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Objective Despite the organ shortage, a significant number of deceased donor kidneys are retrieved but not transplanted (RNTK). This study aims to describe and analyze the main causes of potential grafts discard and to propose adequate solutions. Material and methods We collected data from the Cristal database of the French Biomedicine Agency about RNTK over one year. Expert opinion was taken from urologists with extensive expertise in renal transplantation. They retrospectively analyzed each record to assess the appropriateness of each graft refusal and subsequent kidney discard. Results 252 kidneys were retrieved but not transplanted in France over one year. The main reasons for discard were vascular abnormalities in 43.7% (n=110), suspicion of malignant tumor in 18.7% (n = 47), and severe histological lesions on preimplantation biopsy in 12.3% (n = 31). The reason for kidney refusal was undetermined in 4.8% (n=12). Iatrogenic lesions were responsible for 26.2% (n=66). Overall, 46.0% (n=116) and 25.0% (n=63) of the grafts were respectively properly and improperly denied, and the analysis was not possible in 29.0% (n=73). In total, 36.9% of RNTK could have been transplanted. Conclusion Reduction of iatrogenic lesions, improvement of microsurgical repair skills and proper histological examination are necessary to reduce the number of RNTK. A prospective study applying the proposed principles is undoubtedly essential to complete this work.

The performance of a CMOS transmitter designed for planetary science in situ molecular sensing applications having an operational bandwidth of 180–190 GHz and peak output power of 0.6 mW (−2.22 dBm) is evaluated with a series of spectroscopic-based experimental trials. Continuous wave frequency modulated absorption schemes are exploited to probe the Doppler and sub-Doppler lineshape profiles of the water rotational transition at 183.310 GHz. These results demonstrate the tuning finesse and phase-noise characteristics of the integrated circuit embedded phase lock loop used to generate coherent mm-wave radiation are sufficient for high-precision molecular spectroscopy applications. A description of the pulse modulator designed into the CMOS circuitry allowing for implementation of sensitive emission-based Fourier transform detection schemes is provided with performance characterized for spectroscopically relevant pulse durations (40–500 ns). Results are accompanied by a spectral analysis of the transmitter pulse signal leakage, where the total isolation is measured to be 22 dB. The first emission-based molecular detections obtained with this source are presented demonstrating viability for this transmitter to be incorporated into future planned resonant cavity enhanced in situ molecular sensing systems.

Summary The history of the first transplants is an ideal model for analyzing the different stages of disruptive innovation in surgery. Pioneers have often taken paths that were strewn with pitfalls, mistakes or failures. Sometimes victory, brilliant or more modest, lies at the end of this path. We propose to re-explore the extraordinary pathways that led to the first transplantations of the kidney, liver, lung and heart. That these first transplants should one day become possible required the concurrence of several factors: basic research, laboratory work to perfect the surgical techniques, a favorable legislative and societal context, and, above all, pioneering surgeons who would dare to apply their expertise to human subjects. Initial failures were not technical but immunological. Not everything would be perfect, especially ethical questions in some cases. Furthermore, initial results often humbled the greatest surgeons. Even though the historical and legislative contexts have evolved considerably as have science, society and the organization of the health system, this analysis of the past is rich in lessons for the modern surgeon who wishes to embark today along innovative pathways in the face of a still unresolved problem. Because nothing is ever carved in stone.

A low anti-spike antibody response of 28.6% was observed 28 days after BNT162b2 vaccine second dose among 133 solid organ transplant recipients without previous coronavirus disease 2019 (COVID-19). No serious adverse events were recorded. Four severe COVID-19 cases were reported between or after the 2 doses. Our data suggest to change the vaccine strategy.

Recently, percutaneous microbiopsy needles have been used as a less invasive alternative to the Bergstrom needle for obtaining human skeletal muscle biopsy to assess changes in protein content, gene expression, and enzymatic activities. Unlike the Bergstrom muscle biopsy procedure, potential complications associated with microbiopsies of human skeletal muscle have not been documented. Therefore, the present case report follows a young male's recovery from a muscle biopsy‐induced hemorrhage/hematoma of the right vastus lateralis with the specific aims of (1) informing future participants, researchers, and clinicians on expected time course of recovery and (2) informing methods to minimize future participant adverse event risk during and after the percutaneous microbiopsy procedure. The present case report demonstrates that the inadvertent hemorrhaging of a neighboring vessel by percutaneous microbiopsy procedure can be debilitating. To minimize the risk of muscle biopsy‐induced hemorrhage/hematoma, we advise post‐biopsy compression for up to 15 min and post‐biopsy follow‐up should be completed for up to 72 h. When there is indication of hematoma development, compression should be applied, and the participant should avoid exercise and physical activity., The present case report demonstrates that the inadvertent hemorrhaging of a neighboring vessel by percutaneous microbiopsy procedure can be debilitating. To minimize the risk of muscle biopsy‐induced hemorrhage/hematoma, post biopsy compression is recommended for up to 15 min and post biopsy follow‐up should be completed for up to 72 h.

Direct time-domain sampling oscilloscopic capture of ultra-high bandwidth (32–102 GHz) modulated optical waveforms at 1550 nm is demonstrated at optical power levels below −100 dBm. To detect fast optical waveforms directly at power levels far below what traditional optical oscilloscope methods can measure, we use a time-correlated single-photon counting (TCSPC) sampling acquisition method, recently developed integrated electro-optic devices with >100 GHz electro-optic bandwidth, and single photon detectors with < 5 ps jitter. We show the reconstruction of the time domain signals by collecting histograms of time-binned single photons captured using TCSPC and characterize the spectral components in the frequency domain. The ability to acquire ultra-weak eye diagrams and identify high-frequency spectral components from a relatively small ensemble of single-photon measurements may lead to significant advances in optical waveform capture technology.

