The main objective of this paper is to address the following question: are the containment measures imposed by most of the world governments effective and sufficient to stop the epidemic of COVID-19 beyond the lock-down period? In this paper, we propose a mathematical model which allows us to investigate and analyse this problem. We show by means of the reproductive number, ${\cal R}_0$ that the containment measures appear to have slowed the growth of the outbreak. Nevertheless, these measures remain only effective as long as a very large fraction of population, p, greater than the critical value $1-1/{\cal R}_0$ remains confined. Using French current data, we give some simulation experiments with five scenarios including: (i) the validation of model with p estimated to 93%, (ii) the study of the effectiveness of containment measures, (iii) the study of the effectiveness of the large-scale testing, (iv) the study of the social distancing and wearing masks measures and (v) the study taking into account the combination of the large-scale test of detection of infected individuals and the social distancing with linear progressive easing of restrictions. The latter scenario was shown to be effective at overcoming the outbreak if the transmission rate decreases to 75% and the number of tests of detection is multiplied by three. We also noticed that if the measures studied in our five scenarios are taken separately then the second wave might occur at least as far as the parameter values remain unchanged.

Introduction: This study aims to evaluate the accuracy of the Échelle québécoise de triage préhospitalier en traumatologie (EQTPT) to identify patients who will need urgent and specialized trauma care in the La Capitale-Nationale region, province of Quebec. Methods: A detailed review of prehospital and in-hospital medical charts was conducted for a sample of patients transported following a trauma by ambulance to one of the five CHU de Quebec's emergency departments (ED) between November 2016 and March 2017. Data related to the trauma mechanism, population, injuries sustained, diagnosis, intervention and patient outcomes were extracted. The study primary outcome was the use of at least one urgent and specialized trauma care defined as: admission to the intensive care unit (ICU), urgent surgery within less than 24 hours after arrival (excluding orthopedic surgery for one limb only), intubation in ED, angioembolization within 24 hours after ED arrival, activation of a massive transfusion protocol in the ED. Also, patients who died secondary to their trauma were also considered as requiring urgent care. Results: 902 patients were included. The mean age (SD) was 59 (28.5) years old, 494 (54.8%) were female. The main trauma mechanisms were falls (592 (65.6%)) followed by motor vehicle accident (201 (22%)). 367 (40.7%) patients were transported directly to the tertiary trauma centre from the field. 231 (25.6%) patients had at least one criteria included in the steps 1, 2 or 3 of the EQTPT. Subsequently, most patients (649 (71.9%) were discharged home from the ED while 177 (19.6%) patients were admitted to the hospital. 82 (9.1%) patients required urgent and specialized trauma care. Of these 82 patients, 27 patients (32%) were identified in step 1 of the protocol, 12 patients (14.6%) in step 2, 5 patients (6.1%) in step 3, 13 patients (15.9%) in step 4 and 2 patients (2.4%) in step 5 while 23 (28.0%) patients were not identified by any steps of the EQTPT protocol. Therefore, 44 (53.6%) of the patients requiring urgent and specialized trauma care were identified by the criteria proposed in the steps 1, 2 or 3. Conclusion: In this retrospective cohort study, the EQTPT was insensitive to identify trauma patients who will need prompt and complex trauma management. Studies are required to determine the factors that could help improve its accuracy.

