Lymphomas represent one of the most common malignant diseases in young men and an important issue is how treatments will affect their reproductive health.It has been hypothesized that chemotherapies,similarly to envir...Lymphomas represent one of the most common malignant diseases in young men and an important issue is how treatments will affect their reproductive health.It has been hypothesized that chemotherapies,similarly to environmental chemicals,may alter the spermatogenic epigenome.Here,we report the genomic and epigenomic profiling of the sperm DNA from a 31-year-old Hodgkin lymphoma patient who faced recurrent spontaneous miscarriages in his couple 11-26 months after receiving chemotherapy with adriamycin,bleomycin,vinblastine,and dacarbazine(ABVD).In order to capture the potential deleterious impact of the ABVD treatment on mutational and methylation changes,we compared sperm DNA before and 26 months after chemotherapy with whole-genome sequencing(WGS)and reduced representation bisulfite sequencing(RRBS).The WGS analysis identified 403 variants following ABVD treatment,including 28 linked to genes crucial for embryogenesis.However,none were found in coding regions,indicating no impact of chemotherapy on protein function.The RRBS analysis identified 99high-quality differentially methylated regions(hqDMRs)for which methylation status changed upon chemotherapy.Those hqDRMs were associated with 87 differentially methylated genes,among which 14 are known to be important or expressed during embryo development.While no variants were detected in coding regions,promoter regions of several genes potentially important for embryo development contained variants or displayed an altered methylated status.These might in turn modify the corresponding gene expression and thus affect their function during key stages of embryogenesis,leading to potential developmental disorders or miscarriages.展开更多
Chronic epididymitis and varicocele are frequently observed genital disorders in men consulting for couple infertility, but their impact on semen characteristics at the time of infertility consultation is still a matt...Chronic epididymitis and varicocele are frequently observed genital disorders in men consulting for couple infertility, but their impact on semen characteristics at the time of infertility consultation is still a matter of debate. We investigated 652 male partners of couples who had their first infertility consultation between 1999 and 2015 in Argentina. Men with chronic epididymitis （n = 253）, Grade III varicocele （n = 106）, and both conditions （n = 125） were compared with a control group （n = 168） composed of men without these disorders or any other recognized causes of male infertility. We showed that men who presented isolated chronic epididymitis were more likely to have high percentages of low sperm motility and abnormal sperm morphology as well as a high number of white blood cells. Men with isolated Grade III varicocele had low sperm production and motility and an increased percentage of abnormal sperm morphology. Finally, men who simultaneously presented chronic epididymitis with Grade III varicocele had a low sperm motility and increased percentage of abnormal sperm morphology as well as a high number of white blood cells. Physical examination of the genital organs may identify common disorders, potentially involved as causal factors of patient＇s infertility. These disorders are associated with specific seminal profiles that should help in identifying the best treatment from the available therapeutic options, effectiveness, safety, and allowing as much as possible natural conception.展开更多
Background Spermatozoa interact with oviduct secretions before fertilization in vivo but the molecular players of this dialog and underlying dynamics remain largely unknown.Our objectives were to identify an exhaustiv...Background Spermatozoa interact with oviduct secretions before fertilization in vivo but the molecular players of this dialog and underlying dynamics remain largely unknown.Our objectives were to identify an exhaustive list of sperm-interacting proteins(SIPs)in the bovine oviduct fluid and to evaluate the impact of the oviduct anatomical region(isthmus vs.ampulla)and time relative to ovulation(pre-ovulatory vs.post-ovulatory)on SIPs number and abundance.Methods Pools of oviduct fluid(OF)from the pre-ovulatory ampulla,pre-ovulatory isthmus,post-ovulatory ampulla,and post-ovulatory isthmus in the side of ovulation were collected from the slaughterhouse.Frozen-thawed bull sperm were incubated with OF or phosphate-buffered saline(control)for 60 min at 38.5℃.After protein extraction and digestion,sperm and OF samples were analyzed by nanoLC-MS/MS and label-free protein quantification.Results A quantitative comparison between proteins identified in sperm and OF samples(2333 and 2471 