner.

背景与目标： 残疾年轻人的麻醉处理通常很困难。但是，在文献中发现很少有实例试图专门测量这一组患者在牙科治疗中全身麻醉的频率。本文重点研究在法国南部一家专科牙科诊所接受拔牙手术的弱智或弱智年轻患者的管理。对在39个月内接受全身麻醉（34例）或局部麻醉（150例）的184例年轻患者进行了调查。每位患者的随访时间最少为一年。比较了接受全身麻醉或局部麻醉的患者的主要特征，并评估了指示选择全身麻醉而非局部麻醉的因素。这项研究试图定义精确的选择标准，包括牙科和非牙科因素。发现有限的既往治疗史是需要全身麻醉的有力指标。这项研究的结果表明，非牙科背景因素也很重要。在行为严重障碍或与普通牙科医生接触水平低的组中，全身麻醉的需求明显增加。如果为残疾的年轻患者提供定期牙科服务可以大大减少全麻的需求，则必须注意建立医院与普通牙科医生之间的关系。

BACKGROUND & AIMS: PURPOSE:Inherited retinal dystrophies (IRDs) and inherited optic neuropathies (IONs) are rare diseases defined by specific clinical and molecular features. The relative prevalence of these conditions was determined in Southern France. METHODS:Patients recruited from a specialized outpatient clinic over a 21-year period underwent extensive clinical investigations and 107 genes were screened by polymerase chain reaction/sequencing. RESULTS:There were 1957 IRD cases (1481 families) distributed in 70% of pigmentary retinopathy cases (56% non-syndromic, 14% syndromic), 20% maculopathies and 7% stationary conditions. Patients with retinitis pigmentosa were the most frequent (47%) followed by Usher syndrome (10.8%). Among non-syndromic pigmentary retinopathy patients, 84% had rod-cone dystrophy, 8% cone-rod dystrophy and 5% Leber congenital amaurosis. Macular dystrophies were encountered in 398 cases (30% had Stargardt disease and 11% had Best disease). There were 184 ION cases (127 families) distributed in 51% with dominant optic neuropathies, 33% with recessive/sporadic forms and 16% with Leber hereditary optic neuropathy. Positive molecular results were obtained in 417/609 families with IRDs (68.5%) and in 27/58 with IONs (46.5%). The sequencing of 5 genes (ABCA4, USH2A, MYO7A, RPGR and PRPH2) provided a positive molecular result in 48% of 417 families with IRDs. Except for autosomal retinitis pigmentosa, in which less than half the families had positive molecular results, about 75% of families with other forms of retinal conditions had a positive molecular diagnosis. CONCLUSIONS:Although gene discovery considerably improved molecular diagnosis in many subgroups of IRDs and IONs, retinitis pigmentosa, accounting for almost half of IRDs, remains only partly molecularly defined.

背景与目标： 目的：遗传性视网膜营养不良（IRD）和遗传性视神经病变（IONs）是由特定的临床和分子特征定义的罕见疾病。在法国南部确定了这些疾病的相对患病率。
方法：从专科门诊诊所招募的患者在21年内进行了广泛的临床研究，并通过聚合酶链反应/测序筛选了107个基因。
结果：共有1957例IRD病例（1481个家庭）分布在70％的色素性视网膜病病例中（56％为非综合征，14％综合征），20％为斑块状病变和7％为静止状态。色素性视网膜炎患者最常见（47％），其次是Usher综合征（10.8％）。在非综合征性色素性视网膜病患者中，有84％患有杆锥营养不良，8％的锥杆营养不良和5％的Leber先天性黑病。 398例发生黄斑营养不良（30％患有Stargardt病，11％患有Best病）。共有184例ION病例（127个家庭），其中以占优势的视神经病变分布为51％，具有隐性/散发性形式的占33％，具有Leber遗传性视神经病变的占16％。在417/609个带有IRD的家庭中获得了积极的分子结果（68.5％），在27/58个带有IONs的家庭中获得了积极的分子结果（46.5％）。 5个基因（ABCA4，USH2A，MYO7A，RPGR和PRPH2）的测序为417个IRD家族中的48％提供了阳性分子结果。除常染色体色素性视网膜炎（其中少于一半的家庭的分子结果为阳性）外，约75％患有其他形式视网膜疾病的家庭的分子诊断为阳性。
结论：尽管基因发现大大改善了IRD和IONs的许多亚类的分子诊断，但占IRD几乎一半的色素性视网膜炎仍仅在分子上有部分定义。

BACKGROUND & AIMS: :Since 1994, a new prevention policy has been introduced in France. Over that period, eleven regions have conducted suicide prevention programs. It is possible today to assess the effects of these programs in retrospect. We have compared mortality data of the experimental regions to those of the other regions. We observed a significant difference in favour of the regions with suicide prevention programs. Results are discussed in relation with the achieved program content.

