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Background. Efficacy and safety of belatacept have not been specifically reported for kidney transplantations from donors after circulatory death. Methods. In this retrospective multicenter paired kidney study, we compared the outcome of kidney transplantations with a belatacept-based to a calcineurin inhibitor (CNI)-based immunosuppression. We included all kidney transplant recipients from donors after uncontrolled or controlled circulatory death performed in our center between February 2015 and October 2020 and treated with belatacept (n = 31). The control group included the recipients of the contralateral kidney that were treated with CNI in 8 other centers (tacrolimus n = 29, cyclosporine n = 2). Results. There was no difference in the rate of delayed graft function. A higher incidence of biopsy-proven rejections was noted in the belatacept group (24 versus 6 episodes). Estimated glomerular filtration rate (eGFR) was significantly higher in the belatacept group at 3-, 12-, and 36-mo posttransplant, but the slope of eGFR was similar in the 2 groups. During a mean follow-up of 4.1 y, 12 patients discontinued belatacept and 2 patients were switched from CNI to belatacept. For patients who remained on belatacept, eGFR mean value and slope were significantly higher during the whole follow-up. At 5 y, eGFR was 80.7 ± 18.5 with belatacept versus 56.3 ± 22.0 mL/min/1.73 m2 with CNI (P = 0.003). No significant difference in graft and patient survival was observed. Conclusions. The use of belatacept for kidney transplants from either uncontrolled or controlled donors after circulatory death resulted in a better medium-term renal function for patients remaining on belatacept despite similar rates of delayed graft function and higher rates of cellular rejection.

Summary: Background: Although immunomodulators have established benefit against the new coronavirus disease (COVID-19) in general, it is uncertain whether such agents improve outcomes without increasing the risk of secondary infections in the specific subgroup of previously immunocompromised patients. We assessed the effect of immunomodulators on outcomes of immunocompromised patients hospitalized for COVID-19. Methods: The protocol was prospectively registered with PROSPERO (CRD42022335397). MEDLINE, Cochrane Central Register of Controlled Trials and references of relevant articles were searched up to 01-06-2022. Authors of potentially eligible randomized controlled trials were contacted to provide data on immunocompromised patients randomized to immunomodulators vs control (i.e., placebo or standard-of-care). Findings: Eleven randomized controlled trials involving 397 immunocompromised patients hospitalized for COVID-19 were included. Ten trials had low risk of bias. There was no difference between immunocompromised patients randomized to immunomodulators vs control regarding mortality [30/182 (16.5%) vs 41/215 (19.1%); RR 0.93, 95% CI 0.61–1.41; p = 0.74], secondary infections (RR 1.00, 95% CI 0.64–1.58; p = 0.99) and change in World Health Organization ordinal scale from baseline to day 15 (weighed mean difference 0.27, 95% CI -0.09–0.63; p = 0.15). In subgroup analyses including only patients with hematologic malignancy, only trials with low risk of bias, only trials administering IL-6 inhibitors, or only trials administering immunosuppressants, there was no difference between comparators regarding mortality. Interpretation: Immunomodulators, compared to control, were not associated with harmful or beneficial outcomes, including mortality, secondary infections, and change in ordinal scale, when administered to immunocompromised patients hospitalized for COVID-19. Funding: Hellenic Foundation for Research and Innovation.

Abstract Background Thrombotic microangiopathies (TMAs) are rare but can be severe in kidney transplant. recipients (KTR). Methods We analysed the epidemiology of adjudicated TMA in consecutive KTR during the. 2009–2021 period. Results TMA was found in 77/1644 (4.7%) KTR. Early TMA (n = 24/77 (31.2%); 1.5% of all KTR) occurred during the first two weeks ((median, IQR) 3 [1–8] days). Triggers included acute antibody-mediated rejection (ABMR, n = 4) and bacterial infections (n = 6). Graft survival (GS) was 100% and recurrence rate (RR) was 8%. Unexpected TMA (n = 31/77 (40.2%); 1.5/1000 patient-years) occurred anytime during follow-up (3.0 (0.5–6.2) years). Triggers included infections (EBV/CMV: n = 10; bacterial: n = 6) and chronic active ABMR (n = 5). GS was 81% and RR was 16%. Graft-failure associated TMA (n = 22/77 (28.6%); 2.2% of graft losses) occurred after 8.8 (4.9–15.5) years). Triggers included acute (n = 4) or chronic active (n = 14) ABMR, infections (viral: n = 6; bacterial: n = 5) and cancer (n = 6). 15 patients underwent transplantectomy. RR was 27%. Atypical (n = 6) and typical (n = 2) haemolytic and uremic syndrome, and isolated CNI toxicity (n = 4) were rare. Two-third of biopsies presented TMA features. Conclusions TMA are mostly due to ABMR and infections; causes of TMA are frequently combined. Management often is heterogenous. Our nosology based on TMA timing identifies situations with distinct incidence, causes and prognosis.

