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Over the past year, we have seen significant geopolitical changes driven by the impact of COVID-19, forcing organisations to strengthen their resilience. The realisation has also dawned that the world [...]

The microbiome is an important consideration for the conservation of endangered species. Studies provided evidence of the effect of behavior and habitat change on the microbiota of wild animals and reported various inferences. It indicates the complexity of factors influencing microbiota diversity, including incomplete sampling procedures. Data abnormality may arise due to the procedures warranting preliminary analysis, such as rarefaction, before downstream analysis. This present study demonstrated the effect of data rarefaction and aggregation on the comparison of wild rusa deer’s gut microbial diversity. Eighty-five feces samples were collected from 11 deer populations inhabiting three national parks in Java and Bali islands. Using the Illumina Nova-Seq platform, fragments of 16s rRNA gene were sequenced, and raw data of 51,389 reads corresponding to 2 domains, 22 phyla, 45 classes, 83 orders, 182 families, and 460 genera of bacteria were obtained. Data rarefaction was applied at two different library sizes (minimum and fixed) and aggregation (11 populations into 3 research sites) to investigate its effect on the microbial diversity comparison. There are significant differences in alpha diversity between populations, but not research sites, at all library sizes of rarefaction. A similar finding is also found in beta diversity. Moreover, data rarefaction and aggregation result in different values of the diversity metrics. This present study shows that statistical analysis remains a substantial concern in microbiome studies applied to conservation biology. It suggests reporting a more detailed data normalization in microbiome studies as an inherent control of suboptimal sampling, particularly when involving feces.

Historically, drugs studied in clinical trials are dispensed to participants by pharmacies located at investigating sites--e.g., academic medical centers and hospitals. Both sponsors and patients are keen, however, to deploy [...]

Cet article est basé sur les données recueillies dans le dictionnaire médical de l’Académie nationale de médecine auprès des auteurs qui sont à l’origine de la description des maladies. Ce recueil contient plus de 2500 auteurs américains qui ont publié leurs œuvres au XXesiècle. Notre étude nous a permis de préciser l’origine de ces auteurs américains que nous avons divisés en trois groupes : les « Émigrés », les « Descendants d’immigrés » et les Américains de souche. Il est apparu que la majorité des « Émigrés » et des « Descendants d’immigrés » venaient d’Europe, principalement de l’Est et du centre de l’Europe. Un tiers des « Émigrés » et la moitié des « Descendants d’immigrés » étaient d’ascendance juive et leur migration suivait le pogrom, le nazisme et le fascisme. Dans l’étude de leur carrière scientifique, il est apparu que, comparativement aux Américains de souche, les « Émigrés » et les « Descendants d’immigrés » étaient reconnus pour la notoriété de leur carrière, par des distinctions scientifiques et universitaires. Cet antisémitisme a favorisé l’immigration médico-scientifique aux États-Unis au cours du XXesiècle.

Diabetic foot ulcers are one of the complications of diabetes. Malnutrition is one of the risk factors for wounds but, on the other hand, diabetic foot ulceration may promote malnutrition. In this single-centre retrospective study we evaluated the frequency of malnutrition at first admission and the severity of foot ulceration. We demonstrated that malnutrition at admission correlated with duration of hospitalisation and with death rate rather than with the risk of amputation. Our data challenged the concept that protein-energy deficiency may worsen the prognosis of diabetic foot ulcers. Nevertheless, it is still important to screen nutritional status at baseline and during the follow-up in order to start specific nutritional support therapy as soon as possible in order to reduce morbidity/mortality related to malnutrition.

Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation.

Contemporary management of COPD relies on exacerbation history to risk-stratify patients for future exacerbations. Multivariable prediction models can improve the performance of risk stratification. However, the clinical utility of risk stratification can vary from one population to another.

