Search Results (28)

The reef fish communities of the Guanahacabibes National Park have been studied for 20 years using various methodologies that have allowed us to understand aspects of their diversity and structure. However, due to gaps in information about the abundance and distribution of mesopredators (big fish and sharks), a new study was conducted in 2017 to determine their structure, explore the influence of different factors on their spatial variability, and evaluate their behavior. To achieve this, the Baited Remote Underwater Video Surveys (BRUVs) methodology was successfully applied, locating a single set of BRUVs at 90 sites distributed across 9 sectors of the park’s functional zoning. Variability in mesopredator metrics and their potential prey was assessed through a PERMANOVA analysis; a distance-based linear model (DISTLM) was used to explore the relationship between mesopredator abundance and biological, abiotic, and condition variables; and animal behavior was classified as incidental, cautious, or aggressive. A total of 64 fish species were identified, 7 of which were mesopredators, and 3 were sharks. An uneven distribution and abundance were observed among sectors, with the most abundant mesopredators being Carcharhinus perezi, Sphyraena barracuda, and Mycteroperca bonaci. Mesopredator abundance was more closely related to the condition of zone use and its regulations than to biological and abiotic variables. Sharks were more abundant in strictly protected areas, which coincided with relatively murky waters and stronger currents. More than 50% of the observed sharks displayed exploratory and aggressive behavior towards the bait basket. The analyzed metrics validate the effectiveness of the management of the protected area and suggest the presence of healthy and resilient mesopredator fish communities. Full article

The aim of this work is to present the results of research carried out in a city in the interior of São Paulo that sought to understand the health needs of women released from prisons in the region who are cared for at a Center for Attention to Egress and Family (CAEF) as well as the barriers they report in obtaining support, discussing them in light of educational health interventions described in the international literature. This study conducted formative research to identify the themes and issues that should be included in educational material. Data were collected through body-map storytelling and semi-structured interviews with six and twenty women released from prison, respectively, and nine interviews with professionals from the CAEF and the health sector of a women’s penitentiary in the study location. The main health demands of the women identified in the study were chronic diseases, mental health, gynecological problems, and sexually transmitted diseases, which constitute individual barriers and are aggravated by others of a relational, institutional, and political-systemic nature. It is hoped that the present study will inspire new interventions to be considered in the Brazilian context based on these results. Full article

The etiological diagnosis of diabetes conveys many practical consequences for the care of patients, and often of their families. However, a wide heterogeneity in the phenotypes of all diabetes subtypes, including Type 1 diabetes, Type 2 diabetes, and monogenic diabetes, has been reported and contributes to frequent misdiagnoses. The recently revised WHO classification of diabetes mellitus includes two new classes, namely “hybrid forms” and “unclassified diabetes”, which also reflect the difficulties of this etiological diagnosis. During the last years, many studies aiming at identifying homogenous subgroups on refined phenotypes have been reported. Ultimately, such subtyping may improve the diagnosis, prognosis, and treatment of patients on a pathophysiological basis. Here, we discuss the concepts of typical vs. atypical diabetes in the context of autoimmune Type 1 diabetes, Type 2 diabetes, and its monogenic forms. We discuss the contributions of clinical markers, biological tests, particularly islet cell auto-antibodies, and genetics to improving accurate diagnoses. These data support a systematic evaluation of all newly diagnosed diabetes cases. Full article

Background and aims: the side effects of immune checkpoint inhibitors (ICI) pose a problem for the clinical management of cancer patients. There is a lack of knowledge of the value of liver biopsy in patients with ICI-related drug-induced liver injury (ICI-DILI). The aim of this study was to explore the impact of liver biopsy on clinical management and response to corticosteroids, according to histological findings. Methods: We conducted a retrospective, single-center study to evaluate the biochemical, histological and clinical data of 35 patients with ICI-DILI between 2015 and 2021 in a university hospital in France. Results: Of the 35 patients with ICI-DILI (median [interquartile range] age 62 [48–73] years, 40% males) studied, 20 underwent a liver biopsy. There was no difference in the management of ICI-DILI according to liver biopsy in terms of ICI withdrawal, reduction or rechallenge. According to the histological profile, patients with toxic and granulomatous profiles had a better response to corticosteroids, while patients with cholangitic lesions had the worst response. Conclusion: In ICI-DILI, liver biopsy must not delay patient care but may be useful in identifying patients with a cholangitic profile who have a poorer response to corticosteroids. Full article