In semi-transparent polymers, ignition is not only dependent on conductive thermal transfer into the material but also on in-depth absorption of the radiation. The aim of this work was to investigate the influence of bubbling on the thermo-physical and thermo-radiative properties of PMMA and how it may affect its ignition. PMMA plates of varying thickness were exposed to the heat flux of two radiative sources with different emission spectra. Exposure was stopped after different periods of time to study bubbling kinetics and bubble size distribution by optical microscopy. Front and back surface temperatures of samples were recorded during heat exposure. The results indicate that the bubble size distribution is closely related to the temperature gradient within the sample. Steep thermal gradients lead to small-sized bubbles underneath the exposed surface, while weak thermal gradients generate a wider size distribution with in-depth bubbling. All thermo-physical quantities k, ρ and Cp were shown to decrease with increasing bubbling degree. Likewise, it was highlighted that bubbling modifies the thermo-radiative properties of PMMA, especially in the near-infrared range. Transmittance decreases while absorbance increases with a bubbling degree. The increase in the absorption coefficient was attributed to multiple scattering by bubbles that expand the pathway of radiation into the materials. It was concluded that changes in both the thermo-physical and thermo-radiative properties with bubbling were likely to account for the delay in ignition observed when using the near-infrared heating source.

Highly hydrophobic flax fabrics with durable properties were prepared using the “dip-coating” method for self-cleaning application. Flax fabrics were coated with a polysiloxane coating via a hydrosilylation reaction with a Karstedt catalyst at room temperature. The coated fabrics displayed highly and durable hydrophobic properties (contact angle and sliding angle of about 145° and 23°, respectively) with good self-cleaning ability for certain pollutants and excellent durability. Moreover, the influence of the coating process on the mechanical properties of fabrics was investigated. A decrease in E modulus and an increase in tensile stress at maximum force and elongation at maximum force has been observed. Furthermore, this influence of the coating process can be easily controlled by adjusting the proportion of curing agent in the treatment solution.

Abstract Background In the Lao People's Democratic Republic (Lao PDR), cervical cancer is the third leading cause of women cancer. Aims The objective of this cross‐sectional study was to compare the efficacy of careHPV™ test versus conventional Pap smear or Siriraj liquid‐based cytology in the detection of cervical cancer in women living with human immunodeficiency virus type 1 (HIV‐1). Materials & Methods Overall, 631 women consented to participate. Four cervical specimens were taken for the purpose of conventional Pap smear, Siriraj liquid‐based cytology, careHPV™ test, and HPV‐16 genotyping. The exact McNemar test was used to compare the efficacy and diagnostic performance of the tests. Results Of the 631 women with follow‐up, 331 were human papillomavirus (HPV) negative. High‐grade squamous intraepithelial lesions were found in 37 women, biopsy‐proven high‐grade cervical intraepithelial neoplasia in 50 women, and invasive carcinoma in seven women. The proportion of women with high‐grade cervical lesion or carcinoma detected after abnormal careHPV™ test was higher (6.02%; 95% confidence interval [CI]: 4.4–8.1) than that detected by conventional Pap smear (4.59%; 95% CI: 3.2–6.5). careHPV™ and HPV‐16 genotyping had, respectively, the highest sensitivity (80.8%; 95% CI: 67.4–89.5) and specificity (92.2%; 95% CI: 89.8–94.2). HPV‐16 was the most frequently detected genotype. Conclusions careHPV™ test represents a screening option in Lao PDR, particularly in women living with HIV‐1 because of higher prevalence of chronic HPV in this population.

Abstract Background Due to increased risk of pyelonephritis, patients with intestinal reconstruction of the lower urinary tract (IRLUT) have long been advised against kidney transplantation. The aim of this study was to compare the outcomes of transplantation between patients with IRLUT and patients with normal LUT (NLUT) using propensity score matching method. Methods The study included 23 kidney recipients with IRLUT matched to 46 kidney recipients with NLUT using known allograft survival and pyelonephritis risk factors as covariates. One‐, 5‐, and 10‐year graft survival, pyelonephritis, and surgical complications occurrence and graft function were compared. Results One‐, 5‐, and 10‐year graft survival were 96%, 91%, and 63% in the IRLUT group and 96%, 88%, and 70% in the NLUT group, respectively (p = 0.72). Patients with IRLUT had increased cumulative risk of pyelonephritis at 10 years (70% vs. 19%; log‐rank

Following the publication of their last work on the “didactics of Relation”, the authors offer additional insight from the book by Jean-Luc Nancy, Être singulier pluriel. The aim of this article is to clarify the term “plural” which characterizes the didactics of “pluri”lingualism by extending it to the ontological question of “being plural”. The language-culture didactics is thus invited to make its “Copernican revolution” by explicitly subscribing to social approaches based on collaboration and reticulated mediations.

