65 research outputs found
Perioperative cardiovascular events and mortality after cardiac surgery across the spectrum of chronic kidney disease
Yield performance of 14 novel inter- and intra-species Miscanthus hybrids across Europe
Funding information Bio-Based Industries Joint Undertaking, Grant/Award Number: 745012 ACKNOWLEDGEMENTS For additional information and data collection many thanks to Oberer Lindenhof field station staff (OLI), Unifarm workers (SCH), experimental station Šašinovec technical stuff (ZAG). The authors are grateful for the support of the staff at the research stations at PAC. With particular thanks at the Trawsgoed site (TWS) to Robin Warren, Chris Glover, and the late Kevin Roderick. Thanks also to Michael Squance for use of and assistance with the Physis™ data management platform. FUNDING INFORMATION The GRACE project has received funding from the Bio-based Industries Joint Undertaking (JU) under the European Union's Horizon 2020 research and innovation programme under grant agreement no. 745012. The JU receives support from the European Union's Horizon 2020 research and innovation programme and the Bio-based Industries Consortium.Peer reviewedPublisher PD
Clinical practice guidelines for BRCA1 and BRCA2 genetic testing
BRCA1 and BRCA2 gene pathogenic variants account for most hereditary breast cancer and are increasingly used to determine eligibility for PARP inhibitor (PARPi) therapy of BRCA-related cancer. Because issues of BRCA testing in clinical practice now overlap with both preventive and therapeutic management, updated and comprehensive practice guidelines for BRCA genotyping are needed. The integrative recommendations for BRCA testing presented here aim to (1) identify individuals who may benefit from genetic counselling and risk-reducing strategies; (2) update germline and tumour-testing indications for PARPi-approved therapies; (3) provide testing recommendations for personalised management of early and metastatic breast cancer; and (4) address the issues of rapid process and tumour analysis. An international group of experts, including geneticists, medical and surgical oncologists, pathologists, ethicists and patient representatives, was commissioned by the French Society of Predictive and Personalised Medicine (SFMPP). The group followed a methodology based on specific formal guidelines development, including (1) evaluating the likelihood of BRCAm from a combined systematic review of the literature, risk assessment models and expert quotations, and (2) therapeutic values of BRCAm status for PARPi therapy in BRCA-related cancer and for management of early and advanced breast cancer. These international guidelines may help clinicians comprehensively update and standardise BRCA testing practices
Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial
Prevalent, incident, and persistent insomnia in a population-based cohort tested before (2018) and during the first-wave of COVID-19 pandemic (2020)
Study Objectives: High rates of sleep and mental health problems have been reported during the
COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This
study documented rates of prevalent, incident, and persistent insomnia and psychological
symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018).
Methods: Data were derived from a longitudinal, population-based study of insomnia in Canada.
When the first lockdown started in the province of Quebec, a subsample of participants who had
completed the latest 2018 follow-up were surveyed (April to May 2020) about their sleep,
insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence,
incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive
symptoms were estimated, as well as their associations with confinement, loneliness, social
support, use of electronics, and other lifestyle changes occurring during the pandemic. A
sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue,
anxiety, and depression were administered at both assessments.
Results: The sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women).
Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19%
(syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rate. Of those
classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia
during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence
rate was 76.5% 2 years later. There was a significant worsening of sleep quality, fatigue, anxiety,
and depression (all ps < .005) during the COVID-19 pandemic compared to 2018. Significant
associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced
physical exercise, and higher financial stress.
Conclusions: The COVID-19 pandemic is associated with significant increases in insomnia and
psychological symptoms compared to the pre-pandemic period. Large scale public sleep and
mental health intervention programs should be prioritized during and after a pandemic such as
the COVID-19
Vitamin D time profile based on the contribution of non-genetic and genetic factors in HIV-infected individuals of European ancestry
BACKGROUND
Vitamin D deficiency is prevalent in HIV-infected individuals and vitamin D supplementation is proposed according to standard care. This study aimed at characterizing the kinetics of 25(OH)D in a cohort of HIV-infected individuals of European ancestry to better define the influence of genetic and non-genetic factors on 25(OH)D levels. These data were used for the optimization of vitamin D supplementation in order to reach therapeutic targets.