背景与目标： ：自1994年以来，法国引入了新的预防政策。在此期间，有11个地区实施了自杀预防计划。今天有可能回顾这些计划的效果。我们将实验区域的死亡率数据与其他区域的死亡率数据进行了比较。我们观察到对自杀预防计划有利的地区存在显着差异。讨论结果与已实现的计划内容有关。

BACKGROUND & AIMS: BACKGROUND:In France, cancer incidence figures are produced by cancer registries covering only 13.5% to 16% of the whole population of the country. Thus, to produce national figures, estimates have to be computed. Registration disparities between registries concerning tumors of the Central Nervous System (CNS) could have biased these estimates. METHODS:National estimates are based on modelling of the incidence/mortality ratio. The most recent estimations for year 2000 were calculated by the French Cancer Registry Network (FRANCIM) and the department of biostatistics of Lyon University Hospital. Since benign tumors are not recorded in some cancer registries, a new estimate of the incidence of CNS tumors was produced by estimating the number of benign tumors in these registries. RESULTS:In 2000 in France, the number of estimated cases of CNS tumors was 2697 in men and 2602 in women, with incidence rates (World standard) of 7.4 and 6.4 per 100,000 respectively. The incidence increased between 1978 and 2000, on an average by 2.25% per year in men and 3.01% per year in women. However, these estimates do not provide a correct picture of CNS incidence. First of all, pathological diagnoses are not performed in 3.5%-27.5% of the patients with CNS tumors registered in French registries. Second, figures for benign tumors (mainly meningiomas) were provided by only two of nine cancer registries. If benign tumors had been registered by all cancer registries, computed incidence would have increased by 12% for men and 26% for women. CONCLUSION:Incidence of CNS tumors is increasing in France, as in many other countries. To improve comparability with other countries, French cancer registries should also collect data on benign tumors. The discrepancies observed between registries in the proportion of patients without information on histology show differences in diagnostic practices and should be the starting point for a survey on this topic.

背景与目标： 背景：在法国，癌症登记机构仅记录了该国总人口的13.5％至16％的癌症发病率数据。因此，要产生国家数据，必须计算估计值。有关中枢神经系统（CNS）肿瘤的注册管理机构之间的注册差异可能会使这些估计数产生偏差。
方法：国家估计数基于发病率/死亡率的模型。法国癌症注册网络（FRANCIM）和里昂大学医院生物统计学系计算了2000年的最新估计值。由于在某些癌症登记册中未记录良性肿瘤，因此通过估算这些登记册中良性肿瘤的数目可以得出有关中枢神经系统肿瘤发生率的新估计。
结果：在法国，2000年CNS肿瘤的估计病例数为男性2697例，女性2602例，发病率（世界标准）分别为100,000例7.4和6.4。发病率在1978年至2000年之间增加，男性平均每年增加2.25％，女性平均每年增加3.01％。但是，这些估计不能提供中枢神经系统发病率的正确描述。首先，在法国注册处登记的CNS肿瘤患者中，没有进行病理诊断的占3.5％-27.5％。第二，良性肿瘤（主要是脑膜瘤）的数字仅由九个癌症登记处中的两个提供。如果所有癌症登记处都登记了良性肿瘤，那么男性的计算发病率将增加12％，女性将增加26％。
结论：与许多其他国家一样，法国的中枢神经系统肿瘤发病率正在上升。为了提高与其他国家的可比性，法国癌症注册机构还应该收集有关良性肿瘤的数据。在没有组织学信息的患者中，注册表之间观察到的差异显示出诊断方法的差异，应该成为对此主题进行调查的起点。