Abstract Background Renal resistive index (RI) predicts mortality in renal transplant recipients (RTR). However, its predictive value may be different according to the time of measurement. We analysed RI changes between 1 month and 3 months after transplantation and its predictive value for death with a functioning graft (DWFG). Methods We conducted a retrospective study in 1685 RTR between 1985 and 2017. The long-term predictive value of changes in RI value from 1 month to 3 months was assessed in diabetic and non-diabetic RTR. Results Best survival was observed in RTR with RI

Abstract Background Data on the prevalence of bacterial and viral co-infections among patients admitted to the ICU for acute respiratory failure related to SARS-CoV-2 pneumonia are lacking. We aimed to assess the rate of bacterial and viral co-infections, as well as to report the most common micro-organisms involved in patients admitted to the ICU for severe SARS-CoV-2 pneumonia. Patients and methods In this monocenter retrospective study, we reviewed all the respiratory microbiological investigations performed within the first 48 h of ICU admission of COVID-19 patients (RT-PCR positive for SARS-CoV-2) admitted for acute respiratory failure. Results From March 13th to April 16th 2020, a total of 92 adult patients (median age: 61 years, 1st–3rd quartiles [55–70]; males: n = 73/92, 79%; baseline SOFA: 4 [3–7] and SAPS II: 31 [21–40]; invasive mechanical ventilation: n = 83/92, 90%; ICU mortality: n = 45/92, 49%) were admitted to our 40-bed ICU for acute respiratory failure due to SARS-CoV-2 pneumonia. Among them, 26 (28%) were considered as co-infected with a pathogenic bacterium at ICU admission with no co-infection related to atypical bacteria or viruses. The distribution of the 32 bacteria isolated from culture and/or respiratory PCRs was as follows: methicillin-sensitive Staphylococcus aureus (n = 10/32, 31%), Haemophilus influenzae (n = 7/32, 22%), Streptococcus pneumoniae (n = 6/32, 19%), Enterobacteriaceae (n = 5/32, 16%), Pseudomonas aeruginosa (n = 2/32, 6%), Moraxella catarrhalis (n = 1/32, 3%) and Acinetobacter baumannii (n = 1/32, 3%). Among the 24 pathogenic bacteria isolated from culture, 2 (8%) and 5 (21%) were resistant to 3rd generation cephalosporin and to amoxicillin–clavulanate combination, respectively. Conclusions We report on a 28% rate of bacterial co-infection at ICU admission of patients with severe SARSCoV-2 pneumonia, mostly related to Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae and Enterobacteriaceae. In French patients with confirmed severe SARSCoV-2 pneumonia requiring ICU admission, our results encourage the systematic administration of an empiric antibiotic monotherapy with a 3rd generation cephalosporin, with a prompt de-escalation as soon as possible. Further larger studies are needed to assess the real prevalence and the predictors of co-infection together with its prognostic impact on critically ill patients with severe SARS-CoV-2 pneumonia.

Abstract The World One Health Congresses are biennial gatherings of approximately 1500 professionals from relevant international organisations, OIE, FAO, WHO, World Bank, leading scientific experts and researchers in the field of One Health, animal production and trade, food safety, animal health, human health and environmentology/ecology, government representatives in public health, human health, food safety, environmental health and global health security. The Congress is organized by the One Health Platform. This white paper summarizes highlights of the 5th International One Health Congress in Saskatoon, Canada, June 2018 and serves as a roadmap for the future, detailing several concrete action points to be carried out in the run-up to the 6th World One Health Congress in Edinburgh, Scotland, June 2020.

OBJECTIVE:To better understand factors contributing to underutilization of laboratory services for health care delivery in sub-Saharan Africa, we conducted a study in Senegalese Antenatal Care clinics (ANC) and laboratories to determine the extent of underutilization, contributing factors, and bottlenecks in the cascade of care from first ANC visit, test uptake, to availability of test results and appropriate clinical management. METHODS:At 16 health facilities, pregnant women attending for their first ANC visit were consecutively recruited and information was prospectively collected on the request, execution, results and clinical management of seven nationally recommended laboratory screening tests for normal pregnancy: hemoglobin concentration (Hb), syphilis serology, HIV serology, determination of proteinuria (PU), determination of blood group and Rhesus factor, Emmel test to detect sickle cell disease, and glycaemia. Health facility staff were interviewed on human resource capacity, management of the ANC and the laboratory, and availability and use of guidelines. RESULTS:Of 1246 ANC attendants, 400 (32%) had complete results. Completeness varied between facilities from 0-99%. In multilevel logistic regression analysis of women nested in facilities, complete uptake was lower if women started ANC later in pregnancy; very low in rural ANC attendants who ever delivered compared to urban primigravidae (OR 0.064; 95%CI 0.00-0.52); and higher if the facility routinely recommended all seven tests. In the cascade from test request to clinical management, the most frequent bottleneck was non-execution of requested tests, while unavailability of results for executed test was uncommon (