In 2020, a new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China. SARS-CoV-2 infection has been shown to be highly morbid in pregnant women, being a risk factor for several obstetric conditions leading to increased maternal and neonatal mortality. A few studies since 2020 have shown SARS-CoV-2 maternal–fetal transmission and noted placental abnormalities grouped under the term placentitis. We hypothesized that these placental lesions could be responsible for abnormalities in placental exchange and therefore abnormalities in cardiotocographic monitoring, leading to premature fetal extraction. The objective is to identify the clinical, biochemical, and histological determinants associated with the occurrence of non-reassuring fetal heart rate (NRFHR) outside labor in fetuses of SARS-CoV-2-infected mothers. We conducted a retrospective multicenter case series of the natural history of maternal SARS-CoV-2 infections resulting in fetal delivery outside labor due to NRFHR. Collaboration was sought with the maternity hospitals in the CEGORIF, the APHP and Brussels hospitals. The investigators were contacted by e-mail on three successive occasions over a period of one year. Data from 17 mothers and 17 fetuses were analyzed. Most women had a mild SARS-CoV-2 infection; only two women presented severe infection. No woman was vaccinated. We found a substantial proportion of maternal coagulopathy at birth: elevation of APTT ratio (62%), thrombocytopenia (41%) and liver cytolysis (58.3%). Iatrogenic prematurity was noted in 15 of 17 fetuses, and 100% were born by cesarean delivery due to emergency criteria. One male neonate died on the day of birth due to peripartum asphyxia. Three cases of maternal–fetal transmission were recorded following WHO criteria. Placental analysis in 15 cases revealed eight cases of SARS-CoV-2 placentitis, causing placental insufficiency. In total, 100% of the placentas analyzed showed at least one lesion suggestive of placentitis. SARS-CoV-2 maternal infection during pregnancy is likely to generate neonatal morbidity in relation to placental damage resulting in placental insufficiency. This morbidity may be the consequence of induced prematurity as well as acidosis in the most severe situations. Placental damage occurred in unvaccinated women and in women with no identified risk factor, in contrast to severe maternal clinical forms. Full article

It is now well established that maternal serum markers are often abnormal in fetal trisomy 21. Their determination is recommended for prenatal screening and pregnancy follow-up. However, mechanisms leading to abnormal maternal serum levels of such markers are still debated. Our objective was to help clinicians and scientists unravel the pathophysiology of these markers via a review of the main studies published in this field, both in vivo and in vitro, focusing on the six most widely used markers (hCG, its free subunit hCGβ, PAPP-A, AFP, uE3, and inhibin A) as well as cell-free feto–placental DNA. Analysis of the literature shows that mechanisms underlying each marker’s regulation are multiple and not necessarily directly linked with the supernumerary chromosome 21. The crucial involvement of the placenta is also highlighted, which could be defective in one or several of its functions (turnover and apoptosis, endocrine production, and feto–maternal exchanges and transfer). These defects were neither constant nor specific for trisomy 21, and might be more or less pronounced, reflecting a high variability in placental immaturity and alteration. This explains why maternal serum markers can lack both specificity and sensitivity, and are thus restricted to screening. Full article