proteins,respectively)allowed for the identification of 245 SIPs.The highest number(187)were found in the pre-ovulatory isthmus,i.e.,time and place of the sperm reservoir.In total,41 SIPs(17%)were differentially abundant between stages in a given region or between regions at a given stage and 76 SIPs(31%)were identified in only one region×stage condition.Functional analysis of SIPs predicted roles in cell response to stress,regulation of cell motility,fertilization,and early embryo development.Conclusion This study provides a comprehensive list of SIPs in the bovine oviduct and evidences dynamic spatiotemporal changes in sperm-oviduct interactions around ovulation time.Moreover,these data provide protein candidates to improve sperm conservation and in vitro fertilization media.展开更多
Today, it is well known that ambient air pollution exposures may be related with different health outcomes including adverse birth outcomes (for instance, low birth weight and preterm birth). Then, researchers must es...Today, it is well known that ambient air pollution exposures may be related with different health outcomes including adverse birth outcomes (for instance, low birth weight and preterm birth). Then, researchers must estimate exposure to air pollution during different critical windows of exposure across pregnancy. In the literature, the most commonly examined critical windows of exposure are the first, second, and third trimesters of pregnancy, although the entire pregnancy is also studied. In this context, we developed an automatic procedure which estimates individual exposures by trimester. We illustrate usage of the Pregnancy Air Exposure package for all births within the city of Paris in 2011. Nitrogen dioxide data from monitoring stations and data modeled at the census block level were available from the air quality monitoring networks of Ile de France Region. Nitrogen dioxide, NO2, has been chosen as an indicator of traffic-generated pollution. Newborn health data are available from the first birth certificate registered by the Maternal and Child Care department of Paris;more specifically, we used the date of birth and the gestational age to individually determine the beginning and the end of each trimester. The Pregnancy Air Exposure R package was created to simplify application of the procedure for non-specialists, and is freely available from the Equit’Area project website: (www.equitarea.org/documents/package_Exposure). The package contains two functions as well as the help files needed to run the procedure and yields air pollution exposure estimates by pregnancy trimester. The two functions can be used successively or independently according to the available input data.展开更多
<b>Background:</b> The novel Coronavirus disease 2019 (COVID-19) has rapidly evolved into a global emergency with far-reaching consequences. Multiple models predict mounting morbidity and mortality in the ...<b>Background:</b> The novel Coronavirus disease 2019 (COVID-19) has rapidly evolved into a global emergency with far-reaching consequences. Multiple models predict mounting morbidity and mortality in the absence of appropriate interventions. Screening of sub-clinical cases through technological tools has the potential to eliminate virus containment in the population. <b>Objective: </b>Our aim was to develop an effective application that detected early COVID-19 infections and resulted in four-dimensional (4-D) data visualization systems to develop safe networks whilst respecting user privacy. <b>Methods: </b>We proposed an algorithm for a novel form of contact tracing and screening that can detect infection before manifestation of clinical symptoms and signs. We developed a simulation model that demonstrated impact on the pandemic through percent change in the “trigger point”. <b>Results: </b>A “trigger point” based on personal risk assessment generated a visual report to the community network. The following outcomes were rendered in the app: live surveillance of metadata, hotspot mapping, targeted live health messaging to a large population, an infection control passport technology, and personal hotspot avoidance warnings. Our model suggested that higher adoption of such strategies can potentially eliminate viral carriage in the population. <b>Conclusions: </b>Our proposed technology-enabled screening, detection, and elimination strategy presents a novel approach to eliminate the viral containment. This app could be applied to the COVID-19 pandemic as well as other outbreaks and epidemics in the future to control the unprecedented disease spread.展开更多
