Overwintering behaviour of yellow-stage European eel (Anguilla anguilla) in a natural marine fjord system

Like many animals, northern temperate eel can enter a hibernation-like state and become dormant during the winter. Knowledge of overwintering behaviour in eel is sparse and mainly based on anecdotal observations and a few experimental studies on thermal tolerance. We studied European eel (Anguilla anguilla) overwintering behaviour in a Skagerrak fjord in Southern Norway, during three consecutive years, using an array of acoustic receivers and acoustic tags with depth and temperature sensors. We obtained results from 55 yellow eel, of which 19 were studied for one winter, 35 for two winters and one for three winters. Dormancy was inferred to begin in September for the earliest individuals and lasted until May for the last, with the majority of eel dormant from at least late October–November until mid-April. The timing of dormancy was mainly related to photoperiod and less to temperature. More than 50% of eel became dormant when day length was 14 h. Approximately 10% of eel remained active during the winter and 31% of eel changed their pattern between consecutive years. Some dormant individuals exhibited activity periods that interrupted their dormancy. Eel in the outer fjord nearer the open sea became dormant before eel in the inner more freshwater part of the fjord, and were dormant longer.publishedVersio

435 Pegasus HNSCC, a platform study of SAR444245 (THOR-707, a pegylated recombinant non-alpha IL-2) with anti-cancer agents in patients with recurrent/metastatic head and neck squamous cell carcinoma

BackgroundSAR444245 (THOR-707) is a recombinant human IL-2 molecule that includes a PEG moiety irreversibly bound to a novel amino acid via click chemistry to block the alpha-binding domain while retaining near-native affinity for the beta/gamma subunits. In animal models, SAR444245 showed anti-tumor benefits, but with no severe side effects, both as single agent and when combined with anti-PD1 comparing with historical data from aldeslukin. Preclinical study demonstrated SAR444245 enhances ADCC function of cetuximab. The HAMMER trial, which is the FIH study shows preliminary encouraging clinical results: initial efficacy and safety profile with SAR444245 monotherapy and in combination with pembrolizumab or with cetuximab support a non-alpha preferential activity, validating preclinical models. The Pegasus Head and Neck Ph 2 study will evaluate the clinical benefit of SAR444245 in combination with other anticancer therapies for the treatment of patients with R/M HNSCC.MethodsThe Pegasus Head and Neck will enroll approximately 272 patients in 4 separate cohorts concurrently. In cohorts A1 & A2, 1L R/M HNSCC patients will receive SAR444245 + pembrolizumab, or SAR444245+ pembrolizumab+ cetuximab respectively. In cohort B1 & B2 patients with 2/3L R/M HNSCC failed a checkpoint based regimen & a platinum containing regimen will receive SAR444245 + pembrolizumab, or SAR444245 + cetuximab. Patients to be enrolled in cohort B2 need to be cetuximab-naïve in R/M setting. SAR444245 is administered intravenously IV at a dose of 24 ug/kg Q3W until disease progression (PD) or completion of 35 cycles. Pembrolizumab is administered at a dose of 200 mg Q3W until PD or completion of 35 cycles. Cetuximab is administered at a dose of 400/250 mg/m2 QW until PD. The study primary objective is to determine the antitumor activity of SAR444245 in combination with other anticancer therapies. Secondary objectives include confirmation of dose and safety profile, assess other indicators of antitumor activity, and assess the pharmacokinetic profile and immunogenicity of SAR444245. The study will be conducted in the US, Canada, France, Germany, Italy, Netherlands, Poland, South Korea, Spain and Taiwan.AcknowledgementsThe Pegasus Head and Neck study is sponsored by Sanofi

Obesity and Readmission in Elderly Surgical Patients

BACKGROUND: Reducing readmissions has become a focus in efforts by Medicare to improve health care quality and reduce costs. This study aimed to determine whether causes for readmission differed between obese and nonobese patients, possibly allowing for targeted interventions. METHODS: A matched case control study of Medicare patients admitted between 2002 and 2006 who were readmitted after hip or knee surgery, colectomy, or thoracotomy was performed. Patients were matched exactly for procedure, while also balancing on hospital, age, and sex. Conditional logistic regression was used to study the odds of readmission for very obese cases (body mass index \u3e35 kg/m2) versus normal weight patients (body mass index of 20-30 kg/m2) after also controlling for race, transfer-in and emergency status, and comorbidities. RESULTS: Among 15,914 patient admissions, we identified 1,380 readmitted patients and 2,760 controls. The risk of readmission was increased for obese compared to nonobese patients both before and after controlling for comorbidities (before: odds ratio, 1.35; P = .003; after: odds ratio, 1.25; P = .04). Reasons for readmission varied by procedure but were not different by body mass index category. CONCLUSION: Obese patients have an increased risk of readmission, yet the reasons for readmission in obese patients appear to be similar to those for nonobese patients, suggesting that improved postdischarge management for the obese cannot focus on a few specific causes of readmission but must instead provide a broad range of interventions

Acute Kidney Injury, Renal Function, and the Elderly Obese Surgical Patient: A Matched Case-Control Study