The Royal Belgian Institute of Natural Sciences launched its airborne sniffer program in 2015 whereby a custom-built sniffer sensor was installed onboard the Belgian coastguard aircraft enabling the measurement of SO₂ and NO_x emitted by ocean-going vessels (OGVs). The data gathered on non-compliant OGVs were subsequently sent to port inspection authorities, who were then able to trigger inspections more rapidly than had they not had the data from the aircraft. This study reveals the added value of airborne alerts on port inspection effectiveness, a subject that had not been previously documented. This article demonstrates that airborne alerts have not only led to increased sanctions but have also drastically improved the efficiency of port inspection authorities, leading to a 50% reduction in the enforcement cost per confirmed violation. Port inspection authorities were able to follow up on 46% of the generated Fuel Sulphur Content (FSC) alerts. Of the alerts that were followed up, 43% were confirmed as non-compliant after inspection. This means that 20% of the total number of generated airborne alerts, which includes those that were not able to be followed up, met conditions for legal sanctioning. In contrast, for NO_x alerts, only limited follow-ups were conducted by port inspection authorities. None of the alerts were confirmed with those inspections, mainly due to the lack of inspection mechanisms for real-world NO_x emissions under IMO and EU regulations. In addition, for this study, a large-scale remote FSC measurement validation analysis was conducted for the first time, comparing airborne FSC measurements and FSC reference data. In order to obtain FSC reference data, onboard measurements from exhaust gas cleaning systems (EGCSs) were collected, together with fuel samples from Belgian port inspection authorities. The validation analysis revealed that the empiric deviation in the airborne FSC measurements with the FSC reference data was 9%, which was significantly lower than the 25% uncertainty used in the reporting of the alerts. This study helps pave the way for an increased role of airborne monitoring in the MARPOL Annex VI enforcement chain. Full article

In this study, we attempted to find genetic variants affecting gene expression (eQTL = expression Quantitative Trait Loci) in the human placenta in normal and pathological situations. The analysis of gene expression in placental diseases (Pre-eclampsia and Intra-Uterine Growth Restriction) is hindered by the fact that diseased placental tissue samples are generally taken at earlier gestations compared to control samples. The difference in gestational age is considered a major confounding factor in the transcriptome regulation of the placenta. To alleviate this significant problem, we propose here a novel approach to pinpoint disease-specific cis-eQTLs. By statistical correction for gestational age at sampling as well as other confounding/surrogate variables systematically searched and identified, we found 43 e-genes for which proximal SNPs influence expression level. Then, we performed the analysis again, removing the disease status from the covariates, and we identified 54 e-genes, 16 of which are identified de novo and, thus, possibly related to placental disease. We found a highly significant overlap with previous studies for the list of 43 e-genes, validating our methodology and findings. Among the 16 disease-specific e-genes, several are intrinsic to trophoblast biology and, therefore, constitute novel targets of interest to better characterize placental pathology and its varied clinical consequences. The approach that we used may also be applied to the study of other human diseases where confounding factors have hampered a better understanding of the pathology. Full article

The present study was conducted to evaluate the acute toxicity and anti-inflammatory effect in vivo, as well as the antioxidant activity, of the essential oil of Thymus leptobotrys Murb. The results indicate that the tested essential oil is non-toxic, with an estimated LD50 of 2500 mg kg⁻¹ of mice body weight. The anti-inflammatory test revealed that, at a dose of 200 mg kg⁻¹, the essential oil reduced rat paw edemas by 89.59% within 3 h of oral administration, this reduction in edema size was greater than that obtained with indomethacin (75.78%). The antioxidant activity (IC50) of Thymus leptobotrys Murb essential oil was 346.896 µg mL⁻¹ and 861.136 mg Trolox equivalent/g essential oil in the 2.2-diphenyl1-picryl-hydrazyl radical scavenging capacity (DPPH) and Trolox equivalent antioxidant capacity (TEAC) assays, respectively. The toxicity test reveals an LD₅₀ greater than 2500 mg kg⁻¹ of body weight of mice which classifies it within category 5 of non-toxic substances that can be administered orally. These results suggest that the essential oil of Thymus leptobotrys Murb is not toxic, and it represents a valuable source of anti-inflammatory and antioxidant metabolites. Full article