Wide-range continuous spatial variation of the film composition in lateral compositionally graded epitaxial films requires the development of high throughput measurement techniques for their local and non-destructive characterization with the highest possible spatial resolution. Here we report on the first application of the picosecond laser ultrasonics (PLU) technique for the evaluation of acoustical and optical parameters of lateral compositionally graded film, the Ba1−xSrxTiO3 (0 ≤ x ≤ 1) material library. The film was not dedicatedly prepared for its opto-acousto-optic evaluation by PLU, exhibiting significant lateral variations in thickness and surface roughness. Therefore, the achieved measurements of the sound velocity and of the optical refractive index, and characterization of the surface roughness confirm the robustness of the PLU technique for thin film evaluation. We hope that the first measurements of the acoustical and optical properties of epitaxial grown Ba1−xSrxTiO3 (0 ≤ x ≤ 1) by PLU technique accomplished here provide the parameters required for more extended predictive design of the phononic, photonic and phoxonic mirrors and cavities with superior properties/functionalities for novel multifunctional nanodevices.

The impact of a third dose of COVID-19 vaccine on antibody responses is unclear in immunocompromised patients. The objective of this retrospective study was to characterize antibody responses induced by a third dose of mRNA COVID-19 vaccine in 160 kidney transplant recipients and 20 patients treated for chronic lymphocytic leukemia (CLL). Prevalence of anti-spike IgG ≥ 7.1 and ≥ 30 BAU/mL after the third dose were 47% (75/160) and 39% (63/160) in kidney transplant recipients, and 57% (29/51) and 50% (10/20) in patients treated for CLL. Longitudinal follow-up identified a moderate increase in SARS-CoV-2 anti-spike IgG levels after a third dose of vaccine in kidney transplant recipients (0.19 vs. 5.28 BAU/mL, p = 0.03) and in patients treated for CLL (0.63 vs. 10.7 BAU/mL, p = 0.0002). This increase in IgG levels had a limited impact on prevalence of anti-spike IgG ≥ 30 BAU/mL in kidney transplant recipients (17%, 2/12 vs. 33%, 4/12, p = 0.64) and in patients treated for CLL (5%, 1/20 vs. 45%, 9/20, p = 0.008). These results highlight the need for vaccination of the general population and the importance of non-medical preventive measures to protect immunocompromised patients.

Ring-opening ionic polymerization of cyclosiloxanes in dispersed media has long been discovered, and is nowadays both fundamentally studied and practically used. In this short communication, we show some preliminary results on the cationic ring-opening polymerization of hexamethylcyclotrisiloxane (D3), a crystalline strained cycle, in water. Depending on the catalyst or/and surfactants used, polymers of various molar masses are prepared in a straightforward way. Emphasis is given here on experiments conducted with tris(pentafluorophenyl)borane (BCF), where high-molar polymers were generated at room temperature. In surfactant-free conditions, µm-sized droplets are stabilized by silanol end-groups of thus generated amphiphilic polymers, the latter of which precipitate in the course of reaction through chain extension. Introducing various surfactants in the recipe allows generating smaller emulsions in size with close polymerization ability, but better final colloidal stability, at the expense of low small cycles’ content. A tentative mechanism is finally proposed.

The authors wish to make the following corrections to this paper [...]

The fire behaviour of flexible polyurethane foams was studied using a cone calorimeter, with a special emphasis on the collapse step. Only one peak of heat release rate, ranging from 200 to 450 kW/m2, is observed for thin foams, depending on the foam density and the heat flux. On the contrary, heat release rate (HRR) curves exhibit two peaks for 10 cm-thick foams, the second one corresponding to the pool fire formed after foam collapse. In all cases, the collapse occurs at a constant rate through the whole thickness. The rate of the recession of the front was calculated using digital and infrared cameras. Interestingly, its value is relatively constant whatever the heat flux (especially between 25 and 35 kW/m2), probably because of the very low heat conductivity preventing heat transfer through the thickness. The rate increases for the lightest foam but the fraction of burnt polymer during collapse is constant. Therefore, the pool fire is more intense for the densest foam. A simple macroscopic model taking into account only the heat transfer into the foam leads to much lower front recession rates, evidencing that the collapse is piloted by the cell walls’ rigidity.

