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2. Right Ex-situ split grafts for adult liver transplantation - A Multicenter Benchmarking Analysis

Author

Boulanger, Natacha, Muller, Xavier, Dondero, Federica, Golse, Nicolas, Goumard, Claire, Breton, Antoine, Sepulveda, Ailton, Allard, Marc-Antoine, Savier, Eric, Dokmak, Safi, Pittau, Gabriella, Ciacio, Oriana, Salloum, Chady, Perdigão, Fabiano, Rousseau, Géraldine, Lim, Chetana, Rossignol, Guillaume, Vibert, Eric, Sa Cunha, Antonio, Mohkam, Kayvan, Azoulay, Daniel, Adam, René, Scatton, Olivier, Lesurtel, Mickael, Cherqui, Daniel, Soubrane, Olivier, and Mabrut, Jean Yves

Published
2024
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6. Estudos epidemiológicos ocupacionais em área rural: desafios metodológicos

Author

Neice Muller Xavier Faria, Rodrigo Dalke Meucci, and Anaclaudia Gastal Fassa

Subjects
agricultura, saúde do trabalhador, população rural, estudos epidemiológicos, agrotóxicos, Public aspects of medicine, RA1-1270
Abstract

Resumo Introdução: a produção agrícola no Brasil tem crescido nas últimas décadas e os trabalhadores rurais estão expostos a vários riscos ocupacionais. Estudos epidemiológicos sobre o tema ainda são limitados, especialmente pela complexidade metodológica. Objetivos: apresentar os principais desafios metodológicos para a realização de estudos epidemiológicos ocupacionais rurais. Métodos: as considerações apresentadas neste artigo têm como base a literatura e a experiência dos autores como pesquisadores desta temática. Resultados: foram abordados conceitos sobre população alvo, local de moradia e trabalho, classificação dos trabalhadores e caracterização do contexto da produção agrícola. Foram exploradas as estratégias de amostragem; a caracterização dos indicadores econômicos, incluindo produção agrícola e nível de mecanização; a exposição aos agrotóxicos, como tipos químicos, formas e frequência de exposição; a intoxicação por agrotóxicos; e a disponibilidade e o uso de Equipamentos de Proteção Individual. Foram descritos os cuidados com amostras biológicas, bem como aspectos envolvendo entrevistadores, treinamentos, trabalho de campo, questões climáticas e logísticas. Conclusão: apesar dos desafios metodológicos e logísticos, com o planejamento adequado é possível realizar com êxito pesquisas de grande complexidade e de alto nível científico sobre a relação saúde-trabalho na atividade agropecuária.

Published
2023
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7. A multicenter randomized-controlled trial of hypothermic oxygenated perfusion (HOPE) for human liver grafts before transplantation

Author

Schlegel, Andrea, Mueller, Matteo, Muller, Xavier, Eden, Janina, Panconesi, Rebecca, von Felten, Stefanie, Steigmiller, Klaus, Sousa Da Silva, Richard X., de Rougemont, Olivier, Mabrut, Jean-Yves, Lesurtel, Mickaël, Cerisuelo, Miriam Cortes, Heaton, Nigel D., Allard, Marc Antoine, Adam, Rene, Monbaliu, Diethard, Jochmans, Ina, Haring, Martijn P.D., Porte, Robert J., Parente, Alessandro, Muiesan, Paolo, Kron, Philipp, Attia, Magdy, Kollmann, Dagmar, Berlakovich, Gabriela, Rogiers, Xavier, Petterson, Karin, Kranich, Anne L., Amberg, Stefanie, Müllhaupt, Beat, Clavien, Pierre-Alain, and Dutkowski, Philipp

Published
2023
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9. Utilization of livers donated after circulatory death for transplantation – An international comparison

Author

Eden, Janina, Da Silva, Richard Sousa, Cortes-Cerisuelo, Miriam, Croome, Kristopher, De Carlis, Riccardo, Hessheimer, Amelia J., Muller, Xavier, de Goeij, Femke, Banz, Vanessa, Magini, Giulia, Compagnon, Philippe, Elmer, Andreas, Lauterio, Andrea, Panconesi, Rebecca, Widmer, Jeannette, Dondossola, Daniele, Muiesan, Paolo, Monbaliu, Diethard, de Rosner van Rosmalen, Marieke, Detry, Olivier, Fondevila, Constantino, Jochmans, Ina, Pirenne, Jacques, Immer, Franz, Oniscu, Gabriel C., de Jonge, Jeroen, Lesurtel, Mickaël, De Carlis, Luciano G., Taner, C. Burcin, Heaton, Nigel, Schlegel, Andrea, and Dutkowski, Philipp

