Bivariant class of degree one

Let f : X → Y be a projective birational morphism, between complex quasi-projective varieties. Fix a bivariant class θ ∈ H0(X →f Y ) ∼= H o m D cb ( Y ) ( R f ∗ A X , A Y ) ( h e r e A i s a N o e t h e r i a n c o m m u t a t i v e r i n g with identity, and AX and AY denote the constant sheaves). Let θ0 : H0(X) → H0(Y) be the induced Gysin morphism. We say that θhas degree one if θ0(1X) = 1Y ∈ H0(Y). This is equivalent to say that θ is a section of the pull-back f∗ : AY → Rf∗AX, i.e. θ◦f∗ = idAY , and it is also equivalent to say that AY is a direct summand of Rf∗AX. We investigate the consequences of the existence of a bivariant class of degree one. We prove explicit formulas relating the (co)homology of X and Y , which extend the classic formulas of the blowing-up. These formulas are compatible with the duality morphism. Using which, we prove that the existence of a bivariant class θ of degree one for a resolution of singular- ities, is equivalent to require that Y is an A-homology manifold. In this case θ is unique, and the Betti numbers of the singular locus Sing(Y ) of Y are related with the ones of f−1(Sing(Y ))

Defining the role of extended saphenofemoral junction ligation: A prospective comparative study

AbstractObjective: This study explores the added effect of extended saphenofemoral junction (SFJ) ligation when the greater saphenous vein (GSV) has been eliminated from participating in thigh reflux by means of endovenous obliteration. GSV obliteration, unlike surgical stripping, can be done with or without SFJ ligation to isolate and study SFJ ligation’s specific contribution to treatment results. Methods: Sixty limbs treated with SFJ ligation and 120 limbs treated without high ligation were selected from an ongoing, multicenter, endovenous obliteration trial on the basis of their having primary varicose veins, GSV reflux, and early treatment dates. Results: Five (8%) high-ligation limbs and seven (6%) limbs without high ligation with patent veins at 6 weeks or less were excluded as unsuccessful obliterations. Treatment significantly reduced symptoms and CEAP clinical class in both groups (P =.0001). Recurrent reflux developed in one (2%) of 49 high-ligation limbs and eight (8%) of 97 limbs without high ligation by 6 months (P =.273). New instances of reflux did not appear thereafter in 57 limbs followed to 12 months. Recurrent varicose veins occurred in three high-ligation limbs and four limbs without high ligation by 6 months and in one additional high-ligation limb and two additional limbs without high ligation by 12 months. Actuarial recurrence curves were not statistically different with or without SFJ ligation (P >.156), predicting greater than 90% freedom from recurrent reflux and varicosities at 1 year for both groups. Conclusion: These early results suggest that extended SFJ ligation may add little to effective GSV obliteration, but our findings are not sufficiently robust to warrant abandonment of SFJ ligation as currently practiced in the management of primary varicose veins associated with GSV vein reflux. (J Vasc Surg 2000;32:941-53.

Effective Neutralizing Antibody Response Against SARS-CoV-2 Virus and Its Omicron BA.1 Variant in Fully Vaccinated Hematological Patients

SARS-CoV-2 and its variants cause CoronaVIrus Disease 19 (COVID-19), a pandemic disease. Hematological malignancies increase susceptibility to severe COVID-19 due to immunosuppression. Anti-SARS-CoV-2 neutralizing antibodies protect against severe COVID-19. This retrospective real-life study aimed to evaluate seropositivity and neutralizing antibody rates against SARS-CoV-2 and its Omicron BA.1 variant in hematological patients. A total of 106 patients with different hematologic malignancies, who have mostly received three or more vaccine doses (73%), were included in this study. Serum was collected between May and June 2022. The primary endpoint was anti-SARS-CoV-2 antibody response against ancestral (wild type; wt) and Omicron BA.1 virus, defined as a neutralizing antibody titer ≥ 1:10. Adequate neutralizing antibody response was observed in 75 (71%) and 87 (82%) of patients for wt and Omicron BA.1 variants, respectively.However, patients with B-cell lymphoproliferative disorders and/or those treated with anti-CD20 monoclonal antibodies in the prior 12 months showed a lower seropositivity rate compared to other patients against both Omicron BA.1 variant (73% vs 91%; P = 0.02) and wt virus (64% vs 78%; P = 0.16). Our real-life experience confirmed that full vaccination against SARS-CoV-2 induces adequate neutralizing antibody protection for both the wt virus and Omicron BA.1 variants, even in hematological frail patients. However, protective measures should be maintained in hematological patients, especially those with B-cell lymphoproliferative diseases treated with anti-CD20 monoclonal antibodies, because these subjects could have a reduced neutralizing antibody production