Objective To assess the antibiotic prescribing practices of doctors working in the Lao People's Democratic Republic and their knowledge of local antibiotic resistance patterns. Methods Doctors attending morning meetings in 25 public hospitals in four provinces were asked to complete a knowledge, attitude and practice survey. The questionnaire contained 43 multiple choice questions that the doctor answered at the time of the meeting. Findings The response rate was 83.4% (386/463). Two hundred and seventy doctors (59.8%) declared that they had insufficient information about antibiotics. Only 14.0% (54/386) recognized the possibility of cephalosporin cross-resistance in methicillin-resistant Staphylococcus aureus. Most participants had no information about local antibiotic resistance for Salmonella Typhi (211/385, 54.8%) and hospital-acquired pneumonia (253/384, 65.9%). Unnecessary antibiotic prescriptions were considered as harmless by 115 participants and 148 considered locally-available generic antibiotics to be of poor quality. Nearly three-quarters (280/386) of participants agreed that it was difficult to select the correct antibiotics. Most participants (373/386) welcomed educational programmes on antibiotic prescribing and 65.0% (249/383) preferred local over international antibiotic guidelines. Conclusion Doctors in the Lao People's Democratic Republic seem to favour antibiotic prescribing interventions. Health authorities should consider a capacity building programme that incorporates antibiotic prescribing and hospital infection control.

L’objectif de cet article consiste à montrer qu’il est possible et souhaitable d’organiser une approche «actionnelle» de la formation des enseignants de Français Langue Étrangère. Notre réflexion s’appuie sur une expérimentation auprès d’étudiants du master Enseignement-Éducation-Médiation 1er degré (IUFM Paris Sorbonne). Après un rapide rappel de l’optique institutionnelle en formation initiale (autour de l’approche par tâche scolaire), nous présenterons le construit théorique qui sous-tend l’approche alternative que nous proposons. Nous verrons, à partir de quelques extraits de corpus, comment les étudiants construisent ensemble de nouvelles compétences professionnelles. Nous présenterons aussi les effets produits sur les élèves. Cette approche se situe dans la perspective d’une éducation plurilingue et interculturelle qui s’ouvre sur la nécessité de prendre en compte le développement de la personne et de l’acteur social pour une meilleure citoyenneté.

The dominant theory of what people can learn implicitly is that they learn chunks of adjacent elements in sequences. A type of musical grammar that goes beyond specifying allowable chunks is provided by serialist or 12-tone music. The rules constitute operations over variables and could not be appreciated as such by a system that can only chunk elements together. A series of studies investigated the extent to which people could implicitly (or explicitly) learn the structures of serialist music. We found that people who had no background in atonal music did not learn the structures, but highly selected participants with an interest in atonal music could implicitly learn to detect melodies instantiating the structures. The results have implications for both theorists of implicit learning and composers who may wish to know which structures they put into a piece of music can be appreciated.

In France, one home fire occurs every 2 minutes and these accidents account for 10,000 victims each year. Majority of home fires can spread very quickly because of polymer materials, increasingly used in dwelling houses. Currently, modeling fire development to aid the scale-up from bench to full scale is a big challenge. Studies combining experiments and modeling at increasing scale have already been performed. In this work, radiant panel with heat flux concentrator has been developed and used to study the combustion of household materials. The area of radiative source is equal to 2 m². Ignitability, mass loss and smoke composition (CO, CO2 and O2) data have been recorded to evaluate heat release rate. The results have been compared with those from cone calorimeter on small samples (100 cm²) at 50 kW/m² in order to study the scale effect of the testing device.

BACKGROUND:Interferon-release assays (IGRAs) for diagnosing active pulmonary tuberculosis (PTB) are not yet fully validated, particularly in high TB-endemic areas as the People's Republic of China (PRC). The aim of this report was to assess the performance of the QuantiFERON-TB Gold In-tube (QFT-GIT) and tuberculin skin test (TST), in addition to microbiological results, as contributors for diagnosing active PTB in the PRC. METHODS/PRINCIPAL FINDINGS:A total of 300 PTB patients, 41 disease controls (DC) and 59 healthy community controls (HCC) were included prospectively between May 2010 and April 2011 from two provinces of the PRC (Heilongjiang and Zhejiang). The QFT-GIT and TST yielded an overall sensitivity for active TB of 80.9% and 86.2%, and a specificity of 36.6% and 26.8%, respectively. The province of origin and smear microscopy status did not significantly impact the diagnostic values for PTB. However, using the TST with a 10 mm cut-off point, a significantly higher proportion of LTBI was observed in the DC than the HCC (p=0.01). Discordant results between the QFT-GIT and TST were found among 1/3 of the PTB, HCC and DC. Two-thirds of the individuals presented TST-positive/QFT-GIT-negative discordant results. The TST-negative/QFT-GIT-positive result was not associated with age or bacillary load. Cumulative QFT-GIT and TST positive results increased the overall sensitivity (95.9%), but it was associated with a dramatic decrease of the overall specificity (24.8%) leading to a suboptimal PPV (80.1%) and a low NPV (61.1%). CONCLUSIONS/SIGNIFICANCE:The usefulness of the QFT-GIT to diagnose active TB in high TB-endemic countries remains doubtful because like the TST, the QFT-GIT cannot distinguish between LTBI and active TB. Used as single stand-alone tests, both the QFT-GIT and TST have very limited roles in the diagnosis of active PTB. However, the combined use of SM, the TST and QFT-GIT may allow for the exclusion of ATB.