Toscana virus(TOSV) is an arthropod-borne virus, identified in 1971, from Phlebotomus perniciosus and Phlebotomus perfiliewi in central Italy. TOSV belongs to the Phlebovirus genus within the Bunyaviridae family. As o...Toscana virus(TOSV) is an arthropod-borne virus, identified in 1971, from Phlebotomus perniciosus and Phlebotomus perfiliewi in central Italy. TOSV belongs to the Phlebovirus genus within the Bunyaviridae family. As other bunyaviruses, the genome of TOSV consists of 3 segments(S for small, M for Medium, and L for Large) respectively encoding non structural and capsid proteins, envelope structural proteins, and the viral RNA-dependant RNA-polymerase. It is transmitted by sand flies. Therefore its distribution is dictated by that of the arthropod vectors, and virus circulation peaks during summertime when sandfly populations are active. Here, we reviewed the epidemiology of TOSV in the old world. First evidence of its pathogenicity for humans, specifically its propensity to cause central nervous system(CNS) infections such as meningitis and encephalitis, was reported in central Italy. After 2000, it was recognized that TOSV had a much larger geographic distribution than initially believed, and was present in most of the Western European countries located on the northern border of the Mediterranean Sea(Portugal, Spain, France, Greece, Croatia) as well as eastern countries such as Cyprus and Turkey. In the countries where TOSV is present, it is among the three most prevalent viruses in meningitis during the warm seasons, together with enteroviruses and herpesviruses. Up to now, epidemiological data concerning Northern Africa and other countries located south of the Mediterranean are scarce. TOSV must be considered an emerging pathogen. Despite the important role played by TOSV in CNS infections, it remains a neglected agent and is rarely considered by physicians in diagnostic algorithms of CNS infections and febrile illness during the warm season, probably because of the lack of information.展开更多
Introduction: Worldwide, cervical cancer is the 4<sup>th</sup> most common cancer in women and is a public health problem. The objective of this study was to estimate the prevalence of precancerous cervica...Introduction: Worldwide, cervical cancer is the 4<sup>th</sup> most common cancer in women and is a public health problem. The objective of this study was to estimate the prevalence of precancerous cervical lesions and to describe its associated factors among women of reproductive age in the Kara region of Togo. Methods: A cross-sectional study was conducted from March 6 to 14, 2022 in 11 health centers in Kara. Data were collected using a standardized questionnaire and screening for precancerous cervical lesions was performed by visual inspection of the cervix, after application of 5% acetic acid and Lugol’s. Logistic regression analysis was performed to describe factors associated with precancerous lesions. Results: A total of 728 women with a median age of 36, interquartile range [31 - 41] were enrolled. The prevalence of precancerous cervical lesions was 3.9%, 95% confidence interval (95% CI: [2.6 - 5.4]. Factors associated with the presence of precancerous lesions were age at first sexual intercourse ≥ 18 years (adjusted odds ratio (aOR = 3.67;95% CI [1.17 - 18.4]) and being a sex worker (aOR = 8.14;95% CI [1.96 - 27.1]). HIV infection was not associated with the presence of precancerous lesions. Conclusion: The results of this study underscore the importance of intensifying cervical cancer screening efforts in resource-limited countries for better management. These efforts should prioritize vulnerable populations such as female sex workers.展开更多
In order to study social inequalities, indices can be used to summarize the multiple dimensions of the socioeconomic status. As a part of the Equit’Area Project, a public health program focused on social and environm...In order to study social inequalities, indices can be used to summarize the multiple dimensions of the socioeconomic status. As a part of the Equit’Area Project, a public health program focused on social and environmental health inequalities;a statistical procedure to create (neighborhood) socioeconomic indices was developed. This procedure uses successive principal components analyses to select variables and create the index. In order to simplify the application of the procedure for non-specialists, the R package SesIndexCreatoR was created. It allows the creation of the index with all the possible options of the procedure, the classification of the resulting index in categories using several classical methods, the visualization of the results, and the generation of automatic reports.展开更多
This is a multicenter benchmarking study on liver transplantation(LT)for perihilar cholangiocarcinoma(PHC)after neoadjuvant chemoradiotherapy(1).The study comprises of 134 patients from 2014 to 2018 among whom the maj...This is a multicenter benchmarking study on liver transplantation(LT)for perihilar cholangiocarcinoma(PHC)after neoadjuvant chemoradiotherapy(1).The study comprises of 134 patients from 2014 to 2018 among whom the majority had underlying primary sclerosing cholangitis(PSC).Dropout rate was available from 4 out of 17 centers and was 28%,primarily for oncological reasons(tumor progression and lymph node invasion).All patients followed neo-adjuvant chemoradiotherapy according to the Mayo(88%)or Mayo-like protocol.Liver grafts originated from brain-dead donors in 61.3%of cases and from living donors in 29.7%of cases.展开更多