A complete 183-GHz CMOS/Indium Phosphide (InP) hybrid heterodyne-spectrometer is realized for spaceborne atmospheric remote sensing applications. It captures spontaneous emission from thermally populated pure rotational states for investigating Earth/planetary atmosphere and interstellar media. Recent missions such as the heterodyne instrument for far-infrared, the microwave limb sounder, and the microwave instrument for Rosetta orbiter highlighted the wealth of scientific knowledge that can be attained by utilizing heterodyne-spectrometers. However, major challenges still remain in mission cost, instrument size, weight, and power (SWaP). Highly integrated CMOS circuits are designed to prototype a low-cost/SWaP spectrometer system and conduct challenging science missions. Within the prototype system, a 183-GHz receiver with a frequency synthesizer is designed in the 28-nm CMOS, and a back-end 6-GS/s 4096-point spectrometer processor is designed in the 65-nm CMOS. The receiver's center frequency is tunable from 180 to 200 GHz. An external InP low-noise amplifier is added at the front-end to provide the required receiver sensitivity. The demonstrated 28-nm CMOS receiver and 65-nm CMOS spectrometer consume 515 mW under 1.5/1.15-V and 1500 mW under 1 V supply, respectively. The complete system achieves 700 to 1000 K noise temperature within the interested bandwidth and RMS uncertainty improvement up to 10 s integration according to the Allan deviation measurements. The spectrometer's capability in detecting gas phase molecular compounds is verified with laboratory trials employing water (H2O) and methyl-cyanide (CH3CN).

Perceived fatigability, which has perception of physical strain and of mental strain as its components, can impact exercise tolerance. Upon ascent to high altitude, low landers experience reduced exercise capacity and reduced tolerance for a given absolute submaximal work rate. It is established that perceived physical strain tracks with relative exercise intensity. However, it is not known how altitude ascent affects perceived mental strain relative to perceived physical strain. We tested the hypothesis that when exercising at the same relative exercise intensity perceived physical strain will remain unchanged whereas perceived mental strain will decrease on ascent from low to high altitude in the Everest region in Nepal. Twelve hours after arriving at each of three elevations; 1400 m, 3440 m, and 4240 m, 12 untrained participants used the task effort awareness (TEA) and physical‐rating of perceived exertion (P‐RPE) scales to report perceived mental and physical strain during a 20 min walking test at a self‐monitored heart rate reserve (HRR) range of 40–60% (Polar HR Monitor). TEA and P‐RPE were recorded twice during exercise (5–7 min and 14–16 min). Neither P‐RPE (1400 m: 11.1 ± 1.8, 3440 m: 10.7 ± 1.2, 4240 m: 11.5 ± 1.5) nor %HRR (1400 m: 55.25 ± 7.34, 3440 m: 51.70 ± 6.70, 4240 m: 50.17 ± 4.02) changed as altitude increased. TEA decreased at 4240 m (2.05 ± 0.71) compared to 1400 m (3.44 ± 0.84)––this change was not correlated with any change in %HRR nor was it due to a change in core affect. These findings support our hypothesis and demonstrate the independence of perceived physical and perceived mental strain components of perceived fatigability. Implications for exercise tolerance remain to be determined., Until now, no work had examined the domain of perceived mental strain upon ascent from low to high altitude. We tested and confirmed the hypothesis that at the same relative submaximal exercise intensity, participants would perceive the same amount of physical strain but less mental strain upon ascent from low to high altitude. Therefore, perceived mental strain dissociates from perceived physical strain upon ascent from low to high altitude—the mechanism(s) responsible for this dissociation remain to be determined.

Laboratory studies for planetary science and astrobiology aimat advancing our understanding of the Solar System through the promotion of theoretical and experimental research into the underlying processes that shape it. Laboratory studies (experimental and theoretical) are crucial to interpret observations and mission data, and are key incubators for new mission concepts as well as instrument development and calibration. They also play a vital role in determining habitability of Solar System bodies, enhancing our understanding of the origin of life, and in the search for signs of life beyond Earth, all critical elements of astrobiology. Here we present an overview of the planetary science areas where laboratory studies are critically needed, in particular in the next decade. These areas include planetary & satellites atmospheres, surfaces, and interiors, primitive bodies such as asteroids, meteorites, comets, and trans-Neptunian objects, and signs of life. Generating targeted experimental and theoretical laboratory data that are relevant for a better understanding of the physical, chemical, and biological processes occurring in these environments is crucial. For each area we present i) a brief overview of the state-of-the-art laboratory work, ii) the challenges to analyze and interpret data sets from missions and ground-based observations and to support mission and concept development, and iii) recommendations for high priority laboratory studies., White paper submitted to the Planetary Science Decadal Survey 2013-2022

Summary The history of the first transplants is an ideal model for analyzing the different stages of disruptive innovation in surgery. Pioneers have often taken paths that were strewn with pitfalls, mistakes or failures. Sometimes victory, brilliant or more modest, lies at the end of this path. We propose to re-explore the extraordinary pathways that led to the first transplantations of the kidney, liver, lung and heart. That these first transplants should one day become possible required the concurrence of several factors: basic research, laboratory work to perfect the surgical techniques, a favorable legislative and societal context, and, above all, pioneering surgeons who would dare to apply their expertise to human subjects. Initial failures were not technical but immunological. Not everything would be perfect, especially ethical questions in some cases. Furthermore, initial results often humbled the greatest surgeons. Even though the historical and legislative contexts have evolved considerably as have science, society and the organization of the health system, this analysis of the past is rich in lessons for the modern surgeon who wishes to embark today along innovative pathways in the face of a still unresolved problem. Because nothing is ever carved in stone.

