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Hepatic diseases represent a public health problem. Among the approaches to their management is the use of traditional treatments based on the use of medicinal plants. In Benin, several recipes based on Cochlospermum tinctorium are used in the treatment of hepatitis without a real scientific basis. This study aimed to evaluate the hepatoprotective effects and acute oral toxicity of 10 of these recipes. The variables studied were the variety of C. tinctorium (wild form vs. cultivated form), the species associated with C. tinctorium (Combretum micranthum vs. Chromolaena odorata), and the proportion of C. tinctorium in the recipe (1; 4/5; 1/2). The hepatoprotective effect of these extracts at doses of 100, 200, and 400 mg/kg/bw was evaluated in Wistar rats subjected to hepatotoxicity induction through the administration of 5 g/kg of paracetamol. Acute oral toxicity was assessed following the OECD 423 protocol. The results revealed an absence of acute oral toxicity for the 10 recipes. The hepatoprotective tests conducted indicated that the hepatoprotective effect of C. tinctorium is dose dependent. The wild variety of C. tinctorium had a better hepatoprotective effect than the cultivated one. The association with C. micranthum enhances the hepatoprotective effect of C. tinctorium, unlike that with C. odorata. This study emphasizes that the combination of C. tinctorium with C. micranthum in the treatment of hepatitis is scientifically justified and it exhibits a dose‐dependent hepatoprotective effect. [ABSTRACT FROM AUTHOR]

Background and Objectives. The chest computed tomography (chest CT) has played an important role in the management of COVID-19. Few data on its use in sub-Saharan Africa (SSA) are reported. The objectives of this study conducted in Kinshasa, DR Congo, were to describe the lung lesions on day 1 of hospitalization in patients admitted for suspected COVID-19 and to identify those that were most associated with SARS-CoV-2 infection/RT-PCR and the determinants of chest CT associated with death. Methods. We included all patients with respiratory symptoms (dyspnea, fever, and cough) and/or respiratory failure admitted to the SOS Médecins de nuit SARL hospital, DR Congo, during the 2nd and 3rd waves of the COVID-19 pandemic. The diagnosis of COVID-19 was established based on RT-PCR anti-SARS-CoV-2 tests (G1 (RT-PCR positive) vs. G2 (RT-PCR negative)), and all patients had a chest CT on the day of admission. We retrieved the digital files of patients, precisely the clinical, biological, and chest CT parameters of the day of admission as well as the vital outcome (survival or death). Chest CT were read by a very high-definition console using Advantage Windows software and exported to the hospital network using the RadiAnt DICOM viewer. To determine the threshold for the percentage of lung lesions associated with all-cause mortality, we used ROC curves. Factors associated with death, including chest CT parameters, were investigated using logistic regression analysis. Results. The study included 200 patients (average age 56.2 ± 15.2 years; 19% diabetics and 4.5% obese), and COVID-19 was confirmed among 56% of them (G1). Chest CT showed that ground glass (72.3 vs. 39.8%), crazy paving (69.6 vs. 17.0%), and consolidation (83.9 vs. 22.7%), with bilateral and peripheral locations (68.8 vs. 30.7%), were more frequent in G1 vs. G2 (p < 0.001). No case of pulmonary embolism and fibrosis had been documented. The lung lesions affecting 30% of the parenchyma were informative in predicting death (area under the ROC curve at 0.705, p = 0.017). In multivariate analysis, a percentage of lesions affecting 50% of the lung parenchyma increased the risk of dying by 7.194 (1.656-31.250). Conclusion. The chest CT demonstrated certain characteristic lesions more frequently in patients in whom the diagnosis of COVID-19 was confirmed. The extent of lesions affecting at least half of the lung parenchyma from the first day of admission to hospital increases the risk of death by a factor of 7. [ABSTRACT FROM AUTHOR]

Summary: Obstructive sleep apnea‐hypopnea syndrome (OSAHS) is an underdiagnosed and lesser known disease in sub‐Saharan Africa. We believe that this is the first descriptive and analytical cross‐sectional study in Kinshasa (from February 1 to October 31, 2021), which included respondents aged ≥18 years. The study aimed to determine the prevalence of the risk and factors associated with OSAHS. Each participant signed a free and informed consent. Statistical analyses were performed using XLStat 2020 and the Statistical Package for the Social Sciences version 24 for Windows. Odds ratios (ORs) were calculated to determine the degree of association between these variables and a high risk of OSAHS. The significance threshold was p < 0.05 and confidence interval (CI) at 95%. There were 4,162 participants, including 2,287 men (54.9%), with an mean (SD) age of 32 ± 12.6 years. The prevalence of OSAS risk was 17.4% and 7.9% for men and women, respectively. The associated risk factors were male sex (OR 4, 95% CI 3.20–5.54), hypertension (OR 6.7, 95% CI 4.87–9.30), age ≥60 years (OR 8.7, 95% CI 4.07–18.88), obesity/overweight (OR 1.94, 95% CI 1.13–3.78), and excessive daytime sleepiness (OR 2.63, 95% CI 2.05–3.56). The risk of OSAS in Kinshasa is high and it increases with age, male sex, obesity, and hypertension. The Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and male Gender (STOP‐BANG) questionnaire is an easy‐to‐use tool for diagnostic orientation. [ABSTRACT FROM AUTHOR]

Objective. Mangifera indica Linn, Bridelia ferruginea Benth, and Alstonia boonei De Wild are three plants commonly used in the traditional treatment of urinary tract infections in Benin. This study sets out to assess the cytotoxic and teratogenic effects of extracts of these plants on Artemia salina larvae and hen embryos. Methods and Results. The aqueous and ethanolic extracts were obtained by maceration of the powders in solvents. Larval cytotoxicity was performed on Artemia salina larvae. The teratogenic effect of these plants was evaluated on chick embryos at 100 mg/kg and 300 mg/kg. The extracts were injected on the 7th and 14th days of incubation. The quality of the hatched chicks was evaluated by the Tona score followed by the hematological and the biochemical parameter assays. The extracts did not show cytotoxicity on the larvae. The eggs treated with plant extracts at 300 mg/kg significantly lowered the hatchability rate, except for the Mangifera indica Linn. The chicks obtained were all at the very good quality. Then, no significant variation was observed between hematological parameters except white blood cells. For the biochemical parameters, only ASAT showed some significant variations for a few extracts. It would be important to assess the genotoxicity of the plant extracts to determine more broader toxicity. These data justify the use of these medicinal plants in traditional Beninese medicine and constitute in fact a source of production of anti-infectious drugs. [ABSTRACT FROM AUTHOR]