L’amélioration de la prise en charge médicamenteuse est un objectif constant des équipes en charge de la qualité et de la gestion des risques liés aux soins. En psychiatrie, le circuit du médicament concerne à la fois les secteurs intra et extrahospitaliers, pour lequel l’analyse des risques est parfois moins maîtrisée. L’objectif de ce travail est d’établir une cartographie des risques, a priori, du circuit du médicament du secteur extrahospitalier de notre établissement (800 lits) afin d’aboutir à l’élaboration de recommandations pour la sécurisation de ce circuit. Un état des lieux du fonctionnement du circuit du médicament en secteur extrahospitalier a été réalisé en collaboration avec la cellule qualité de janvier à juin 2015 au sein de 11 centres médico-psychologiques et 10 centres et/ou hôpitaux de jour. Les données recueillies lors de cette étude observationnelle ont été analysées selon la méthode AMDEC (analyse des modes de défaillance, de leurs effets, et de leur criticité). Après pondération (construction d’une matrice), les divers circuits ont été modélisés en logigrammes intégrant différents points (conciliation médicamenteuse, conditions de prescriptions, de délivrance, et d’administration) et comportant sept issues potentielles allant de la situation la plus à risque vers la plus sécurisée (pondérée à 100 %). Les étapes du circuit les plus critiques sont l’absence de conciliation, la non-informatisation des prescriptions et l’administration médicamenteuse sans prescription. Dans seulement 2 situations sur 28 (7 %) le circuit extrahospitalier est sécurisé à 100 % et dans 13 cas sur 28 (46 %), un niveau de sécurisation supérieur à 50 % (seuil d’acceptabilité défini) est atteint. Si le choix de la valeur seuil (50 %) et la pertinence d’un tel outil restent critiquables, ce travail préliminaire a permis la mise en évidence des situations les plus à risque, la création d’un groupe de travail pluridisciplinaire et l’élaboration de mesures correctives.

Previous research in clinical, community, and school settings has demonstrated positive outcomes for the Secret Agent Society (SAS) social skills training program. This is designed to help children on the autism spectrum become more aware of emotions in themselves and others and to ‘problem-solve’ complex social scenarios. Parents play a key role in the implementation of the SAS program, attending information and support sessions with other parents and providing supervision, rewards, and feedback as their children complete weekly ‘home mission’ assignments. Drawing on data from a school-based evaluation of the SAS program, we examined whether parents’ engagement with these elements of the intervention was linked to the quality of their children’s participation and performance. Sixty-eight 8–14-year-olds (M age = 10.7) with a diagnosis of autism participated in the program. The findings indicated that ratings of parental engagement were positively correlated with children’s competence in completing home missions and with the quality of their contribution during group teaching sessions. However, there was a less consistent relationship between parental engagement and measures of children’s social and emotional skill gains over the course of the program.

Individuals working for the emergency services often bear witness to distressing events. This outcome study examines therapeutic interventions for Fire Service personnel (FSP) experiencing symptoms of trauma, depression, anxiety and low levels of self-compassion. This study aims to investigate the effectiveness of using Compassion-Focused Therapy (CFT) as an adjunct to Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) in reducing symptoms of trauma, anxiety and depression and increasing self-compassion. A convenience sample (n = 17) of participants, referred for therapy following a traumatic incident, were allocated to receive 12 sessions of either TF-CBT or TF-CBT coupled with CFT. The study employed a repeated-measures design. Data were gathered pre- and post-therapy, using three questionnaires: (1) Hospital Anxiety and Depression Scale; (2) Impact of Events Scale-R; (3) Self-Compassion Scale – Short Form. TF-CBT combined with CFT was more effective than TF-CBT alone on measures of self-compassion. Significant reductions in symptoms of depression, anxiety, hyperarousal, intrusion and avoidance and a significant increase in self-compassion occurred in both groups post-therapy. The study provides some preliminary evidence to suggest that FSP may benefit from therapeutic interventions aimed at cultivating self-compassion. Further research is warranted using a larger sample size and adequately powered randomized controlled trial, to detect statistically significant differences and to negate the risk of confound due to low numbers resulting in significant differences between groups at baseline. Using CFT as an adjunct to TF-CBT may help FSP, who bear witness to the distress of others, cultivate compassion for their own suffering.

Episodic memory is one of the most important cognitive domains that involves acquiring, storing and recalling new information. In this article, we describe a new measure developed for the NIH Toolbox, called the Picture Sequence Memory Test (PSMT) that is the first to examine episodic memory across the age range from 3 to 85. We describe the development of the measure and present validation data for ages 20 to 85. The PSMT involves presentation of sequences of pictured objects and activities in a fixed order on a computer screen and simultaneously verbally described, that the participant must remember and then reproduce over three learning trials. The results indicate good test–retest reliability and construct validity. Performance is strongly related to well-established “gold standard” measures of episodic memory and, as expected, much less well correlated with those of a measure of vocabulary. It shows clear decline with aging in parallel with a gold standard summary measure and relates to several other demographic factors and to self-reported general health status. The PSMT appears to be a reliable and valid test of episodic memory for adults, a finding similar to those found for the same measure with children. (JINS, 2014, 20, 1–9)