We read with great interest the study of Mergental et al.(1)reporting the 5-year outcomes of the VITTAL trial(2,3).VITTAL was a prospective,non-randomized,single-arm trial that tested end-ischemic oxygenated normother...We read with great interest the study of Mergental et al.(1)reporting the 5-year outcomes of the VITTAL trial(2,3).VITTAL was a prospective,non-randomized,single-arm trial that tested end-ischemic oxygenated normothermic machine perfusion(NMP)with a“back-to-base”strategy to evaluate,and potentially transplant,liver grafts declined by all liver transplantation(LT)centers in the United Kingdom.For a liver to be considered viable,it had to metabolize perfusate lactate to a concentration of≤2.5 mmol/L within four hours from the start of perfusion,and meet at least two of the following criteria:bile production without a defined quantity;maintenance of perfusate pH above 7.3;glucose consumption in the perfusate;maintenance of stable arterial and portal flow above 150 and 500 mL/min,respectively;maintenance of graft suppleness and homogeneous perfusion(4).Thirty-one discarded human donor livers underwent viability testing by using end-ischemic NMP,of which 22(71%)livers were subsequently transplanted.The primary outcome of the trial was graft survival rate at 90 days and it was 100%.展开更多
In July 2023,the Center of Excellence in Respiratory Pathogens organized a two-day workshop on infectious diseases modelling and the lessons learnt from the Covid-19 pandemic.This report summarizes the rich discussion...In July 2023,the Center of Excellence in Respiratory Pathogens organized a two-day workshop on infectious diseases modelling and the lessons learnt from the Covid-19 pandemic.This report summarizes the rich discussions that occurred during the workshop.The workshop participants discussed multisource data integration and highlighted the benefits of combining traditional surveillance with more novel data sources like mobility data,social media,and wastewater monitoring.Significant advancements were noted in the development of predictive models,with examples from various countries showcasing the use of machine learning and artificial intelligence in detecting and monitoring disease trends.The role of open collaboration between various stakeholders in modelling was stressed,advocating for the continuation of such partnerships beyond the pandemic.A major gap identified was the absence of a common international framework for data sharing,which is crucial for global pandemic preparedness.Overall,the workshop underscored the need for robust,adaptable modelling frameworks and the integration of different data sources and collaboration across sectors,as key elements in enhancing future pandemic response and preparedness.展开更多
文摘Lymphomas represent one of the most common malignant diseases in young men and an important issue is how treatments will affect their reproductive health.It has been hypothesized that chemotherapies,similarly to environmental chemicals,may alter the spermatogenic epigenome.Here,we report the genomic and epigenomic profiling of the sperm DNA from a 31-year-old Hodgkin lymphoma patient who faced recurrent spontaneous miscarriages in his couple 11-26 months after receiving chemotherapy with adriamycin,bleomycin,vinblastine,and dacarbazine(ABVD).In order to capture the potential deleterious impact of the ABVD treatment on mutational and methylation changes,we compared sperm DNA before and 26 months after chemotherapy with whole-genome sequencing(WGS)and reduced representation bisulfite sequencing(RRBS).The WGS analysis identified 403 variants following ABVD treatment,including 28 linked to genes crucial for embryogenesis.However,none were found in coding regions,indicating no impact of chemotherapy on protein function.The RRBS analysis identified 99high-quality differentially methylated regions(hqDMRs)for which methylation status changed upon chemotherapy.Those hqDRMs were associated with 87 differentially methylated genes,among which 14 are known to be important or expressed during embryo development.While no variants were detected in coding regions,promoter regions of several genes potentially important for embryo development contained variants or displayed an altered methylated status.These might in turn modify the corresponding gene expression and thus affect their function during key stages of embryogenesis,leading to potential developmental disorders or miscarriages.