Faced with global warming, the surface area of coffee cultivation regions is expected to diminish significantly in the near future. As a result, new varieties or agronomical practices improving drought tolerance need to be found. The aim of this work is to characterize drought tolerance of Coffea canephoragenotypes and their reciprocal grafted plants with physiological tools and biochemical analyses. Under greenhouse conditions, control plants (sensitive or tolerant) and reciprocal grafted plants submitted to 14 days of water deprivation show variations of the monitored parameters, such as soil and leaf water potential, stomatal conductance, and osmoprotectant compounds (sugars, polyols, amino acids). The variations observed confirm the differences between the phenotypes defined as drought-tolerant and drought-sensitive. Reciprocal grafting shows enhanced and contrasting situations. A sensitive clone grafted onto tolerant rootstock presents higher tolerance to drought and physiological or biochemical parameters similar to a drought-tolerant clone. The opposite is observed for tolerant clones grafted onto a sensitive one. More contrasted results are obtained with glucose, fructose, proline, and mannitol content which could be used as indicators for drought tolerance. Our finding shows strong variability for drought tolerance in our Robusta clones and demonstrates the impact of grafting on physiological and biochemical parameters linked to drought tolerance. The use of drought-tolerant rootstock leads to better regulation of water management and biochemical composition of the scion in drought-sensitive clones. This could be an approach to improving drought tolerance of Coffea canephoragenotypes and to limiting the impact of global warming on coffee farming.

Variability in the age of onset and number of tumors is occasionally described among retinoblastoma patients, and possible genetic modifiers might lie in the pRB or p53 pathways, both of which are involved in the development of retinoblastoma. MDM2, which increases p53 and pRB catabolism, is therefore a prominent candidate. The minor allele of MDM2 that includes a 309T>G transversion (single-nucleotide polymorphism rs2279744) in the MDM2 promoter is known to enhance MDM2 expression. Its genetic transmission was studied in 326 individuals including 212 RB1 mutation carriers in 70 retinoblastoma families, and the marker genotype was tested for association with age at diagnosis and disease phenotype. In family-based association analyses, the MDM2 309G allele was found to be statistically significantly associated with incidence of bilateral or unilateral retinoblastoma among members of retinoblastoma families (Z = 3.305, two-sided exact P = .001) under a recessive model (ie, affected patients tend to be homozygous for the G allele); in transmission disequilibrium analyses using the recessive model, the association was also observed (estimated odds ratio = 4.0, 95% confidence interval = 1.3 to 12.0). The strong association of this genotype with retinoblastoma development designates MDM2 as the first modifier gene to be identified among retinoblastoma patients and suggests that enhancement of pRB haploinsufficiency and/or resistance to p53-mediated apoptosis is critical to tumor formation. J Natl Cancer Inst 2010;102:1805-1808 DOI: 10.1093/jnci/djq416

ABSTRACTIntroductionTherapy-related myeloid neoplasms (t-MN) are frequently categorized according to previous therapy or pattern of cytogenetic abnormalities. Our objective was to evaluate and compare the mutational profile of de novoand t-MN by next generation sequencing.MethodsSixty-four samples from patients with t-MN, previously treated for a solid tumor (mainly breast), or de novoAML, MDS, MDS/MPN were selected for our study. The library was prepared using diagnostic samples and the TruSight Myeloid sequencing panel targeting 54 genes. Samples were sequenced on a MiSeq. The classification system of the Belgian ComPerMed Expert Panel was used for the biological variant classification.ResultsTaking only pathogenic, probably pathogenic variants and variants of unknown significance into account 141 variants in 33 genes were found in 52 of 64 samples (81%; mean number of variants per patient = 2; range = [1–11]; 67 variants in 25 genes in t-MN and 74 variants in 25 genes in de novoMN). Overall, the most frequently detected variants included TET2(n = 22), TP53(n = 12), DNMT3A(n = 10) and FLT3, NPM1, RUNX1(n = 8 each).ConclusionOur study revealed a high variety of variants both in t-MN and de novoMN patients. There was a higher incidence of FLT3and TP53variants in t-MN compared to de novoMN.