International audience; The aim of this article is to assess the outcomes of a low-intensity extracorporeal shock wave therapy (LiESWT) protocol for the treatment of Peyronie's disease (PD). Patients treated for PD were prospectively recorded, and data were retrospectively reviewed. Age, characteristics of fibrous plaques, concomitant treatments, International Index of Erectile Function (IIEF-5), Lue score, and pain score on Likert scale were collected. Patients in acute phase of PD and an angulation of

This paper presents an overview of the current status of the Virtual Atomic and Molecular Data Centre (VAMDC) e-infrastructure, including the current status of the VAMDC-connected (or to be connected) databases, updates on the latest technological development within the infrastructure and a presentation of some application tools that make use of the VAMDC e-infrastructure. We analyse the past 10 years of VAMDC development and operation, and assess their impact both on the field of atomic and molecular (A&amp, M) physics itself and on heterogeneous data management in international cooperation. The highly sophisticated VAMDC infrastructure and the related databases developed over this long term make them a perfect resource of sustainable data for future applications in many fields of research. However, we also discuss the current limitations that prevent VAMDC from becoming the main publishing platform and the main source of A&amp, M data for user communities, and present possible solutions under investigation by the consortium. Several user application examples are presented, illustrating the benefits of VAMDC in current research applications, which often need the A&amp, M data from more than one database. Finally, we present our vision for the future of VAMDC.

Summary Introduction Renal arterial vasculature presents a great anatomical variation. A good knowledge of this anatomy is essential in the field of kidney transplantation. The aim of this study is to describe the anatomical variations of the renal arterial vasculature based on the retrieved but not transplanted kidneys (RNTK) and their contralateral grafted kidneys (CGK), which anatomy is described by surgeons themselves after aortic dissection during multi-organ procurement (MOP). Material and methods Using the “Crystal” database of the French “Agence de la biomedecine” (ABM), all RNTK were retrospectively selected over one year. Then, the arterial anatomy of each RNTK and their CGK was studied using the surgical and the histopathological reports. The surgical report was completed by the surgeon at the end of the MOP from deceased donors. The qualitative variables were expressed in numbers (percentage of the population) and were compared by a Chi2 test or an exact Fisher test depending on the sample size. A P-value of less than 0.05 was considered statistically significant. Results In total, 356 kidneys were studied (241 RNTK – 115 CGK), 69% had a single artery and 31% had multiple arteries (26% with two arteries and 5% with three or more). The incidence of multiple arteries was similar between the right and left kidneys (32% vs. 30% respectively). A modal arrangement with 1 artery on each side was present in 51% of cases. Thus, 1 in 2 donors had at least 2 arteries on one side. Multiple arteries were bilateral in 12% of cases. The RNTK group presented more kidneys with multiple arteries than the CGK group (35% vs. 22%). Conclusion Our study shows a higher incidence of multiple renal arteries than the literature (31% vs. 25%). Thus, MOP can be considered as an accurate and reliable method of describing renal arterial anatomy, especially that some small arteries may be missed when using radiological or cadaveric dissection techniques.

Sarcopenia or adipose tissue distribution within obese and overweight renal transplanted have been poorly evaluated. Our objective was to evaluate morphometric markers to predict surgical complications in kidney transplantation. We retrospectively included patients with a BMI > 25 kg/m2 undergoing kidney transplantation from 2012 to 2017. Following measurements were performed on CT-scan sections: Sub-cutaneous Adipose Tissue surface (SAT), Visceral Adipose Tissue surface (VAT), Vessel-to-Skin distance (VSK), Abdominal Perimeter (AP), and Psoas surface. A multivariable logistic regression model with BMI was compared to a model containing morphometric variables to determine the best predictive model for surgical complications. 248 patients were included, 15 (6%) experienced transplant nephrectomy, 18 (7.3%) urinary leakage, and 29 (11.7%) subcapsular renal hematoma. Multivariable logistic regression evidenced that sarcopenia and VSK were risk factors of surgical complication within a year post-transplantation (respectively, OR = 0.9, 95%CI (0.8–0.9), p = 0.04 and OR = 1.2, 95%CI (1.1–1.3), p = 0.002). Area under the curve for a predictive model including VSK, age and psoas surface was 0.69, whereas BMI model was 0.65. Combined morphometric parameters of obesity were associated with surgical complications in kidney transplantation. Morphometric threshold may provide a more accurate and objective criteria than BMI to evaluate kidney transplantation outcomes. External validation is needed.

This study tested the hypotheses that 1) skeletal muscle biopsies performed with the Bergström needle evoke larger perceptions of pain and greater hemodynamic reactivity compared to biopsies performed with the microbiopsy needle, and 2) both needles yield samples with similar fibre type compositions when samples are collected at similar skeletal muscle depths. Fourteen healthy (age: 21.6 ± 3.2 years; VO2peak: 41.5 ± 5.8 mL/kg/min) males (n = 7) and females (n = 7) provided two resting skeletal muscle biopsies, one with each needle type, following a randomized crossover design. Participants completed the short-form McGill Pain Questionnaire and the Brief Pain Inventory before, during, and after the skeletal muscle biopsies. Hemodynamic reactivity was assessed by measuring heart rate (HR) and mean arterial pressure (MAP) at rest and during the biopsy procedures. Immunofluorescence analysis was used to assess fibre type composition in vastus lateralis samples. Compared to the microbiopsy needle, the Bergström needle elicited a larger perception of pain but similar hemodynamic reactivity during the biopsy. Both needles yielded skeletal muscle samples with similar fibre type composition and resulted in similar perceptions of pain and pain-related interference during the post-biopsy recovery period. Collectively, these findings suggest that studies should consider using the microbiopsy needle rather than the Bergström needle unless large amounts of muscle tissue or certain muscle fibre lengths are required. However, future work should determine whether our findings are generalizable to biopsies performed with different procedures and/or types of Bergström/microbiopsy needles., Graphical abstract Image 1, Highlights • The first characterization of responses to two muscle biopsy techniques. • Compared to the Bergström, the microbiopsy needle evokes smaller pain responses. • Both needles resulted in similar hemodynamic reactivity and fibre type composition. • If analysis permits, future work should consider using the microbiopsy needle.