文摘Chronic epididymitis and varicocele are frequently observed genital disorders in men consulting for couple infertility, but their impact on semen characteristics at the time of infertility consultation is still a matter of debate. We investigated 652 male partners of couples who had their first infertility consultation between 1999 and 2015 in Argentina. Men with chronic epididymitis （n = 253）, Grade III varicocele （n = 106）, and both conditions （n = 125） were compared with a control group （n = 168） composed of men without these disorders or any other recognized causes of male infertility. We showed that men who presented isolated chronic epididymitis were more likely to have high percentages of low sperm motility and abnormal sperm morphology as well as a high number of white blood cells. Men with isolated Grade III varicocele had low sperm production and motility and an increased percentage of abnormal sperm morphology. Finally, men who simultaneously presented chronic epididymitis with Grade III varicocele had a low sperm motility and increased percentage of abnormal sperm morphology as well as a high number of white blood cells. Physical examination of the genital organs may identify common disorders, potentially involved as causal factors of patient＇s infertility. These disorders are associated with specific seminal profiles that should help in identifying the best treatment from the available therapeutic options, effectiveness, safety, and allowing as much as possible natural conception.
基金funded by INRAE and Agence Nationale de la Recherche under the grant number ANR-18-CE92-0049supported by grants from Biogenouest+1 种基金Infrastructures en Biologie Santéet Agronomie (IBiSA)Conseil Régional de Bretagne awarded to Protim proteomics core facility。
文摘Background Spermatozoa interact with oviduct secretions before fertilization in vivo but the molecular players of this dialog and underlying dynamics remain largely unknown.Our objectives were to identify an exhaustive list of sperm-interacting proteins(SIPs)in the bovine oviduct fluid and to evaluate the impact of the oviduct anatomical region(isthmus vs.ampulla)and time relative to ovulation(pre-ovulatory vs.post-ovulatory)on SIPs number and abundance.Methods Pools of oviduct fluid(OF)from the pre-ovulatory ampulla,pre-ovulatory isthmus,post-ovulatory ampulla,and post-ovulatory isthmus in the side of ovulation were collected from the slaughterhouse.Frozen-thawed bull sperm were incubated with OF or phosphate-buffered saline(control)for 60 min at 38.5℃.After protein extraction and digestion,sperm and OF samples were analyzed by nanoLC-MS/MS and label-free protein quantification.Results A quantitative comparison between proteins identified in sperm and OF samples(2333 and 2471 proteins,respectively)allowed for the identification of 245 SIPs.The highest number(187)were found in the pre-ovulatory isthmus,i.e.,time and place of the sperm reservoir.In total,41 SIPs(17%)were differentially abundant between stages in a given region or between regions at a given stage and 76 SIPs(31%)were identified in only one region×stage condition.Functional analysis of SIPs predicted roles in cell response to stress,regulation of cell motility,fertilization,and early embryo development.Conclusion This study provides a comprehensive list of SIPs in the bovine oviduct and evidences dynamic spatiotemporal changes in sperm-oviduct interactions around ovulation time.Moreover,these data provide protein candidates to improve sperm conservation and in vitro fertilization media.