Reprogrammed metabolism is regarded as a hallmark of cancer and offers a selective advantage to tumor cells during carcinogenesis. The redox equilibrium is necessary for growth, spread and the antioxidant pathways are boosted following Reactive Oxygen Species (ROS) production to prevent cell damage in tumor cells. Human herpesvirus 8 (HHV-8), the etiologic agent of Kaposi sarcoma KS and primary effusion lymphoma (PEL), is an oncogenic virus that disrupts cell survival-related molecular signaling pathways leading to immune host evasion, cells growths, angiogenesis and inflammatory tumor-environment. We recently reported that primaquine diphosphate causes cell death by apoptosis in HHV-8 infected PEL cell lines in vivo and exhibits therapeutic anti-tumor activity in mice models and advanced KS. Our findings also suggest that the primaquine-induced apoptosis in PEL cells is mostly influenced by ROS production and targeting the redox balance could be a new approach to treat HHV-8 related diseases. In this review, we summarized the knowledge about the influence of ROS in cancer development; more specifically, the proof of evidence from our work and from the literature that redox pathways are important for the development of HHV-8 pathologies. Full article

Women going through a termination of their pregnancy (VTP) face a stressful situation that should be managed by hospitals in a multidisciplinary way: law, public health, and communication. This paper aims to analyze how the information sessions organized by hospitals influence women’s decisions when facing a VTP. To achieve that, we resorted to four main methodologies: (a) literature review about law, public health, and communication; (b) a 4-week participant observation at Port Royal Hospital (France) and in a social restaurant in Katowice (Poland), as well as three focus groups in the first institution (2012); (c) an online survey addressed to 500 women in Poland, France, and Switzerland (2012–2014); and (d) two focus groups and one deep interview with doctors and nurses from Geneva University Hospitals and Lausanne University Hospital in Switzerland (2017–2018). Based on our quantitative results, we developed a medical protocol to help doctors interact with patients going through a VTP. This protocol was approved by the Geneva University Hospitals’ Ethics Committee (BASEC 2018-01983). We concluded that women’s informed consent is an intimate, reciprocal decision; doctors should help them to make independent decisions; and hospitals need to establish a harmonized discourse based on a code of internal communication, train their doctors in communication skills, and help them adopt a more flexible approach when taking care of these patients. Full article

High interindividual variability (IIV) of the clinical response to epidermal growth factor receptor (EGFR) inhibitors such as osimertinib in non-small-cell lung cancer (NSCLC) might be related to the IIV in plasma exposure. The aim of this study was to evaluate the exposure–response relationship for toxicity and efficacy of osimertinib in unselected patients with advanced EGFR-mutant NSCLC. This retrospective analysis included 87 patients treated with osimertinib. Exposure–toxicity analysis was performed in the entire cohort and survival analysis only in second-line patients (n = 45). No significant relationship between occurrence of dose-limiting toxicity and plasma exposure was observed in the entire cohort (p = 0.23, n = 86). The median overall survival (OS) was approximately two-fold shorter in the 4th quartile (Q4) of osimertinib trough plasma concentration (>235 ng/mL) than in the Q1–Q3 group (12.2 months [CI95% = 8.0–not reached (NR)] vs. 22.7 months [CI95% = 17.1–34.1]), but the difference was not statistically significant (p = 0.15). To refine this result, the exposure–survival relationship was explored in a cohort of 41 NSCLC patients treated with erlotinib. The Q4 erlotinib exposure group (>1728 ng/mL) exhibited a six-fold shorter median OS than the Q1–Q3 group (4.8 months [CI95% = 3.3-NR] vs. 22.8 months (CI95% = 10.6–37.4), p = 0.00011). These results suggest that high exposure to EGFR inhibitors might be related to worse survival in NSCLC patients. Full article