BACKGROUND & AIMS: :France is located in an area with a medium to high prevalence of multiple sclerosis, where its epidemiology is not well known. We estimated the national and regional prevalence of multiple sclerosis in France on 31 October 2004 and the incidence between 31 October 2003 and 31 October 2004 based on data from the main French health insurance system: the Caisse Nationale d'Assurance Maladie des Travailleurs Salariés. The Caisse Nationale d'Assurance Maladie des Travailleurs Salariés insures 87% of the French population. We analysed geographic variations in the prevalence and incidence of multiple sclerosis in France using the Bayesian approach. On the 31 October 2004, 49 417 people were registered with multiple sclerosis out of the 52 359 912 insured with the Caisse Nationale d'Assurance Maladie des Travailleurs Salariés. Among these, 4497 were new multiple sclerosis cases declared between 31 October 2003 and 31 October 2004. After standardization for age, total multiple sclerosis prevalence in France was 94.7 per 100,000 (94.3-95.1); 130.5 (129.8-131.2) in females and 54.8 (54.4-55.3) in males. The national incidence of multiple sclerosis between 31 October 2003 and 31 October 2004 was 7.5 per 100,000 (7.3-7.6); 10.4 (10.2-10.6) in females and 4.2 (4.0-4.3) in males. The prevalence and incidence of multiple sclerosis were higher in North-Eastern France, but there was no obvious North-South gradient. This study is the first performed among a representative population of France (87%) using the same method throughout. The Bayesian approach, which takes into account spatial heterogeneity among geographical units and spatial autocorrelation, did not confirm the existence of a prevalence gradient but only a higher prevalence of multiple sclerosis in North-Eastern France and a lower prevalence of multiple sclerosis in the Paris area and on the Mediterranean coast.

背景与目标： 法国位于多发性硬化症的中度至高度流行地区，其流行病学尚未广为人知。我们根据法国主要健康保险体系：法国国民健康保险组织的数据，估计了2004年10月31日法国在全国和地区的多发性硬化症患病率，以及2003年10月31日至2004年10月31日的发病率。国民储蓄担保组织向萨拉瓦列人的萨拉迪埃人提供保险，使法国人口获得87％的保险。我们使用贝叶斯方法分析了法国多发性硬化症患病率和发病率的地理差异。在2004年10月31日，有52,359,912例因凯撒国民保险（Calasse Nationale d'Assurance Maladie des TravailleursSalariés）投保的52,359,912人中，有49,417人患有多发性硬化症。其中，有4497例是在2003年10月31日至2004年10月31日之间宣布的新的多发性硬化症病例。按照年龄标准化后，法国的多发性硬化症总患病率为每10万人中94.7（94.3-95.1）；女性为130.5（129.8-131.2），男性为54.8（54.4-55.3）。在2003年10月31日至2004年10月31日期间，全国多发性硬化症的发病率是每100,000例7.5（7.3-7.6）；女性为10.4（10.2-10.6），男性为4.2（4.0-4.3）。法国东北部多发性硬化症的患病率和发病率较高，但没有明显的南北梯度。这项研究是在法国有代表性的人群（87％）中首次使用相同的方法进行的。贝叶斯方法考虑了地理单位之间的空间异质性和空间自相关性，并未证实存在患病率梯度，而仅证实法国东北部多发性硬化症的患病率较高，而巴黎地区的多发性硬化症的患病率较低在地中海沿岸。

BACKGROUND & AIMS: :Microalgae worldwide regularly cause harmful effects, considered from the human perspective, in that they cause health problems and economic damage to fisheries and tourism. Cyanobacteria cause similar problems in freshwaters. These episodes encompass a broad range of phenomena collectively referred to as "harmful algal blooms" (HABs). For adequate management of these phenomena, monitoring of microalgae is required. However, effective monitoring is time-consuming because cell morphology as determined by light microscopy may be insufficient to give definitive species and toxin attribution. In the European Union FP7 project MIDTAL (Microarrays for the Detection of Toxic Algae), we achieved rapid species identification using rRNA genes as the target. These regions can be targeted for probe design to recognise species or even strains. We also included antibody reactions to specific toxins produced by these microalgae because, even when cell numbers are low, toxins can be present and can accumulate in the shellfish. Microarrays are the state-of-the-art technology in molecular biology for the processing of bulk samples for detection of target RNA/DNA sequences. After 36 months, we have completed RNA-cell number-signal intensity calibration curves for 18 HAB species and the analysis of monthly field samples from five locations from year 1. Results from one location, Arcachon Bay (France), are reported here and compared favourably with cell counts in most cases. In general, the microarray was more sensitive than the cell counts, and this is likely a reflection in the difference in water volume analysed with the volume filtered for the microarray an order of magnitude greater.

背景与目标： 从人类的角度来看，全世界的微藻类经常造成有害影响，因为它们会对渔业和旅游业造成健康问题和经济损失。蓝细菌在淡水中引起类似的问题。这些事件包含广泛的现象，统称为“有害藻华”（HABs）。为了适当处理这些现象，需要监控微藻。但是，有效的监视非常耗时，因为通过光学显微镜确定的细胞形态可能不足以提供确定的物种和毒素归因。在欧盟FP7项目MIDTAL（用于检测有毒藻类的微阵列）中，我们实现了以rRNA基因为目标的快速物种鉴定。这些区域可以作为探针设计的目标，以识别物种甚至菌株。我们还包括了针对这些微藻产生的特定毒素的抗体反应，因为即使细胞数量很少，毒素也可能存在并可以在贝类中积聚。微阵列是分子生物学中用于处理大量样品以检测目标RNA / DNA序列的最新技术。 36个月后，我们已经完成了针对18种HAB物种的RNA细胞数信号强度校准曲线，并从第一年开始对五个地点的月度田间样品进行了分析，在此处报告并比较了一个地点阿尔卡雄湾（法国）的结果在大多数情况下，细胞计数都非常有利。通常，微阵列比细胞计数更敏感，这很可能反映了用微阵列过滤的水量分析的水量差异大了一个数量级。