文摘Today, it is well known that ambient air pollution exposures may be related with different health outcomes including adverse birth outcomes (for instance, low birth weight and preterm birth). Then, researchers must estimate exposure to air pollution during different critical windows of exposure across pregnancy. In the literature, the most commonly examined critical windows of exposure are the first, second, and third trimesters of pregnancy, although the entire pregnancy is also studied. In this context, we developed an automatic procedure which estimates individual exposures by trimester. We illustrate usage of the Pregnancy Air Exposure package for all births within the city of Paris in 2011. Nitrogen dioxide data from monitoring stations and data modeled at the census block level were available from the air quality monitoring networks of Ile de France Region. Nitrogen dioxide, NO2, has been chosen as an indicator of traffic-generated pollution. Newborn health data are available from the first birth certificate registered by the Maternal and Child Care department of Paris;more specifically, we used the date of birth and the gestational age to individually determine the beginning and the end of each trimester. The Pregnancy Air Exposure R package was created to simplify application of the procedure for non-specialists, and is freely available from the Equit’Area project website: (www.equitarea.org/documents/package_Exposure). The package contains two functions as well as the help files needed to run the procedure and yields air pollution exposure estimates by pregnancy trimester. The two functions can be used successively or independently according to the available input data.
文摘<b>Background:</b> The novel Coronavirus disease 2019 (COVID-19) has rapidly evolved into a global emergency with far-reaching consequences. Multiple models predict mounting morbidity and mortality in the absence of appropriate interventions. Screening of sub-clinical cases through technological tools has the potential to eliminate virus containment in the population. <b>Objective: </b>Our aim was to develop an effective application that detected early COVID-19 infections and resulted in four-dimensional (4-D) data visualization systems to develop safe networks whilst respecting user privacy. <b>Methods: </b>We proposed an algorithm for a novel form of contact tracing and screening that can detect infection before manifestation of clinical symptoms and signs. We developed a simulation model that demonstrated impact on the pandemic through percent change in the “trigger point”. <b>Results: </b>A “trigger point” based on personal risk assessment generated a visual report to the community network. The following outcomes were rendered in the app: live surveillance of metadata, hotspot mapping, targeted live health messaging to a large population, an infection control passport technology, and personal hotspot avoidance warnings. Our model suggested that higher adoption of such strategies can potentially eliminate viral carriage in the population. <b>Conclusions: </b>Our proposed technology-enabled screening, detection, and elimination strategy presents a novel approach to eliminate the viral containment. This app could be applied to the COVID-19 pandemic as well as other outbreaks and epidemics in the future to control the unprecedented disease spread.
文摘Toscana virus(TOSV) is an arthropod-borne virus, identified in 1971, from Phlebotomus perniciosus and Phlebotomus perfiliewi in central Italy. TOSV belongs to the Phlebovirus genus within the Bunyaviridae family. As other bunyaviruses, the genome of TOSV consists of 3 segments(S for small, M for Medium, and L for Large) respectively encoding non structural and capsid proteins, envelope structural proteins, and the viral RNA-dependant RNA-polymerase. It is transmitted by sand flies. Therefore its distribution is dictated by that of the arthropod vectors, and virus circulation peaks during summertime when sandfly populations are active. Here, we reviewed the epidemiology of TOSV in the old world. First evidence of its pathogenicity for humans, specifically its propensity to cause central nervous system(CNS) infections such as meningitis and encephalitis, was reported in central Italy. After 2000, it was recognized that TOSV had a much larger geographic distribution than initially believed, and was present in most of the Western European countries located on the northern border of the Mediterranean Sea(Portugal, Spain, France, Greece, Croatia) as well as eastern countries such as Cyprus and Turkey. In the countries where TOSV is present, it is among the three most prevalent viruses in meningitis during the warm seasons, together with enteroviruses and herpesviruses. Up to now, epidemiological data concerning Northern Africa and other countries located south of the Mediterranean are scarce. TOSV must be considered an emerging pathogen. Despite the important role played by TOSV in CNS infections, it remains a neglected agent and is rarely considered by physicians in diagnostic algorithms of CNS infections and febrile illness during the warm season, probably because of the lack of information.