The plant Saussurea costus (Falc) Lipsch has many biological activities and a strong curative and preventive power against a variety of diseases including cancer, diabetes, and hemorrhoids. In the current study, phytochemical screening was carried out as well as an investigation of the antilithiatic and antioxidant activities of aqueous and ethanolic extracts of this plant. The results showed that aqueous and ethanolic extracts were effective in reducing cystine stone mass and that the aqueous extract of Saussurea costus (Falc) Lipsch had the highest percentage of dissolution (6.756 ± 1.024) (p < 0.05). A turbidimetric method and a crystallization test were used to evaluate the antilithiatic activity of an aqueous and ethanolic extract of this plant on calcium oxalate crystallization. The results of these methods revealed that the ethanolic extract of this plant has a significant inhibitory effect on calcium oxalate crystallization, with a percentage inhibition of (91.017 ± 0.299) (p < 0.05) for a concentration of 2 mg mL⁻¹. The DPPH method revealed that the ethanolic extract of Saussurea costus (Falc) Lipsch with a concentration of (IC50 = 0.12325 mg mL⁻¹) had the highest IC50, whereas the FRAP method revealed that the aqueous extract of Saussurea costus (Falc) Lipsch with a concentration of 300 µg mL⁻¹ has the most significant reducing power with (OD = 0.56 ± 0.05). These findings indicate that aqueous and ethanolic extracts of Saussurea costus (Falc) Lipsch had a significant effect on whewellite and weddellite and a greater free radical scavenging effect but had no effect on cystine dissolution. Full article

Background: Postnatal steroids (PNS) have been used to prevent bronchopulmonary dysplasia (BPD) in preterm infants but have potential adverse effects on neurodevelopment. These effects might be modulated by their risk of BPD. We aimed to compare patients’ neurodevelopment with PNS treatment according to their risk of BPD in a European cohort. Methods: We developed a prediction model for BPD to classify infants born between 24 + 0 and 29 + 6 weeks of gestation in three groups and compared patients’ neurological outcome at two years of corrected age using the propensity score (PS) method. Results: Of 3662 neonates included in the analysis, 901 (24.6%) were diagnosed with BPD. Our prediction model for BPD had an area under the ROC curve of 0.82. In the group with the highest risk of developing BPD, PNS were associated with an increased risk of gross motor impairment: OR of 1.95 after IPTW adjustment (95% CI 1.18 to 3.24, p = 0.010). This difference existed regardless of the type of steroid used. However, there was an increased risk of cognitive anomalies for patients treated with dexa/betamethasone that was no longer observed with hydrocortisone. Conclusions: This study suggests that PNS might be associated with an increased risk of gross motor impairment regardless of the group risk for BPD. Further randomised controlled trials exploring the use of PNS to prevent BPD should include a risk-based evaluation of neurodevelopmental outcomes. This observation still needs to be confirmed in a randomised controlled trial. Full article

We report the 5^1/2 year prevalence of visual and oculomotor impairments in preterm children born at 24–34 weeks’ gestation (WG) using the population-based cohort study EPIPAGE-2, set in France, 2011. The main outcomes were imputed prevalence of refractive errors (REs), strabismus, and binocular visual acuity (VA). Children were clinically assessed by specially trained pediatricians. The population was also analyzed in terms of cerebral palsy at 5^1/2 years (no CP, stage 1, stage 2, or stage 3–5) and retinopathy of prematurity in the neonatal period (no ROP, stage 1 or 2, or severe ROP). Among the 4441 children included, 2718 (weighted percentage 58.7%) were clinically assessed. REs were reported in 43.1% (95% confidence interval 37.6–48.4), 35.2% (32.7–37.6), and 28.4% (25.0–31.8) of children born at 24–26, 27–31, and 32–34 WG (p < 0.01), respectively; strabismus rates were 19.5% (14.6–24.4), 14.8% (12.9–16.7), and 8.3% (6.2–10.4) (p < 0.001), respectively. Moderate/severe visual deficiencies (VA < 3.2/10) were present in 1.7% (0.2–3.3) of children born at 24–26 WG, and in less than 1% in other groups. A suboptimal VA 5/10–6.3/10 was measured in 40.6% (35.3–45.8) of children born at 24–26 WG, 35.8% (33.5–38.1) at 27–31 WG, and 33.7% (30.4–37.0) at 32–34 WG. CP and ROP were associated with strabismus and RE. The association between CP and VA was strong, while it was not observed for ROP. In this large cohort of preterm-born children, we found a high prevalence of RE and strabismus regardless of WG, supporting the need for specific attention in this population. High prevalence of suboptimal VA could be challenging for these children at the age of reading and writing acquisition. Full article