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High tacrolimus intra-patient variability is associated with graft rejection,and de novo donor-specific antibodies occurrence after liver transplantation

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World Journal of Gastroenterology 2018年第16期24卷 1795-1802页

作者： Arnaud Del Bello Nicolas Congy-Jolivet Marie Danjoux Fabrice Muscari laurence lavayssière Laure Esposito Anne-Laure Hebral Julie Bellière Nassim Kamar Department of Nephrology and Organ Transplantation CHU RangueilToulouse 31000France Université Paul Sabatier Toulouse 31000France Molecular Immunogenetics Laboratory Facultéde Médecine PurpanIFR150(INSERM)Montréal H3G 1Y6France Department of Immunology CHU de ToulouseHopital de RangueilCHU de ToulouseToulouse 31000France Department of Pathology Institut Universitaire du CancerCHU Toulouse 31000France Department of Surgery and Liver Transplantation Toulouse 31000France INSERM IFR-BMTCHU PurpanToulouse 31000France

AIM To investigate the role of tacrolimus intra-patient variability(IPV) in adult liver-transplant recipients.METHODS We retrospectively assessed tacrolimus variability in a cohort of liver-transplant recipients and analyzed its effect on the occurrence of graft rejection and de novo donor-specific antibodies(dn DSAs), as well as graft survival during the first 2 years posttransplantation. Between 02/08 and 06/2015, 116 patients that received tacrolimus plus mycophenolate mofetil(with or without steroids) were included. reSULTS Twenty-two patients(18.5%) experienced at least one acute-rejection episode(BPAR). Predictive factors for a BPAR were a tacrolimus IPV of > 35% [OR = 3.07 95%CI(1.14-8.24), P = 0.03] or > 40% [OR = 4.16(1.38-12.50), P = 0.01), and a tacrolimus trough level of 35% [OR = 4.83, 95%CI(1.39-16.72), P = 0.01] and > 40% [OR = 9.73, 95%CI(2.65-35.76), P = 0.001] were identified as predictors to detect dn DSAs. IPV did not impact on patient-or graft-survival rates during the follow-up. CONCLUSION Tacrolimus-IPV could be a useful tool to identify patients with a greater risk of graft rejection and of developing a de novo DSA after liver

关键词： Variability Liver transplantation Donorspecific antibodies Immunosuppression

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Early plasmapheresis and rituximab for acute humoral rejection after ABO-compatible liver transplantation

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World Journal of Gastroenterology 2009年第27期15卷 3426-3430页

作者： Nassim Kamar laurence lavayssière Fabrice Muscari Janick Selves Céline Guilbeau-Frugier Isabelle Cardeau Laure Esposito Olivier Cointault Marie Béatrice Nogier Jean Marie Peron Philippe Otal Marylise Fort Lionel Rostaing Department of Nephrology Dialysis and Multi-Organ Transplantation CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France INSERM U858 IFR 31 CHU Rangueil TSA 50032 31059 Toulouse Cédex 9 France Department of Liver Transplantation CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France Department of Histopathology CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France Department of Histopathology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France Department of Histopathology CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France Department of Radiology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France Department of Immunology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France INSERM U563 IFR 30 CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France

Acute humoral rejection (AHR) is uncommon after ABO-compatible liver transplantation. Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specif ic antibodies. Patient 1 experienced a biopsy-proven AHR at day 10 post-transplant. She was treated by steroid pulses, and OKT3. Because of persisting signs of biopsy-proven AHR at day 26, she was treated by plasmapheresis and rituximab. Liver enzyme levels did not improve, and she died on day 41. Patient 2 experienced a biopsy-proven AHR on day 10 post-transplant. She was treated by steroid pulses, plasmapheresis, and rituximab. Liver enzymes returned to within normal range 18 d after diagnosis. Liver biopsies, at 3 and 9 mo post-transplant, showed complete resolution of AHR. We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy.