Background: Acute pancreatitis (AP) can be one of the earliest clinical presentation of pancreatic ductal adenocarcinoma (PDAC). Information about the impact of AP on postoperative outcomes as well as its influences on PDAC survival is scarce. This study aimed to determine whether AP as initial clinical presentation of PDAC impact the short- and long-term outcomes of curative intent pancreatic resection. Patients and methods: From 2004 to 2009, 1449 patients with PDAC underwent pancreatic resection in 37 institutions (France, Belgium and Switzerland). We used univariate and multivariate analysis to identify factors associated with severe complications and pancreatic fistula as well as overall and disease-free survivals. Results: There were 764 males (52,7%), and the median age was 64 years. A total of 781 patients (53.9%) developed at least one complication, among whom 317 (21.8%) were classified as Clavien–Dindo ≥ 3. A total of 114 (8.5%) patients had AP as the initial clinical manifestation of PDAC. This situation was not associated with any increase in the rates of postoperative fistula (21.2% vs 16.4%, P = 0.19), postoperative complications (57% vs 54.2%, P = 0.56), and 30 day mortality (2.6% vs 3.4%, P = 1). In multivariate analysis, AP did not correlate with postoperative complications or pancreatic fistula. The median length of follow-up was 22.4 months. The median overall survival after surgery was 29.9 months in the AP group and 30.5 months in the control group. Overall recurrence rate and local recurrence rate did not differ between groups. Conclusion: AP before PDAC resection did not impact postoperative morbidity and mortality, as well as recurrence rate and survival. [ABSTRACT FROM AUTHOR]

In the MITICA (Mother‐to‐Infant TransmIssion of microbiota in Central‐Africa) study, 48 mothers and their 50 infants were followed from delivery to 6 months between December 2017 and June 2019 in Bangui (Central‐African Republic). Blood tests and stool analyses were performed in mothers at delivery, and their offspring at birth, 11 weeks and 25 weeks. Stool cultures were performed in specific growth media for Salmonella, Shigella, E. coli, Campylobacter, Enerobacter, Vibrio cholerae, Citrobacter and Klebsiella, as well as rotavirus, yeasts and parasitological exams. The median vitamin C levels in mothers at delivery were 15.3 μmol/L (inter‐quartile‐range [IQR] 6.2–27.8 μmol/L). In infants, the median vitamin C levels at birth were 35.2 μmol/L (IQR 16.5–63.9 μmol/L). At 11 and 25 weeks, the median vitamin C levels were 41.5 μmol/L (IQR 18.7–71.6 μmol/L) and 18.2 μmol/L (IQR 2.3–46.6 μmol/L), respectively. Hypovitaminosis C was defined as seric vitamin C levels <28 μmol/L and vitamin C deficiency was defined as vitamin C levels <11 μmol/L according to the WHO definition. In mothers, the prevalence of hypovitaminosis‐C and vitamin C deficiency at delivery was 34/45 (75.6%) and 19/45 (42.2%), respectively. In infants, the prevalence of hypovitaminosis‐C and vitamin C deficiency at 6 months was 18/33 (54.6%) and 11/33 (33.3%), respectively. Vitamin C levels in mothers and infants were correlated at birth (Spearman's rho = 0.5; P value = 0.002), and infants had significantly higher levels of vitamin C (median = 35.2 μmol/L; IQR 16.5–63.9 μmol/L), compared to mothers (median = 15.3 μmol/L; IQR 6.2–27.8 μmol/L; P value <0.001). The offspring of vitamin C‐deficient mothers had significantly lower vitamin C levels at delivery (median = 18.7 μmol/L; IQR 13.3–30.7 μmol/L), compared to the offspring of non‐deficient mothers (median = 62.2 μmol/L; IQR 34.6–89.2 μmol/L; P value <0.001). Infants with hypovitaminosis‐C were at significantly higher risk of having a positive stool culture during the first 6 months of life (adjusted OR = 5.3, 95% CI 1.1; 26.1; P value = 0.038). [ABSTRACT FROM AUTHOR]

Previous work stated that Khaya senegalensis, Anacardium ouest L., Pterocarpus erinaceus, Diospyros mespiliformis, Ocimum gratissimum, Manihot esculenta, Vernonia amygdalina Delile, and Daniellia oliveri have a great potential for the fight against infectious diarrhea. However, data on their antibacterial activity on strains of bacteria responsible for infectious diarrhea are not available. This study is aimed at elucidating the mechanism of action of the antibacterial effect of these plants on some bacterial strains responsible for diarrheal infections. The design of the study included first evaluating the degree of sensitivity of Salmonella typhimurium 14028, Escherichia coli ATCC 25922, Shigella spp., and Salmonella spp. strains to aqueous and hydroethanolic extracts of each plant, followed by the determination of minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and antibiotic power (Pa). This screening was completed with the evaluation of the possible mode of action of the extracts by testing the membrane permeability of these bacterial strains. The data collected indicate that the bacterial strains tested were sensitive to the extracts to varying degrees, except Cassia sieberiana DC and Pseudocedrela kotschyi extracts. For the active extracts, inhibition diameters ranged from 18.33 mm to 7 mm. With the exception of Escherichia coli, all strains were sensitive to the aqueous and hydroethanolic extracts of Anacardium occidentale. MICs vary between 3.37 and 25 mg/ml. Membrane permeability test data show that all active extracts affect the bacterial strains tested by attacking the stability of their outer membrane. For all active extracts, the high percentage of membrane destabilization of the bacteria is significantly (p < 0.05) better than that of cefixime used as a reference. Thus, it appears that these extracts can destroy Gram-negative bacteria and increase the fluidity and permeability of their cytoplasmic membrane. The knowledge of the mechanism of action of these extracts is an interesting contribution to the fundamental knowledge on the alternative that medicinal plants represent to antibiotics. These extracts can be used in the management of infectious diarrhea. [ABSTRACT FROM AUTHOR]

