NAFLD and liver transplantation: Current burden and expected challenges

Because of global epidemics of obesity and type 2 diabetes, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing both in Europe and the United States, becoming one of the most frequent causes of chronic liver disease and predictably, one of the leading causes of liver transplantation both for end-stage liver disease and hepatocellular carcinoma. For most transplant teams around the world this will raise many challenges in terms of preand post-transplant management. Here we review the multifaceted impact of NAFLD on liver transplantation and will discuss: (1) NAFLD as a frequent cause of cryptogenic cirrhosis, end-stage chronic liver disease, and hepatocellular carcinoma; (2) prevalence of NAFLD as an indication for liver transplantation both in Europe and the United States; (3) the impact of NAFLD on the donor pool; (4) the access of NAFLD patients to liver transplantation and their management on the waiting list in regard to metabolic, renal and vascular comorbidities; (5) the prevalence and consequences of post-transplant metabolic syndrome, recurrent and de novo NAFLD; (6) the alternative management and therapeutic options to improve the long-term outcomes with particular emphasis on the correction and control of metabolic comorbidities

Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference

BACKGROUND: Blood tests of liver injury are less well validated in non‐alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis. AIMS: To improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading. METHODS: We pre‐included new NAFLD patients with biopsy and blood tests from a single‐centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary‐ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing. RESULTS: A total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant (P < 0.0001): 0.878 (0.864–0.892) for FibroTest and fibrosis stages, 0.846 (0.830–0.862) for ActiTest and activity grades, and 0.822 (0.804–0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820–0.852; P = 0.0001), FIB4 (0.845; 0.829–0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850–0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05). CONCLUSIONS: In patients with NAFLD, SteatoTest, ActiTest and FibroTest are non‐invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis

RELIER : Un réseau pour travailler ensemble et promouvoir la qualité au sein des Universités Françaises

The purpose of this communication is to present a very recent initiative lead by the French higher education and research institutions (ESR) : the creation of a network of quality referents named Higher Education and Research Quality Network : RELIER (for REseau quaLIté pour l’Enseignement supérieur et la Recherche) which aims to connect (relier in French) universities, institutes, colleges and engineering schools.Established by and for higher education and research institutions in order to support organizational, management, evaluation and improvement initiatives, this network gathers the people in charge of quality assessment within their institutions on both a political and an operational level. A 15-people steering committee was introduced in January 2013. Gathering every six weeks this committee's main objective is to reinforce a quality culture within the ESR, share good practices, promote and favor the appropriation of the reference tables and the standards of quality for a better management of the institutions.L’objectif de cette communication est de présenter une toute récente initiative au sein des établissements supérieurs d’enseignement et de recherche français (ESR) : la création d’un réseau des référents de la qualité dénommé REseau quaLIté pour l’Enseignement supérieur et la Recherche : RELIER, qui a pour vocation de relier des universités, des instituts, des écoles d’ingénieurs.Constitué par et pour les établissements supérieurs d’enseignement et de recherche afin de soutenir les démarches d’organisation, de pilotage, d’évaluation et d’amélioration avec les outils de la qualité, ce réseau regroupe des acteurs en charge de la démarche qualité au sein de leur établissement, au niveau politique comme opérationnel. Un comité de pilotage de 15 personnes a été mis en place en janvier 2013. Il se réunit toutes les six semaines, son objectif principal est de renforcer une culture de la Qualité dans les ESR, former les acteurs et partager des bonnes pratiques, faire connaître et favoriser l’appropriation de référentiels et standards de la qualité pour un meilleur pilotage des établissements

RELIER: a network to work together and promote quality within French universities

The purpose of this communication is to present a very recent initiative lead by the French higher education and research institutions (ESR) : the creation of a network of quality referents named Higher Education and Research Quality Network : RELIER (for REseau quaLIté pour l’Enseignement supérieur et la Recherche) which aims to connect (relier in French) universities, institutes, colleges and engineering schools.Established by and for higher education and research institutions in order to support organizational, management, evaluation and improvement initiatives, this network gathers the people in charge of quality assessment within their institutions on both a political and an operational level. A 15-people steering committee was introduced in January 2013. Gathering every six weeks this committee's main objective is to reinforce a quality culture within the ESR, share good practices, promote and favor the appropriation of the reference tables and the standards of quality for a better management of the institutions

RELIER: a network to work together and promote quality within French universities