Published
2023
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10. HOPE Mitigates Ischemia-Reperfusion Injury in Ex-Situ Split Grafts: A Comparative Study With Living Donation in Pediatric Liver Transplantation

Author

Rossignol, Guillaume, primary, Muller, Xavier, additional, Ruiz, Mathias, additional, Collardeau-Frachon, Sophie, additional, Boulanger, Natacha, additional, Depaulis, Celia, additional, Antonini, Teresa, additional, Dubois, Remi, additional, Mohkam, Kayvan, additional, and Mabrut, Jean-Yves, additional

Published
2024
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11. Novel Benchmark Values for Redo Liver Transplantation: Does the Outcome Justify the Effort?

Author

Abbassi, Fariba, Gero, Daniel, Muller, Xavier, Bueno, Alba, Figiel, Wojciech, Robin, Fabien, Laroche, Sophie, Picard, Benjamin, Shankar, Sadhana, Ivanics, Tommy, van Reeven, Marjolein, van Leeuwen, Otto B., Braun, Hillary J., Monbaliu, Diethard, Breton, Antoine, Vachharajani, Neeta, Bonaccorsi Riani, Eliano, Nowak, Greg, McMillan, Robert R., Abu-Gazala, Samir, Nair, Amit, Bruballa, Rocio, Paterno, Flavio, Weppler Sears, Deborah, Pinna, Antonio D., Guarrera, James V., de Santibañes, Eduardo, de Santibañes, Martin, Hernandez-Alejandro, Roberto, Olthoff, Kim, Ghobrial, R Mark, Ericzon, Bo-Göran, Ciccarelli, Olga, Chapman, William C., Mabrut, Jean-Yves, Pirenne, Jacques, Müllhaupt, Beat, Ascher, Nancy L., Porte, Robert J., de Meijer, Vincent E., Polak, Wojciech G., Sapisochin, Gonzalo, Attia, Magdy, Soubrane, Olivier, Weiss, Emmanuel, Adam, René A., Cherqui, Daniel, Boudjema, Karim, Zieniewicz, Krzysztof, Jassem, Wayel, Dutkowski, Philipp, and Clavien, Pierre-Alain

Published
2022
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14. Brief O2 uploading during continuous hypothermic machine perfusion is simple yet effective oxygenation method to improve initial kidney function in a porcine autotransplant model

Author

Darius, Tom, Vergauwen, Martial, Smith, Thomas, Gerin, Isabelle, Joris, Virginie, Mueller, Matteo, Aydin, Selda, Muller, Xavier, Schlegel, Andrea, Nath, Jay, Ludwig, Christian, Dessy, Chantal, Many, Marie-Christine, Bommer, Guido, Dutkowski, Philipp, Gianello, Pierre, and Mourad, Michel

Published
2020
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16. Caracterização das unidades de produção agrícola que usam agrotóxicos em Vacaria (RS)

Author

Nilva Lúcia Rech Stedile, Neice Muller Xavier Faria, Suzete Marchetto Claus, and Danusa Santos Brandão

Subjects
agrotóxicos, uso de praguicidas, agricultura, saúde ocupacional, saúde ambiental, Agriculture (General), S1-972
Abstract

Resumo As características das unidades produtivas (UP) e o uso de agrotóxicos são importantes para avaliar riscos à saúde humana e ambiental. Este estudo buscou descrever os aspectos das UP relacionados ao uso dos agrotóxicos e identificar possíveis práticas de risco para os trabalhadores. Estudo descritivo, a partir de entrevistas realizadas em 426 UP. Foi avaliada área (em módulos fiscais), mata nativa, produção vegetal e animal, nível de mecanização, uso e manejo de agrotóxicos e orientações técnicas. A análise incluiu medida de tendência central e de dispersão e análise de proporções. Associações foram examinadas com teste qui-quadrado de Pearson e de tendência linear. Não houve diferença na proporção de mata nativa conforme área. As UP maiores apresentavam maior nível de mecanização. O uso de agrotóxicos foi relatado por 96,5% das UP. As maiores UP usavam práticas mais adequadas no armazenamento, no destino das embalagens e tinham mais orientações de técnicos. Independentemente do tamanho da UP foram verificados problemas de gerenciamento dos riscos, em especial nas embalagens de produtos veterinários. Existem diferenças importantes no manejo de agrotóxicos entre as diversas UP, mas em geral os trabalhadores agrícolas estão em situação de vulnerabilidade socioambiental devido à exposição química intensa.