Stable isotope analysis has provided crucial new insights into dietary change at the Neolithic transition in north-west Europe, indicating an unexpectedly sudden and radical shift from marine to terrestrial resources in coastal and island locations. Investigations of early Neolithic skeletal material from Sumburgh on Shetland, at the far-flung margins of the Neolithic world, suggest that this general pattern may mask significant subtle detail. Analysis of juvenile dentine reveals the consumption of marine foods on an occasional basis. This suggests that marine foods may have been consumed as a crucial supplementary resource in times of famine, when the newly introduced cereal crops failed to cope with the demanding climate of Shetland. This isotopic evidence is consistent with the presence of marine food debris in contemporary middens. The occasional and contingent nature of marine food consumption underlines how, even on Shetland, the shift from marine to terrestrial diet was a key element in the Neolithic transition.

We present a status report of the accelerator mass spectrometry (AMS) facility at the University of California, Irvine, USA. Recent spectrometer upgrades and repairs are discussed. Modifications to preparation laboratory procedures designed to improve sample throughput efficiency while maintaining precision of 2–3‰ for 1-mg samples (Santos et al. 2007c) are presented.

Three factors—contamination, a dietary reservoir effect, and a regional δ14C anomaly—are considered as possible contributing explanations for an almost 2-century offset between the historically documented age of 612 BCE and the calibrated ages of 9 14C determinations obtained on 3 human skeletons directly associated stratigraphically with an archaeologically—and historically—defined 612 BCE event at the ancient site of Nineveh in northern Mesopotamia (Iraq). We note that on the order of a 1% (∼80 yr) offset caused by one or a combination of these 3 factors, or other as yet unidentified additional factor(s), would be sufficient to move the average measured 14C age of these bone samples within the major “warp” in the 14C timescale during the mid-1st millennium BCE. We provide what we believe to be sufficient evidence that contamination is not a major factor in the case of these bone samples. At this time, we lack appropriate data to determine with sufficient rigor the degree to which a dietary reservoir effect may be contributing to the offset. At present, a posited regional δ14C anomaly does not appear to be supported on the basis of data from several other localities in the Near East of similar age. One purpose of presenting this data set is to solicit comparisons with 14C values obtained on samples from additional, historically well-documented, known-age archaeological contexts for this time period in this and adjacent regions.

Mytilus edulis (Mollusca: Bivalvia) collected as spat from the wild in 1990 and held in the laboratory for 18 months were divided into four groups: fed (control); starved; fed with 100 ppb added copper; and starved with 100 ppb added copper. Following >60% mortalities in the starved and copper stressed groups (but negligible mortalities in the control) surviving mussels from all four groups were genotyped at seven allozyme loci (Gpi, Lap, Pgtn, Idh, Odh, Gsr and Est). Allele frequencies did not vary significantly between any of the four groups at any loci, except Gsr where fed and starved groups differed. Mortalities were not genotype dependent at the Pgm locus but, in contrast, genotype frequencies at most other loci varied significantly between groups. At the Gpi, Lap, Gsr and Odh loci there were significant changes in proportions of heterozygotes following copper induced mortalities such that, in general, heterozygotes survived longer and homozygotes succumbed sooner. No similar pattern was evident in relation to mortalities caused by starvation; at only one locus (Idh) was there evidence of a significant effect but this was not apparently independent of the effect of copper.

A survey by Yonge (1962) of the byssal apparatus in the Bivalvia indicates that the formation of byssus is a larval characteristic which may or may not be retained in the adult. Some species such as the mussel, Mytilus edulis, retain the byssal attachment but have the ability to break the byssus and move over a limited area. Others, such as the scallop, Pecten maximus, lose the byssus entirely, become unattached and move by swimming. Yet others, such as the oyster, Ostrea edulis, relinquish all mobility at metamorphosis by cementing the shell to the substratum, and after metamorphosis lose all trace of the foot. Ostrea, Mytilus and Pecten therefore encompass a wide variety of life styles in the adult and are chosen as examples for detailed comparison of the byssus forming glands and other foot glands in the pediveligers.