The purpose of this communication is to present a very recent initiative lead by the French higher education and research institutions (ESR) : the creation of a network of quality referents named Higher Education and Research Quality Network : RELIER (for REseau quaLIté pour l’Enseignement supérieur et la Recherche) which aims to connect (relier in French) universities, institutes, colleges and engineering schools.Established by and for higher education and research institutions in order to support organizational, management, evaluation and improvement initiatives, this network gathers the people in charge of quality assessment within their institutions on both a political and an operational level. A 15-people steering committee was introduced in January 2013. Gathering every six weeks this committee's main objective is to reinforce a quality culture within the ESR, share good practices, promote and favor the appropriation of the reference tables and the standards of quality for a better management of the institutions

The PB-Zn ore deposits of San Felipe, Sonora, Mexico: "Detached" mineralization in the Basin And Range Province

La minas de plomo-zinc-plata de San Felipe (Sonora, México) se encuentran en las cercanías de una estructura que presenta las características de un complejo metamórfico (“metamorphic core complex”) por lo menos en su parte noreste. Esta estructura esta caracterizada por una denudación asociada a la extensión terciaria, la cual afecto el norte de México y el oeste de los Estados Unidos durante el Mioceno. Las unidades del bloque superior, entre las cuales se encuentra el pórfido eocénico superior que contiene en parte los yacimientos de San Felipe, se deslizaron varios kilómetros desde su posición original a lo largo de una falla de despegue: la falla El Amol. Esta falla corta la zona mineralizada dejando las partes mas profundas (skarns) en el bloque inferior, en la parte mas alta de la Sierra. Este ejemplo muestra que la distensión debe ser tomada en cuenta en el marco de una exploración minera moderna o en el caso de nuevas búsquedas de reservas en yacimientos conocidos. Se conocen por lo menos dos otros yacimientos en Sonora afectados por procesos similares, un depósito de tungsteno en el flanco oeste de la Sierra de Mazatlán, y una parte de la zona oxidada de La Caridad (falla La Caridad). En Arizona, el depósito de San Manuel-Kalamazoo es un ejemplo clásico de un pórfido cuprífero afectado por la extensión terciaria. doi: https://doi.org/10.22201/igeof.00167169p.1996.35.2.85

Le Cloud Computing, une réponse aux problématiques de gestion de la qualité des projets pour des équipes géographiquement disperséesCas issus du pilotage de projet pour des équipes administratives et recherches géographiquement éloignés

To put at data layout, to work together this data to make information of it concerns a complex exercise in term of division of information between the members of a team, which more is when the members of the team are located in geographical spaces distant. To guarantee the quality of these same data concerns a challenge then. The object of this article of is shown on the basis of experience feedback resulting from the piloting of research project and the piloting of network of manager how the use of technology innovating in term of computer infrastructure makes it possible to guarantee the fundamental concepts of qualityMettre à disposition de la donnée, travailler ensemble cette donnée pour en faire de l’information relève d’un exercice complexe en terme de partage d’information entre les membres d’une équipe, qui plus est lorsque les membres de l’équipe sont situés dans des espaces géographiques distant. Garantir la qualité de ces mêmes données relève alors d’une gageure.L’objet de cet article est de démontrer, en partant de retour d’expérience issus du pilotage de projet de recherche et du pilotage de réseau de cadre de pilotage comment l’utilisation de technologies innovantes en terme d’infrastructure informatique permet de garantir les concepts fondamentaux de la qualité

Le Cloud Computing, une réponse aux problématiques de gestion de la qualité des projets pour des équipes géographiquement dispersées : Cas issus du pilotage de projet pour des équipes administratives et recherches géographiquement éloignés

To put at data layout, to work together this data to make information of it concerns a complex exercise in term of division of information between the members of a team, which more is when the members of the team are located in geographical spaces distant. To guarantee the quality of these same data concerns a challenge then. The object of this article of is shown on the basis of experience feedback resulting from the piloting of research project and the piloting of network of manager how the use of technology innovating in term of computer infrastructure makes it possible to guarantee the fundamental concepts of qualityMettre à disposition de la donnée, travailler ensemble cette donnée pour en faire de l’information relève d’un exercice complexe en terme de partage d’information entre les membres d’une équipe, qui plus est lorsque les membres de l’équipe sont situés dans des espaces géographiques distant. Garantir la qualité de ces mêmes données relève alors d’une gageure.L’objet de cet article est de démontrer, en partant de retour d’expérience issus du pilotage de projet de recherche et du pilotage de réseau de cadre de pilotage comment l’utilisation de technologies innovantes en terme d’infrastructure informatique permet de garantir les concepts fondamentaux de la qualité