BACKGROUND & AIMS: :Since the post-War period, social protection systems have experienced continuous reforms, either extending or, more often, reducing the scope and the scale of public provision. This paper seeks to present how healthcare systems have evolved both in France and in Brazil recently, in order to comprehend mechanisms through which financialization has been reshaping public care provision. This comparative analysis unveils distinct financialization dynamics of healthcare systems, built upon universalism principles. After featuring both systems, underlying their private dimension - either complementary or supplementary - the article points out how the financial sector is broadening its share in the supply of healthcare services. In what follows, the sector's process of internationalization/centralization is analyzed and lastly the regulatory role of the State in strengthening private provision is defined. Despite radically different institutional paths, the findings corroborate that in both cases finance is a driving force in reshaping the healthcare sector. :Desde a segunda metade do século XX, reformas tornaram-se contínuas no âmbito dos sistemas de proteção social, ampliando ou, com mais frequência, restringindo o escopo e a escala da provisão pública. Neste artigo, cotejamos a evolução recente dos sistemas de saúde na França e no Brasil, de modo a apreender os mecanismos através dos quais a “financeirização” vem reformatando a provisão pública. Essa abordagem comparada tem por finalidade explicitar dinâmicas diferenciadas de penetração do capital financeiro em sistemas de saúde que se pautaram por princípios universalistas. Após caracterizar brevemente ambos os sistemas de saúde, destacando o alcance da provisão privada seja complementar, seja suplementar, o artigo mostra como o setor financeiro vem ampliando sua participação na oferta de serviços de saúde. Em seguida, analisa como se dá o processo de internacionalização/centralização do setor, e, finalmente, sintetiza o papel regulatório do Estado no fortalecimento da provisão privada. Os resultados indicam que, a despeito de trajetórias institucionais radicalmente opostas, a marcha da financeirização avança no setor de saúde.

背景与目标： ：自战后以来，社会保护体系经历了不断的改革，要么扩大，要么更经常地减少公共服务的范围和规模。本文旨在介绍最近在法国和巴西的医疗体系如何发展，以便理解金融化重塑公共医疗服务的机制。这项比较分析揭示了基于普遍主义原则的独特的医疗保健系统金融化动态。在对这两种系统进行了介绍之后，它们指出了它们的私有维度（互补的或补充的）的基础，并指出了金融部门如何扩大其在医疗服务供应中的份额。接下来，分析了该部门的国际化/集中化进程，最后定义了国家在加强私人供给方面的监管作用。尽管机构路径截然不同，但研究结果证实，在这两种情况下，金融都是重塑医疗保健行业的动力。
：在XX世卫组织第二次世界大战期间，改革社会保护，两栖，两栖，后备队，再三队或后备队。sproculaséculoséculoséculoXX，séculoséculoséculoXX。巴西的Neste artigo，巴西的最近的发展机构，巴西的先例，后继的墨西哥人和西班牙人。通用金融公司与首都金融公司之间的最终对决萨尔瓦多地区发展银行，西班牙私有企业，塞维利亚超级企业，阿尔及利亚最普通的企业，西班牙金融服务公司。塞古达（Em seguida），国际定居点/定居点，定居点，圣帕特里克（sintetiza o papel）或私人户口（saledo no fortalecimento）。您可以在结果显示，在根本上解决问题的机构，在金融机构工作的人。