Securing data in wireless environmental monitoring systems based jointly on Deoxyribonucleic Acid (DNA) database and chaotic sequences is a hot new research topic. This paper deals with the implementation of an encryption scheme combining DNA cryptography and the pseudorandom property of hyperchaotic behavior to secure data from air quality monitoring stations. We propose an appropriate cryptography algorithm, which guarantees the confidentiality, integrity, and authentication of data. The dynamics of the hyperchaotic system was studied in order to be able to make a wise choice of the sequence to be used in the encryption and decryption processes, which will be used at all stages of the cryptosystem to strengthen data security. Several studies including security analysis, execution times as well as a comparative study with some existing algorithms were carried out to assess the resistance to attacks of the proposed scheme. The performance analysis demonstrated the ability of the proposed cryptosystem to resist various attacks through a low execution time and a large key space.

ABSTRACTA few studies suggest that, in interpreter-mediated mental health settings, the interpreter participates in the therapeutic alliance (TA) via relational agency within the triad. We have explored this hypothesis through the thematic analysis of 19 semi-structured interviews and the discursive analysis of three excerpts from an authentic interpreter-mediated French-Russian psychotherapeutic consultation using the conceptual tools of Brown and Levinson’s politeness theory enriched by Kerbrat-Orecchioni (1992) and taking into consideration discourse markers. The results of this descriptive and exploratory study show that the interpreter actively co-creates a supportive relationship in each of the three dyads, in particular through mitigation of Face-Threatening Acts and Face-Flattering Acts. In doing so, it may be that the interpreter co-constructs the affective dimension of a triadic TA that promotes the patient’s self-expression and underpins therapeutic work. A better understanding of the mechanisms of establishing and maintaining TA in interpreted mental health settings is crucial since research in monolingual contexts shows that the quality of TA is predictive of successful care.

Allogeneic chimeric antigen receptor (CAR) T holds the promise of taking this therapeutic approach to broader patient populations while avoiding the intensive manufacturing demands of autologous cell products. One limitation to delivering an allogeneic CAR T is T-cell receptor (TCR) driven toxicity. In this work, the expression of a peptide to interfere with TCR signaling was assessed for the generation of allogeneic CAR T cells. The expression of a truncated CD3ζ peptide was shown to incorporate into the TCR complex and to result in blunted TCR responses. When coexpressed with a natural killer group 2D (NKG2D) CAR, the allogeneic T cells (called CYAD-101) failed to induce graft-versus-host disease in mouse models while maintaining antitumor activity driven by the CAR in vitro and in vivo. Two clinical grade discrete batches of CYAD-101 cells were produced of single donor apheresis resulting in 48 billion CAR T cells sufficient for the entire dose-escalation phase of the proposed clinical trial. The 2 batches showed high consistency producing a predominantly CD4+T-cell population that displayed an effector/central memory phenotype with no evidence of exhaustion markers expression. These clinical grade CYAD-101 cells secreted cytokines and chemokines in response to ligands expressing target cells in vitro, demonstrating effector function through the CAR. Moreover, CYAD-101 cells failed to respond to TCR stimulation, indicating a lack of allogeneic potential. This bank of clinical grade, non–gene-edited, allogeneic CYAD-101 cells are used in the alloSHRINK clinical trial (NCT03692429).

Activated T cells secrete interferon-γ, which triggers intracellular tryptophan shortage by upregulating the indoleamine 2,3-dioxygenase 1 (IDO1) enzyme1–4. Here we show that despite tryptophan depletion, in-frame protein synthesis continues across tryptophan codons. We identified tryptophan-to-phenylalanine codon reassignment (W>F) as the major event facilitating this process, and pinpointed tryptophanyl-tRNA synthetase (WARS1) as its source. We call these W>F peptides ‘substitutants’ to distinguish them from genetically encoded mutants. Using large-scale proteomics analyses, we demonstrate W>F substitutants to be highly abundant in multiple cancer types. W>F substitutants were enriched in tumours relative to matching adjacent normal tissues, and were associated with increased IDO1 expression, oncogenic signalling and the tumour-immune microenvironment. Functionally, W>F substitutants can impair protein activity, but also expand the landscape of antigens presented at the cell surface to activate T cell responses. Thus, substitutants are generated by an alternative decoding mechanism with potential effects on gene function and tumour immunoreactivity.