OBJECTIVE: To investigate the association between obesity and perioperative acute kidney injury (AKI), controlling for preoperative kidney dysfunction. BACKGROUND: More than 30% of patients older than 60 years are obese and, therefore, at risk for kidney disease. Postoperative AKI is a significant problem. METHODS: We performed a matched case-control study of patients enrolled in the Obesity and Surgical Outcomes Study, using data of Medicare claims enriched with detailed chart review. Each AKI patient was matched with a non-AKI control similar in procedure type, age, sex, race, emergency status, transfer status, baseline estimated glomerular filtration rate, admission APACHE score, and the risk of death score with fine balance on hospitals. RESULTS: We identified 514 AKI cases and 694 control patients. Of the cases, 180 (35%) followed orthopedic procedures and 334 (65%) followed colon or thoracic surgery. After matching, obese patients undergoing a surgical procedure demonstrated a 65% increase in odds of AKI within 30 days from admission (odds ratio = 1.65, P \u3c 0.005) when compared with the nonobese patients. After adjustment for potential confounders, the odds of postoperative AKI remained elevated in the elderly obese (odds ratio = 1.68, P = 0.01.) CONCLUSIONS: : Obesity is an independent risk factor for postoperative AKI in patients older than 65 years. Efforts to optimize kidney function preoperatively should be employed in this at-risk population along with keen monitoring and maintenance of intraoperative hemodynamics. When subtle reductions in urine output or a rising creatinine are observed postoperatively, timely clinical investigation is warranted to maximize renal recovery

Sens de la vie, sens du travail et orientation professionnelle : un dispositif innovant d’accompagnement des adultes

Cet article expose la méthodologie d’un dispositif innovant d’accompagnement pour adultes visant l’appropriation du « sens de sa vie », dans la perspective de construire son orientation professionnelle. Partant des cadres théoriques de la psychologie positive et du « life-designing », la méthodologie s’appuie sur une animation de groupe comportant sept séances de deux heures et incluant des exercices originaux. Une première évaluation permet de dégager certains constats et de formuler des préconisations relatives aux interventions à développer pour que les personnes soient davantage actrices de leur vie et y trouvent du sens.This article presents the methodology for an innovative approach to guidance counseling for adults, by having them take ownership of the meaning of life in order to develop their career choice. Based on the theoretical framework of positive psychology and life-designing models, the methodology is based on seven 2-hour group-counseling sessions and original exercises. An initial assessment will present certain findings and make recommendations on which actions to develop so that the people become better actors of their own lives and will find meaning in it

Staphylococcus aureus seroproteomes discriminate ruminant isolates causing mild or severe mastitis

Staphylococcus aureus is a major cause of mastitis in ruminants. In ewe mastitis, symptoms range from subclinical to gangrenous mastitis. S. aureus factors or host-factors contributing to the different outcomes are not completely elucidated. In this study, experimental mastitis was induced on primiparous ewes using two S. aureus strains, isolated from gangrenous (strain O11) or subclinical (strain O46) mastitis. Strains induced drastically distinct clinical symptoms when tested in ewe and mice experimental mastitis. Notably, they reproduced mild (O46) or severe (O11) mastitis in ewes. Ewe sera were used to identify staphylococcal immunoreactive proteins commonly or differentially produced during infections of variable severity and to define core and accessory seroproteomes. Such SERological Proteome Analysis (SERPA) allowed the identification of 89 immunoreactive proteins, of which only 52 (58.4%) were previously identified as immunogenic proteins in other staphylococcal infections. Among the 89 proteins identified, 74 appear to constitute the core seroproteome. Among the 15 remaining proteins defining the accessory seroproteome, 12 were specific for strain O11, 3 were specific for O46. Distribution of one protein specific for each mastitis severity was investigated in ten other strains isolated from subclinical or clinical mastitis. We report here for the first time the identification of staphylococcal immunogenic proteins common or specific to S. aureus strains responsible for mild or severe mastitis. These findings open avenues in S. aureus mastitis studies as some of these proteins, expressed in vivo, are likely to account for the success of S. aureus as a pathogen of the ruminant mammary gland

Medical and Financial Risks Associated with Surgery in the Elderly Obese

OBJECTIVE: To study the medical and financial outcomes associated with surgery in elderly obese patients and to ask if obesity itself influences outcomes above and beyond the effects from comorbidities that are known to be associated with obesity. BACKGROUND: Obesity is a surgical risk factor not present in Medicare\u27s risk adjustment or payment algorithms, as BMI is not collected in administrative claims. METHODS: A total of 2045 severely or morbidly obese patients (BMI ≥ 35 kg/m, aged between 65 and 80 years) selected from 15,914 elderly patients in 47 hospitals undergoing hip and knee surgery, colectomy, and thoracotomy were matched to 2 sets of 2045 nonobese patients (BMI = 20-30 kg/m). A limited match controlled for age, sex, race, procedure, and hospital. A complete match also controlled for 30 additional factors such as diabetes and admission clinical data from chart abstraction. RESULTS: Mean BMI in the obese patients was 40 kg/m compared with 26 kg/m in the nonobese. In the complete match, obese patients displayed increased odds of wound infection: OR (odds ratio) = 1.64 (95% CI: 1.21, 2.21); renal dysfunction: OR = 2.05 (1.39, 3.05); urinary tract infection: OR = 1.55 (1.24, 1.94); hypotension: OR = 1.38 (1.07, 1.80); respiratory events: OR = 1.44 (1.19, 1.75); 30-day readmission: OR = 1.38 (1.08, 1.77); and a 12% longer length of stay (8%, 17%). Provider costs were 10% (7%, 12%) greater in obese than in nonobese patients, whereas Medicare payments increased only 3% (2%, 5%). Findings were similar in the limited match. CONCLUSIONS: Obesity increases the risks and costs of surgery. Better approaches are needed to reduce these risks. Furthermore, to avoid incentives to underserve this population, Medicare should consider incorporating incremental costs of caring for obese patients into payment policy and include obesity in severity adjustment models

Molecular Basis of Virulence in Staphylococcus aureus Mastitis

S. aureus is one of the main pathogens involved in ruminant mastitis worldwide. The severity of staphylococcal infection is highly variable, ranging from subclinical to gangrenous mastitis. This work represents an in-depth characterization of S. aureus mastitis isolates to identify bacterial factors involved in severity of mastitis infection