Ethanol consumption is a risk factor of male infertility. The use of medicinal plants offers an alternative for the treatment of male infertility in developing countries. This study aimed to evaluate the Rourea coccinea effect on ethanol‐induced male infertility in Wistar rats. Twenty‐five (25) male Wistar rats were randomised into five groups of five rats and treated by oesophageal gavage over a 28‐day period. Group 1 (negative control) received distilled water; Group 2 (positive control) received 30% ethanol at 7 mg/kg body weight; Group 3 (reference control) received 30% ethanol co‐treated with the reference drug, clomiphene citrate; Groups 4 and 5 (test groups) received 30% ethanol co‐treated with Rourea coccinea hydro‐ethanolic extract at 200 and 400 mg/kg respectively. Testosterone hormone, sperm parameters and testicular histopathology were evaluated. Ethanol treatment induced a significant reduction (p <.05) in sperm count, motility, viability and a significant increase in sperm abnormalities because of the significant decrease (p <.05) in testosterone levels. These data correlate with the alterations observed in the seminiferous tubule on histopathological examination of the testes. However, co‐treatment of ethanol with Rourea coccinea extract or the reference drug restored the ethanol‐induced toxic effects on the reproductive organs, sperm profile and testosterone level. [ABSTRACT FROM AUTHOR]

Objectives: To describe the psychosocial functioning and assess the quality of life of children, adolescents and young adults with T1DM; and to identify the risk factors associated with the psychosocial experience and quality of life of these patients. Material and methods: A cross‐sectional, descriptive study of children, adolescents and young adults with type 1 diabetes. Symptoms of anxiety and depression, and the quality of life were assessed using the Beck's Anxiety and Depression Scales and the pedsQL diabetes module score respectively. Results: A total of 74 patients were recruited. The mean age was 18 ± 4.1 years. Minimal symptoms of anxiety were noted in 51 (69%) patients, 23 (31%) had non‐minimal symptoms of anxiety (mild:14, moderate: 5, severe: 4). Symptoms of depression were absent in 43 (58.1%) patients and present in 31 (41.9%) patients (mild: 19, moderate: 12). The patients total score of quality of life was 65.4. Higher socioeconomic status (p = 0.03) was a protective factor against Symptoms of anxiety, while the age above 14 years (p = 0.01) was a risk factor for symptoms of depression. The quality of life was lower in patients from low socio‐economic status (p = 0.01), those with poor glycemic control (p = 0.03), and when symptoms of depression were present (p = 0.02). Conclusions: Patients with type 1 diabetes in Congo experienced a significant elevated symptoms of anxiety and depression, and a fairly good quality of life. These findings support recommendations for integrating psychosocial aspects in the management of these patients. [ABSTRACT FROM AUTHOR]

Although the lungs remain the main target of SARS-CoV-2, other organs, such as kidneys, can be affected, which has a negative impact on the outcomes of COVID-19 patients. Although previous studies of kidney disease in COVID-19 reported mainly SARS-CoV-2-induced tubular and interstitial injury, there is growing evidence coming out of Africa of glomerular involvement, especially collapsing glomerulopathy seen particularly in people of African descent. We report a case of collapsing glomerulopathy revealed by acute kidney injury and a new onset of full blown nephrotic syndrome in a black Congolese patient coinfected with COVID-19 and malaria. [ABSTRACT FROM AUTHOR]

MOX fuels (UO2‐PuO2) are used in light water nuclear reactors of several countries and are also potential candidates for the fast neutron reactors. Industrial MOX is currently manufactured by a dry route process, involving steps with fine powders. To reduce dusting, enhance MOX powder flow properties, and decrease manufacturing scrap rate, a new wet route process is investigated: the freeze granulation of concentrated water‐based powder suspensions having optimized rheology and dispersion properties. Highly flowable, dustless, and easy‐to‐press MOX granules have been elaborated. Sintering green compacts made of such granules gives highly dense and defect‐free pellets that have a very homogeneous U‐Pu spatial distribution, thus improving the fuel characteristics. Indeed, MOX fuels devoid of large Pu‐rich aggregates are thought to have a better behavior under irradiation in reactors by limiting/preventing the formation of the typical high burnup structure. [ABSTRACT FROM AUTHOR]

Decision‐makers often face incentives to increase risk‐taking on behalf of others (e.g., they are offered bonus contracts and contracts based on relative performance). We conduct an experimental study of risk‐taking on behalf of others using a large heterogeneous sample, and we find that people respond to such incentives without much apparent concern for stakeholders. Responses are heterogeneous and mitigated by personality traits. The findings suggest that a lack of concern for others' risk exposure hardly requires "financial psychopaths" in order to flourish, but it is diminished by social concerns. [ABSTRACT FROM AUTHOR]

We analyzed the single‐grain mineralogical composition of aeolian dust transported to central East Antarctica for provenance purposes. Comparison with data from the last glacial period shows for the first time disappearance of carbonates during the Holocene related to sea level rise and suppressed deflation from the Argentinean continental shelf, exposed during Marine Isotope Stage 2. Zeolites, related to alteration of volcanic glass in the subglacial/periglacial environment of Patagonia, show a similar behavior. The remaining minerals, remarkably similar between the two climatic periods, are compatible with a Pampean and Patagonian provenance, but Holocene data show a more pronounced volcanic and metamorphic imprint and presence of minerals related to warm climate weathering environments compatible with an additional contribution from subtropical latitudes of South America. These results do not imply a major large‐scale reorganization of atmospheric circulation after the last climatic transition. Plain Language Summary: Aeolian mineral dust particles transported through the atmosphere from the austral continents to the Antarctic ice sheet represent a tracer of atmospheric circulation and transport, as well as being a source of information about environmental conditions within dust source regions. Many lines of evidence suggest that central East Antarctic dust is sourced from South America during the last glacial period, whereas there is not a general consensus about dust provenance during the Holocene. A major limitation to this problem is represented by the extremely low dust concentration in Antarctic ice during interglacials. In this study, we analyzed the single‐grain mineralogy of more than 2,300 mineral dust particles transported by winds to Dome C during four different time windows within the Holocene, the current interglacial. Comparing results with those obtained from dust deposited during the last glacial period, we observe that some minerals that are typically associated to glacial climate conditions in Patagonia almost disappear during Holocene, while the remaining minerals are compatible with a South American provenance in both climate periods. Data thus suggest that the dominant atmospheric circulation patterns did not experience a significant change with climate. However, data suggest an additional contribution from subtropical South American latitudes during Holocene. Key Points: The mineralogy of more than 2,300 aeolian dust particles windblown to central East Antarctica (Dome C) during the Holocene was identifiedDisappearance of carbonate dust during the Holocene relates to sea level rise and suppressed deflation from the Argentinean shelfAeolian dust suggests Pampean and Patagonian provenance in the Holocene and a lower latitude contribution, without major circulation changes [ABSTRACT FROM AUTHOR]