ABSTRACTWith the introduction of immunomodulatory drugs, proteasome inhibitors, and anti-CD38 monoclonal antibodies, major improvements have been achieved in the treatment of multiple myeloma (MM), with a significant impact on the outcome of this disease. Different treatment combinations are now in use and other therapies are being developed. Based on an extensive review of the recent literature, we propose practical recommendations on myeloma management, to be used by hematologists as a reference for daily practice.

Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematopoietic stem cell disorders characterized by ineffective hematopoiesis leading to peripheral cytopenias and in a substantial proportion of cases to acute myeloid leukemia. The deletion of the long arm of chromosome 11, del(11q), is a rare but recurrent clonal event in MDS. Here, we detail the largest series of 113 cases of MDS and myelodysplastic syndromes/myeloproliferative neoplasms (MDS/MPN) harboring a del(11q) analyzed at clinical, cytological, cytogenetic, and molecular levels. Female predominance, a survival prognosis similar to other MDS, a low monocyte count, and dysmegakaryopoiesis were the specific clinical and cytological features of del(11q) MDS. In most cases, del(11q) was isolated, primary and interstitial encompassing the 11q22-23 region containing ATM, KMT2A, and CBL genes. The common deleted region at 11q23.2 is centered on an intergenic region between CADM1 (also known as Tumor Suppressor in Lung Cancer 1) and NXPE2. CADM1 was expressed in all myeloid cells analyzed in contrast to NXPE2. At the functional level, the deletion of Cadm1 in murine Lineage-Sca1+Kit+ cells modifies the lymphoid-to-myeloid ratio in bone marrow, although not altering their multilineage hematopoietic reconstitution potential after syngenic transplantation. Together with the frequent simultaneous deletions of KMT2A, ATM, and CBL and mutations of ASXL1, SF3B1, and CBL, we show that CADM1 may be important in the physiopathology of the del(11q) MDS, extending its role as tumor-suppressor gene from solid tumors to hematopoietic malignancies.

Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematopoietic stem cell disorders characterized by ineffective hematopoiesis leading to peripheral cytopenias and in a substantial proportion of cases to acute myeloid leukemia. The deletion of the long arm of chromosome 11, del(11q), is a rare but recurrent clonal event in MDS. Here, we detail the largest series of 113 cases of MDS and myelodysplastic syndromes/myeloproliferative neoplasms (MDS/MPN) harboring a del(11q) analyzed at clinical, cytological, cytogenetic, and molecular levels. Female predominance, a survival prognosis similar to other MDS, a low monocyte count, and dysmegakaryopoiesis were the specific clinical and cytological features of del(11q) MDS. In most cases, del(11q) was isolated, primary and interstitial encompassing the 11q22-23 region containing ATM, KMT2A, and CBLgenes. The common deleted region at 11q23.2 is centered on an intergenic region between CADM1(also known as Tumor Suppressor in Lung Cancer 1) and NXPE2. CADM1was expressed in all myeloid cells analyzed in contrast to NXPE2. At the functional level, the deletion of Cadm1 in murine Lineage-Sca1+Kit+cells modifies the lymphoid-to-myeloid ratio in bone marrow, although not altering their multilineage hematopoietic reconstitution potential after syngenic transplantation. Together with the frequent simultaneous deletions of KMT2A, ATM, and CBLand mutations of ASXL1, SF3B1, and CBL, we show that CADM1may be important in the physiopathology of the del(11q) MDS, extending its role as tumor-suppressor gene from solid tumors to hematopoietic malignancies.