Salinity is a major limiting factor in littoral and estuarine environments and the salinity encountered in such habitats fluctuates with tide, season and weather. Despite this variable situation, most investigations of salinity tolerance and osmoregulation have involved laboratory experiments at steady salinities. The literature devoted to such investigations is extensive, and has been reviewed on several occasions, notably by Krogh (1939), Potts & Parry (1964) and Kinne (1971).

A cohort of newly settled Mytilus edulis (L.) (Mollusca: Bivalvia) spat (mean shell length 530 µm) was collected from red filamentous algae at a site on the North Wales coast. After a period of growth in the laboratory, cellulose acetate and starch gel electrophoresis were used to investigate genotype frequencies at the Gpi, Odh, Lap, Pgm, Idh and Mpi loci. Individual testing of each locus, using the X2 test revealed significant deficiencies of heterozygotes at the Pgm, Mpi and Idh loci. However, further testing using a sequential Bonf erroni test, designed to assess the probability of observing at least one significant result from a number of tests by chance alone, revealed that only the deficiency of heterozygotes at Pgm and Mpi loci was significant at the table-wide 95% level. Since post-collection mortality was <3%, these heterozygote deficits must have existed at the time of collection. The conclusion drawn is that heterozygote deficiencies in mussels are generated during the larval stage or at early settlement.

A number of species of the family Pectinidae (Lamellibranchia, Mollusca) are of considerable commercial importance in many parts of the world. Many of these are being reared in laboratories and hatcheries and this has made easier studies of cytogenetics using eggs and embryos, and ultimately will make studies of their genetics feasible. Recently, simple squash techniques have provided a fast and reliable method for obtaining chromosome numbers from eggs and embryos of several bivalves including Mercenaria spp. (Menzel & Menzel, 1965), Ostrea lurida and Crassostera gigas (Ahmed & Sparks, 1967), Mytilus spp. (Ahmed & Sparks, 1970), and Crassostrea spp. (Menzel, 1968). In 1967, Longwell, Stiles & Smith published the karyotype of Crassostrea virginica obtained from embryos which had been treated with colchicine.

Geographic variation of allele frequencies at four loci in Chlamys opercularis was investigated using electrophoresis on polyacrylamide gels. Large differences were observed between populations at a protein locus, while some small but significant variations occurred at the phosphoglucomutase-2 and octopine dehydrogenase loci. The leucine aminopeptidase locus appeared monomorphic. On the basis of mean genetic identities derived from three loci in nine populations and hydrographic data on coastal current systems, it is proposed that there are at least four relatively genetically isolated populations of this scallop around the British Isles, namely (1) North and West Scottish coast, (2) the Irish Sea, (3) the Celtic Sea (Brittany coast) and (4) the English Channel. It is argued that both random genetic drift and selection may play a significant part in the establishment and retention of large allele frequency differences between isolated populations of this species.

Bonamiosis is a parasitic disease (causative agent: Bonamia ostreae) affecting the European flat oyster Ostrea edulis, responsible for a drastic decline in its aquaculture production. Selective breeding programs for resistance to bonamiosis have been undertaken to counter this disease. In the present study, a 6-month cohabitation challenge experiment was performed in order to transmit the disease from wild oysters injected with the parasite to two tested families of oysters (20 and 8-month old at the beginning of the experiment, with different genetic backgrounds) originating from a selective breeding program developed by IFREMER in France. Mortalities were checked daily and ventricular heart smears were performed on dying or moribund oysters to detect the level of infection by B. ostreae. Mortality started after 4 months of cohabitation in the tested oysters. The cumulative mortalities after 6 months were 58% for the wild oysters, 9% for Family 1 (20-month old) and 20% for Family 2 (8-month old). In the dying oysters, the parasite could be detected in 67% of the wild oysters, 68% of Family 1 and 89% of Family 2. It was detected in only 11% of the surviving oysters of Family 2. The mortality and the level of infection by the parasite were significantly higher in Family 2 than in Family 1. Our results demonstrate that prespawning oysters as young as 1 year-old can become infected with the parasite and, most importantly, can die from bonamiosis. This result is inconsistent with the commonly accepted critical age of 2 years-old for the disease development. Additionally, no clear relationship between shell length and level of infection was observed. We also review the different methods for infection of the European flat oyster O. edulis with B. ostreae under experimental conditions and their main results.