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Article: Evolution of illness severity in hospital admissions due to COVID-19, Québec, Canada, January to April 2022.

Lo, Ernest / Fortin, Élise / Gilca, Rodica / Trépanier, Pierre-Luc / Geagea, Hany / Zhou, Zhou

Canada communicable disease report = Releve des maladies transmissibles au Canada

2024 Volume 50, Issue 1-2, Page(s) 63–76

Abstract: Background: The coronavirus disease 2019 (COVID-19) severity is influenced by multiple factors, such as age, underlying medical conditions, individual immunity, infecting variant, and clinical practice. The highly transmissible Omicron variants resulted ...

Abstract	Background: The coronavirus disease 2019 (COVID-19) severity is influenced by multiple factors, such as age, underlying medical conditions, individual immunity, infecting variant, and clinical practice. The highly transmissible Omicron variants resulted in decreased COVID-19 screening capacity, which limited disease severity surveillance. Objective: To report on the temporal evolution of disease severity among patients admitted to Québec hospitals due to COVID-19 between January 2, 2022, and April 23, 2022, which corresponded to the peak period of hospitalizations due to Omicron. Methods: Retrospective population-based cohort study of all hospital admissions due to COVID-19 in Québec, between January 2, 2022, and April 23, 2022. Study period was divided into four-week periods, corresponding roughly to January, February, March and April. Regression using Cox and Poisson generalized estimating equations (GEEs) was used to quantify temporal variations in length of stay and risk of complications (intensive care admission or in-hospital death) through time, using the Omicron peak (January 2022) as reference. Measures were adjusted for age, sex, vaccination status, presence of chronic diseases, and clustering by hospital. Results: During the study period, 9,178 of all 18,272 (50.2%) patients hospitalized with a COVID-19 diagnosis were admitted due to COVID-19. Of these, 1,026 (11.2%) were admitted to intensive care and 1,523 (16.6%) died. Compared to January, the risk of intensive care admission was 25% and 31% lower in March and April respectively, while in-hospital fatality continuously decreased by 45% lower in April. The average length of stay was temporarily lower in March (9%). Conclusion: Severity of admissions due to COVID-19 decreased in the first months of 2022, when predominant circulating variants were considered to be of similar severity. Monitoring hospital admissions due to COVID-19 can contribute to disease severity surveillance.
Language	English
Publishing date	2024-01-01
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1146585-2
ISSN	1188-4169
ISSN	1188-4169
DOI	10.14745/ccdr.v50i12a08
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Article ; Online: Neighborhood-level vaccine impact on COVID-19 infection and hospital admission in Quebec, Canada, during the Delta and early Omicron periods.

Lo, Ernest / Brousseau, Nicholas / Defay, Fannie / Fortin, Élise / Kiely, Marilou

Vaccine

2023 Volume 42, Issue 3, Page(s) 636–644

Abstract: Objective: To assess the impact of COVID-19 vaccination on COVID-19 infection and hospitalisation at the population-level, and to assess the indirect effects of vaccination in the province of Quebec, Canada.: Methods: We performed a time-stratified, ... ...

Abstract	Objective: To assess the impact of COVID-19 vaccination on COVID-19 infection and hospitalisation at the population-level, and to assess the indirect effects of vaccination in the province of Quebec, Canada. Methods: We performed a time-stratified, neighborhood-level ecologic study. The exposure was neighborhood-level vaccination (primary series) coverage; outcomes were COVID-19 infection and hospitalisation rates. We used robust Poisson regression to estimate weekly relative rates of infection and hospitalisation versus vaccination. Results: Higher vaccination coverage was associated with lower COVID-19 infection rates from July 18-December 4 for the year 2021 (Delta period) (RR≈0.46 [0.39; 0.54] - 0.94 [0.83; 1.05], 85-100% vs. 60-74% coverage). From December 5-December 25, this association reversed (RR≈1.28 [1.16; 1.41] - 1.41 [1.31; 1.52]), possibly due to the Omicron variant, social behaviors and accumulation of susceptibles in more vaccinated neighborhoods. Vaccine impact against hospitalisation was maintained throughout (RR≈0.43 [0.29; 0.65] - 0.88 [0.64; 1.22]). Vaccination provided substantial indirect protection (RR≈0.43 [0.34; 0.54] - 0.81 [0.65; 1.03]). Conclusions: This study confirmed the protective impact of vaccination against severe disease regardless of variant, at the population level. Ecological analyses are a valuable strategy to evaluate vaccination programs. Population-level effects can have substantial effects and should be accounted for in public health and vaccination program planning.
MeSH term(s)	Humans ; Quebec/epidemiology ; COVID-19 Vaccines ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; Vaccines ; Hospitalization ; Hospitals
Chemical Substances	COVID-19 Vaccines ; Vaccines
Language	English
Publishing date	2023-12-22
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2023.12.043
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Article: Dr. Gottlieb et al reply.