Karyotype complexity has major prognostic value in many malignancies. There is no consensus on the definition of a complex karyotype, and the prognostic impact of karyotype complexity differs from one disease to another. Due to the importance of the complex karyotype in the prognosis and treatment of several hematological diseases, the Francophone Group of Hematological Cytogenetics (Groupe Francophone de Cytogénétique Hématologique, GFCH) has developed an up-to-date, practical document for helping cytogeneticists to assess complex karyotypes in these hematological disorders. The evaluation of karyotype complexity is challenging, and it would be useful to have a consensus method for counting the number of chromosomal abnormalities (CAs). Although it is not possible to establish a single prognostic threshold for the number of CAs in all malignancies, a specific consensus prognostic cut-off must be defined for each individual disease. In order to standardize current cytogenetic practices and apply a single denomination, we suggest defining a low complex karyotype as having 3 CAs, an intermediate complex karyotype as having 4 CAs, and a highly complex karyotype as having 5 or more CAs.

The dynamic natural processes which occur in the world terrestrial system are highly nonlinear and exhibit unpredictable oscillations and behaviors. One way to imitate and follow the essential characteristics of these processes is a similar study of the nonlinear dynamics of two subsystems whose evolution is fast and slow, respectively. These dynamic systems are commonly used to describe various aspects of the dynamics of natural disasters in order to predict a solution. This article examines the dynamic properties and phenomena of a slow–fast 4D system consisting of the Duffing equation coupled to a proposed memristive system. The dynamics of the obtained system reveals the presence of multistability which is an unpredictable phenomenon whose different coexisting states must be quantified in order to adopt a means of control for better forecasting of disasters. Furthermore, the effect and strength of the coupling parameter on the interaction between the slow–fast dynamics of the subsystems is observed. Other dynamic properties such as offset boosting and bursting oscillations are also observed, further justifying the complexity of the system. An analog validation of the mathematical model is proposed through PSpice simulations of the corresponding electronic circuit, and the results sufficiently justify the feasibility.

Les pneumopathies d’hypersensibilité (PHS) font partie des pneumopathies interstitielles diffuses les plus courantes. Elles sont caractérisées par une réaction inflammatoire et/ou fibrosante pulmonaire vis-à-vis d’antigènes inhalés.

Nous rapportons le cas d’un patient de 68 ans présentant une encéphalite à anticorps anti-Ma2 responsable d’une narcolepsie secondaire. Le patient présentait une somnolence diurne excessive persistante malgré la ventilation nocturne en pression positive continue dans le cadre de son syndrome d’apnées obstructives du sommeil sévère. L’IRM cérébrale était évocatrice d’encéphalite à anticorps anti-Ma2, qui étaient effectivement retrouvés dans le sang et le LCS, avec des hypersignaux FLAIR autour du 3eventricule et de l’aqueduc du mésencéphale. Les tests itératifs de latence d’endormissement (TILE) étaient pathologiques, avec une latence moyenne d’endormissement de 6,2min (normale>8min) mais sans endormissement en sommeil paradoxal. En revanche, le taux d’hypocrétine effondré dans le liquide cérébro-spinal permettait de porter le diagnostic de narcolepsie de type 1.

Background: Micronutrient deficiencies affect over one quarter of the world’s population. Biofortification is an evidence-based nutrition strategy that addresses some of the most common and preventable global micronutrient gaps and can help improve the health of millions of people. Since 2013, HarvestPlus and a consortium of collaborators have made impressive progress in the enrichment of staple crops with essential micronutrients through conventional plant breeding.Objective: To review and highlight lessons learned from multiple large-scale delivery strategies used by HarvestPlus to scale up biofortification across different country and crop contexts.Results: India has strong public and private sector pearl millet breeding programs and a robust commercial seed sector. To scale-up pearl millet, HarvestPlus established partnerships with public and private seed companies, which facilitated the rapid commercialization of products and engagement of farmers in delivery activities. In Nigeria, HarvestPlus stimulated the initial acceptance and popularization of vitamin A cassava using a host of creative approaches, including “crowding in” delivery partners, innovative promotional programs, and development of intermediate raw material for industry and novel food products. In Uganda, orange sweet potato (OSP) is a traditional subsistence crop. Due to this, and the lack of formal seed systems and markets, HarvestPlus established a network of partnerships with community-based nongovernmental organizations and vine multipliers to popularize and scale-up delivery of OSP.Conclusions: Impact of biofortification ultimately depends on the development of sustainable markets for biofortified seeds and products. Results illustrate the need for context-specific, innovative solutions to promote widespread adoption.