关键词： ABO血型肝移植治疗血浆体液相容急性单抗

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Exploring the effects of anthropogenic disturbance on predator inspection activity in Trinidadian guppies

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Current Zoology 2024年第1期70卷 109-111页

作者： Alix J.P Brusseau laurence E.A.Feyten Adam L.Crane Grant E.Brown Department of Biology Concordia UniversityMontrealQCH4B 1R6Canada Department of Biomedical Sciences WCVMUniversity of SaskatchewanSaskatoonSKCanada

Prey animals are often faced with uncertainty due to having imperfect information regarding current local conditions,including predation risks and the availability of reliable foraging opportunities(Dall 2010).As this uncertainty increases,the probability of making costly behavioral errors also increases,leading to more risk averse behavioral tactics(Feyten et al.2019).For example,Trinidadian guppies Poecilia reticulata are far more risk averse when faced with multiple unknown sources of risk assessment information than when faced with a mix of known and unknown cues(Feyten et al.2019).Prey can reduce uncertainty by gathering and integrating private and social information regarding current risk levels within microhabitats(Dall 2010;Munoz and Blumstein 2012).

关键词： human disturbance information availability information reliability predator-prey interactions risk assessment uncertainty

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A Speculation: Avian Migration and the K-T Extinction

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Natural resources 2024年第5期15卷 125-129页

作者： laurence Stephenson Association of Professional Engineers and Geologists of British Columbia Vancouver Canada

One caveat to the dinosaur’s extinction is the conclusion that avian dinosaurs survived and became ancestors of birds. Their mobility enabled them to migrate great distances and find the nutrients needed to survive. Given this scenario, could the current observable migration of birds (the “dinosaurian offspring”) now be related? Migration is the regular seasonal movement undertaken by many species of birds, with the most common pattern, flying north in the Northern spring to breed in the temperate or Arctic summer and returning in the Northern autumn to wintering grounds in warmer regions of the south. The primary motivation for migration appears to be food. None of the major North-South migratory pathways fly over the Caribbean but three main fly ways, past to the west of the theorized K-T impact centre. Due to their ability to fly, the “avian Dinosaurs” adapted and survived very quickly in response to the disaster that marked the K-T boundary. It is an interesting speculation that the avian migration that we witness today is rooted in an event that occurred 66 million years ago! But it does explain why the migratory birds mostly fly from Polar summer to polar summer when they could just be as easily fly from Polar zone to the warmer equatorial region and back. In the recent article in Nature by Melanie During about identifying the late spring timing of the “Astro disaster”, it can be cited as consistent with my speculation. A late April early May Impact as suggested by During would have seen these migrations completely. The western migratory routes would have been found to be “luxurious” in vegetation in that first northern autumn after the “Astro-impact” while all eastern routes would have still been barren.

关键词： Dinosaur Clades K-T Mass Extinction Avian Migration Migratory Pathways Avian Dinosaurs K-T Impact Centre

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Demineralized Bone Matrix Fibers plus Allograft Bone for Multilevel Posterolateral Spine Fusion: A Game Changer?

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Open Journal of Orthopedics 2024年第2期14卷 105-113页

作者： Bodin Arnaud Barnouin laurence Coulomb remy Haignere Vincent Kouyoumdjian Pascal Department of Orthopaedic and Traumatological Spine Surgery Groupe Hospitalier Mutualiste Grenoble France Tissue Bank of France Mions France Department of Orthopaedic and Traumatologic Surgery & Spinal Surgery Centre Hospitalier Universitaire N&icircmes France LMGC Université de Montpellier CNRS Montpellier France

Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.

关键词： Spine Surgery Demineralized Bone Fibers Bone Substitutes retrospective Study

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Semisynthetic Derivatives of Sissotrin Isolated from Trifolium baccarinii Chiov. (Fabaceae) and Evaluation of Their Antibacterial Activities

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Advances in Biological Chemistry 2024年第1期14卷 27-39页

作者： Donald Léonel Feugap Tsamo Cyrille Ngoufack Tagousop Arnaud Joseph Nguetse Dongmo laurence Voutquenne-Nazabadioko David Ngnokam research Unit of Applied and Environmental Chemistry Department of Chemistry Faculty of Science University of Dschang Dschang Cameroon Department of Organic Chemistry Faculty of Science University of Yaoundé I Yaoundé Cameroon Department of Basic Scientific Studies University Institute of Technology University of Ngaoundéré Ngaoundéré Cameroon Groupe Isolement et Structure Institut de Chimie Moléculaire de Reims (ICMR) Reims France