BACKGROUND & AIMS: :Background Although stroke and acute coronary events share several risk factors, few studies have compared population-level epidemiological surveillance indicators of the two diseases in the same age range and in the same geographical area. Design The objective of the present study was to compare the rate of acute coronary events with that of stroke among inhabitants aged from 35-74 years in Northern France (Lille). Methods All incident and recurrent acute coronary events and stroke events occurring in men and women over 2008-2014 were recorded using two population-based registries with several overlapping sources of case ascertainment for hospitalised/non-hospitalised and fatal/non-fatal events. Log-linear Poisson regression models were used to compare the event and mortality rates. Results The results showed that the incident rates of acute coronary event and stroke were similar except under 60 years. In this group (35-59 years), the incident rate of acute coronary events was 1.6-fold higher than that of stroke. In contrast, the attack (incident and recurrent) rates were higher for acute coronary events than for stroke (1.5-fold; p < 0.0001) - especially in men (1.8-fold; p < 0.0001). The mortality rate was 2.2-fold higher for acute coronary events than for stroke, independent of sex and age group ( p < 0.0001), as was the case-fatality rate (1.5-fold, p < 0.0001). Conclusion In Lille, the overall acute coronary event rate was higher than the stroke rate - especially among men, due to a higher risk of incident acute coronary event under the age of 65 and a higher risk of recurrent acute coronary event in the 65-74 year-old age range. Further efforts should be devoted to primary and secondary prevention strategies after acute coronary events.

背景与目标： 背景：尽管中风和急性冠状动脉事件具有多种危险因素，但很少有研究比较相同年龄范围和相同地理区域的两种疾病的人群水平流行病学监测指标。设计本研究的目的是比较法国北部（里尔）年龄在35-74岁之间的居民的急性冠脉事件发生率和中风发生率。方法使用两个基于人口的登记处记录了2008-2014年期间男性和女性的所有突发事件和复发性事件以及复发性事件和中风事件，其中有几个重叠的病例确定源，用于确定住院/非住院和致命/非致命事件。对数线性泊松回归模型用于比较事件和死亡率。结果结果表明，除了60岁以下，急性冠心病和中风的发生率相似。在这一组（35-59岁）中，急性冠状动脉事件的发生率比中风高1.6倍。相反，急性冠状动脉事件的发作（事件和复发）率比中风要高（1.5倍； p <0.0001），尤其是男性（1.8倍； p <0.0001）。与性别和年龄组无关（p <0.0001），急性冠脉事件的死亡率比中风高2.2倍（p <0.0001），病死率也是如此（1.5倍，p <0.0001）。结论在里尔，总体急性冠脉事件发生率高于中风发生率-特别是在男性中，这是由于65岁以下的急性冠脉事件的发生风险较高，而65-74岁的复发性急性冠脉事件的发生风险较高岁年龄段。急性冠状动脉事件后，应进一步努力进行一级和二级预防策略。

BACKGROUND & AIMS: :Several French regions where coronavirus disease (COVID-19) has been reported currently show a renewed increase in ILI cases in the general practice-based Sentinelles network. We computed the number of excess cases by region from 24 February to 8 March 2020 and found a correlation with the number of reported COVID-19 cases so far. The data suggest larger circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the French population than apparent from confirmed cases.

背景与目标： ：目前已报道了几个冠状病毒病（COVID-19）的法国地区，在以常规医疗为基础的Sentinelles网络中，ILI病例再次出现增加。我们计算了2020年2月24日至2020年3月8日各地区的超额病例数，发现与迄今报告的COVID-19病例数相关。数据表明，与确诊病例相比，法国人群中严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）的传播更大。

BACKGROUND & AIMS: :The ecology of viruses in shallow artificial freshwaters is poorly documented and there is no reference for sand pit lakes. We examined the seasonal abundances and infection rates of viruses in the sand pit Lake Créteil (France). Bacteria were the best predictor of viral abundance (4.0-7.8 × 10(10) viruses L(-1) ), with an average virus-to-bacteria ratio of 13.5 ± 1.9. Virus-induced bacterial mortality (range 37-86%, mean 65%) was higher than that in typical pelagic situations. This was related to high specific contact rates between viruses and bacterial hosts and high burst size (BS) estimates. Seasonal fluctuations in viruses and bacteria were rather homeostatic, although temperature was a major driver of microbial activities. Different bacterial morphotypes, i.e. 'morphopopulations', were analysed. Rod cells dominated the total (90%) and infected (89%) communities. Elongated rods were the most infected (45% of infected cells), whereas fat rods exhibited the highest BS estimates (mean=72 viruses per bacterium) due to a larger specific cell volume. We conclude that the lytic activity of viruses is high and heterogeneous for different bacterial-host phenotypes in the sand pit Lake Créteil. A theoretical exercise shows that this can exert a strong influence on the processes occurring in plankton food webs.