Compromising oxygen delivery (O2D) during exercise requires compensatory vasodilatory and/or pressor responses to protect O2D:demand matching. The purpose of the study was to determine whether compensatory vasodilation is absent in some healthy young individuals in the face of a sudden reduction in exercising forearm perfusion pressure and whether this affects the exercise pressor response. Twenty-one healthy young men (21.6 ± 2.0 yr) completed rhythmic forearm exercise at a work rate equivalent to 70% of their own maximal exercise vasodilation. During steady-state exercise, the exercising arm was rapidly adjusted from below to above heart level, resulting in a reduction in forearm perfusion pressure of −30.7 ± 0.9 mmHg. Forearm blood flow (ml/min; brachial artery Doppler and echo ultrasound), mean arterial blood pressure (mmHg; finger photoplethysmography), and exercising forearm venous effluent (antecubital vein catheter) measurements revealed distinct compensatory vasodilatory differences. Thirteen individuals responded with compensatory vasodilation (509 ± 128 vs. 632 ± 136 ml·min−1·100 mmHg−1; P < 0.001), while eight individuals did not (663 ± 165 vs. 667 ± 167 ml·min−1·100 mmHg−1; P = 0.6). Compensatory pressor responses between groups were not different (5.5 ± 5.5 and 9.7 ± 9.5 mmHg; P = 0.2). Forearm blood flow, O2D, and oxygen consumption were all protected in compensators (all P > 0.05) but not in noncompensators, who therefore suffered compromises to exercise performance (6 ± 14 vs. −36 ± 29 N; P = 0.004). Phenotypic differences were not explained by potassium or nitric oxide bioavailability. In conclusion, both compensator and noncompensator vasodilator phenotype responses to a sudden compromise to exercising muscle blood flow are evident. Interindividual differences in the mechanisms governing O2D:demand matching should be considered as factors influencing exercise tolerance. NEW & NOTEWORTHY In healthy young individuals, compromising submaximally exercising muscle perfusion appears to evoke compensatory vasodilation to defend oxygen delivery. Here we report the absence of compensatory vasodilation in 8 of 21 such individuals, despite their vasodilatory capacity and increases in perfusion with increasing exercise intensity being indistinguishable from compensators. The absence of compensation impaired exercise tolerance. These findings suggest that interindividual differences in oxygen delivery:demand matching efficacy affect exercise tolerance and depend on the nature of a delivery:demand matching challenge.

A compact and low-power complementary metal oxide semiconductor (CMOS)-based transmitter with an operational bandwidth of 90–105 GHz has been deployed as the radiation source in a high-resolution sub-Doppler (Lamb-dip) absorption spectrometer. The source output can be both frequency and amplitude modulated allowing for the application of highly sensitive detection schemes commonly used in molecular spectroscopy. The CMOS transmitter has been shown to have sufficient output power to perform spectral hole burning saturation experiments and a phase-noise floor low enough to determine spectral line positions with a precision of 1 part in 10 $^{\mathbf 9}$ to accuracy within the error of measurements made with traditional millimeter-wave sources.

The Fabry-Perot cavity in a miniature pulsed Fourier transform millimeter-wave spectrometer operating between 94 and 104 GHz is characterized in detail. The new device measures gas or volatile composition in situ and has a nominal volume of 12 cm3, which is 200 times smaller than cavities operating at comparable frequencies in laboratory gas spectrometers. Scans of mode amplitude are presented as a function of mirror spacing and transmitter frequency. Primary (TEM00) and secondary (TEM10) modes are both observed and are matched to an eigenmode calculation. The modes are well-behaved and have quality factors in the range of 1000–6000, which is a desirable compromise between field strength and mode width. Measurements of pulse bandwidth versus duration agree with time-bandwidth product predictions. Measurements of rotational transitions in N2O and CH3OH are plotted at various pressures and collisional broadening is resolved at mTorr pressures. Through these gas detections, we demonstrate that it is possible to significantly reduce the size of cavity spectrometers for in situ deployment. The new device opens new possibilities for molecular sensing in pollution monitoring, planetary science, and other fields.

This manuscript reports an effort to improve the absolute accuracy of ozone intensities in the 10 µm region via a transfer of the precision of the rotational dipole moment onto the infrared measurement. The approach determines the ozone mixing ratio through alternately measuring seven pure rotation ozone lines from 692 to 779 GHz. A multispectrum fitting technique was employed. The results determine the column with absolute accuracy of 1.5% and the intensities of infrared transitions measured at this accuracy reproduce the recommended values to within a standard deviation of 2.8%.

Over twenty-five years ago, Herb Pickett introduced his quantum-mechanical fitting programs to the spectroscopic community. The utility and flexibility of the software has enabled a whole generation of spectroscopists to analyze both simple and complex spectra without having to write and compile their own code. Last year Stewart Novick provided a primer for the coming generation of users. This follow-on work will serve as a guide to intermediate and advanced usage of the software. It is meant to be used in concert with the online documentation as well as the spectral line catalog archive.

A new CMOS-based spectroscopy instrument for in situ rotational spectroscopy of gases in space is presented. The design is based on the pulsed Fourier transform method of Balle–Flygare but operates at mm-wave frequencies as oppose to traditional microwave implementations. The core of the instrument consists of a 65 nm CMOS transceiver chipset with integrated mixers, synthesizers, and amplifiers covering the 95–105 GHz frequency band. The CMOS chips are coupled with a semiconfocal cavity which builds field strength for pumping rotational transitions. Details of the CMOS chip design as well as system level testing are discussed.

Several previously unmeasured transitions of 12 CH 3 D have been recorded by a terahertz photomixing continuous-wave spectrometer up to Q R (10) branch at 2.5 THz. An improved set of rotational constants has been obtained utilizing a THz frequency metrology based on a frequency comb that achieved an averaged frequency position better than 150 kHz on more than fifty ground-state transitions. A detailed analysis of the measured line intensities was undertaken using the multispectrum fitting program and has resulted in a determination of new dipole moment parameters. Measurements at different pressures of the Q R (7) transitions provide the first determination of self-broadening coefficients from pure rotational CH 3 D lines. The THz rotational measurements are consistent with IR rovibrational data but no significant vibrational dependence of self-broadening coefficient may be observed by comparison.