Accelerated bone mass senescence after hematopoietic stem cell transplantation

Osteoporosis and avascular necrosis (AVN) are long-lasting and debilitating complications of hematopoietic stem cell transplantation (HSCT). We describe the magnitude of bone loss, AVN and impairment in osteogenic cell compartment following autologous (auto) and allogeneic (allo) HSCT, through the retrospective bone damage revaluation of 100 (50 auto- and 50 allo-HSCT) longterm survivors up to 15 years after transplant. Current treatment options for the management of these complications are also outlined. We found that auto- and allo-HSCT recipients show accelerated bone mineral loss and microarchitectural deterioration during the first years after transplant. Bone mass density (BMD) at the lumbar spine, but not at the femur neck, may improve in some patients after HSCT, suggesting more prolonged bone damage in cortical bone. Phalangeal BMD values remained low for even more years, suggesting persistent bone micro-architectural alterations after transplant. The incidence of AVN was higher in allo-HSCT recipients compared to autoHSCT recipients. Steroid treatment length, but not its cumulative dose was associated with a higher incidence of bone loss. Allo-HSCT recipients affected by chronic graft versus host disease seem to be at greater risk of continuous bone loss and AVN development. Reduced BMD and higher incidence of AVN was partly related to a reduced regenerating capacity of the normal marrow osteogenic cell compartment. Our results suggest that all patients after autoHSCT and allo-HSCT should be evaluated for their bone status and treated with anti-resorptive therapy as soonas abnormalities are detected

Acute GVHD prophylaxis plus ATLG after myeloablative allogeneic haemopoietic peripheral blood stem-cell transplantation from HLA-identical siblings in patients with acute myeloid leukaemia in remission : final results of quality of life and long-term outcome analysis of a phase 3 randomised study

Background We previously showed that human anti-T-lymphocyte globulin (ATLG) plus ciclosporin and methotrexate given to patients with acute leukaemia in remission, having allogeneic haemopoietic stem-cell transplantation with peripheral blood stem cells from an HLA-identical sibling donor after myeloablative conditioning, significantly reduced 2-year chronic graft-versus-host disease (cGVHD) incidence and severity, without increasing disease relapse and infections, and improves cGVHD-free and relapse-free survival (cGRFS). The aim of an extended follow-up study was the assessment of long-term outcomes, which are, in this context, scarcely reported in the literature. We report unpublished data on quality of life (QoL) from the original study and the results of a follow-up extension. Methods In the original open-label study, patients with acute myeloid and lymphoblastic leukaemia in first or subsequent remission, having sibling HLA-identical allogeneic peripheral blood stem-cell transplantation, were randomly assigned (1:1) to receive ATLG plus standard GVHD prophylaxis with ciclosporin and short-term methotrexate (ATLG group) or standard GVHD prophylaxis without ATLG (non-ATLG group). Conditioning regimens were cyclophosphamide 120 mg/kg with either total body irradiation (12 Gy) or busulfan (12 . 8 mg/kg intravenously or 16 mg/kg orally), with or without etoposide (30-60 mg/kg). Randomisation was stratified according to centre and disease risk. The primary endpoint was cumulative incidence of cGVHD at 2 years. The primary and secondary endpoints, excluding QoL, have been published. QoL, assessed using European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-HDC29 questionnaires, was an unpublished secondary endpoint, which we now report here. A follow-up extension was then done, with the primary endpoint cumulative incidence of cGVHD. Enrolment has been completed for both studies. Findings In the original study, from Dec 14, 2006, to Feb 2, 2012, 161 patients were enrolled and 155 were randomly assigned to either the ATLG group (n=83) or to the non-ATLG group (n=72). In the follow-up study, which started on Feb 7, 2017, and was completed on June 30, 2017, 61 patients were included in the ATLG group and 53 were included in the non-ATLG group. Global health status showed a more favourable time course in the ATLG group compared with the non-ATLG group (p=0 . 02; treatment by visit interaction). ATLG was descriptively superior to non-ATLG at 24 months for physical function (points estimate -14.8 [95% CI -26.4 to-3.1]; p= 0.014) and social function (-19.1 [-38.0 to -0.2]; p=0.047), gastrointestinal side-effects (8 . 8 [2.5-15.1]; p=0 . 008) and effect on family (13.5 [1.2-25.8]; p=0.032). Extended follow-up (median 5 . 9 years [IQR 1.7-7.9]) confirmed a lower 5-year cGVHD incidence (30.0% [95% CI 21.4-41.9] vs 69.1% [59.1-80.1]; analysis for entire follow-up, p Interpretation The addition of ATLG to standard GVHD prophylaxis improves the probability of surviving without disease relapse and cGVHD after myeloablative peripheral blood stem-cell transplantation from an HLA-identical sibling donor for patients with acute leukaemia in remission. Further additional benefits are better QoL and shorter immunosuppressive treatment compared with standard GVHD prophylaxis without ATLG. Therefore, in this setting, ATLG plus standard GVHD prophylaxis should be preferred over the standard GVHD prophylaxis alone. Copyright (C) 2019 Elsevier Ltd. All rights reserved.Peer reviewe