Lenalidomide, an antineoplastic and immunomodulatory drug, has therapeutic activity in acute myeloid leukemia (AML), but definitive studies about its therapeutic utility have been lacking. In a phase 3 study, we compared 2 induction regimens in newly diagnosed patients age 18 to 65 years with AML: idarubicine-cytarabine (cycle 1) and daunorubicin and intermediate-dose cytarabine (cycle 2) without or with lenalidomide (15 mg orally on days 1-21). One final consolidation cycle of chemotherapy or autologous stem cell transplantation (auto-SCT) or allogeneic SCT (allo-SCT) was provided according to a prognostic risk and minimal residual disease (MRD)–adapted approach. Event-free survival (EFS; primary end point) and other clinical end points were assessed. A second random assignment in patients in complete response or in complete response with incomplete hematologic recovery after cycle 3 or auto-SCT involved 6 cycles of maintenance with lenalidomide (10 mg on days 1-21) or observation. In all, 392 patients were randomly assigned to the control group, and 388 patients were randomly assigned to lenalidomide induction. At a median follow-up of 41 months, the study revealed no differences in outcome between the treatments (EFS, 44% ± 2% standard error and overall survival, 54% ± 2% at 4 years for both arms) although in an exploratory post hoc analysis, a lenalidomide benefit was suggested in SRSF2-mutant AML. In relation to the previous Dutch-Belgian Hemato-Oncology Cooperative Group and Swiss Group for Clinical Cancer Research (HOVON-SAKK) studies that used a similar 3-cycle regimen but did not pursue an MRD-guided approach, these survival estimates compare markedly more favorably. MRD status after cycle 2 lost prognostic value in intermediate-risk AML in the risk-adjusted treatment context. Maintenance with lenalidomide showed no apparent effect on relapse probability in 88 patients randomly assigned for this part of the study.

T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive leukemia that is most frequent in children and is characterized by the presence of few chromosomal rearrangements and 10 to 20 somatic mutations in protein-coding regions at diagnosis. The majority of T-ALL cases harbor activating mutations in NOTCH1 together with mutations in genes implicated in kinase signaling, transcriptional regulation, or protein translation. To obtain more insight in the level of clonal heterogeneity at diagnosis and during treatment, we used single-cell targeted DNA sequencing with the Tapestri platform. We designed a custom ALL panel and obtained accurate single-nucleotide variant and small insertion-deletion mutation calling for 305 amplicons covering 110 genes in about 4400 cells per sample and time point. A total of 108 188 cells were analyzed for 25 samples of 8 T-ALL patients. We typically observed a major clone at diagnosis (>35% of the cells) accompanied by several minor clones of which some were less than 1% of the total number of cells. Four patients had >2 NOTCH1 mutations, some of which present in minor clones, indicating a strong pressure to acquire NOTCH1 mutations in developing T-ALL cells. By analyzing longitudinal samples, we detected the presence and clonal nature of residual leukemic cells and clones with a minor presence at diagnosis that evolved to clinically relevant major clones at later disease stages. Therefore, single-cell DNA amplicon sequencing is a sensitive assay to detect clonal architecture and evolution in T-ALL.

The gray wolf Canis lupusrange in central Europe is dynamically expanding, reconnecting previously isolated populations. Thus, a recent paper has proposed to merge the current Baltic and Central European (CE) wolf management units, which are no longer isolated by distance. However, recent genetic findings indicate that these two populations are not genetically homogenous. Here we review the most recent data on wolf genetic structure in central Europe and show that even though the CE and Baltic wolves represent the same phylogeographic lineage, their demographic history has resulted in significant genetic structure between these two populations. While the groups are interconnected by moderate gene flow, it is not high enough to reduce the strong founder signal observed in the CE population, suggesting that population dynamics within the CE wolf range are largely independent from those of its source (Baltic) population. Consequently, a management unit combining the CE and Baltic wolves would not form a demographically coherent entity. Thus, we recommend that conservation management units maintain their separate status.