More than 2,000 analyses of beryllium‐10 (10Be) and sulfate concentrations were performed at a nominal subannual resolution on an ice core covering the last millennium as well as on records from three sites in Antarctica (Dome C, South Pole, and Vostok) to better understand the increase in 10Be deposition during stratospheric volcanic eruptions. A significant increase in 10Be concentration is observed in 14 of the 26 volcanic events studied. The slope and intercept of the linear regression between 10Be and sulfate concentrations provide different and complementary information. Slope is an indicator of the efficiency of the draining of 10Be atoms by volcanic aerosols depending on the amount of SO2 released and the altitude it reaches in the stratosphere. Intercept gives an image of the 10Be production in the stratospheric reservoir, ultimately depending on solar modulation. The Samalas event (1257 CE) stands out from the others as the biggest eruption of the last millennium with the lowest positive slope of all the events. We hypothetize that the persistence of volcanic aerosols in the stratosphere after the Samalas eruption has drained the stratospheric 10Be reservoir for a decade, meaning that solar reconstructions based on 10Be should be considered with caution during this period. The slope of the linear regression between 10Be and sulfate concentrations can also be used to correct the 10Be snow/ice signal of the volcanic disturbance. Key Points: Beryllium‐10 deposition on polar ice sheets is influenced by stratospheric volcanic eruptionsThe biggest volcanic eruption of the last millennium, the Samalas (1257 CE), probably drained out the polar stratospheric 10Be reservoir over a decadeSolar reconstructions based on 10Be ice core records must take into account volcanic disturbance [ABSTRACT FROM AUTHOR]

Mg–Al‐rich orthopyroxene–sillimanite‐bearing granulites from In Hihaou, In Ouzzal terrane, NW Hoggar were previously determined to have experienced ultrahigh‐temperature metamorphism at 1,050°C and 10 kbar. Multilayer corona and symplectite reaction textures that pervasively replace peak metamorphic porphyroblasts were interpreted to have formed during near‐isothermal decompression. Pseudosection calculations using new and realistic activity–composition models give estimates of 900 ± 20°C and 8 ± 0.5 kbar for the reaction texture assemblage. Calculated chemical potential relations show that reaction textures formed due to very minor decompression from peak conditions, when the removal of intracrystalline melt led to the development of local equilibrium domains around garnet and sillimanite porphyroblasts. The growth of initial monomineralic coronas further isolated the porphyroblasts from the matrix, leading to the later development of the symplectites. These results indicate that the derivation and interpretation of UHT conditions using the occurrence of diagnostic assemblages on classic petrogenetic grids can overestimate temperature and/or pressure conditions. Similarly, the interpretation of reaction textures to derive retrograde conditions and P–T paths without considering their spatial development is unlikely to be reliable, as textures do not typically form in this way or routinely record this information. [ABSTRACT FROM AUTHOR]

North American Midwestern oak (Quercus spp.) savannas are rare fire‐dependent ecosystems that can support high levels of biodiversity and are the focus of considerable restoration effort due to widespread fire suppression. Due to the predominance of understory forbs in oak savannas, many of which require insect pollination, restoration practices should be evaluated for their potential impacts on pollinator communities. We evaluated bee community responses during the first 2 years of experimental restoration of fire‐suppressed oak savanna in southern Michigan. We used unmanaged references and two different restoration methods (burning only and burning with thinning) to examine the effects of restoration intensity on the abundance, diversity, and functional groups of bees. We found that thinning and burning rapidly increased bee abundance, richness, and Shannon's diversity, relative to unmanaged references, whereas burn‐only restoration largely failed to do so. Thinning and burning also resulted in a distinct bee community after two seasons, while bee communities in burn‐only restoration plots were similar to those from unmanaged references. Differences in bee diversity and community structure between treatments may be due to the influence of restoration on nesting resources, which is reflected in the differential captures of various nesting guilds. Overall, oak savanna restoration by thinning and burning had positive effects on bee diversity, while burning alone only increased bee abundance. We thus illustrate how restoration strategies that typically target plants have broader‐reaching biodiversity benefits. Although restoring savannas through burning alone may eventually shift bee communities, coupling thinning with burning will influence pollinator communities over the shorter term. [ABSTRACT FROM AUTHOR]

Ice core records from Antarctica show mostly synchronous temperature variations during the last deglacial transition, an indication that the climate of the entire continent reacted as one unit to the global changes. However, a record from the Taylor Dome ice core in the Ross Sea sector of East Antarctica has been suggested to show a rapid warming, similar in style and synchronous with the Oldest Dryas—Bølling warming in Greenland. Since publication of the Taylor Dome record, a number of lines of evidence have suggested that this interpretation is incorrect and reflects errors in the underlying time scale. The issues raised regarding the dating of Taylor Dome currently linger unresolved, and the original time scale remains the de facto chronology. We present new water isotope and chemistry data from nearby Taylor Glacier to resolve the confusion surrounding the Taylor Dome time scale. We find that the Taylor Glacier record is incompatible with the original interpretation of the Taylor Dome ice core, showing that the warming in the area was gradual and started at ∼18 ka BP (before 1950) as seen in other East Antarctic ice cores. We build a consistent, up‐to‐date Taylor Dome chronology from 0 to 60 ka BP by combining new and old age markers based on synchronization to other ice core records. The most notable feature of the new TD2015 time scale is a gas age—ice age difference of up to 12,000 years during the Last Glacial Maximum, by far the largest ever observed. Key Points: We present a new stable isotope and dust record from Taylor Glacier, Ross Sea area, AntarcticaThe Taylor Glacier record is incompatible with North‐South synchronous deglacial warmingTD2015: A revised Taylor Dome time scale for both ice and gas phases is introduced [ABSTRACT FROM AUTHOR]

Background: The occurrence of post‐operative pancreatic fistula (POPF) after pancreaticoduodenectomy is a challenging issue. The aim was to identify variables on preoperative computed tomography (CT) scan, useful to predict clinically significant POPF (grades B–C) after pancreaticoduodenectomy. Methods: Patients presented POPF after pancreaticoduodenectomy were included from two tertiary referral centres. B/W ratio was defined by ratio of pancreas body thickness (B) to main pancreatic duct (W). The predictive parameters of POPF on CT scan were assessed with a receiving operator characteristics (ROC) curve and intrinsic characteristics. Results: Between 2010 and 2013, 186 patients who underwent pancreaticoduodenectomy were included. POPF occurred in 25% of them, and was clinically significant in 13%. After univariate analysis, endocrine tumours (P = 0.03), main pancreatic duct size (P < 0.01) and B/W ratio (P = 0.04) were significantly associated with POPF. ROC curve showed a greater area under curve for B/W ratio (0.68) than for main pancreatic duct size (0.33). A 3.8 threshold displayed 80 and 51% for sensibility and specificity, respectively, and a negative predictive value of 94%. A B/W ratio >3.8 increased the rates of post‐operative haemorrhage (odds ratio = 4.3 (1.4–13.2), P = 0.01), and reintervention (odds ratio = 3.4 (1.2–9.6), P = 0.02). Conclusions: B/W ratio superior to 3.8 assessed on preoperative CT scan may be an easy tool to predict clinically significant POPF after pancreaticoduodenectomy. [ABSTRACT FROM AUTHOR]