Starting from sissotrin (1), a natural isoflavonoid isolated from Trifolium baccarinii (Fabaceae), one new semisynthetic derivative, 6-nitrobiochanin A (1b) and two known derivatives, 8-nitrobiochanin A (1a) and 2",3",4",6"-tetraacetylsissotrin (1c) have been obtained after performing nitration and acetylation reactions. Their structures were assigned after interpretation of their spectrometric (HR-ESI-MS) and spectroscopic (NMR 1D and 2D) data and by comparison with those reported in the literature. The substrate as well as the semisynthetic derivatives were evaluated for their antibacterial activities against six strains. The results reveal that they are inactive or weakly active on the strains tested with the exception of 8-nitrobiochanin A (1a) which showed moderate activity (MIC = 62.5 μg∙mL−1) on Staphylococcus aureus ATCC 43300.

关键词： Trifolium baccarinii Isoflavonoid Nitration Acetylation Antibacterial Activity

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Cardiac Surgery at Yaoundé General Hospital by a Local Team: Activity report from September 2022 to January 2024

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World Journal of Cardiovascular Surgery 2024年第6期14卷 87-94页

作者： laurence Carole Ngo Yon Charles Mve Mvondo Hermann Nestor Tsague Kengni Zephanie Kobe Fokalbo Sépolin Lowe Mireille Dakleu Alain Patrick Menanga William Ngatchou Djomo Vincent De Paul Djientcheu Department of Cardiothoracic and Vascular Surgery Yaound General Hospital Yaound Cameroon Department of Surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Clinical Sciences Faculty of Medicine and Biomedical Sciences University of Yaound Yaound Cameroon Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences University of Yaound Yaound Cameroon

Introduction: The practice of cardiac surgery (CS) in sub-Saharan Africa faces a number of challenges. We report on the surgical activities of the first 17 months of the program launched at the Yaoundé General Hospital (YGH), describing the types of interventions and the early results. Patients and Methods: This was a descriptive cross-sectional study including patients who underwent CS from September 2022 to January 2024 at the YGH. Clinical, operative and postoperative data were collected and analysed retrospectively by R software. results: A total of 37 patients underwent CS during the study period, divided into 23 (62.2%) open-heart and 14 (37.8%) closed-heart cases. Males predominated (sex ratio 1.17). The median age and interquartile range (IQR) were 36 years (9 - 51). Isolated valve surgery, in 15 (40.5%) cases, was the most common procedure in open-heart surgery cases. Closed-heart surgery involved closure of the patent ductus arteriosus in 9 (24.3%) cases, coronary artery bypass grafting in 3 (8.1%) cases, and pericardectomy in 2 (5.4%) cases. The median duration of extracorporeal circulation and aortic cross-clamping was 101 min (IQR 84 - 143) and 74 min (IQR 54 - 112) respectively. The median duration of mechanical ventilation was 2 hours (IQR 2 - 3). The median intensive care unit stay and median hospital stay were 2 days (IQR 2 - 3) and 7 days (IQR 5 - 8) respectively. Operative mortality was 2 (5.4%). Conclusion: Cardiac surgery remains a major challenge for African populations. The early results achieved by the local team are satisfactory. An increase in surgical activity should be strongly encouraged to facilitate local training and ensure the sustainability of the activity.

