Recent clinical articles have suggested that amniotic fluid embolism (AFE) may be the result of anaphylactic reactions to fetal antigens and that the major part of this clinical syndrome is the result of mast cell degranulation and of the release of histamine, tryptase and other mediators. Tryptase, a neutral protease, is known to be the dominant protein component of the secretory granules of T and TC mast cells. In this paper we have examined the presence and the pulmonary distribution of mast cell tryptase utilizing specific immunohistochemical studies and morphometric evaluation in six cases of fatal amniotic fluid embolism compared to six subjects who died following anaphylactic shock and two control groups (five and six cases respectively) of traumatic death. The results demonstrate a numerical increase of pulmonary mast cells in the subjects who died of AFE (average cell number 54.095) with values corresponding to those encountered in cases of death due to anaphylactic shock (average cell number 51.378) compared with that of the traumatic control groups (average cell number 24.477 and 9.995 respectively). These results can shed light on additional criteria for the diagnosis of amniotic fluid embolism.

This study aims to better understand coastal processes associated with extreme cyclonic events through the study of the coastal changes, flooding and damage that resulted from the passage of a category 5 hurricane (Irma) on 6 September 2017 over the islands of Saint-Martin and Saint-Barthélemy in the Lesser Antilles. Hurricane Irma was contextualized from tropical cyclone track data and local weather observations collected by Météo-France, as well as high-resolution numerical modelling. Field work involved the study of accretion coasts through qualitative observations, topo-morphological and sedimentary surveys, as well as image acquisition with Unmanned Aerial Vehicle (UAV) surveys during two trips that were made 2 and 8 months after the catastrophe. Wave propagation and flood numerical models are presented and compared to field data. Our field analysis also reports on the devastating impacts of storm surges and waves, which reached 4 and 10 meters height, respectively, especially along east-facing shores. The approaches reveal a variety of morpho-sedimentary responses over both natural and highly urbanized coasts. The analysis shows the effects of coastal structures and streets on flow channeling, on the amplification of some erosion types, and on water level increase. Positive spatial correlation is found between damage intensity and marine flood depth. The signatures of ocean-induced damage are clear and tend to validate the relevance of the intensity scale used in this study.

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Background: Climate change and rising sea level will certainly lead to significant changes in the management of low-lying coastal areas in the coming decades. While the most recent studies in the field of coastal storms-related flooding are increasingly integrated, simultaneously addressing hazards and vulnerability, as well as population risk perception, there is still little work to consider the preparedness of stakeholders to manage crises whose frequency and intensity are likely to increase in the next years. Methods: The aim of this paper is to expose the major results of the CRISSIS research program, which proposed a multidisciplinary approach to the management of coastal flood risk in a town particularly exposed on the French Mediterranean coast. The originality of the project was to offer both an integrated approach to risk by analysing its 3 dimensions (hazard, impact and vulnerability, and representations and perceptions held by populations and stakeholders, or « risk culture ») and a very operational section focused on the evaluation of crisis management measures led by local stakeholders. To achieve this objective, two crisis exercises were organized, the first one to test the assimilation by the municipality staff of existing crisis management procedures and the second to allow local actors to integrate in their crisis management procedures the new risk knowledge data issued from research conducted under the program. Results: The project has had three main features; (i) it accurately mapped the submersible areas that present a critical vulnerability, both material and human; (ii) it revelated the poor social representation of marine submersion risk, as well as the obvious lack of awareness of crisis management systems and tools and the behavior to adopt in the event of flooding; (iii) Finally, it highlighted the need, through the crisis exercises, for a better assimilation by the municipality staff of the crisis management procedures defined in the Municipal Rescue Plan. Conclusion: The CRISSIS project has demonstrated the usefulness of an integrated and operational approach of coastal flood risk, not only in terms of studying hazards, stakes and vulnerability, but also in terms of crisis management, in particular through the organisation of crisis simulation exercises.