背景与目标： ：浅水人工淡水中的病毒生态学文献很少，对于沙坑湖也没有参考。我们检查了沙坑克里特伊湖（法国）中病毒的季节性丰富度和感染率。细菌是病毒丰度（4.0-7.8×10（10）病毒L（-1））的最佳预测因子，平均病毒与细菌的比率为13.5±1.9。病毒引起的细菌死亡率（37-86％，平均65％）高于典型的中上层鱼类。这与病毒与细菌宿主之间的高特异性接触率以及高爆发大小（BS）估计有关。尽管温度是微生物活动的主要驱动力，但病毒和细菌的季节性波动相当稳定。分析了不同的细菌形态型，即“形态种群”。杆状细胞占据了全部（90％）和感染（89％）社区。伸长的杆感染最多（占感染细胞的45％），而脂肪杆则由于其比细胞较大而表现出最高的BS估计值（平均每细菌72个病毒）。我们得出结论，沙坑湖克雷泰伊中不同细菌-宿主表型的病毒裂解活性很高且异质。理论研究表明，这可以对浮游生物食物网中发生的过程产生重大影响。

BACKGROUND & AIMS: Background:Obama nungara is a species of land flatworm originating from South America; the species was recently described and distinguished from a similar species, Obama marmorata. Obama nungara has invaded several countries of Europe, but the extent of the invasion has not been thoroughly mapped. Methods:In this article, based on a five and a half-year survey undertaken by citizen science, which yielded 530 records from 2013 to 2018, we analysed information about the invasion of Metropolitan France by O. nungara. We also investigated the variability of newly obtained cytochrome c oxidase 1 (COI) sequences of specimens from France, Italy and Switzerland. Results:Obama nungara was recorded from 72 of the 96 Departments of Metropolitan France. The species is especially abundant along the Atlantic coast, from the Spanish border to Brittany, and along the Mediterranean coast, from the Spanish border to the Italian border. More than half of the records were from an altitude below 50 m, and no record was from above 500 m; mountainous regions such as the Alps, Pyrenees and Massif Central are not invaded. Local abundance can be impressive, with 100 of specimens found in a small garden. An analysis of our new COI sequences, combined with published sequences of specimens from several countries, confirmed that three clades comprise the species. The first clade, 'Brazil', is currently confined to this country in South America; the second clade, 'Argentina 2', was found in Argentina and in Europe, only in Spain; and the third, 'Argentina 1', was found in Argentina and in Europe, in Spain, Portugal, France, UK, Italy, Belgium, and Switzerland. This suggests that two clades of O. nungara from Argentina have invaded Europe, with one widely spread. Discussion:The present findings strongly suggest that O. nungara is a highly invasive species and that the population which has invaded several countries in Europe comes from Argentina. The wide dispersion of the species and its reported local abundance, combined with the predatory character of the species, make O. nungara a potential threat to the biodiversity and ecology of the native soil fauna in Europe, and probably the most threatening species of all invasive land planarians present in Europe.

背景与目标： 背景：美洲狮ung（Obama nungara）是一种起源于南美的陆地扁虫。最近对该物种进行了描述，并与类似的物种奥巴马marmorata区别开来。奥巴马nungara入侵了欧洲的几个国家，但入侵的程度尚未完全确定。
方法：在本文中，根据公民科学进行的为期五年半的调查（从2013年到2018年产生了530条记录），我们分析了O. nungara入侵法国大都市的信息。我们还研究了来自法国，意大利和瑞士的标本的新获得的细胞色素C氧化酶1（COI）序列的变异性。
结果：从法国大都会的96个省中的72个省中记录到了奥巴马·恩加拉（Obama nungara）。从西班牙边界到布列塔尼的大西洋沿岸，以及从西班牙边界到意大利边界的地中海沿岸，该物种特别丰富。超过一半的记录来自50 m以下的高度，没有记录来自500 m以上的高度；诸如阿尔卑斯山，比利牛斯山脉和地块中部等山区没有被入侵。在一个小花园中发现了100个标本，当地的丰富程度令人印象深刻。对我们新的COI序列进行分析后，结合来自多个国家/地区的标本的公布序列，证实该物种由三个进化枝组成。第一个进化枝“巴西”目前仅限于南美的这个国家。第二个进化枝“ Argentina 2”在阿根廷和欧洲被发现，仅在西班牙。第三个是“阿根廷1号”，在阿根廷和欧洲，西班牙，葡萄牙，法国，英国，意大利，比利时和瑞士被发现。这表明来自阿根廷的两株O. nungara入侵了欧洲，其中一个已广泛传播。
讨论：本研究结果强烈表明，O。nungara是一种高度入侵的物种，入侵欧洲几个国家的人口来自阿根廷。该物种的广泛分布及其报告的局部丰富性，再加上该物种的掠食性特征，使得O. nungara成为对欧洲本土土壤动物的生物多样性和生态的潜在威胁，并且可能是所有入侵物种中威胁最大的物种出现在欧洲的陆地涡虫。

