Modelling the microelimination of chronic hepatitis C in the canton of Bern, Switzerland: Reaching the Swiss Hepatitis Strategy goals despite the impact of the COVID 19 pandemic.

AIMS OF THE STUDY Since 2014, the Swiss Hepatitis Strategy (SHS) has targeted the elimination of Hepatitis C Virus (HCV) in Switzerland. The epidemiology of HCV is diverse across Swiss cantons, therefore cantonal-level screening and treatment strategies should be developed. This study aimed to identify scenarios to achieve HCV elimination in the canton of Bern by 2030. METHODS A preexisting Markov disease burden model was populated with data for Bern, and used to forecast the current and future prevalence of HCV, annual liver-related deaths (LRDs), and incidence of hepatocellular carcinoma and decompensated cirrhosis until 2030. Scenarios were developed to assess the current standard of care and potential long-term impact of the COVID-19 crisis on the HCV infected population. Additionally, potential scenarios for achieving the WHO 2030 targets and the SHS 2025 and 2030 targets (reduction of new cases of HCV, HCV-related mortality and viremic HCV cases) were identified. RESULTS In 2019, there were an estimated 4,600 (95% UI: 3,330-4,940) viremic infections in the canton of Bern and 57% (n = 2,600) of viremic cases were diagnosed. This modelling forecasted a 10% increase in LRDs (28 in 2020 to 31 in 2030) with the current standard of care and a 50% increase in LRDs in a scenario assuming long-term delays. To achieve the WHO and SHS targets, the canton of Bern needs to increase the annual number of patients diagnosed (from 90 in 2019 to 250 per year in 2022-2024 [WHO], or 500 per year in 2022-2025 [SHS]) and treated (from 130 in 2019 to 340 per year in 2022-2024 [WHO] or 670 per year in 2022-2025 [SHS]). CONCLUSIONS The SHS goals and the WHO targets for HCV elimination can be achieved in the Swiss canton of Bern by 2030; however, not at the current pace of screening, linkage to care and treatment

Black-spruce-lichen woodlands growth and carbon drawdown potentials as revealed by mature stands

The afforestation of widely distributed boreal open woodlands such as lichen woodlands (LWs) could provide both a restoration of the closed-crown forest structure in the boreal forest and a mitigation measure against global warming. By comparing natural, mature stands of LW with their dense counterparts — black-spruce–feathermoss stands as a plantation surrogate — this study aims to validate the long-term LW growth support capacity for a high tree density and their carbon sequestration potential after afforestation. Our results reveal that the site potential of LWs can be either lower or equivalent to that of dense stands. This finding contradicts the paradigm of systematic lower tree growth in LWs. The site potential of LWs can be assessed by dominant tree volume at 50 years. This study also shows that the CBM-CFS3 model can simulate the conservative net carbon balance of afforested LW, and, as such, can help reduce uncertainties regarding the long-term net carbon drawdown of afforested LWs

AdaWCT: Adaptive Whitening and Coloring Style Injection

Adaptive instance normalization (AdaIN) has become the standard method for style injection: by re-normalizing features through scale-and-shift operations, it has found widespread use in style transfer, image generation, and image-to-image translation. In this work, we present a generalization of AdaIN which relies on the whitening and coloring transformation (WCT) which we dub AdaWCT, that we apply for style injection in large GANs. We show, through experiments on the StarGANv2 architecture, that this generalization, albeit conceptually simple, results in significant improvements in the quality of the generated images.Comment: 4 pages + ref

Wireless sensor web for rover planetary exploration

Together with the “traditional“ approach, during the last years a new concept of planetary surface exploration has been introduced and investigated by the space community, including the European Space Agency (ESA). The concept consists in deploying a number of sensors communicating among themselves in a wireless networked architecture (WSN). These sensors, altogether, constitute a distributed instrument with the potential of broadening the capabilities of making science on and around a planetary body. When compared to big and monolithic planetary probes, with payloads able to obtain high-quality local measurements (e.g. by imaging or sampling), wireless sensor networks allow mapping larger planetary surfaces and/or volumes over a large time span. This concept is particularly suitable to retrieve localised simple measurements such as pressure, temperature, humidity or gas type, which could support the major interests of space exploration: 1) determine if life ever arose on a certain celestial body, 2) characterise the geology and topology of the body surface, 3) characterise its climate, and 4) prepare for human exploration. In line with this trend ESA initiated the RF-WIPE project (RF Wireless for Planetary Exploration), with GMV leading a consortium completed by SUPSI (University of Applied Sciences and Arts of Southern Switzerland) and UPM (Technical University of Madrid

The impact of perceived donor liver quality on post-transplant outcome.