This paper deals with the development of a portable electronic device that simultaneously measures toxic gases and suspended particles in real time. It is based on a microcontroller board and low-cost sensors including dust sensor, smoke sensor, liquefied petroleum gas sensor, carbon dioxide (CO2) sensor, carbon monoxide (CO) sensor, temperature, and humidity sensors. The proposed electronic device presents several advantages, namely low energy consumption, low-cost equipment, easily deployable in the field, real-time, and large number measurements of parameters (in situ). It can also send automatically alert information and transmit emergency calls to the supervisor if the concentration of measured pollutant (particulate matter PM2.5) is beyond the threshold WHO limit of 25 µg/m3. The proposed electronic device can also be used as an outdoor or indoor air quality monitoring system. Compared to WHO limits, all the values of the parameters measured are generally acceptable, except CO value which slightly exceeds the average threshold value allowed in workplaces. A comparative analysis of particulate matter concentrations obtained from the proposed prototype and a conventional method based on the GENT Stacked Filter Unit Sampler (reference method) is carried out by placing both devices on the same fixed sampling site and collecting data at the same time over a period of two months. A statistical analysis based on linear regression highlighted a good agreement between these two methods with R2= 0.8897. Furthermore, a reliability coefficient of 1.008 ± 0.01 confirms the effectiveness of the proposed device.

AbstractObjective:To assess the prevalence of influenza and respiratory syncytial virus (RSV) in adults hospitalized for a respiratory infection in the winter months and to evaluate the impact of a viral diagnosis on empirical antimicrobial management (antibiotics and antivirals).Design:Observational cohort study.Setting:Acute-care university hospital.Patients:The study included 963 adult patients hospitalized over a 4-year surveillance period.Methods:Annual surveillance timelines were defined according to epidemiological criteria related to the circulation of RSV and influenza viruses in the general population. Patients were screened following a severe acute respiratory infection (SARI) case definition at the emergency department and were enrolled for molecular assay targeting influenza/RSV viruses after oral informed consent. Epidemiological and clinical data were recorded prospectively, microbiological investigations, antimicrobial management, and outcome data were reviewed retrospectively.Results:An influenza or RSV virus was documented in 316 of 963 patients (33%). Optimization of antimicrobial management (AM) was achieved in 162 of 265 patients (61%) with a positive viral diagnosis and no bacterial infection at admission (AM treatment not initiated, n = 111; discontinued, n = 51). In contrast, only 128 of 462 patients (28%) with negative microbiological investigations did not have AM treatment initiated (n = 116) or had such treatment discontinued (n = 12). Early, targeted antiviral treatment was prescribed in 235 of 253 patients (93%) confirmed with influenza. Epidemiological, clinical, and outcome data were similar in both groups.Conclusion:Epidemiological surveillance associated with influenza/RSV molecular diagnosis in adults hospitalized for severe winter respiratory infections dramatically enhanced antimicrobial management.

More effective treatment modalities are urgently needed in patients with acute myeloid leukemia (AML) of older age. We hypothesized that adding lenalidomide to intensive standard chemotherapy might improve their outcome. After establishing a safe lenalidomide, dose elderly patients with AML were randomly assigned in this randomized Phase 2 study (n?=?222) to receive standard chemotherapy (“3?+?7”) with or without lenalidomide at a dose of 20?mg/day 1–21. In the second cycle, patients received cytarabine 1000?mg/m2twice daily on days 1–6 with or without lenalidomide (20?mg/day 1–21). The CR/CRi rates in the two arms were not different (69 vs. 66%). Event-free survival (EFS) at 36 months was 19% for the standard arm versus 21% for the lenalidomide arm and overall survival (OS) 35% vs. 30%, respectively. The frequencies and grade of adverse events were not significantly different between the treatment arms. Cardiovascular toxicities were rare and equally distributed between the arms. The results of the present study show that the addition of lenalidomide to standard remission induction chemotherapy does not improve the therapeutic outcome of older AML patients. This trial is registered as number NTR2294 in The NederlandsTrial Register (www.trialregister.nl).