METHODS
1,397 25(OH)D plasma levels and relevant clinical information were collected in 664 participants during medical routine follow up visits. They were genotyped for 7 SNPs in 4 genes known to be associated with 25(OH)D levels. 25(OH)D concentrations were analyzed using a population pharmacokinetic approach. The percentage of individuals with 25(OH)D concentrations within the recommended range of 20-40ng/ml during 12 months of follow up and several dosage regimens were evaluated by simulation.
RESULTS
A one-compartment model with linear absorption and elimination was used to describe 25(OH)D pharmacokinetics, while integrating endogenous baseline plasma concentrations. Covariate analyses confirmed the effect of seasonality, body mass index, smoking habits, the analytical method, darunavir/r and the genetic variant in GC (rs2282679) on 25(OH)D concentrations. 11% of the interindividual variability in 25(OH)D levels was explained by seasonality and other non-genetic covariates and 1% by genetics. The optimal supplementation for severe vitamin D deficient patients was 300000 IU two times per year.
CONCLUSIONS
This analysis allowed identifying factors associated with 25(OH)D plasma levels in HIV-infected individuals. Improvement of dosage regimen and timing of vitamin D supplementation is proposed based on those results
The Effects of Steroids on Coagulation Dysfunction Induced by Cardiopulmonary Bypass: A Steroids in Cardiac Surgery (SIRS) Trial Substudy
Cardiopulmonary bypass (CPB) surgery, despite heparin administration, elicits activation of coagulation system resulting in coagulopathy. Anti-inflammatory effects of steroid treatment have been demonstrated, but its effects on coagulation system are unknown. The primary objective of this study is to assess the effects of methylprednisolone on coagulation function by evaluating thrombin generation, fibrinolysis, and platelet activation in high-risk patients undergoing cardiac surgery with CPB. The Steroids In caRdiac Surgery study is a double-blind, randomized, controlled trial performed on 7507 patients worldwide who were randomized to receive either intravenous methylprednisolone, 250 mg at anesthetic induction and 250 mg at initiation of CPB (n = 3755), or placebo (n = 3752). A substudy was conducted in 2 sites to collect blood samples perioperatively to measure prothrombin fragment 1.2 (PF1+2, thrombin generation), plasmin-antiplasmin complex (PAP, fibrinolysis), platelet factor 4 (PF4 platelet activation), and fibrinogen. Eighty-one patients were enrolled in the substudy (37 placebo vs 44 in treatment group). No difference in clinical outcome was detected, including postoperative bleeding and need for blood products transfusion. All patients showed changes of all plasma biomarkers with greater values than baseline in both groups. This reaction was attenuated significantly in the treatment group for PF1.2 (P = 0.040) and PAP (P = 0.042) values at the first intraoperative measurement. No difference between groups was detected for PF4. Methylprednisolone treatment attenuates activation of coagulation system in high-risk patients undergoing CPB surgery. Reduction of thrombin generation and fibrinolysis activation may lead to reduced blood loss after surgery
France’s reluctant parliamentarisation of military deployments: the 2008 constitutional reform in practice
Le réel à l'épreuve des technologies
L'art est-il soluble dans la technologie ? demande avec humour l'un des collaborateurs de ce volume. La réponse est évidente, comme le prouvent tous les textes rassemblés ici. Ils mettent en lumière que cette navigation dans les eaux technologiques, loin de nous éloigner des questions esthétiques, nous ramène toujours à l'essentiel : au corps scénique, au dialogue du performeur avec l'espace et le temps, au processus d'absorption du spectateur. En effet la technologie, au cœur de ce recueil, se décline sous des formes variées. Surface de réception ou d'accueil, machine désirante, source de leurre et d'illusion, environnement immersif, pôle réactif à la présence d'un spectateur, elle est ce qui met en branle la performativité des processus offerts au public. Véhicule puissant de présence et d'effets de présence, elle suscite des effets perceptifs, sensitifs, cognitifs, forçant le spectateur non seulement à expérimenter de nouvelles sensations et perceptions, et à sortir ainsi de ses chemins habituels, mais à être confronté à de nouvelles formes de narrativité en lien étroit avec l'espace et le temps de l'action. À ces développements s'ajoute une section entièrement consacrée à l'œuvre impressionnante de Janet Cardiff dont les environnements immersifs tiennent à la fois de l'installation et du spectacle et qui nous a paru être emblématique de ces environnements technologisés en expansion qui permettent d'entrer dans l'intimité des corps
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