Jellyfish invasion shuts down French nuclear reactors
'These shutdowns are the result of the massive and unforeseeable presence of jellyfish in the filter drums of the pumping stations, located in the non-nuclear part of the installations,' an EDF spokesperson said in a statement to POLITICO.
The company is currently carrying out diagnostics and necessary interventions to restart the plant safely, the spokesperson added.
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Three of the four reactors stopped working automatically late Sunday, with the fourth unit shutting down early Monday morning. The plant has six reactors in total, with each producing 5.4 gigawatts of power in total. The remaining two units are undergoing maintenance.
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Medscape
34 minutes ago
- Medscape
GLP-1 Receptor Agonists Improve HS in Patients With Obesity
TOPLINE: Investigators reported that glucagon-like peptide 1 receptor agonists (GLP-1 RAs) were associated with significant improvements in clinical severity, patient-reported outcomes, and weight in patients with hidradenitis suppurativa (HS) and obesity. METHODOLOGY: The retrospective multicenter cohort study evaluated 66 adults (median age, 46 years; 58% women) with HS who received semaglutide, dulaglutide, or liraglutide for at least 3 months, using data from eight French hospitals, between 2017 and 2024. Their median BMI was 39.4, and 86% of patients had diabetes; 45%, 32%, and 23% of patients had Hurley stages I, II, and III disease, respectively. Outcomes included HS-Physician's Global Assessment (HS-PGA), flare frequency, Numerical Rating Scale (NRS)-Pain, NRS-Suppuration, Dermatology Life Quality Index (DLQI), and BMI at 6 months. Median follow-up was 18.5 months. TAKEAWAY: At 6 months, 54% of patients had achieved at least one-point reduction in HS-PGA and 12% of patients demonstrated at least two-point reduction; flares were reduced in 60% patients. NRS-Pain scores decreased in 52% of patients, NRS-Suppuration scores decreased in 53% patients, and improved quality of life, based on DLQI scores, was observed in 50% patients at 6 months. Among 34 patients with stable HS treatment, all outcome measures showed statistically significant improvements at 6 months (P < .001). Median BMI decreased from 39.4 to 37.2 at 6 months. IN PRACTICE: 'GLP-1 RAs offer promise for patients with HS and obesity and potentially for patients without obesity through immunological effects,' the study authors wrote. 'Randomized clinical trials are warranted to confirm the role of GLP-1 RAs in HS management,' they added. SOURCE: The study was led by Louise Gouvrion, MD, Department of Dermatology, Rennes University Hospital in Rennes, France, and was published online on August 13 in JAMA Dermatology. LIMITATIONS: The retrospective design, concurrent use of diverse HS therapies, potential selection bias, and absence of glycemic and inflammatory biomarker data limit causal inference. DISCLOSURES: The authors did not disclose any funding information. Several authors reported receiving personal fees, conference invitations, nonfinancial support from AbbVie, Almirall, Amgen, Bristol Myers Squibb, Lilly, Janssen, LEO Pharma, MSD, Novartis, UCB, and others. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
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Drug Combinations for CVDs Tied to Bullous Pemphigoid Risk
TOPLINE: A case-control study revealed that combinations of drugs for cardiovascular diseases and hypertension were frequently prescribed before a diagnosis of bullous pemphigoid (BP), but the risk associated with combinations did not exceed that associated with individual agents. The most common drug combinations included angiotensin-converting enzyme (ACE) inhibitors with statins and antiplatelets with statins. METHODOLOGY: Researchers conducted a nested case-control study using healthcare records from the Clinical Practice Research Datalink between 1998 and 2021 and analysed 16,844 BP cases and 79,493 age- and sex-matched control individuals having no BP diagnosis at the index date (the first date a BP diagnosis code was recorded). Association rule mining (ARM) identified the 10 most common drug class or active substance pairs prescribed to cases or control individuals on the same day and within 6 months before the index date. In the sensitivity analysis, researchers identified medication pairs prescribed within 30 days of each other and during the 6 months preceding the index date. Researchers quantified how often two drugs are co-prescribed compared with their independent prescribing by calculating a lift. They then derived the fold change (FC) as the ratio of a lift in cases vs control individuals. The analysis included multivariable conditional logistic regression to estimate the risk for BP following drug combinations and their constituent drugs. TAKEAWAY: The most frequent drug combinations associated with an increased risk for BP were ACE inhibitors-statins (FC of the lifts in the main analysis vs sensitivity analysis: 1.31 vs 1.18), antiplatelets-statins (1.23 vs 1.11), proton pump inhibitors (PPI)-antiplatelets (1.22 vs 1.14), PPI-statins (1.22 vs 1.14), and ACE inhibitors-antiplatelets (1.20 vs 1.09). For drug substances, combinations with a greater lift in BP cases were simvastatin-ramipril (FC, 1.30), simvastatin-aspirin (FC, 1.21), and ramipril-aspirin (FC, 1.19). After adjusting for BP-associated drugs, the Charlson Comorbidity Index, and relevant confounders, the increased risk remained significant for these drug class combinations: antiplatelets-statins (odds ratio [OR], 1.20), ACE inhibitors-statins (OR, 1.16), PPI-statins (OR, 1.22), ACE inhibitors-antiplatelets (OR, 1.26), and PPI-antiplatelets (OR, 1.43; P < .001 for all). The risk for BP associated with