Angioplastie des lésions de l'artère mésentérique supérieure dans le traitement de l'ischémie mésentérique chronique

Le but de cette étude rétrospective est d'évaluer les résultats de l'angioplastie avec ou sans stent pour le traitement des lésions sténosantes atheromateuses de l'artère mésentérique supérieure chez 6 patients pendant un suivi moyen de 25,8 mois.les résultats sont satisfaisants en terme de perméabilité primaire et primaire assistée, comparables à ceux des autres études publiées .GRENOBLE1-BU Médecine pharm. (385162101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Endothélium, athérome et infection

Les techniques biologiques d'amplification génique, et l'étude de la réactivité vasculaire in vitro, ont confirmé les interactions physiopathologiques qui existent entre l'endothélium, l'athérome et l'infection artérielle. La présence dans l'athérome carotidien d'une voie enzymatique de formation de l'angiotensine II, avec les cathepsines D et G du système des cystéines protéases, apporte des éléments supplémentaires à la compréhension de la physiopathologie de l'athérome.La mise en évidence de nouveaux germes intracellulaires, tels que Coxiella burnetii dans les anévrysmes infectés, doit inciter à développer les techniques d'amplification génique tels que la PCR " en temps réel " pour une meilleure identification bactériologique des infections artérielles. L'altération de la fonction endothéliale des greffons veineux autologues en présence d'athérosclérose, et des allogreffes artérielles au cours de la cryoconservation, peut expliquer les risques de complications et de dégradation de ces substituts vasculaires au cours des revascularisations en milieu septique et irradié. , infection, Coxiella burnetii, amplification génique, allogreffes artérielles, .Molecular biology techniques using gene amplification and in vitro study of vascular reactivity have confirmed the potential pathophysiological links between endothelium, atheroma and infection. Presence of cathepsin D and G, components of the angiotensin II system, has shown to be associated with atheroma formation in human carotid artery and has brought new insight in the understanding of atheroma. Intracellular pathogens such as Coxiella burnetii involved in infected aortic aneurysms should warrant further developpement of gene amplification techniques such as " real time " PCR for a better identification of new offenders. Imparement of endothelial fonction of autologous vein graft in the presence of risk factor of atherosclerosis and during cryopreservation of arterial allograft may explain the potential risk of degradations and complications in contaminated and irradiated field.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

An effective decomposition theorem for Schubert varieties

Given a Schubert variety Scontained in a Grassmannian Gk(Cl), we show how to obtain further information on the direct sum-mands of the derived pushforward Rπ∗Q˜S given by the application of the decomposition theorem to a suitable resolution of singularities π:˜S→S. As a by-product, Poincaré polynomial ex-pressions are obtained along with an algorithm which computes the unknown terms in such expressions and which shows that the actual number of direct summands happens to be less than the number of supports of the decomposition