BACKGROUND & AIMS: INTRODUCTION:Though depressive disorders are major problems of public health, general population data about use of services and treatment adequacy are scarce in France. The literature suggests that the percentage of people suffering from mental disorders who are adequately treated is low. AIM OF THE STUDY:The objective of this study was to estimate the 12-month use of services in the French general population suffering from major depressive episodes (MDE) and levels of treatment adequacy. METHOD:This analysis was conducted on data from the Health barometer 2005, an epidemiological survey concerning several health topics. Thirty thousand five hundred and fourteen individuals from 12 to 75 years old were interviewed by telephone from October 2004 to February 2005. Depressive disorders were assessed by a standardized tool, the CIDI-SF, according to DSM-IV classification. RESULTS:The mental health questions were answered by 16,883 individuals; i.e. by 60% of individuals aged 15 or older. One year prevalence of MDE was 7.8%. In this group, 58.2% used services in a 12-month period, though only 21% of the service users received adequate treatment. Amongst those who used services, 2/3 consulted health care professionals (i.e. 1/3 of people presenting a MDE). The remaining percentage - 21.4% - of people presenting a MDE used psychotropic drugs without mentioning any use of services for mental health problems. The vast majority of individuals with MDE who used services (34.6% of those with MDE) consulted a professional trained to treat depression (general practitioner, psychiatrist, psychologist and psychotherapist). Only a small proportion (19.9%) of those consulting a professional went to a non-specialist professional as well; and even less (6%) consulted only a non-specialist professional. Amongst trained professionals, most consultations (61%, or 21.1% of the MDE group) concern general practitioners; another 38.4% (13.3% of the MDE group) involved psychiatrists; and 27.8% (9.6% of the MDE group) went to psychologists or psychotherapists. Amongst the psychologists and psychotherapists, most consultations were with psychologists (74.1%). The proportion with adequate treatment differed according to the type of professional. Consulting a general practitioner is associated with the lowest levels of adequate treatment (37.2%, and for general practitioners only, 21.5%). Consulting a psychiatrist is associated with higher proportions of adequate treatment (65.1%, and for consulting a psychiatrist only, 60.7%). Consulting both a general practitioner and a psychiatrist is associated with the highest levels of adequate treatment (79.7%). Antidepressants (ATD) are used far more frequently than psychotherapy (PT): 33.4% of individuals with MDE used ATD, and among the latter, 58.4% had also used anxiolytic drugs (AXL). Finally, 26.9% of the MDE group used AXL, 7.5% without any use of ATD. For PT, 10.8% used PT, and 8.1% used PT and ATD. DISCUSSION:Improving use of professionals and treatment adequacy are two primary objectives from a public health perspective. Since most adequately treated people used an antidepressant therapy (90%), and only 30% a PT, use of psychotherapeutic approaches might be improved. Moreover, levels of treatment adequacy are very low in people presenting an MDE who did not consult for "mental health reasons". Improving the recognition of symptoms of depression might contribute to better treatment adequacy.

背景与目标： 简介：尽管抑郁症是公共卫生的主要问题，但法国缺乏有关服务使用和治疗充分性的一般人群数据。文献表明，经过适当治疗的患有精神疾病的人所占的比例很低。
研究目的：本研究的目的是评估法国患有严重抑郁发作（MDE）和治疗水平适当的普通人群在12个月内使用服务的情况。
方法：本分析是根据《 2005年健康晴雨表》的数据进行的，该数据是一项涉及多个健康主题的流行病学调查。 2004年10月至2005年2月，通过电话采访了3 154名12至75岁的人。根据DSM-IV分类，通过标准化工具CIDI-SF对抑郁症进行了评估。
结果：心理健康问题得到了16,883个人的回答；即60％的15岁或15岁以上的人。一年的MDE患病率为7.8％。在这一组中，有58.2％的人在12个月内使用过服务，尽管只有21％的服务使用者得到了适当的治疗。在使用服务的人中，有2/3咨询过医疗保健专业人员（即，有MDE的人中有1/3）。其余的21.4％的MDE患者使用精神药物但未提及对精神健康问题的任何服务使用。绝大多数使用过MDE的人（使用MDE的人中有34.6％）咨询了接受过抑郁症培训的专业人员（全科医生，精神病医生，心理学家和心理治疗师）。也只有一小部分（19.9％）的咨询专业人士去过非专业人士。甚至只有6％（6％）的人咨询了非专业人士。在受过培训的专业人员中，大多数咨询（占MDE组的61％，即21.1％）与全科医生有关。另有38.4％（占MDE组的13.3％）涉及精神科医生； 27.8％（占MDE组的9.6％）去找心理学家或心理治疗师。在心理学家和心理治疗师中，多数会诊是与心理学家进行的（74.1％）。接受适当治疗的比例因专业人员的类型而异。咨询全科医生与最低水平的适当治疗相关（37.2％，仅对全科医生而言为21.5％）。向精神科医生咨询的比例较高，其得到的适当治疗的比例较高（65.1％，而仅向精神科医生咨询的比例为60.7％）。咨询全科医生和精神科医生都可获得最高水平的适当治疗（79.7％）。抗抑郁药（ATD）的使用频率远高于心理疗法（PT）：33.4％的MDE患者使用ATD，而后者中58.4％的患者也使用过抗焦虑药（AXL）。最后，MDE组中26.9％的人使用AXL，7.5％的人不使用ATD。对于PT，使用了10.8％的PT，使用了8.1％的PT和ATD。
讨论：从公共卫生的角度来看，改善专业人员的使用和治疗的充分性是两个主要目标。由于治疗最充分的人使用抗抑郁药治疗（90％），而PT仅30％，因此心理治疗方法的使用可能会得到改善。而且，在没有因“精神健康原因”而就诊的MDE患者中，治疗的充分性水平很低。改善对抑郁症状的认识可能有助于更好的治疗充分性。