these frequently prescribed drug combinations was lower than the risk linked to each constituent drug at both class and substance levels. In both main and sensitivity analyses, patients who developed BP were more likely than control individuals to have received combinations of cardiovascular or antihypertensive drugs before diagnosis. IN PRACTICE: "The ARM algorithm exploratory analysis identified the most commonly prescribed drug combinations prior to BP. Logistic regression confirmed drug combinations for CVDs [cardiovascular diseases] or hypertension associated with increased BP risk," the authors wrote. "The increased BP risk following reported combinations was modest and was not greater than their constituent drugs. Given that the number of patients with BP is low, we do not suggest avoiding the reported drugs but instead being on the lookout for any skin reactions following treatments for CVDs or hypertension," they concluded. SOURCE: This study was led by Mikolaj Swiderski, University of Nottingham, Nottingham, England. It was published online on August 06, 2025, in Clinical and Experimental Dermatology. LIMITATIONS: The ARM algorithm considered only the frequency of prescriptions to obtain drug combinations. Additionally, the algorithm demonstrated limited clinical value, linking only half of the inferred drug class combinations with BP and failing to capture the sequence or precise timing of prescriptions. It also lacked dosage and treatment duration data, and as an exploratory tool, ARM could not establish causal relationships between drug exposures and the risk for BP. DISCLOSURES: This research was supported by the National Institute for Health and Care Research grant via the Research for Patient Benefit Programme. Swiderski reported receiving salary funding from this grant. Another author reported receiving salary funding from King's College London, University of Nottingham, and the National Institute for Health and Care Research East Midlands scholarship scheme. Additional disclosures are noted in the original article. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
an hour ago
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Graft Failure Risk Rises in Paediatric Kidney Retransplants
TOPLINE: In paediatric kidney transplant recipients, the risk for graft failure increased with each subsequent transplantation. After the second transplant, older donor age, transplantation from a deceased donor, shorter survival of the primary graft in non-sensitised recipients, higher panel-reactive antibody (PRA) levels, and an increasing number of human leucocyte antigen DR (HLA-DR) mismatches predicted a higher risk for graft failure. METHODOLOGY: Researchers analysed data from a European registry to determine the incidence and risk factors for graft failure and death after repeat kidney transplantation in paediatric recipients across Eurotransplant countries. They included 4527 primary paediatric kidney transplant recipients (median age, 11 years; 41% girls), of whom 1155 underwent a second, 259 a third, and 41 a fourth kidney transplantation. The median follow-up duration for the first, second, third, and fourth kidney transplantation was 8.83, 6.67, 5.75, and 5.58 years, respectively. The probability of graft failure (the need for dialysis or retransplantation) and death with a functioning graft was analysed in kidney transplantation recipients. Patient data collection included recipient sex and age; country; transplantation dates; PRA levels; primary kidney disease; graft failure dates; donor source, age, and sex; and the number of HLA mismatches. TAKEAWAY: The risk for graft failure increased with each subsequent kidney transplant, with 5-year rates of 15% after the first, 24% after the second, 30% after the third, and 40% after the fourth transplant. The risk for graft failure or death with a functioning graft was the highest in the first month after primary kidney transplantation and increased even further after each subsequent transplantation. After the second transplant, transplantation from deceased donors, older donor and recipient age, shorter survival of the first graft in non-sensitised recipients, higher PRA levels (1%-100%), and an increasing number of HLA-DR mismatches were associated with an increased probability of graft failure and death with a functioning graft. Transplants performed in more recent years were also associated with better survival outcomes. IN PRACTICE: "Each subsequent kidney transplantation in pediatric recipients carried a higher risk of GF [graft failure], particularly in the first months post-transplant. After the second transplantation, older calendar year of KTx [kidney transplantation], deceased donor (DD), older donor and recipient age, and increasing HLA-DR mismatches were associated with a higher predicted GF and death with functioning graft," the authors wrote. "In DD kidney allocation schemes, 2 HLA-DR mismatches should be avoided," they added. SOURCE: This study was led by Ferran Coens, Ghent University Hospital, Ghent, Belgium. It was published online on August 07, 2025, in Pediatric Nephrology. LIMITATIONS: This study had substantial missing data for HLA mismatches in living donor transplants, limiting the analysis of HLA mismatches to deceased donor kidney transplant recipients alone. Additionally, the analysis did not adjust for certain relevant peri- and post-transplant predictors of graft failure, such as cold and warm ischaemia time, socioeconomic status, and allograft rejection. DISCLOSURES: The registry involved in this study received funding through a grant from the Dietmar Hopp Stiftung, the European Society for Paediatric Nephrology, the German Society for Pediatric Nephrology, and other sources. The authors declared having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
