Exchange of Best Practices Within the European Union:Surgery Standardization of Abdominal Organ Retrieval

AbstractConsidering the growing organ demand worldwide, it is crucial to optimize organ retrieval and training of surgeons to reduce the risk of injury during the procedure and increase the quality of organs to be transplanted. In the Netherlands, a national complete trajectory from training of surgeons in procurement surgery to the quality assessment of the procured organs was implemented in 2010. This mandatory trajectory comprises training and certification modules: E-learning, training on the job, and a practical session. Thanks to the ACCORD (Achieving Comprehensive Coordination in Organ Donation) Joint Action coordinated by Spain and co-funded under the European Commission Health Programme, 3 twinning activities (led by France) were set to exchange best practices between countries. The Dutch trajectory is being adapted and implemented in Hungary as one of these twinning activities. The E-learning platform was modified, tested by a panel of Hungarian and UK surgeons, and was awarded in July 2013 by the European Accreditation Council for Continuing Medical Education of the European Union of Medical Specialists. As a pilot phase for future national training, 6 Hungarian surgeons from Semmelweis University are being trained; E-learning platform was fulfilled, and practical sessions, training-on-the-job activities, and evaluations of technical skills are ongoing. The first national practical session was recently organized in Budapest, and the new series of nationwide selected candidates completed the E-learning platform before the practical. There is great potential for sharing best practices and for direct transfer of expertise at the European level, and especially to export this standardized training in organ retrieval to other European countries and even broader. The final goal was to not only provide a national training to all countries lacking such a program but also to improve the quality and safety criteria of organs to be transplanted

Targeted Next Generation Sequencing for malaria research in Africa:Current status and outlook

Targeted Next Generation Sequencing (TNGS) is an efficient and economical Next Generation Sequencing (NGS) platform and the preferred choice when specific genomic regions are of interest. So far, only institutions located in middle and high-income countries have developed and implemented the technology, however, the efficiency and cost savings, as opposed to more traditional sequencing methodologies (e.g. Sanger sequencing) make the approach potentially well suited for resource-constrained regions as well. In April 2018, scientists from the Plasmodium Diversity Network Africa (PDNA) and collaborators met during the 7th Pan African Multilateral Initiative of Malaria (MIM) conference held in Dakar, Senegal to explore the feasibility of applying TNGS to genetic studies and malaria surveillance in Africa. The group of scientists reviewed the current experience with TNGS platforms in sub-Saharan Africa (SSA) and identified potential roles the technology might play to accelerate malaria research, scientific discoveries and improved public health in SSA. Research funding, infrastructure and human resources were highlighted as challenges that will have to be mitigated to enable African scientists to drive the implementation of TNGS in SSA. Current roles of important stakeholders and strategies to strengthen existing networks to effectively harness this powerful technology for malaria research of public health importance were discussed

Composition and Distribution of Mosquito Vectors in a Peri-Urban Community Surrounding an Institution of Learning in Lafia Metropolis, Nasarawa State, Central Nigeria

Vector surveillance is very key in solving mosquito-borne health problems in Nigeria. To this end, the composition and distribution of mosquito vectors in a peri-urban community surrounding an institution of learning in Lafia metropolis, Nasarawa State, Central Nigeria was carried out between December 2016 and June 2017. The Prokopack Aspirator was used to collect indoor resting mosquitoes between 6:00 a.m. and 9:00 a.m. from 30 randomly selected houses. Mosquitoes collected were knocked down and transferred into a well labelled petri-dish and taken to the laboratory for processing. A total of 664 mosquitoes were collected which spread across Culex quinquefasciatus 572 (86.14%), Anopheles gambiae 88 (13.25%) and Aedes aegypti 4 (0.60%). The abundance of mosquitoes in relation to seasons, species, sex, abdominal conditions as well as transmission indices across seasons significantly varied (P 0.05). The inhabitants of the area should ensure that all drainages flow through so as to reduce mosquito breeding grounds. Also, members of the community should always protect themselves by sleeping under insecticide treated bed nets

Immune Reconstitution During the First Year of Antiretroviral Therapy of HIV-1-Infected Adults in Rural Burkina Faso