Robot-assisted radical cystectomy with intracorporeal urinary diversion is one of the most challenging procedures in urological surgery. Over the past 15 years, this procedure has gained in popularity and the number of procedures performed has increased significantly. While ileal conduit remains the most common diversion, orthotopic neobladders are also formed in a few expert centres that have developed their technique for totally intracorporeal neobladder. The objective of this review is to summarise the techniques currently used to perform totally intracorporeal neobladder with a special focus on their functional outcomes, such as continence or sexual function. The techniques described are the Karolinska-modified Studer neobladder, the USC-modified Studer neobladder, the pyramid pouch, the Y-pouch, and the vesica Ileale Padovana, some trying to totally reproduce the steps of open surgery and others trying to simplify them. Functional outcomes vary depending on the technique performed. Standardisation in assessing outcomes is lacking, as well as objective outcome measurements with questionnaires or urodynamic assessments. Current evidence shows acceptable functional outcomes after totally intracorporeal neobladder construction, but larger prospective randomised series with longer follow-up, better defined outcomes, and more objective measurements are needed in the future.

KEY POINTS The immediate increase in skeletal muscle blood flow following contraction is greater when the contracting muscle is below vs. above heart level. This has been attributed to muscle pump-mediated venous emptying and subsequent widening of the arterial to venous pressure gradient, which can occur below but not above heart level. However, alternative explanations could include greater rapid onset vasodilatation and/or transmural pressure-mediated mechanical distension of resistance vessels, but these remain unexplored. We demonstrate that active vasodilatation is not responsible for greater post-contraction hyperaemia below the heart. Instead, an increased transmural pressure-mediated mechanical distension of resistance vessels is a key mechanism responsible for this phenomenon. Our findings establish the importance of considering/accounting for local mechanical arteriolar distension effects when investigating exercise hyperaemia. They also inform the application of exercise for rehabilitative purposes and prompt investigation into whether arteriolar distension accompanying vasodilatation is reduced with diseases or ageing, thereby compromising exercising muscle perfusion. ABSTRACT We tested the hypotheses that increased post-contraction hyperaemia in higher (H; below heart) vs. lower (L; above heart) transmural pressure conditions is due to (1) greater active vasodilatation or (2) greater transmural pressure-mediated arteriolar distension. Participants (n = 20, 12 male, 8 female; combined mean age 24.5 ± 2 years) performed a 2 s isometric handgrip contraction, where arm position was maintained within or changed between H and L during contraction, resulting in four starting-finishing arm position conditions (LL, HL, LH, HH). Post-contraction forearm blood flow (echo and Doppler ultrasound) was higher with contraction release in H vs. L environments (P

This work presents focal plane modules for Polar Radiant Energy in the Far InfraRed Experiment, a passive remote-sensing instrument aimed to determine errors in the estimated outgoing longwave radiation in the Earth’s polar regions to reduce uncertainties in surface emissivity, mass balance, and ice flux. The focal plane arrays are micromachined at JPL and integrated into sub-assembly modules to be mounted on the optical telescope of the instrument.

Evaluate the safety, feasibility and efficiency of robot-assisted radical prostatectomy (RARP) in kidney transplant recipients, performed in high-volume French referral centres, and describe intra- and postoperative, oncological and functional outcomes.A multicentre study was conducted on prospective RARP databases from 5 centres between 2008 and 2017. We retrospectively identified a first group (G1) of transplant patients. The following data were collected: age, body mass index, prostate-specific antigen, ISUP score, TNM stage, stratification according to d'Amico, renal function, renal disease, time between renal transplant and prostate cancer (PCa), operating time, bleeding, pre- and postoperative complications (according to Clavien). Group 1 data were matched with a second group (G2) of nontransplanted PTRA patients.A total of 321 patients were included (G1 N = 39 and G2 N = 282). The median operating time was 180 minutes (interquartile range 125-227) for G1 and 150 minutes (120-180) in G2 (P = 0.0623) and the median bleeding volume was 150 mL (150-400) and 250 mL (175-400), respectively (P = 0.1826). No grafts were damaged by RARP. Postoperative complication rate was significantly higher in G1: 51.2% vs. G2: 8.2% with a majority of minor complications (41%) according to Clavien Dindo (P0.001). Pathological assessment was as follows in G1: T2 = 28 (71.8%), T3 = 11 (28.2%), and G2: T2 = 206 (73.3%), T3 = 75 (26.7%) (P = 0.77). Postoperative ISUP scores were mainly grade 1: G1 = 14 (35.9%) vs. 99 (35.2%) in G2 and grade 2: respectively 18 (46.1%) 94 (33.5%). The rate of positive surgical margins was comparable in both groups: 13.2% for transplant patients vs. 18.1% (P = 0.65). Renal function was not significantly different at one year (P = 0.07). The median follow-up was 47.9 months (42.3; 52.5).RARP is conceivable to treat localized prostate cancer in kidney transplant recipients. This procedure does not appear to have any negative impact on graft renal function and cancer prognosis.