关键词： Cardiac Surgery Sub-Saharan Africa Cameroon

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Urban heat mitigation by green and blue infrastructure:Drivers,effectiveness,and future needs

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The Innovation 2024年第2期5卷 145-166页

作者： Prashant Kumar Sisay E.Debele Soheila Khalili Christos H.Halios Jeetendra Sahani Nasrin Aghamohammadi Maria de Fatima Andrade Maria Athanassiadou Kamaldeep Bhui Nerea Calvillo Shi-Jie Cao Frederic Coulon Jill L.Edmondson David Fletcher Edmilson Dias de Freitas Hai Guo Matthew C.Hort Madhusudan Katti Thomas Rodding Kjeldsen Steffen Lehmann Giuliano Maselli Locosselli Shelagh K.Malham Lidia Morawska Rajan Parajuli Christopher D.F.Rogers Runming Yao Fang Wang Jannis Wenk laurence Jones Global Centre for Clean Air research(GCAre) School of SustainabilityCivil and Environmental EngineeringFaculty of Engineering and Physical SciencesUniversity of SurreyGuildford GU27XHUK Institute for Sustainability University of SurreyGuildford GU27XHSurreyUK School of Built Environment University of ReadingWhiteknightsReading RG66BUUK School Design and the Built Environment Curtin University Sustainability Policy InstituteKent StBentley 6102Western Australia Harry Butler Institute Murdoch UniversityMurdoch 6150Western Australia Atmospheric Sciences Department Institute of AstronomyGeophysics and Atmospheric SciencesUniversity of Sao PauloSao Paulo 05508-090Brazil Met Office FitzRoy RoadExeter EX13PBUK Department of Psychiatry and Nuffield Department of Primary Care Health Sciences Wadham CollegeUniversity of OxfordOxfordUK Centre for Interdisciplinary Methodologies University of WarwickWarwickUK School of Architecture Southeast University2 SipailouNanjing 210096China Cranfield University School of WaterEnvironment and EnergyCranfield MK430ALUK Plants PhotosynthesisSoil ClusterSchool of BiosciencesUniversity of SheffieldSheffield S102TNUK UK Centre for Ecology&Hydrology Environment Centre WalesDeiniol RoadBangor LL572UWUK Air Quality Studies Department of Civil and Environmental EngineeringThe Hong Kong Polytechnic UniversityHong KongChina Department of Forestry and Environmental resources Faculty Excellence Program for Leadership in Public ScienceNorth Carolina State UniversityChancellorRaleighNC 27695USA Departments of Architecture&Civil Engineering and Chemical EngineeringUniversity of BathBath BA27AYUK School of Architecture University of NevadaLas VegasNV 89154USA Department of Tropical Ecosystems Functioning Center of Nuclear Energy in AgricultureUniversity of São PauloPiracicaba 13416-000Sao PauloBrazil School of Ocean Sciences Bangor UniversityMenai BridgeAnglesey LL595 ABUK International Laboratory for Air Quality and Health Science and Engine

The combination of urbanization and global warming leads to urban overheating and compounds the frequency and intensity of extreme heat events due to climate change.Yet,the risk of urban overheating can be mitigated by urban green-blue-grey infrastructure(GBGI),such as parks,wetlands,and engineered greening,which have the potential to effectively reduce summer air temperatures.Despite many reviews,the evidence bases on quantified GBGI cooling benefits remains partial and the practical recommendations for implementation are unclear.This systematic literature review synthesizes the evidence base for heat mitigation and related co-benefits,identifies knowledge gaps,and proposes recommendations for their implementation to maximize their benefits.After screening 27,486 papers,202 were reviewed,based on 51 GBGI types categorized under 10 main divisions.Certain GBGI(green walls,parks,street trees)have been well researched for their urban cooling capabilities.However,several other GBGI have received negligible(zoological garden,golf course,estuary)or minimal(private garden,allotment)attention.The most efficient air cooling was observed in botanical gardens(5.0±3.5℃),wetlands(4.9±3.2℃),green walls(4.1±4.2℃),street trees(3.8±3.1℃),and vegetated balconies(3.8±2.7℃).Under changing climate conditions(2070–2100)with consideration of RCP8.5,there is a shift in climate subtypes,either within the same climate zone(e.g.,Dfa to Dfb and Cfb to Cfa)or across other climate zones(e.g.,Dfb[continental warm-summer humid]to BSk[dry,cold semi-arid]and Cwa[temperate]to Am[tropical]).These shifts may result in lower efficiency for the current GBGI in the future.Given the importance of multiple services,it is crucial to balance their functionality,cooling performance,and other related co-benefits when planning for the future GBGI.This global GBGI heat mitigation inventory can assist policymakers and urban planners in prioritizing effective interventions to reduce the risk of urban overheating,filling research gaps,and promoting community resi