Aim: Glomerular hyperfiltration is an early marker of sickle cell nephropathy and can lead to microalbuminuria and renal failure. Our aim was to identify the associated risk factors, as these could be of preventative importance.Methods: We recruited 150 children with sickle cell anaemia (SCA), aged two to 18 years and living in Kinshasa, the Democratic Republic of Congo. Hyperfiltration and microalbuminuria were defined as an estimated glomerular filtration rate of less than 140 mL/min/1.73 m² and an albumin creatinine ratio of between 30 and 299 mg/g, respectively. Independent determinants of hyperfiltration were assessed using logistic regression analysis.Results: Glomerular hyperfiltration was observed in 60 (40%) children, who were significantly older (10.2 ± 4.1 versus 7.9 ± 4.3 years, p = 0.001) and had a lower body mass index level (14.7 ± 2.3 versus 15.0 ± 2.3 kg/m2 ) than the 60% without. A higher proportion had microalbuminuria (25.0 versus 13.3%), but the difference was not statistically significant (p>0.05). Increased age and decreased body mass index were the main independent factors associated with glomerular hyperfiltration in the multivariate analysis. A quarter (25%) of the 60 children with SCA with glomerular hyperfiltration had microalbuminuria.Conclusion: Glomerular hyperfiltration was a common finding in this study and was significantly associated with age. [ABSTRACT FROM AUTHOR]

c- MYC controls more than 15% of genes responsible for proliferation, differentiation, and cellular metabolism in pancreatic as well as other cancers making this transcription factor a prime target for treating patients. The transcriptome of 55 patient-derived xenografts show that 30% of them share an exacerbated expression profile of MYC transcriptional targets ( MYC-high). This cohort is characterized by a high level of Ki67 staining, a lower differentiation state, and a shorter survival time compared to the MYC-low subgroup. To define classifier expression signature, we selected a group of 10 MYC target transcripts which expression is increased in the MYC-high group and six transcripts increased in the MYC-low group. We validated the ability of these markers panel to identify MYC-high patient-derived xenografts from both: discovery and validation cohorts as well as primary cell cultures from the same patients. We then showed that cells from MYC-high patients are more sensitive to JQ1 treatment compared to MYC-low cells, in monolayer, 3D cultured spheroids and in vivo xenografted tumors, due to cell cycle arrest followed by apoptosis. Therefore, these results provide new markers and potentially novel therapeutic modalities for distinct subgroups of pancreatic tumors and may find application to the future management of these patients within the setting of individualized medicine clinics. [ABSTRACT FROM AUTHOR]

We experimentally examine the effects of price competition in markets for experience goods where sellers can build up reputations for quality. We compare price competition to monopolistic markets and markets where prices are exogenously fixed. Although oligopolies benefit consumers regardless of whether prices are fixed or endogenously chosen, we find that price competition lowers efficiency as consumers pay too little attention to reputation for quality. This provides empirical support to recent models in behavioral industrial organization that assume that consumers may, with increasing complexity of the marketplace, focus on selected dimensions of products. [ABSTRACT FROM AUTHOR]

Introduction. The number of Salmonella isolated from clinical samples that are resistant to multiple antibiotics has increased worldwide. The aim of this study was to determine the prevalence of resistant Salmonella enterica isolated in Bangui. Methods. All enteric Salmonella strains isolated from patients in 2008 were identified and serotyped, and the phenotypes of resistance were determined by using the disk diffusion method. Nine resistance-associated genes, blaTEM, blaOXA, blaSHV, tetA, aadA1, catA1, dhfrA1, sul I, and sul II, were sought by genic amplification in seven S.e. Typhimurium strains. Results. The 94 strains isolated consisted of 47 S.e. Typhimurium (50%), 21 S.e. Stanleyville (22%), 18 S.e. Enteritidis (19%), 4 S.e. Dublin (4%), 4 S.e. Hadar (4%), and 1 S.e. Papuana (1%). Twenty-five (28%) were multiresistant, including 20 of the Typhimurium serovar (80%). Two main phenotypes of resistance were found: four antibiotics (56%) and to five antibiotics (40%). One S.e. Typhimurium isolate produced an extended-spectrum β-lactamase (ESBL). Only seven strains of S.e. Typhimurium could be amplified genically. Only phenotypic resistance to tetracycline and aminosides was found. Conclusion. S. Typhimurium is the predominant serovar of enteric S. enterica and is the most widely resistant. The search for resistance genes showed heterogeneity of the circulating strains. [ABSTRACT FROM AUTHOR]

Background According to knowledge, patients with resectable pancreatic adenocarcinoma ( PA) should receive adjuvant gemcitabine-based chemotherapy. Thus, the tumour node metastasis ( TNM) classification is not used to determine post-operative treatment but rather only to establish patient prognosis. However, the TNM classification does not include strong factors influencing survival, such as perineural invasion or margin status. This study compared the survival of patients with very similar tumours. Methods From 1997 to 2007, 118 patients underwent pancreatectomy for PA. Twenty-six patients (22%) had long-term survival (>5 years; LTS group). According to the major prognostic factors of PA, we matched (1:1) patients in the LTS group with patients who did not have long-term survival (<5 years; control group). Results Surprisingly, we did not have any difficulty identifying patients to include in the control group. Consequently, no differences were noted between patients of the LTS group when compared with patients of the control group according to major prognostic factors and the TNM classification. Three patients (12%) in the LTS group had positive margin status, and two patients (8%) had positive lymph node status. Unsurprisingly, the median survival for the control group versus the LTS group was 16 months versus not reached ( P < 0.01). Conclusion The lack of difficulty in matching the two groups confirmed that patients of the LTS group did not have an exclusive tumour pattern. TNM classification is outdated because it did not influence adjuvant therapies and did not include two crucial factors: tumour biology and tumour response to chemo/radio therapies. [ABSTRACT FROM AUTHOR]