The oxygen-conforming response (OCR) of skeletal muscle refers to a downregulation of muscle force for a given muscle activation when oxygen delivery (O2D) is reduced, which is rapidly reversed when O2D is restored. We tested the hypothesis that the OCR exists in voluntary human exercise and results in compensatory changes in muscle activation to maintain force output, thereby altering perception of effort. In eight men and eight women, electromyography (EMG), oxyhemoglobin (O2Hb) and deoxyhemoglobin (HHb), forearm blood flow (FBF), and task effort awareness (TEA) were measured. Participants completed two nonfatiguing rhythmic handgrip tests consisting of 5-min steady state (SS) followed by two bouts of 2-min brachial artery compression to reduce FBF by ~50% of SS (C1 and C2), separated by 2 min of no compression (NC1) and ending with 2 min of no compression (NC2). When FBF was compromised during C1, EMG/Force (1.58 ± 0.39) increased compared with SS (1.31 ± 0.33, P = 0.001). However, EMG/Force was not restored upon FBF restoration at NC1 (1.48 ± 0.38, P = 0.479), consistent with C1 evoking skeletal muscle fatigue. When FBF was compromised during C2, EMG/Force increased (1.73 ± 0.50) compared with NC1 (1.48 ± 0.38, P = 0.013). EMG/Force returned to NC1 levels during NC2 (1.50 ± 0.39, P = 0.016), consistent with an OCR in C2. TEA (SS 2.2 ± 2.3, C1 3.9 ± 2.5, NC1 3.4 ± 2.7, C2 4.6 ± 2.7, NC2 3.9 ± 2.8) mirrored changes in EMG. It is noteworthy that during the second compromise and then restoration of muscle oxygenation EMG and TEA were rapidly restored to precompromise levels. We interpreted these findings to support the existence of an OCR and its ability to rapidly modify perception of effort during voluntary exercise. NEW & NOTEWORTHY In healthy individuals, when force output is maintained during rhythmic handgrip exercise, muscle activation and perception of effort rapidly increase with compromised muscle oxygen delivery (O2D) and then return to precompromised levels when muscle O2D is restored. These findings suggest that an oxygen-conforming response (OCR) exists and is able to modify perception of effort during voluntary exercise. Therefore, similar to fatigue, an OCR may have implications for exercise tolerance.

Terahertz absorption spectroscopy was employed to measure the ground state pure rotational transitions of the water isotopologue HD 18 O . A total of 105 pure rotational transitions were observed in the 0.5–5.0 THz region with ∼ 100 kHz accuracy for the first time. The observed positions were fit to experimental accuracy using the Euler series expansion of the asymmetric-top Hamiltonian together with the literature Microwave, Far-IR and IR data in the ground state and ν 2 . The new measurements and predictions reported here support the analysis of astronomical observations by high-resolution spectroscopic telescopes such as SOFIA and ALMA where laboratory rest frequencies with uncertainties of 1 MHz or less are required for proper analysis of velocity resolved astrophysical data.

Pressure-broadened line shapes in the 30013←00001 (ν1+4 ν 2 0 +ν3) band of 12C16O2 at 6228 cm−1 are reanalyzed using new spectra recorded with sample temperatures down to 170 K. High resolution, high signal-to-noise (S/N) laboratory measurements of line shapes (Lorentz air- and self-broadened half-width coefficients, pressure-shift coefficients and off-diagonal relaxation matrix element coefficients) as a function of gas sample temperatures for various pressures and volume mixing ratios are presented. The spectra were recorded using two different Fourier transform spectrometers (FTS): (1) the McMath-Pierce FTS located at the National Solar Observatory on Kitt Peak, Arizona (and reported in Devi et al., J Mol Spectrosc 2007;245:52-80) and, (2) the Bruker IFS-125HR FTS at the Jet Propulsion Laboratory in Pasadena, California. The 19 spectra taken at Kitt Peak were all recorded near room temperature while the 27 Bruker spectra were acquired both at room temperature and colder temperatures (170-296 K). Various spectral resolutions (0.004–0.011 cm−1), absorption path lengths (2.46–121 m) and CO2 samples (natural and 12C-enriched) were included in the dataset. To maximize the accuracies of the various retrieved line parameters, a multispectrum nonlinear least squares spectrum fitting software program was used to adjust the ro-vibrational constants (G,B,D etc.) and intensity parameters (including Herman-Wallis terms) instead of directly measuring the individual line positions and intensities. To minimize systematic residuals, line mixing (via off-diagonal relaxation matrix elements) and quadratic speed dependence parameters were included in the analysis. Contributions from other weakly absorbing bands: the 30013←00001 and 30012←00001 bands of 13C16O2, the 30013←00001 band of 12C16O18O, hot bands 31113←01101 and 32212←02201 of 12C16O2, as well as the 40013←10001 and the 40014←10002 bands of 12C16O2, present within the fitted interval were also measured. Results from previous works and new calculations are compared to present measurements, where appropriate.

Objectifs L’arret cardiaque recupere (ACR) du donneur decede de mort encephalique (DDME) est responsable d’une ischemie renale precedant le prelevement et la transplantation, cependant l’ACR n’est pas associe a un pronostic fonctionnel defavorable des transplantations issues de DDME. L’objectif de cette etude est d’identifier des facteurs de risque de reprise retardee de fonction (RRF) specifiques aux DDME avec ACR. Methodes Sur les 6266 transplantations a partir de DDME de la base de donnees CRISTAL entre 2015 et 2017, 1760 proviennent de DDME ayant presentes un ACR. Nous avons extrait les caracteristiques des donneurs et des receveurs a partir de CRISTAL, le delai entre l’ACR et le clampage aortique, la duree de low-flow et no-flow ont ete codees en double lecture a partir des commentaires libres de la base. Nous avons exclu les donneurs sous assistance circulatoire, les ACR multiples et les greffes preemptives chez les receveurs. Nous avons etudie l’association des variables avec la RRF incluant la non-fonction primaire (NFP) chez les DDME avec ACR. Resultats Au total, 1475 greffes renales issues de donneurs DDME avec ACR ont ete incluses. L’âge moyen des donneurs etait de 49,9 ans, 56,7 % etaient des hommes. Les durees moyennes de no-flow et low-flow ont ete 7,5 minutes et 23,5 minutes respectivement. Le delai moyen entre ACR et prelevement etait de 3,3 jours. Le taux de RRF etait de 31,7 %, dont 2,7 % de NFP. En analyse univariee, il n’avait pas de difference significative entre les patients avec ou sans RRF sur la duree du low-flow et du no-flow. Le delai entre l’ACR et le prelevement chez les patients avec RRF etait de 3,4 jours contre 3,2 jours chez les patients sans RRF (p = 0,08) avec une distribution de cette variable differente en fonction du critere RRF dans notre population ( Fig. 1 ). Conclusion Bien que la survenue d’un ACR ne constitue pas un sur-risque de RRF chez les DDME, des parametres specifiques a cette situation pourraient affecter la fonction du greffon. La duree de conditionnement du donneur entre ACR et prelevement pourrait modifier le risque de RRF. Une analyse multivariee doit etre effectuee pour preciser les facteurs de risque specifiques a cette population.