文摘Introduction: Worldwide, cervical cancer is the 4<sup>th</sup> most common cancer in women and is a public health problem. The objective of this study was to estimate the prevalence of precancerous cervical lesions and to describe its associated factors among women of reproductive age in the Kara region of Togo. Methods: A cross-sectional study was conducted from March 6 to 14, 2022 in 11 health centers in Kara. Data were collected using a standardized questionnaire and screening for precancerous cervical lesions was performed by visual inspection of the cervix, after application of 5% acetic acid and Lugol’s. Logistic regression analysis was performed to describe factors associated with precancerous lesions. Results: A total of 728 women with a median age of 36, interquartile range [31 - 41] were enrolled. The prevalence of precancerous cervical lesions was 3.9%, 95% confidence interval (95% CI: [2.6 - 5.4]. Factors associated with the presence of precancerous lesions were age at first sexual intercourse ≥ 18 years (adjusted odds ratio (aOR = 3.67;95% CI [1.17 - 18.4]) and being a sex worker (aOR = 8.14;95% CI [1.96 - 27.1]). HIV infection was not associated with the presence of precancerous lesions. Conclusion: The results of this study underscore the importance of intensifying cervical cancer screening efforts in resource-limited countries for better management. These efforts should prioritize vulnerable populations such as female sex workers.
文摘In order to study social inequalities, indices can be used to summarize the multiple dimensions of the socioeconomic status. As a part of the Equit’Area Project, a public health program focused on social and environmental health inequalities;a statistical procedure to create (neighborhood) socioeconomic indices was developed. This procedure uses successive principal components analyses to select variables and create the index. In order to simplify the application of the procedure for non-specialists, the R package SesIndexCreatoR was created. It allows the creation of the index with all the possible options of the procedure, the classification of the resulting index in categories using several classical methods, the visualization of the results, and the generation of automatic reports.
文摘This is a multicenter benchmarking study on liver transplantation(LT)for perihilar cholangiocarcinoma(PHC)after neoadjuvant chemoradiotherapy(1).The study comprises of 134 patients from 2014 to 2018 among whom the majority had underlying primary sclerosing cholangitis(PSC).Dropout rate was available from 4 out of 17 centers and was 28%,primarily for oncological reasons(tumor progression and lymph node invasion).All patients followed neo-adjuvant chemoradiotherapy according to the Mayo(88%)or Mayo-like protocol.Liver grafts originated from brain-dead donors in 61.3%of cases and from living donors in 29.7%of cases.
文摘We read with great interest the study of Mergental et al.(1)reporting the 5-year outcomes of the VITTAL trial(2,3).VITTAL was a prospective,non-randomized,single-arm trial that tested end-ischemic oxygenated normothermic machine perfusion(NMP)with a“back-to-base”strategy to evaluate,and potentially transplant,liver grafts declined by all liver transplantation(LT)centers in the United Kingdom.For a liver to be considered viable,it had to metabolize perfusate lactate to a concentration of≤2.5 mmol/L within four hours from the start of perfusion,and meet at least two of the following criteria:bile production without a defined quantity;maintenance of perfusate pH above 7.3;glucose consumption in the perfusate;maintenance of stable arterial and portal flow above 150 and 500 mL/min,respectively;maintenance of graft suppleness and homogeneous perfusion(4).Thirty-one discarded human donor livers underwent viability testing by using end-ischemic NMP,of which 22(71%)livers were subsequently transplanted.The primary outcome of the trial was graft survival rate at 90 days and it was 100%.
文摘In July 2023,the Center of Excellence in Respiratory Pathogens organized a two-day workshop on infectious diseases modelling and the lessons learnt from the Covid-19 pandemic.This report summarizes the rich discussions that occurred during the workshop.The workshop participants discussed multisource data integration and highlighted the benefits of combining traditional surveillance with more novel data sources like mobility data,social media,and wastewater monitoring.Significant advancements were noted in the development of predictive models,with examples from various countries showcasing the use of machine learning and artificial intelligence in detecting and monitoring disease trends.The role of open collaboration between various stakeholders in modelling was stressed,advocating for the continuation of such partnerships beyond the pandemic.A major gap identified was the absence of a common international framework for data sharing,which is crucial for global pandemic preparedness.Overall,the workshop underscored the need for robust,adaptable modelling frameworks and the integration of different data sources and collaboration across sectors,as key elements in enhancing future pandemic response and preparedness.