Gottlieb, Chloe / Berard, Roberta A / Levy, Deborah M / Fortin, Eric

The Journal of rheumatology

2023

Abstract: We thank the author for their ... ...

Abstract	We thank the author for their reply
Language	English
Publishing date	2023-07-01
Publishing country	Canada
Document type	Letter
ZDB-ID	194928-7
ISSN	1499-2752 ; 0315-162X
ISSN (online)	1499-2752
ISSN	0315-162X
DOI	10.3899/jrheum.2023-0509
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Zs.MO 135: Show issues

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Article: Evaluation of influenza case definitions for use in real-world evidence research.

Doyon-Plourde, Pamela / Fortin, Élise / Quach, Caroline

Canada communicable disease report = Releve des maladies transmissibles au Canada

2022 Volume 48, Issue 9, Page(s) 392–395

Abstract: Background: Laboratory confirmation of influenza is not routinely done in practice. With the advent of big data, it is tempting to use healthcare administrative databases for influenza vaccine effectiveness studies, which often rely on clinical ... ...

Abstract	Background: Laboratory confirmation of influenza is not routinely done in practice. With the advent of big data, it is tempting to use healthcare administrative databases for influenza vaccine effectiveness studies, which often rely on clinical diagnosis codes. The objective of this article is to compare influenza incidence curves using international case definitions derived from clinical diagnostic codes with influenza surveillance data from the United States (US) Centers for Disease Control and Prevention (CDC). Methods: This case series describes influenza incidence by CDC week, defined using International Classification of Disease diagnostic codes over four influenza seasons (2015-2016 to 2018-2019) in a cohort of US individuals three years of age and older who consulted at least once per year between 2015 and 2019. Results were compared to the number of influenza-positive specimens or outpatient visits for influenza-like illness obtained from the CDC flu surveillance data. Results: The incidence curves of influenza-related medical encounters were very similar to the CDC's surveillance data for laboratory-confirmed influenza. Conversely, the number of influenza-like illness encounters was high when influenza viruses started to circulate, leading to a discrepancy with CDC-reported data. Conclusion: A specific case definition should be prioritized when data for laboratory-confirmed influenza are not available, as a broader case definition would conservatively bias influenza vaccine effectiveness toward the null.
Language	English
Publishing date	2022-09-01
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1146585-2
ISSN	1188-4169
ISSN	1188-4169
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Article ; Online: Evaluation of the 2018-2019 vaccine effectiveness against medically attended influenza-like illness using medical records and claims data.

Doyon-Plourde, Pamela / Fortin, Élise / Quach, Caroline

Vaccine

2022 Volume 40, Issue 39, Page(s) 5732–5738

Abstract: Background: Healthcare administrative databases are a rich source of information that could be leveraged to estimate real-world influenza vaccine effectiveness (VE). We aimed to evaluate the VE of standard egg-based influenza vaccines and determine if ... ...