BACKGROUND We analysed the impact of perceived liver donor quality on transplant recipient outcomes. METHODS this prospective cohort study included all deceased liver donors during 2008-2018 in the Swiss Transplant Cohort Study. Perceived low-quality liver donors were defined when refused for ≥5 top listed recipients or for all recipients in at least one centre before being transplanted. The effect of liver donor quality on relisting or recipient death at 1 week and 1 year after transplantation was analysed using Kaplan-Meier and Cox proportional hazard models. A 1:3 matching was also performed using a recipient score. RESULTS Of 973 liver donors, 187 (19.2%) had perceived poor-quality. Males, obesity, donation after circulatory death and alanine aminotransferase values were significantly associated with perceived poor-quality, with no significant effect of the perceived quality on re-listing or death within the first week and first year post-transplant [(aHR) = 1.45, 95% CI: (0.6, 3.5), P = 0.41 and aHR = 1.52 (95% CI 0.98-2.35), P = 0.06], adjusting by recipient age and gender, obesity, diabetes, prior liver transplantation and model for end-stage liver disease (MELD) score. At 1 year, prior liver transplantation and higher MELD score associated with higher risk of re-listing or death. CONCLUSION Comparable post-transplant outcomes with different perceived quality liver donors stresses the need to improve donor selection in liver transplantation

Machine learning approaches to enhance diagnosis and staging of patients with MASLD using routinely available clinical information

Aims: Metabolic dysfunction Associated Steatotic Liver Disease (MASLD) outcomes such as MASH (metabolic dysfunction associated steatohepatitis), fibrosis and cirrhosis are ordinarily determined by resource-intensive and invasive biopsies. We aim to show that routine clinical tests offer sufficient information to predict these endpoints. Methods: Using the LITMUS Metacohort derived from the European NAFLD Registry, the largest MASLD dataset in Europe, we create three combinations of features which vary in degree of procurement including a 19-variable feature set that are attained through a routine clinical appointment or blood test. This data was used to train predictive models using supervised machine learning (ML) algorithm XGBoost, alongside missing imputation technique MICE and class balancing algorithm SMOTE. Shapley Additive exPlanations (SHAP) were added to determine relative importance for each clinical variable. Results: Analysing nine biopsy-derived MASLD outcomes of cohort size ranging between 5385 and 6673 subjects, we were able to predict individuals at training set AUCs ranging from 0.719-0.994, including classifying individuals who are At-Risk MASH at an AUC = 0.899. Using two further feature combinations of 26-variables and 35-variables, which included composite scores known to be good indicators for MASLD endpoints and advanced specialist tests, we found predictive performance did not sufficiently improve. We are also able to present local and global explanations for each ML model, offering clinicians interpretability without the expense of worsening predictive performance. Conclusions: This study developed a series of ML models of accuracy ranging from 71.9—99.4% using only easily extractable and readily available information in predicting MASLD outcomes which are usually determined through highly invasive means

Long Time to Diagnosis of Medulloblastoma in Children Is Not Associated with Decreased Survival or with Worse Neurological Outcome

International audienceBACKGROUND: The long time to diagnosis of medulloblastoma, one of the most frequent brain tumors in children, is the source of painful remorse and sometimes lawsuits. We analyzed its consequences for tumor stage, survival, and sequelae. PATIENTS AND METHODS: This retrospective population-based cohort study included all cases of pediatric medulloblastoma from a region of France between 1990 and 2005. We collected the demographic, clinical, and tumor data and analyzed the relations between the interval from symptom onset until diagnosis, initial disease stage, survival, and neuropsychological and neurological outcome. RESULTS: The median interval from symptom onset until diagnosis for the 166 cases was 65 days (interquartile range 31-121, range 3-457). A long interval (defined as longer than the median) was associated with a lower frequency of metastasis in the univariate and multivariate analyses and with a larger tumor volume, desmoplastic histology, and longer survival in the univariate analysis, but not after adjustment for confounding factors. The time to diagnosis was significantly associated with IQ score among survivors. No significant relation was found between the time to diagnosis and neurological disability. In the 62 patients with metastases, a long prediagnosis interval was associated with a higher T stage, infiltration of the fourth ventricle floor, and incomplete surgical resection; it nonetheless did not influence survival significantly in this subgroup. CONCLUSIONS: We found complex and often inverse relations between time to diagnosis of medulloblastoma in children and initial severity factors, survival, and neuropsychological and neurological outcome. This interval appears due more to the nature of the tumor and its progression than to parental or medical factors. These conclusions should be taken into account in the information provided to parents and in expert assessments produced for malpractice claims