Time-domain sampling oscilloscopic capture of ultra-high bandwidth modulated optical waveforms at 1550 nm is demonstrated at ultra-low power levels below −100dBm, with eye SNR varying from 13dB at 30 GHz to 6dB at 100 GHz.

In 2012, an expert working group from the French Transplant Health Authority recommended the use of hypothermic machine perfusion (HMP) to improve kidney preservation and transplant outcomes from expanded criteria donors, deceased after brain death. This study compares HMP and cold storage (CS) effects on delayed graft function (DGF) and transplant outcomes. We identified 4,316 kidney transplants from expanded criteria donors (2011-2014) in France through the French Transplant Registry. DGF occurrence was analyzed with a logistic regression, excluding preemptive transplants. One-year graft failure was analyzed with a Cox regression. A subpopulation of 66 paired kidneys was identified: one preserved by HMP and the other by CS from the same donor. Kidneys preserved by HMP (801) vs CS (3515) were associated with more frequent recipient comorbidities and older donors and recipients. HMP had a protective effect against DGF (24% in HMP group and 38% in CS group, OR = 0.49 [0.40-0.60]). Results were similar in the paired kidneys (OR = 0.23 [0.04-0.57]). HMP use decreased risk for 1-year graft failure (HR = 0.77 [0.60-0.99]). Initial hospital stays were shorter in the HMP group (P < 0.001). Our results confirm the reduction in DGF occurrence among expanded criteria donors kidneys preserved by HMP.

Resume Introduction Les reimplantations uretero-vesicales (RUV) chez l’adulte sont des interventions complexes le plus souvent decidees en cas de pathologie de l’uretere distal. L’objectif de ce travail etait de proposer une mise au point concernant les indications de RUV, les differentes techniques chirurgicales et leurs resultats fonctionnels. Materiel et methode Une recherche bibliographique a ete effectuee a partir de PubMed, GoogleScholar et Embase avec les mots cles suivants : ureter ; laparoscopy ; robotics, reimplantation ; surgery ; obstruction ; morbidity ; complications ; psoas hitch ; Boari flap ; ureteroneocystostomy . Resultats Dans plus de 50 % l’etiologie etait une lesion de l’uretere d’origine iatrogene. Lorsque la perte de substance ureterale etait inferieure a 2 cm, une RUV directe ou antireflux etait la technique de choix. En cas de perte de substance superieure a 2 cm, le lambeau de Boari ou la vessie psoique etait privilegie. Plusieurs voies d’abord chirurgicales etaient envisageables : ouverte, laparoscopique pure ou robot assistee. Les pertes sanguines estimees, la douleur et la duree moyenne de sejour semblaient etre meilleures par voie cœlioscopique conventionnelle ou robot assistee. En revanche, les complications, la fonction renale pre-/postoperatoire, la duree operatoire semblaient equivalentes. La complication majeure la plus frequemment retrouvee etait la fuite sur anastomose. Conclusion Les techniques de RUV sont desormais bien codifiees meme s’il s’agit d’une intervention assez rare en pratique courante. Les resultats fonctionnels sont satisfaisants d’apres la litterature et la morbidite de plus en plus reduite mais le niveau de preuve des etudes disponibles est faible.

Purpose The purpose of this study was to evaluate precise location criteria on magnetic resonance imaging (MRI) to improve detection of transition zone (TZ) and anterior stroma (AS) prostate cancers using targeted MRI/transrectal ultrasound fusion biopsies as a reference standard. Material and methods Ninety-six men (mean age: 65 years ± 7.7 [SD] [range: 46–83 years]) with an elevated prostate-specific antigen (PSA) (PSA ≥ 4 ng/mL) who underwent standard and targeted biopsies on a TZ/AS suspicious lesion were included. The database was reviewed to assess topographical and morphological features of each suspicious lesion on MR images (T2-weighted anatomical images on 1.5 T MRI or 3 T) including PI-RADS score assessed by a senior radiologist. Histopathological examination of MRI-transrectal ultrasound fusion biopsy specimens was used as the reference standard. Results Ninety patients had a positive targeted biopsy with a median [IQR] lesion size of 16 mm [13–20 mm]. Homogeneous hypointensity on T2-weighted mages, lenticular shape, lack of capsule and indistinct margins were present in 77/90 (85%) patients. All TZ/AS prostate cancers were located in the anterior half of the prostate: 3% at the base, 69% in the mid gland and 28% at the apex. Lesions were mainly located close to or within the AS (74%) and more rarely laterally compressed close to the peripheral anterior horn. Conclusion Our results suggest that specific topographic criteria of TZ and AS prostate cancers could add independent information to the usual diagnostic criteria in prostate MRI. Transrectal ultrasound fusion-targeted biopsies based on these specific criteria improve volume estimation of prostate cancers with substantial impact for prognosis and treatment planning.