Education is one of the most important drivers behind helping people in developing countries lift themselves out of poverty. However, even when schooling is available absenteeism rates can be high. Recently interest has focussed on whether or not WASH interventions can help reduce absenteeism in developing countries. However, none has focused exclusively on the role of drinking water provision. We report a study of the association between absenteeism and provision of treated water in containers into schools.We undertook a quasi-experimental longitudinal study of absenteeism rates in 8 schools, 4 of which received one 20 L container of treated drinking water per day. The water had been treated by filtration and ultraviolet disinfection. Weekly absenteeism rates were compared across all schools using negative binomial model in generalized estimating equations. There was a strong association with provision of free water and reduced absenteeism (Incidence rate ratio = 0.39 (95% Confidence Intervals 0.27-0.56)). However there was also a strong association with season (wet versus dry) and a significant interaction between receiving free water and season. In one of the intervention schools it was discovered that the water supplier was not fulfilling his contract and was not delivering sufficient water each week. In this school we showed a significant association between the number of water containers delivered each week and absenteeism (IRR = 0.98 95%CI 0.96-1.00).There appears to be a strong association between providing free safe drinking water and reduced absenteeism, though only in the dry season. The mechanism for this association is not clear but may in part be due to improved hydration leading to improved school experience for the children.

It was demonstrated that combination antiretroviral therapy (cART) reduces the HIV-1 viral load (VL) in the blood and the seminal compartment. Some studies have reported that the seminal HIV-1 VL is undetectable in individuals with an undetectable blood plasma viral load (bpVL) under cART. However, some recent studies have demonstrated that seminal HIV-1 RNA may still be detected, and potentially infectious, even in the case of an undetectable bpVL. The aim of this retrospective study was to determine the detection rate of a seminal VL and whether shedding could be intermittent over a very short time. From January 2006 to December 2011, 88 HIV-1 infected men, enrolled in an Assisted Reproduction program, provided 306 semen samples, corresponding to 177 frozen sperm samples (two samples delivered at a one-hour interval (n = 129) or one sample (n = 48)). All enrolled men were under cART, with an undetectable bpVL for more than 6 months. HIV-1 RNA was quantified in seminal plasma using a Roche COBAS Ampliprep COBAS TaqMan HIV-1 test. Seminal HIV-1 RNA was detected in 23 samples (7.5%) from 17 patients (19.3%). This detection rate was stable over years. With regards to the freezing of two samples delivered at a one-hour interval, the proportion of discordance between the first and second samples was 9.3% (12/129). Our results confirm the intermittent shedding of HIV-1 in semen. While this finding has been shown by studies examining longer time intervals, to our knowledge, this has never been demonstrated over such a short time interval.

BACKGROUND: The aim of this multi-centric prospective study in India was to assess the accuracy of a serological test as an additional tool for diagnosing active tuberculosis (ATB). In particular, an assay based on ELISA using a phenolic glycolipid (PGL-Tb1) or a fusion protein (ESAT-6/CFP10) was compared to the tuberculin skin test (TST) and the microbiological results according to HIV status. METHODS: Individuals with and without ATB and HIV infection were enrolled. Serology and TST results were analyzed per se and in combination with the microbiological data. RESULTS: Among the 778 ATB patients, 102 were HIV-infected, 316 HIV-uninfected and 360 had an HIV-unknown status. Of the 945 non-ATB subjects, 559 were at low risk (community adults) and 386 at high risk of M. tuberculosis exposure. Among those with ATB, the sensitivity of ELISA-PGL-Tb1 for ATB was higher than that of ELISA-ESAT-6/CFP10, both in HIV-infected (72.3% versus 63.7%, p = 0.29) and HIV-uninfected/HIV-unknown groups (40.5% versus 28.6%; p