There are no data on the outcome of highly active antiretroviral therapy (HAART) in HIV-infected adults in rural Burkina Faso. We therefore assessed CD4+ T-cell counts and HIV-1 plasma viral load (VL), the proportion of naive T-cells (co-expressing CCR7 and CD45RA) and T-cell activation (expression of CD95 or CD38) in 61 previously untreated adult patients from Nouna, Burkina Faso, at baseline and 2 weeks, 1, 3, 6, 9 and 12 months after starting therapy. Median CD4+ T-cell counts increased from 174 (10th-90th percentile: 33-314) cells/µl at baseline to 300 (114- 505) cells/µl after 3 months and 360 (169-562) cells/µl after 12 months of HAART. Median VL decreased from 5.8 (4.6- 6.6) log10 copies/ml at baseline to 1.6 (1.6-2.3) log10 copies/ml after 12 months. Early CD4+ T-cell recovery was accompanied by a reduction of the expression levels of CD95 and CD38 on T-cells. Out of 42 patients with complete virological follow-up under HAART, 19 (45%) achieved concordant good immunological (gain of ≥100 CD4+ T-cells/µl above baseline) and virological (undetectable VL) responses after 12 months of treatment (intention-to-treat analysis). Neither a decreased expression of the T-cell activation markers CD38 and CD95, nor an increase in the percentage of naive T-cells reliably predicted good virological treatment responses in patients with good CD4+ T-cell reconstitution. Repeated measurement of CD4+ T-cell counts during HAART remains the most important parameter for immunologic monitoring. Substitution of repeated VL testing by determination of T-cell activation levels (e.g., CD38 expression on CD8+ T-cells) should be applied with caution

Structures of the stator complex that drives rotation of the bacterial flagellum

The bacterial flagellum is the prototypical protein nanomachine and comprises a rotating helical propeller attached to a membrane-embedded motor complex. The motor consists of a central rotor surrounded by stator units that couple ion flow across the cytoplasmic membrane to generate torque. Here, we present the structures of the stator complexes from Clostridium sporogenes, Bacillus subtilis and Vibrio mimicus, allowing interpretation of the extensive body of data on stator mechanism. The structures reveal an unexpected asymmetric A5B2 subunit assembly where the five A subunits enclose the two B subunits. Comparison to structures of other ion-driven motors indicates that this A5B2 architecture is fundamental to bacterial systems that couple energy from ion flow to generate mechanical work at a distance and suggests that such events involve rotation in the motor structures

Lack of artemisinin resistance in Plasmodium falciparum in northwest Benin after 10 years of use of artemisinin-based combination therapy

Aim: In Benin, artemisinin-based combination therapy (ACT) has been recommended as the first-line treatment for uncomplicated Plasmodium falciparum malaria since 2004. The emergence in Southeast Asia of parasites that are resistant to artemisinins poses a serious threat to global control of this disease. The presence of artemisinin resistance genotypes in parasite populations in Benin is currently unknown. The present study investigated the prevalence of relevant K13-propeller gene polymorphisms in parasite isolates from the north-western region of Benin. Method: Plasmodium falciparum isolates were collected from children with a confirmed diagnosis of malaria aged 6 months to 5 years in two towns, Cobly and Djougou, in the north-western part of Benin. The study was conducted during the rainy season from July to November 2014 in local health facilities. The K13-propeller gene was amplified in parasite isolates using nested PCR and subsequently sequenced. Results: A total of 108 children were recruited into the study. The efficiency of amplification reactions was 72% (78/108). The propeller domain of the K13 gene was successfully sequenced in 78 P. falciparum isolates; all of them were wild type with no polymorphisms detectable. Conclusion: The absence of mutations in the K13 gene indicates that P. falciparum parasite populations in the study area are still fully susceptible to artemisinins

Vectopole Sud, a french network of platforms for research in medical, veterinary and agricultural entomology

Six institutional partners, CIRAD, CNRS, EID Méditerranée, INRA, IRD and the Univer-sity of Montpellier have been working together since 2010 on the issue of arthropod vectors of pathogens that cause infectious diseases in humans and animals, and insect pests responsible for damages to crops. This collaboration for over 8 years has resulted in the creation of “Vectopole Sud”, a Montpellier network of platforms dedicated to re-searches on arthropods of medical, veterinary and agricultural importance. The network draws from the infrastructure and expertise of each partner to improve early warning systems, monitoring, control of pests and vectors in order to protect hu-man health, agriculture and livestock production. The network has received continuous funding by the French Government and the Occitanie Region enabling it to modernize its different laboratories and rearing facilities and support the research activities. Vectopole Sud includes four experimental platforms, confined insectariums and associ-ated laboratories, which are open to national and international partners. Overall, the Vec-topole Sud has a network of partners in Europe and tropical regions worldwide, notably through IRD and CIRAD, two French institutions supporting research for development. Vectopole Sud brings together over 400 researchers and technicians from five research units belonging to the Montpellier University of Excellence and Agropolis International scientific communities. It conducts multidisciplinary research and expertise on biolo-gy, public & animal health, ecology, environmental science, genetics, and evolutionary medicine. It contributes to a better environment, animal health and human wellbeing through an integrated One Health approach, by fighting human and animal diseases to ensure more productive and sustainable farming systems (food security). We will present the different platforms of the Vectopole Sud network, its various activi-ties (infrastructures, research, services and training) as well as its different perspectives. www.vectopole-sud.f