Resume Objectif Le but de ce travail etait de decrire les principaux facteurs pronostiques identifies avec un impact sur la survie des patients diagnostiques avec une tumeur de la voie excretrice superieure (TVES). Materiel et methodes Une revue systematique de la litterature a ete realisee en utilisant le moteur de recherche Pubmed sans restriction de periode avec les mots cles suivants (MeSH) : urothelial carcinoma ; ureter ; renal pelvis ; prognosis ; recurrence ; survival ; predictive models ; nomogram . Resultats Le niveau de preuve etait faible (3) dans toutes les etudes. Il existait 4 categories de facteurs pronostiques dans les TVES : cliniques (caracteristiques du patient et de la tumeur), chirurgicaux, anatomopathologiques et moleculaires. Les facteurs pronostiques preoperatoires les plus importants etaient la taille > 3 cm, le grade (biopsie), la multifocalite, une hydronephrose importante, les comorbidites (ASA), le statut ECOG et le delai operatoire (> 3 mois). Apres chirurgie, les facteurs pronostiques les plus importants etaient : le stade, le grade, le carcinome in situ, les emboles tumoraux et l’invasion ganglionnaire. La biologie de l’inflammation (CRP) pourrait etre utile dans la prediction des stades localement avances. Les marqueurs moleculaires sont encore en evaluation. Conclusion L’identification de facteurs pronostiques des TVES a progresse au cours de ces dernieres annees. Ces facteurs sont a prendre en consideration seuls ou groupes au sein d’outils predictifs pour determiner au mieux la survie des malades.

Objectifs Les variations eventuelles du taux de PSA en fonction de l’obesite, chez les hommes porteurs d’un cancer de prostate (CaP) localise, sont peu explorees et pour le moins contradictoires. L’objectif de cette etude etait de confirmer ou infirmer que l’hemodilution, liee a l’obesite, entraine des variations du taux serique et de la masse de PSA en cas de CaP localise. Methodes La cohorte ANDROCAN ( NCT02235142 ), prospective, multicentrique, a recrute de juin 2013 a juin 2016, 1343 hommes porteurs d’un CaP localise, traites par prostatectomie radicale robot-assistee. Les mesures preoperatoires du poids, de la taille, de l’IMC, du pourcentage de masse graisseuse sur balance a impedance, et du PSA dans un laboratoire centralise, ont ete rapportees a l’histologie, confirmee par un anatomopathologiste unique, de la piece operatoire. La masse de PSA a ete calculee a partir du volume plasmatique suivant la formule simplifiee du Baltimore Longitudinal study of aging : volume plasmatique = 1,67 × surface corporelle. Resultats Parmi les 1343 patients, 432, 556 et 224 avaient un IMC 30 ng/mL respectivement. Au total, 912 patients etaient ISUP ≤ 2, d’âge median 63,6 (IQR : 59,50–68,0) ans. Au total, 431 patients etaient ISUP ≥ 3, d’âge median 65,6 (IQR : 61,0–69,1) ans. Les patients ISUP ≥ 3 etaient significativement plus âge. La comparaison des dosages de PSA et des masses de PSA par groupe ISUP est rapporte dans le Tableau 1 . La seule difference significative observait etait entre les masse de PSA des patients ISUP ≤ 2 avec un IMC > 30 vs [25–30]. Conclusion La concentration serique de PSA, en cas de cancer de prostate localise, n’est pas influencee par le poids du sujet. La masse de PSA semble plus discriminante, mais la mesure approchee du volume plasmatique relativise ces resultats.

Objectifs L’impact de la prise des statines sur le cancer de prostate (CaP) localise reste discute et tres diversement apprecie. L’objectif de cette etude a ete de comparer les concentrations des steroides sexuels de patients operes d’un CaP localise en fonction qu’ils soient traites ou non par statines. Methodes Etude prospective (2013–2016), multicentrique, sur 1343 hommes porteurs d’un CaP localise, traites par prostatectomie radicale robot-assistee. Les mesures preoperatoires du poids total et gras, de la taille, de l’IMC, du PSA,FSH, LH, SHBG et par chromatographie gazeuse-spectrometrie de masse de la DHEA, Δ4, Δ5, DHEA sulfate, testosterone totale (TT), bio-disponible (BT), DHT, E1, E2 de patients prenant des statines depuis au moins 6 mois, ont ete comparees a celles de patients ne recevant pas de statines. La probabilite de la difference entre les 2 groupes est obtenue par un test t par randomisation (10 000 iterations) tenant compte d’une eventuelle difference de variance entre groupes. Resultats Les concentration des 285 patients qui prenaient des statines depuis au moins 6 mois, ont ete comparees a celles des 71 patients ne recevant pas de statines ( Tableau 1 ). Le groupe recevant des statines est significativement plus âge ; TT, BT, DHT, Δ 4 y etait significativement plus faibles. Les differences sur E2 et le poids prostatique tangentent la significativite sans l’atteindre. Conclusion La prise de statine, de facon prolongee (≥ 6 mois) est associee a un hypogonadisme franc. Ce parametre devrait etre integre dans le profil metabolique pre-therapeutique des CaP localise.

Objectifs L’impact des traitements du cancer de la prostate localise sur la qualite de vie globale des patients est peu evalue. Nous avons etudie la qualite de vie des patients avant et un an apres prostatectomie totale. Methodes Nous reportons les resultats de l’etude prospective multicentrique ANDROCAN evaluant la qualite de vie des patients avant et un an apres prostatectomie totale. Le questionnaire standardise Aging Male's Symptoms Scale (AMS) mesurait la qualite de vie somatique, psychologique et sexuelle a l’aide de 3 sous-scores et un score global. Resultats Mille cent quatre-vingt-dix-sept sur 1347 (89 %) patients inclus dans l’etude ANDROCAN ont accepte de repondre aux questionnaires AMS avant prostatectomie totale. A un an postoperatoire, 701 (59 %) patients ont ete evalues. L’âge moyen des patients etaient de 63,9 ans (63,6–64,3). Le score global moyen AMS augmentait de 31,8 (31,1–32,5 IC95 %) a 35,9 (35,1–36,7 IC95 %) a un an postoperatoire, traduisant une alteration significative de la qualite de vie globale (p Conclusion La qualite de vie est un sujet d’interet pour la majorite des patients pris en charge pour un cancer de la prostate localise. Une alteration significative de la qualite de vie globale, sexuelle et psychologique etait observee un an apres prostatectomie totale. Les patients ayant un syndrome metabolique avaient un risque plus eleve d’alteration de la qualite de vie.