The number of people living with HIV/AIDS in the People’s Democratic Republic of Laos (also known as Laos PDR) is estimated at 13,600 and the number of people in need of antiretroviral therapy at 8,000. Today, around 3,200 HIV infected individuals receive treatment in seven centres throughout the country. Until recently, antiretroviral treated patients were followed-up only on the basis of clinical and immunological criteria. In 2009 the Centre d'Infectiologie Christophe Mérieux in Laos PDR (CICML) signed a collaboration agreement with the national Centre of HIV/AIDS/STI (CHAS) for the implementation of HIV viral load testing (VLT) in the country, leading to the technological transfer of the ANRS generic assay (HIV Generic charge virale, Biocentric, Bandol, France). The introduction of HIV VLT has been accompanied through national HIV workshops every 6 months. From June 2009 to December 2011, HIV viral load has been measured in 1,782 antiretoviral-treated patients. Of these, 97% were on reverse-transcriptase inhibitor -based 1st line regimen. HIV viral load was undetectable (

ObjectiveTo assess 2009 A(H1N1) seroconversion rates and their determinants within an unvaccinated population in Vientiane Capital, Laos.MethodsCoPanFlu Laos, a general population cohort of 807 households and 4,072 participants was established in March 2010. Sociodemographic data, epidemiological data, and capillary blood samples were collected from all the household members in March, and again in October 2010, in order to assess the level of antibodies to 2009 A(H1N1) with the haemagglutination inhibition assay. 2009 A(H1N1) seroconversion was defined as a fourfold or greater increase in titre between inclusion and follow-up. Determinants for pandemic influenza infection were studied using the generalized estimating equations model, taking household clustering into account.ResultsBetween March and November 2010, 3,524 paired sera were tested. Prior to the pandemic, our cohort was almost completely vaccine-naive for seasonal influenza. The overall seroconversion rate among nonvaccinated individuals (n = 2,810) was 14.3% (95%CI [13.0, 15.6]), with the highest rate for participants under 20 yo (19.8%, 95%CI [17.4, 22.4]) and the lowest rate for participants over 60 yo (6.5%, 95%CI [3.7, 10.4]). Participants with lower baseline titres had significantly higher infection rates, with a dose-effect relationship. Odds ratios (ORs) ranged from 76.5 (95%CI [27.1, 215.8]), for those with a titre at inclusion of 1∶10, to 8.1 (95%CI [3.3, 20.4]), for those with a titre of 1∶40. Having another household member with a titre ≥1∶80 was associated with a higher likelihood of immunity (OR = 3.3, 95%CI [2.8, 3.9]).ConclusionThe determinants and age distribution for seroconversion within a vaccine-naive population were similar to those found in developed countries. This pandemic was characterized by strong epidemiological determinants, regardless of geographical zone and level of development. Moreover, we detected pre-existing cross-reacting antibodies in participants over 60 yo, which could not have originated from former multiple vaccination as has been suggested elsewhere.

BACKGROUND: The aim of this multicentric prospective study in India was to assess the performance of the QuantiFERON TB-Gold in tube (QFT-GIT), Tuberculin Skin Test (TST) and microbiological results as additional tools for diagnosing active tuberculosis (TB) and latent infection (LTBI) according to Human Immunodeficiency Virus (HIV) status. METHODS: Individuals with and without active TB and HIV infection were enrolled between 2006-2008. QFT-GIT and TST results were analyzed per se and in combination with microbiological data. RESULTS: Among the 276 individuals (96 active pulmonary TB and 180 no active TB) tested by QFT-GIT, 18 indeterminate results (6.5%) were found, more significantly numerous in the HIV-infected (15/92; 16.3%) than the HIV-uninfected (3/184; 1.6%)(p

BACKGROUND: The aim of this multicentric prospective study in India was to assess the value of several microbiological tools that contribute to the diagnosis of tuberculosis (TB) according to HIV status. METHODS: Standard microbiological tools on individual specimens were analyzed. RESULTS: Among the 807 patients with active TB, 131 were HIV-infected, 316 HIV-uninfected and 360 had HIV-unknown status. Among the 980 non-active TB subjects, 559 were at low risk and 421 were at high risk of M. tuberculosis (Mtb) exposure. Sensitivity of smear microscopy (SM) was significantly lower in HIV-infected (42.2%) than HIV-uninfected (75.9%) (p = 0.0001) and HIV-unknown pulmonary TB patients (61.4%) (p = 0.004). Specificity was 94.5% in non-TB patients and 100% in health care workers (HCW) and healthy family contacts. Automated liquid culture has significantly higher diagnostic performances than solid culture, measured by sensitivity (74.7% vs. 55.9%) (p = 0.0001) and shorter median time to detection (TTD) (12.0 vs. 34.0 days) (p = 0.0001). Specificity was 100% in HCW and cured-TB patients, but was lower in non-TB patients (89%) due to isolation of Mycobacteria other than tuberculosis (MOTT). TTD by both methods was related to AFB score. Contamination rate was low (1.4%). AccuProbe hybridization technique detected Mtb in almost all culture-positive specimens, but MOTT were found in 4.7% with a significantly higher frequency in HIV-infected (15%) than HIV-uninfected TB patients (0.5%) (p = 0.0007). Pre-test classification significantly increased the diagnostic value of all microbiological tests in pulmonary TB patients (p