Abstract	Background: Healthcare administrative databases are a rich source of information that could be leveraged to estimate real-world influenza vaccine effectiveness (VE). We aimed to evaluate the VE of standard egg-based influenza vaccines and determine if administrative healthcare data provide accurate VE estimates compared to the US CDC data. Methods: This retrospective cohort study was conducted during the 2018-2019 influenza season. Individuals who had at least one relevant record per year between 2015 and 2019 in their electronic medical record were included. Individuals were considered protected 14 days after receiving an influenza vaccine. The outcome was the occurrence of medically attended influenza-like illness (MA-ILI) defined by clinical diagnostic codes. Adjusted odds ratios (aORs) were derived from multivariate logistic regression and adjusted VE (aVEs) were calculated using 100 × (1-aORs). Results: A total of 5,066,980 individuals were included in the analysis with 1,307,702 (25.8%) considered vaccinated. Overall, the median age was 54 (IQR, 32-66) and 58.1% were female. Vaccine protection against MA-ILI was moderate in children and low in adults. All estimates were lower than VEs reported by the CDC for the 2018-2019 influenza season. Our results were robust to potential loss to follow up, but misclassification bias and residual confounding led to underestimation of the 2018-2019 aVE. When stratified by the number of primary care visits, aVE estimates and vaccination coverage increased with the number of primary care visits, reaching estimates similar to those obtained by the US CDC and US national vaccination coverage among those with ≥ 6 primary care visits, resulting in significant positive vaccine protection in frequent healthcare users. Conclusions: Moderate and low aVEs were observed during the 2018-2019 season using administrative healthcare data, which was likely due to detection and misclassification biases, correlated with healthcare seeking behaviour, leading to an underestimation of the 2018-2019 influenza VE.
MeSH term(s)	Adult ; Case-Control Studies ; Child ; Female ; Humans ; Influenza A Virus, H3N2 Subtype ; Influenza Vaccines ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Male ; Medical Records ; Middle Aged ; Retrospective Studies ; Seasons ; Vaccination ; Vaccine Efficacy
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2022-08-27
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2022.08.012
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Article: Repoliticising multi-stakeholder standards processes: the Roundtable on Sustainable Biomaterials’ standards and certification scheme

Fortin, Elizabeth

Journal of peasant studies. 2018 Apr. 17, v. 45, no. 4

2018

Abstract: The Roundtable on Sustainable Biomaterials (RSB) is one of a number of sustainability standards schemes that have been approved by the European Union under its 2009 Renewable Energy Directive (EU RED). The RSB scheme is often referred to positively not ... ...

Abstract	The Roundtable on Sustainable Biomaterials (RSB) is one of a number of sustainability standards schemes that have been approved by the European Union under its 2009 Renewable Energy Directive (EU RED). The RSB scheme is often referred to positively not only because the sustainability standard is considered to exemplify greater rigour than many of the other EU-approved standards in terms of their claims to protect ‘sustainability’, but also because it provides an example of a ‘multi-stakeholder’ model of standards development that is assumed to confer greater legitimacy on the sustainability standards that are produced. In recognising that standards processes are part of wider processes of neoliberalisation, this paper explores the process in which the RSB standard was produced. In doing so it considers how notions of sustainability embodied in the RSB standards were shaped not only by its ‘multi-stakeholder’ process, but also by wider influences that were brought to bear in that process, including the growing spectre of a ‘standards market’ produced by the EU’s approval of different schemes.
Keywords	biocompatible materials ; certification ; energy policy ; European Union ; models
Language	English
Dates of publication	2018-0417
Size	p. 805-824.
Publishing place	Routledge
Document type	Article
ISSN	1743-9361
DOI	10.1080/03066150.2017.1285286
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Light prevents pathogen-induced aqueous microenvironments via potentiation of salicylic acid signaling.

Lajeunesse, Gaële / Roussin-Léveillée, Charles / Boutin, Sophie / Fortin, Élodie / Laforest-Lapointe, Isabelle / Moffett, Peter

Nature communications

2023 Volume 14, Issue 1, Page(s) 713

Abstract: Many plant pathogens induce water-soaked lesions in infected tissues. In the case of Pseudomonas syringae (Pst), water-soaking effectors stimulate abscisic acid (ABA) production and signaling, resulting in stomatal closure. This reduces transpiration, ... ...