We investigate experimentally the effects of corrupt experts on information aggregation in committees. We find that nonexperts are significantly less likely to delegate through abstention when there is a probability that experts are corrupt. Such decreased abstention, when the probability of corrupt experts is low, actually increases information efficiency in committee decision-making. However, if the probability of corrupt experts is large, the effect is not sufficient to offset the mechanical effect of decreased information efficiency due to corrupt experts. Our results demonstrate that the norm of 'letting the expert decide' in committee voting is influenced by the probability of corrupt experts, and that influence can have, to a limited extent, a positive effect on information efficiency. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the incidence and predisposing factors of biliary complications (BCs) after pancreaticoduodenectomy (PD) and report our experience in managing these BCs. Pancreatic surgery, particularly PD, has benefited from improvements in operative techniques and postoperative care and is currently safer in terms of mortality. However, the morbidity associated with PD remains high, including frequent complications such as delayed gastric emptying and pancreatic fistulas. Rarer but important BCs are those that manifest as bile leaks (BLs) and biliary strictures (BSs). Methods: Between April 2005 and December 2011, a total of 397 patients underwent PD at two centers. All data were retrospectively studied with respect to age, gender, pancreatic pathology, neoadjuvant treatment, preoperative biliary stenting, intraoperative data, postoperative pancreatic fistula, BL and BS rates, and mortality. The management of BCs was also analyzed. Results: Thirty patients experienced a BC: 13 BLs (3.3 %) and 17 BSs (4.3 %). A thin bile duct (<5 mm), measured during surgery, was the only predisposing factor for developing a BL or a BS. The management of the BLs consisted of surveillance in six patients (46 %), percutaneous drainage of bilioma in four patients (31 %), and reintervention in three patients (23 %). No patient with a BS had surgery as the frontline treatment: the initial management consisted of an endoscopic procedure, a percutaneous procedure, or medical treatment. Four patients (23.5 %) underwent surgical treatment after failure of nonsurgical procedures. Conclusions: The only identified predictive factor of BC, either a BS or a BL, was a thin bile duct. Although the noninvasive technique was the treatment of choice initially, reintervention was required in almost 25 % of the cases. [ABSTRACT FROM AUTHOR]

Objective To assess the mortality profile of systemic lupus erythematosus (SLE) patients in France using multiple-cause-of-death analysis. Methods Data were collected between 2000 and 2009 in the French Epidemiological Center for the Medical Causes of Death database, and death certificates issued upon the death of an adult for whom SLE was an underlying cause of death (UCD) or a non-underlying cause of death (NUCD) were evaluated using multiple-cause-of-death analysis. Sex, age, sex ratio, standardized mortality rates, as well as frequency of the various causes of death were assessed, at both a national and a regional level. For the main causes of death, the observed number of deaths in relation to the expected number of deaths (O:E ratio) (standardized for age and sex) was calculated. Results During the study period, 1,593 deaths related to SLE were identified. The mean ± SD age at death was 63.5 ± 18.4 years and the sex ratio (female:male) was 3.5. The mean standardized mortality rate was 3.2 per 1 million people (range 2.7-4.1). When SLE was the UCD (n = 637), the main NUCDs were cardiovascular diseases (49.5%), infectious diseases (24.5%), and renal failure (23.2%). When SLE was an NUCD (n = 956), the most common UCDs were cardiovascular diseases (35.7%), neoplasms (13.9%), and infectious diseases (10.3%). The overall O:E ratio was >1 for infectious and cardiovascular diseases and renal failure (especially among people <40 years of age for the latter 2 causes), but was <1 for neoplasms. Conclusion Cardiovascular disease is the leading cause of death associated with SLE in France. [ABSTRACT FROM AUTHOR]

Objective The role of interferon-α (IFNα) in the pathogenesis of systemic lupus erythematosus (SLE) is strongly supported by gene expression studies. The aim of this study was to improve characterization of the blood IFN signature in adult SLE patients. Methods Consecutive patients were enrolled and followed up prospectively. Microarray data were generated using Illumina BeadChips. A modular transcriptional repertoire was used as a framework for the analysis. Results Our repertoire of 260 modules, which consisted of coclustered gene sets, included 3 IFN-annotated modules (M1.2, M3.4, and M5.12) that were strongly up-regulated in SLE patients. A modular IFN signature was observed in 54 of 62 patients (87%) or 131 of all 157 samples (83%). The IFN signature was more complex than expected, with each module displaying a distinct activation threshold (M1.2 < M3.4 < M5.12), thus providing a modular score by which to stratify SLE patients based on the presence of 0, 1, 2, or 3 active IFN modules. A similar gradient in modular IFN signature was observed within patients with clinically quiescent disease, for whom moderate/strong modular scores (2 or 3 active IFN modules) were associated with higher anti-double-stranded DNA titers and lower lymphocyte counts than those in patients with absent/mild modular scores (0 or 1 active IFN modules). Longitudinal analyses revealed both stable (M1.2) and variable (M3.4 and M5.12) components of modular IFN signature over time in single patients. Interestingly, mining of other data sets suggested that M3.4 and M5.12 could also be driven by IFNβ and IFNγ. Conclusion Modular repertoire analysis reveals complex IFN signatures in SLE, which are not restricted to the previous IFNα signature, but which also involve IFNβ and IFNγ. [ABSTRACT FROM AUTHOR]

Objective To evaluate the usefulness of 2-[18F]-fluoro-2-deoxy- d-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in IgG4-related disease (IgG4-RD) for the staging of the disease and the followup under treatment. Methods All patients included in the French IgG4-RD registry who underwent ≥1 FDG-PET/CT scan were included in the study. Clinical, biologic, pathologic, radiologic, and FDG-PET/CT qualitative and quantitative findings were retrospectively collected and analyzed. Results Twenty-one patients were included in the study and 46 FDG-PET/CT examinations were evaluated. At either diagnosis or relapse, all evaluated patients presented abnormal 18F-FDG uptake in typical IgG4-RD localizations. In most cases, FDG-PET/CT was more sensitive than conventional imaging to detect organ involvement, especially in arteries, salivary glands, and lymph nodes. In few cases (small-sized lesions and brain or kidney contiguous lesions), false-negative results were noted. Evaluation before and after treatment showed in most cases a good correlation of FDG-PET/CT results with treatment response and disease activity. Conclusion This large retrospective study shows that FDG-PET/CT imaging is useful for the staging of IgG4-RD. Moreover, FDG-PET/CT is useful to assess the response to treatment during followup. [ABSTRACT FROM AUTHOR]