BackgroundThe suboptimal sensitivity of Interferon (IFN)-γ-based in-vitro assays, especially in immunocompromised individuals, emphasizes the need for alternative markers for diagnosing tuberculosis (TB). The objective of this study was to evaluate whether interferon-inducible protein (IP)-10, monocyte chemotactic protein (MCP)-2 and interleukin (IL)-2 can be useful biomarkers for evaluating a specific response to RD1 antigens associated to active TB disease in HIV-infected individuals.Methodology/principal findingsThe study was carried out in India, the country with the highest TB burden in the world. Sixty-six HIV-infected individuals were prospectively enrolled, 28 with active-pulmonary-TB and 38 without. The whole blood assay based on RD1-selected peptides (experimental test) and QuantiFERON-TB Gold In tube (QFT-IT) was performed. Plasma was harvested at day-1-post-culture and soluble factors were evaluated by ELISA. The results indicate that by detecting IP-10, the sensitivity of the experimental test and QFT-antigen (75% and 85.7% respectively) for active TB was higher compared to the same assays based on IFN-γ (42.9% and 60.7% respectively) and was not influenced by the ability to respond to the mitogen. By detecting IP-10, the specificity of the experimental test and QFT-antigen (57.9% and 13.2% respectively) for active TB was lower than what was reported for the same assays using IFN-γ-detection (78.9% and 68.4% respectively). On the other side, in vitro IL-2 and MCP-2 responses were not significantly associated with active TB.ConclusionsHIV infection does not impair RD1-specific response detected by IP-10, while it significantly decreases IFN-γ-mediated responses. At the moment it is unclear whether higher detection is related to higher sensitivity or lower specificity of the assay. Further studies in high and low TB endemic countries are needed to elucidate this.

Haïti is the poorest country on the American continent. It is also the Caribbean nation where HIV prevalence is the highest: 2.2% of the adults carry the virus. In 2005, GHESKIO, a centre for the care of people living with HIV/AIDS; ACME, Association for Cooperation with Micro Enterprise; and Fondation Mérieux launched a microcredit programme to help women living with HIV/AIDS. The programme was subsequently extended to vulnerable women who had consulted at GHESKIO. In 2006, an impact assessment of the programme among the first 66 women benefiting from a loan showed better living conditions compared to a control group of 30 women with similar initial medical and socioeconomic status but no loan. By mid-2008, 1061 women were the beneficiaries of 1538 loans totalling 11 373 000 gourdes, i.e. approximately 216 000€. Of these, 247 received several loans (up to seven loans to date). Although the women are very poorly educated and live in arduous economic circumstances, the loan repayment records are excellent – around 94% as of mid 2008. There is no difference between HIV-negative women and those living with HIV. Combined with antiretroviral treatment, micro-financing is certainly one of the major instruments for reducing the impact of HIV on the infected populations in countries with limited resources. This programme in Haiti is a demonstration of the feasibility of microcredit in a difficult environment. The great professionalism of the institutions implementing the programme is a key factor in its success.

Parmi les textes que j’ai dû mettre de côté lors de mes recherches, j’ai pensé immédiatement à celui de Pierre Juvernay, Le Foudre foudroyant et ravageant, contre les péchez mortels, Paris, Pierre Le Mur, datant de 1637. Le titre m’avait interpelé étant donné le sujet de ma thèse dont le titre est le suivant : « De la foudre à la lumière. Enquête sur les formes de la luminosité et leur signification dans l’œuvre de Dante. » La nature du document est un texte d’exhortation proche des exempla médiévaux pour son contenu. Écrit pour mettre au jour une doctrine religieuse catholique propre au XVIIe siècle,ce livre m’a permis de m’intéresser aux exempla médiévaux, aux exhortations et aux sermons. Dieu, affligé par les péchés mortels, s’adresse aux hommes par l’intermédiaire du foudre qui est la représentation de la foudre. Il symbolise la puissance de Dieu et sert à faire peur afin d’éviter aux hommes de commettre des péchés. L’auteur utilise indifféremment le foudre pour la foudre, mais cela implique une érudition qui fait référence à Jupiter armé dufoudre le portant dans ses serres. Ce feu du ciel effraie et fait trembler tout en inspirant le respect de la Toute-puissance. La foudre n’est pas encore considérée comme un phénomène naturel, mais elle est un châtiment divin. Il faudra attendre le XVIIIe siècle, en effet, pour que la physique se lance dans l’examen de la foudre en tant que telle après la découverte de l’électricité.