Abstract	Many plant pathogens induce water-soaked lesions in infected tissues. In the case of Pseudomonas syringae (Pst), water-soaking effectors stimulate abscisic acid (ABA) production and signaling, resulting in stomatal closure. This reduces transpiration, increases water accumulation, and induces an apoplastic microenvironment favorable for bacterial growth. Stomata are sensitive to environmental conditions, including light. Here, we show that a period of darkness is required for water-soaking, and that a constant light regime abrogates stomatal closure by Pst. We find that constant light induces resistance to Pst, and that this effect requires salicylic acid (SA). Constant light did not alter effector-induced accumulation of ABA, but induced greater SA production, promoting stomatal opening despite the presence of ABA. Furthermore, application of a SA analog was sufficient to prevent pathogen-induced stomatal closure and water-soaking. Our results suggest potential approaches for interfering with a common virulence strategy, as well as providing a physiological mechanism by which SA functions in defense against pathogens.
MeSH term(s)	Arabidopsis/physiology ; Salicylic Acid ; Plant Stomata/physiology ; Abscisic Acid/pharmacology ; Water ; Arabidopsis Proteins
Chemical Substances	Salicylic Acid (O414PZ4LPZ) ; Abscisic Acid (72S9A8J5GW) ; Water (059QF0KO0R) ; Arabidopsis Proteins
Language	English
Publishing date	2023-02-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-023-36382-7
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Article ; Online: Sex differences in the association between insulin resistance and non-fatal myocardial infarction across glycaemic states.

Riccio, Alessia / Fortin, Elena / Mellbin, Linda / Norhammar, Anna / Näsman, Per / Rydén, Lars / Sesti, Giorgio / Ferrannini, Giulia

Cardiovascular diabetology

2024 Volume 23, Issue 1, Page(s) 25

Abstract: Background: Females are generally less prone to cardiovascular (CV) events than males, but this protection is trumped by diabetes. The mechanism behind the increased relative risk in females with diabetes is not fully understood. Insulin resistance (IR) ...

Abstract	Background: Females are generally less prone to cardiovascular (CV) events than males, but this protection is trumped by diabetes. The mechanism behind the increased relative risk in females with diabetes is not fully understood. Insulin resistance (IR) is suggested to be a more important contributor to CV morbidity in females than in males. We aim to investigate differences in the association between IR indexes (Homeostatic Model Assessment of IR - HOMA-IR, visceral adiposity index - VAI, and triglycerides/high-density lipoprotein-cholesterol - TG/HDL-C index), and a first non-fatal myocardial infarction (MI) across different glycaemic states. Methods: IR indexes were calculated in a population with (n = 696) and without (n = 707) a first non-fatal MI, free from known diabetes. MI cases were investigated at least six weeks after the event. All participants were categorized by an oral glucose tolerance test as having normal glucose tolerance, impaired fasting glucose, impaired glucose tolerance, or newly diagnosed diabetes. Comparison of proportion of glycaemic states by sex was tested by chi-square test. The associations between sex, a first non-fatal MI, IR indexes, and traditional CV risk factors were analysed by multivariate logistic regression models. Continuous variables were logarithmically transformed. Results: Of the total population 19% were females and 81% males, out of whom 47% and 50% had a first non-fatal MI, respectively. Compared with males, females were older, less often smokers, with lower body mass index and higher total cholesterol and high-density lipoprotein cholesterol levels. The proportion of glycaemic states did not differ between the sexes (p = 0.06). Females were less insulin resistant than males, especially among cases and with normal glucose tolerance. In logistic regression models adjusted for major CV risk factors including sex, the associations between VAI and TG/HDL-C index and a first non-fatal MI remained significant only in females (odds ratios and 95% confidence intervals: 1.7, 1.0-2.9, and 1.9, 1.1-3.4 respectively). Conclusions: These results support the assumption that IR indexes based on anthropometrics and lipid panel, i.e., VAI and TG/HDL-C, could be a better measure of IR and CV-predictor for non-fatal MI in females, even without glycaemic perturbations.
MeSH term(s)	Humans ; Male ; Female ; Insulin Resistance ; Sex Characteristics ; Biomarkers ; Glucose ; Lipoproteins, HDL ; Triglycerides ; Cholesterol, HDL ; Prediabetic State ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Body Mass Index ; Blood Glucose/analysis
Chemical Substances	Biomarkers ; Glucose (IY9XDZ35W2) ; Lipoproteins, HDL ; Triglycerides ; Cholesterol, HDL ; Blood Glucose
Language	English
Publishing date	2024-01-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2093769-6
ISSN	1475-2840 ; 1475-2840
ISSN (online)	1475-2840
ISSN	1475-2840
DOI	10.1186/s12933-023-02093-y
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Article ; Online: In vivo measures of mammary development in gestating gilts.