To determine the prevalence and associated factors of prehypertension (pre-HT) and hypertension (HT) in schoolchildren at Brazzaville (Congo). Methods. This cross-sectional study was conducted from March to May 2011 in five representative urban schools in Brazzaville. American Pediatric Society's definition of pre-HT and HT was used. The measurement of blood pressure was obtained using auscultator method. Univariable and multivariable analyses were performed to establish associations between blood pressure levels and sociobiographical factors. Results. 603 children were included. The mean age was 11.8 ± 3.6 years (range 5-18 years). The prevalence of pre-HT was 20.7% (n = 125). Factors associated with pre-HT were secondary school (P = 0.02), private schools (P < 0.004), migrants (P = 0.03), the obese (P = 0.004), high socioeconomic level (P < 0.01), and overweight (_P = 0.02). In logistic regression, the independent determinants of pre-HT were secondary school (_P = 0.0001), migration (_P = 0.04), obesity (_P = 0.004), and overweight (_P = 0.01). The prevalence of HT was 10.1% (« = 61) during the first screening and 3.3% (« = 20) in second screening. The independent determinants of HT were obesity (_P = 0.0001) and overweight (_P = 0.0001). Conclusion. Pre-HT and HT are emerging as a mass problem in Congolese schoolchildren with urban migration and overweight/obesity to be controlled and prevented. [ABSTRACT FROM AUTHOR]

BACKGROUND This study compared the physical-chemical characteristics and the nutrient potential of brewery wastewater ( BWW) and apple juice industry sludge referred to as pomace ( POM). The use of these wastes as alternative nutrients by replacing the standard components (soya flour, wheat germ and yeast extract) allowed production of a balanced diet for rearing codling moth ( CM) larvae. RESULTS The hydrolysis pretreatment (100 °C/30 min) contributed to enhancing the nutritive potential (almost 600%) and improved the viscosity (decreased from 770.5 to 435 mPa s for BWW and from 460 to 383 mPa s for POM) of the waste. The BWWH+ SF diet supplied higher assimilated nutrients (2.071 mg proteins, 2.274 mg carbohydrates and 0.974 mg lipids) showing higher breeding efficiency (93% hatching, 85% larvae, 76% cocoon and 70% adults). Furthermore, the results of the larvae breeding on BWWH+ SF diet was the best which for the enzymatic activity (59.7 UI mL-1 protease, 2.9 mg L−1 amylase and 1.93 U mg−1 lipase), consumption rates of proteins (451.79 mg kg−1), carbohydrates (396.43 mg kg−1) and lipids (91.07 mg kg−1) consumed on these diets. CONCLUSIONS BWWH+ SF was the best diet with respect to enzymatic activity, consumption of nutrients and larval breeding efficiency compared with POMH+ SF and the standard diet. © 2013 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Total organic carbon ( TOC) determination, Rock- Eval pyrolysis, extractable organic matter content ( EOM) fractionation, gas chromatography ( GC) and gas chromatography-mass spectrometry ( GC-MS) analyses, were carried out on 79 samples from eleven outcrop cross sections of the Bahloul Formation in central and northern Tunisia. The TOC content varied between 0.23 to 35.6%, the highest average values (18.73%, 8.46% and 4.02%) being at the east of the study area (at Ain Zakkar, Oued Bahloul and Dyr Ouled Yahia localities, respectively). The Rock- Eval maximum pyrolysis temperature ( Tmax) values in the 424-453° C range delineated a general east-west trend increase in the organic matter ( OM) maturity. The disparity in hydrogen index ( HI) values, in the range 114-824 mg hydrocarbons ( HC) g−1 TOC, is relevant for the discrepancy in the level of OM preservation and maturity among localities and samples. The n-alkane distributions, maximizing in the C17 to C20 range, are typical for a marine planktonic origin, whereas pristine/phytane ( Pr/ Ph) average values in the 1-2 range indicate an oxic to suboxic depositional environment. Pr/n- C17 and Ph/n- C18 ratios in the 0.38-6.2 and 0.68-3.25 range, respectively, are consistent with other maturity indicators and the contribution of specific bacteria to phytol as a precursor of isoprenoids. The thermal maturity varies between late diagenesis to main-stage of petroleum generation based on the optic and the cis-trans isomerisation of the C29 sterane [20 S/(20 S+20 R) and 14β( H),17β( H)/(14β( H),17β( H)+14α( H),17α( H)), respectively] and the terpane [18α( H)22,29,30-Trisnorneohopane/(18α( H)22,29,30-Trisnorneohopane+17α( H)22,29,30- Trisnorhopane): Ts/( Ts+ Tm)] ratios. The Bahloul OM is represented by an open marine to estuarine algal facies with a specific bacterial contribution as revealed by the relative abundance of the ααα-20 R C27 (33-44%), C28 (22-28%) and C29 (34-41%) steranes and by the total terpanes/total steranes ratio (1.2-5.33). These results attested that the Bahloul OM richness was controlled both by an oxygen minimum zone induced by high productivity and restricted circulation in narrow half graben structures and around diapirs of the Triassic salt. [ABSTRACT FROM AUTHOR]

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Immunoglobulin free light chains are produced in excess during normal antibody synthesis. Their evaluation is commonly used in case of a monoclonal gammopathy. In polyclonal hypergammaglobulinemia related to the Sjögren syndrome or systemic lupus, erythematosus serum free light chain levels are increased and could correlate with disease activity. We show here that the κ (P < 0.0001) and ? (P = 0.0003) free light chains and the κ : λ ratio (P = 0.0049) are increased in sixteen patients with IgG4-related disease when compared to healthy controls. The increase of κ and λ free light chains probably reflects the marked polyclonal B cell activation of the disease. We could not assess in this small cohort of patients a significative correlation of serum free light chain levels and disease activity or extension. [ABSTRACT FROM AUTHOR]

Freshwater prawns, particularly, the Giant Freshwater prawn Macrobrachium rosenbergii, are one of the most economically important farmed species in the world. Faced with increasing disease problems in penaeid shrimp culture, farmers turned to freshwater prawn farming. Freshwater prawns were considered relatively less susceptible to diseases. However, with intensification of culture and increased world trade of the farmed species, emerging diseases are beginning to constitute an increasingly serious health problem in freshwater prawn culture. This article is a review of the important diseases reported in freshwater prawns, with particular emphasis on the white tail disease of M. rosenbergii as it is the most important disease recorded to date and also the most well studied among the diseases of freshwater prawns. Steps to be taken for proper health management in the farming of this species is also touched upon. [ABSTRACT FROM AUTHOR]