关键词： estuary walls extreme

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Outpatient insulin use in type 2 diabetes mellitus and acute respiratory distress syndrome outcomes:A retrospective cohort study

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World Journal of Clinical Cases 2024年第17期12卷 2966-2975页

作者： Georges Khattar Samer Asmar laurence Aoun Fares Saliba Shaza Almardini Saif Abu Baker Catherine Hong Carolla El Chamieh Fadi Haddadin Toni Habib Omar Mourad Zeina Morcos Fatema Arafa Jonathan Mina Khalil El Gharib Mohammad Aldalahmeh Salman Khan Elie Bou Sanayeh Department of Medicine Holy Spirit University of KaslikJounieh 00000Lebanon Department of Internal Medicine Staten Island University HospitalStaten IslandNY 10305United States Public Heath and Biostatistics Independent ResearchBeirut 0000Lebanon Department of Medicine Lebanese UniversityBeirut 00000Lebanon Department of Medicine University of BalamandBeirut 00000Lebanon Department of Medicine Lebanese American UniversityBeirut 00000Lebanon Department of Medicine Northwell Health Staten Island University HospitalNew YorkNY 10305United States

BACKGROUND The impact of type 2 diabetes mellitus(T2DM)on acute respiratory distress syndrome(ARDS)is debatable.T2DM was suspected to reduce the risk and complications of ARDS.However,during coronavirus disease 2019(COVID-19),T2DM predisposed patients to ARDS,especially those who were on insulin at home.AIMTo evaluate the impact of outpatient insulin use in T2DM patients on non-COVID-19 ARDS outcomes.METHODS We conducted a retrospective cohort analysis using the Nationwide Inpatient Sample database.Adult patients diagnosed with ARDS were stratified into insulin-dependent diabetes mellitus(DM)(IDDM)and non-insulindependent DM(NIDDM)groups.After applying exclusion criteria and matching over 20 variables,we compared cohorts for mortality,duration of mechanical ventilation,incidence of acute kidney injury(AKI),length of stay(LOS),hospitalization costs,and other clinical outcomes.reSULTS Following 1:1 propensity score matching,the analysis included 274 patients in each group.Notably,no statistically significant differences emerged between the IDDM and NIDDM groups in terms of mortality rates(32.8%vs 31.0%,P=0.520),median hospital LOS(10 d,P=0.537),requirement for mechanical ventilation,incidence rates of sepsis,pneumonia or AKI,median total hospitalization costs,or patient disposition upon discharge.CONCLUSION Compared to alternative anti-diabetic medications,outpatient insulin treatment does not appear to exert an independent influence on in-hospital morbidity or mortality in diabetic patients with non-COVID-19 ARDS.

关键词： Acute respiratory distress syndrome Type 2 diabetes mellitus Insulin Length of stay Mortality Endotracheal intubation Acute kidney injury Coronavirus disease 2019

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在中国经济转型与生态文明建设中不得不说的往事

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国际人才交流 2024年第2期 56-68页

作者：龙安志张佳艺(译) 不详

作为一名多次为跨国公司与中国国有企业谈判合资项目的律师,我无意中成了国有企业改革的专家。1997年,我被委任领导一个特别工作组,为全国性改革方案绘制蓝图。在诸多地域中,试验从安徽省开始。这不足为奇,安徽省早在20年前便吹起市场... 详细信息

作为一名多次为跨国公司与中国国有企业谈判合资项目的律师,我无意中成了国有企业改革的专家。1997年,我被委任领导一个特别工作组,为全国性改革方案绘制蓝图。在诸多地域中,试验从安徽省开始。这不足为奇,安徽省早在20年前便吹起市场化改革的春风。

关键词：国有企业改革中国国有企业中国经济转型跨国公司生态文明建设合资项目改革方案市场化改革

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