BACKGROUND & AIMS: BACKGROUND:Fabry disease (FD) is a rare, X-linked, inherited lysosomal disease caused by absent or reduced α-galactosidase A activity. Due to the heterogeneity of disease presentation and progression, generic patient-reported outcome (PRO) tools do not provide accurate insight into patients' daily lives and impact of disease specific treatments. Also, the French National Health Authority, (HAS) actively encourages a patient-centric approach to improve the quality of care throughout the patient journey. In response to this initiative, we aimed to develop and validate a specific, self-reported, Patient Needs Questionnaire for people living with Fabry disease to appraise patient needs and expectations towards their treatment (PNQ Fabry). This endeavour was led with the help of French patient associations (APMF & VML) and dedicated expert centres. PNQ Fabry was developed according to the FDA/EMA methodologies and best practices for the development of PRO tools in rare diseases. Our approach comprised of three steps, as follows: concept elicitation and item generation, item reduction, and final validation of the questionnaire through a two-stage survey. RESULTS:Intrinsic and extrinsic reliability was established, using a validated benchmark questionnaire. With the invaluable help of patient associations, we recruited a satisfactory population in this rare disease setting, to ensure robust participation to validate our PNQ (final number of questionnaires: 76). At the end of the process, a 26-item patient-reported questionnaire was obtained with excellent psychometric properties, exhibiting very satisfactory measurement outcomes for reliability and validity. The results of this initiative demonstrate that the PNQ Fabry is accurate, suitable and tailored to FD patients, as it addresses themes identified during patient interviews, that were further validated through statistical analyses of quantitative surveys. An ongoing phase IV study is using this tool. CONCLUSION:We believe the PNQ Fabry will be a reliable and insightful tool in clinical practice, to improve patient management in FD.

背景与目标： 背景：法布里病（FD）是一种罕见的X连锁遗传性溶酶体疾病，由缺乏或降低的α-半乳糖苷酶A活性引起。由于疾病表现和进展的异质性，通用的患者报告结局（PRO）工具无法准确了解患者的日常生活和疾病特异性治疗的影响。此外，法国国家卫生局（HAS）积极鼓励以患者为中心的方法，以提高患者整个旅程的护理质量。为了响应这一倡议，我们旨在为患有法布里疾病的人开发并验证一份具体的，自我报告的患者需求调查表，以评估患者对治疗的需求和期望（PNQ Fabry）。这项工作是在法国患者协会（APMF＆VML）和专门的专家中心的帮助下进行的。 PNQ Fabry是根据FDA / EMA方法和最佳实践开发的，用于开发稀有疾病中的PRO工具。我们的方法包括以下三个步骤：概念启发和项目生成，项目减少以及通过两阶段调查对问卷进行最终验证。
结果：使用经过验证的基准问卷，建立了内部和外部可靠性。在患者协会的宝贵帮助下，我们在这种罕见的疾病环境中招募了令人满意的人群，以确保强大的参与度来验证我们的PNQ（问卷的最终数量：76）。在该过程的最后，获得了由患者报告的26个项目的问卷，这些问卷具有出色的心理测量特性，在信度和效度方面显示出非常令人满意的测量结果。该计划的结果表明，PNQ Fabry可以准确，适合并适合FD患者，因为它解决了患者访谈中确定的主题，并通过定量调查的统计分析进一步验证了这些主题。正在进行的第四阶段研究正在使用此工具。
结论：我们认为PNQ Fabry将成为临床实践中可靠而有见地的工具，以改善FD患者的管理。