Summary This study presents the carbon footprint of a paperback book for which the cover and inside papers were produced in the United States and printed in Canada. The choice of paper mills for both cover and page papers was based on criteria such as percentage of recycled content in the pulp mix, transport distances (pulp mill to paper mill, paper mill to print), and technologies. The cradle-to-gate assessment of greenhouse gas (GHG) emissions follows recognized guidelines for carbon footprint assessment. The results show that the production of 400,000 books, mainly distributed in North America, would generate 1,084 tonnes carbon dioxide equivalent (CO2-eq), or 2.71 kilograms (kg) CO2-eq per book. The impact of using deinked market pulp (DMP) is shown here to be detrimental, accounting for 54% of total GHG emissions and being 32% higher than reference virgin Kraft pulp. This supports findings that DMP mill GHG emissions strongly correlate with the carbon intensity of the power grid supplying the pulp mill and that virgin Kraft mills that reuse wood residue and black liquor to produce heat and electricity can achieve lower GHG emissions per tonne of pulp produced. Although contrary to common thinking, this is consistent with the Paper Task Force 2002 conclusion for office paper (the closest paper grade to writing paper or fine paper) (EDF 2002a). To get a cradle-to-grave perspective, three different end-of-life (EOL) scenarios were analyzed, all of which included a harvested wood product (HWP) carbon storage benefit for 25 years. The GHG offset concept within the context of the book editor's 'carbon-neutral' paper claims is also discussed. [ABSTRACT FROM AUTHOR]

Statement of Purpose. IgG4-related disease (IgG4-RD) is usually associated to an increase of serum IgG4 levels. However other conditions have also been associated to high serum IgG4 levels. Methods. All IgG subclasses analyses performed in our hospital over a one-year period were analyzed. When IgG4 level were over 1.35 g/L, the patient's clinical observation was analyzed and both final diagnosis and reason leading to IgG subclasses analysis were recorded. Only polyclonal increases of IgG4 were considered. Summary of the Results. On 646 IgG subclass analysis performed, 59 patients had serum IgG4 over 1.35 g/L. The final diagnosis associated to serum IgG4 increase was very variable. Most patients (25%) presented with repeated infections, 13.5% with autoimmune diseases, and 10% with IgG4-RD. Other patients presented with cancer, primary immune deficiencies, idiopathic interstitial lung disease, cystic fibrosis, histiocytosis, or systemic vasculitis and 13.5% presented with various pathologies or no diagnosis. Mean IgG4 levels and IgG4/IgG ratio were higher in IgG4-RD than in other pathologies associated to elevated IgG4 levels. Conclusions. Our study confirms that elevation of serum IgG4 is not specific to IgG4-RD. Before retaining IgG4-RD diagnosis in cases of serum IgG4 above 1.35 g/L, several other pathological conditions should be excluded. [ABSTRACT FROM AUTHOR]

Since several years, the use of intravenous immunoglobulins (IVIg) has increased. This growth has encouraged some countries to publish guidelines. In parallel, some countries have conducted audits to know how IVIg are used in clinical practice in the light of the available guidelines. The objective of this study was to assess IVIg use in three French university hospitals in 2006. All IVIg administrations were evaluated during 6 months (12 September 2005-12 March 2006) in French university hospitals of Marseille. Different data were recorded for each administration: patient characteristics, indication, formulation and quantity. During the study period, 2802 administrations of IVIg (corresponding to a total quantity of 76 780 g) have been recorded. Four hundred and thirty-five patients received at least one of these administrations. The five most reported indications were multifocal motor neuropathy (11.0% of total quantity), chronic inflammatory demyelinating polyradiculoneuropathy (10.2%), corticoresistant dermatomyositis (10.2%), immune thrombocytopaenia (9.9%) and primary immune deficiency (9.1%). According to available French recommendations, 70% of the IVIg use was for 'acknowledged indications', 9% for 'indications to be assessed' and 18% for 'unwarranted indications'. The 10 most reported indications were 'acknowledged indications' according to available recommendations of the French expert group. Nevertheless, the two most reported indications were not approved by the French Health Products Agency (AFSSAPS) at the time of the study and were approved since. [ABSTRACT FROM AUTHOR]

A series of experiments was conducted to determine the capacity of an archaeal strain, Methanocaldococcus jannaschii, to bind metals and to study the effects of metal binding on the subsequent silicification of the microorganisms. The results showed that M. jannaschii can rapidly bind several metal cations (Fe3+, Ca2+, Pb2+, Zn2+, Cu2+). Considering the lack of silicification of this strain without metal binding, these experiments demonstrate that Fe(III) ion binding to the cell wall components was of fundamental importance for successful silicification and, especially, for the excellent preservation of the cell wall. This study brings new elements to the understanding of fossilization processes, showing that the positive effect of Fe(III) on silicification, already known for Bacteria, can also apply to Archaea and that this preliminary binding can be decisive for the subsequent fossilization of these organisms. Knowledge of these mechanisms can be helpful for the search and the identification of microfossils in both terrestrial and extraterrestrials rocks, and in particular on Mars. [ABSTRACT FROM AUTHOR]

Natural killer (NK) cells have been implicated in tumour surveillance and in the early control of several microbial infections. In autoimmune disease their involvement in these processes has been evaluated in animal models, with conflicting results. Both a disease-controlling and a disease-promoting role have been suggested. In human autoimmune disease only a few studies, mainly descriptive, have demonstrated qualitative and quantitative modification of NK cells. These changes were observed on blood- or tissue-infiltrating NK cells. Taken together with our expanding knowledge of the genetical variability of NK cell receptors and NK cell physiology, these findings pave the way for the dissection of the role of NK cells in human autoimmune diseases. NK cells may be directly involved in these diseases through their potential autoreactivity or through their interaction with dendritic cells, macrophages or T lymphocytes, thereby inducing excessive inflammation or favouring the adaptive autoimmune response. Thus, NK cells may be implicated in the onset, the maintenance or the progression of autoimmune diseases. Some reports also suggest the involvement of NK cells in the treatment of human autoimmune disease by biotherapies. All these observations suggest that NK cells are involved in the complex processes of autoimmune diseases. Nevertheless, further careful analysis of NK cells at different steps of these diseases, in different tissues and through combined genetical and functional studies will contribute to a better understanding of their role in autoimmune diseases. This knowledge might allow the development of new therapeutic strategies based on NK cells for the treatment of some autoimmune diseases. [ABSTRACT FROM AUTHOR]