Farmer, C / Fortin, É / Méthot, S

Journal of animal science

2017 Volume 95, Issue 12, Page(s) 5358–5364

Abstract: Potential links between measures of udder morphology obtained in live pregnant gilts and mammary gland development and composition measured in mammary tissue collected at slaughter were studied. Thirty-three gilts were used. In vivo measures of gland ... ...

Abstract	Potential links between measures of udder morphology obtained in live pregnant gilts and mammary gland development and composition measured in mammary tissue collected at slaughter were studied. Thirty-three gilts were used. In vivo measures of gland morphology using a tape or ultrasound imaging (parenchymal area measured by ultrasound [AREA]) were obtained on d 108 ± 1 of gestation. Gilts were then slaughtered on d 110 ± 1 of gestation to collect mammary glands for dissection and compositional analyses. The various tape measures were the distance between each teat on one side of the udder (DIST-TEAT), the distance between each teat pair (DIST-PAIR), the length of the udder (sum of all DIST-TEAT), the distance between the base of the teat and the ventral midline section of the udder (MID), and the distance between the base of the teat and the exterior junction of the udder with the abdomen (EXT). The variables MID, DIST-TEAT, DIST-PAIR, and length had very poor correlations with parenchymal weight, extraparenchymal weight, or any of the measured compositional variables. On the other hand, both AREA and EXT were correlated ( < 0.01) with the weight of parenchymal tissue, total parenchymal protein, total DNA, and total RNA. The ultrasound measure AREA and the tape measure EXT were also correlated with each other ( < 0.05). These measures could, therefore, be helpful to estimate mammary development in studies where animals cannot be slaughtered. The tape measure EXT seemed to better reflect the volume of the gland than MID, and it provided as reliable an estimate of parenchymal weight as the measure of parenchymal area using ultrasound while being much easier and cheaper to obtain.
MeSH term(s)	Animals ; Body Weight ; Female ; Mammary Glands, Animal/diagnostic imaging ; Mammary Glands, Animal/growth & development ; Pregnancy ; Swine/anatomy & histology ; Swine/growth & development ; Ultrasonography/veterinary
Language	English
Publishing date	2017-12-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	390959-1
ISSN	1525-3163 ; 0021-8812
ISSN (online)	1525-3163
ISSN	0021-8812
DOI	10.2527/jas2017.1768
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Article ; Online: Pseudohemangioma in Nonarteritic Anterior Ischemic Optic Neuropathy.

Fortin, Elizabeth / Gaier, Eric D

Ophthalmology

2018 Volume 125, Issue 6, Page(s) 903

MeSH term(s)	Arteritis/diagnosis ; Arteritis/physiopathology ; Fluorescein Angiography ; Hemangioma/diagnosis ; Humans ; Male ; Middle Aged ; Optic Disk/blood supply ; Optic Nerve Neoplasms/diagnosis ; Optic Neuropathy, Ischemic/diagnosis ; Optic Neuropathy, Ischemic/physiopathology ; Pupil Disorders/diagnosis ; Visual Acuity/physiology ; Visual Field Tests ; Visual Fields/physiology
Language	English
Publishing date	2018-05-21
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	392083-5
ISSN	1549-4713 ; 0161-6420
ISSN (online)	1549-4713
ISSN	0161-6420
DOI	10.1016/j.ophtha.2018.01.029
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Zs.MO 533: Show issues

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