Published
2021
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20. Learning invariant features through local space contraction

Author

Rifai, Salah, Muller, Xavier, Glorot, Xavier, Mesnil, Gregoire, Bengio, Yoshua, and Vincent, Pascal

Subjects
Computer Science - Artificial Intelligence
Abstract

We present in this paper a novel approach for training deterministic auto-encoders. We show that by adding a well chosen penalty term to the classical reconstruction cost function, we can achieve results that equal or surpass those attained by other regularized auto-encoders as well as denoising auto-encoders on a range of datasets. This penalty term corresponds to the Frobenius norm of the Jacobian matrix of the encoder activations with respect to the input. We show that this penalty term results in a localized space contraction which in turn yields robust features on the activation layer. Furthermore, we show how this penalty term is related to both regularized auto-encoders and denoising encoders and how it can be seen as a link between deterministic and non-deterministic auto-encoders. We find empirically that this penalty helps to carve a representation that better captures the local directions of variation dictated by the data, corresponding to a lower-dimensional non-linear manifold, while being more invariant to the vast majority of directions orthogonal to the manifold. Finally, we show that by using the learned features to initialize a MLP, we achieve state of the art classification error on a range of datasets, surpassing other methods of pre-training.

Published
2011

21. Deep Self-Taught Learning for Handwritten Character Recognition

Author

Bastien, Frédéric, Bengio, Yoshua, Bergeron, Arnaud, Boulanger-Lewandowski, Nicolas, Breuel, Thomas, Chherawala, Youssouf, Cisse, Moustapha, Côté, Myriam, Erhan, Dumitru, Eustache, Jeremy, Glorot, Xavier, Muller, Xavier, Lebeuf, Sylvain Pannetier, Pascanu, Razvan, Rifai, Salah, Savard, Francois, and Sicard, Guillaume

Subjects
Computer Science - Learning, Computer Science - Computer Vision and Pattern Recognition, Computer Science - Neural and Evolutionary Computing, 68T05, I.2.6
Abstract

Recent theoretical and empirical work in statistical machine learning has demonstrated the importance of learning algorithms for deep architectures, i.e., function classes obtained by composing multiple non-linear transformations. Self-taught learning (exploiting unlabeled examples or examples from other distributions) has already been applied to deep learners, but mostly to show the advantage of unlabeled examples. Here we explore the advantage brought by {\em out-of-distribution examples}. For this purpose we developed a powerful generator of stochastic variations and noise processes for character images, including not only affine transformations but also slant, local elastic deformations, changes in thickness, background images, grey level changes, contrast, occlusion, and various types of noise. The out-of-distribution examples are obtained from these highly distorted images or by including examples of object classes different from those in the target test set. We show that {\em deep learners benefit more from out-of-distribution examples than a corresponding shallow learner}, at least in the area of handwritten character recognition. In fact, we show that they beat previously published results and reach human-level performance on both handwritten digit classification and 62-class handwritten character recognition.

Published
2010

25. Dor na coluna torácica e fatores associados em fumicultores

Author

Maitê Peres de Carvalho, Nadia Spada Fiori, Rodrigo Dalke Meucci, Neice Muller Xavier Faria, and Anaclaudia Gastal Fassa

Subjects
saúde do trabalhador, coluna vertebral, fumo, transtornos traumáticos cumulativos, agricultores, Public aspects of medicine, RA1-1270
Abstract

Resumo Introdução: dor na coluna torácica diz respeito a traumas cumulativos envolvendo má postura, movimentos repetitivos e longos períodos na mesma posição. Objetivo: avaliar a prevalência de dor na coluna torácica e fatores associados em fumicultores no sul do Brasil. Métodos: estudo transversal cuja associação entre o desfecho e os fatores sociodemográficos e comportamentais, atividades laborais, cargas de trabalho e comorbidades foram examinadas pelo teste de Wald para heterogeneidade e tendência linear. A análise multivariável foi realizada utilizando modelo hierárquico e regressão de Poisson com variância robusta. Resultados: o estudo envolveu 2.469 indivíduos de ambos os sexos. A prevalência de dor na coluna torácica foi de 21,2%. Limpar equipamento para aplicação de agrotóxico, número de episódios de Doença da Folha Verde, sintomas respiratórios e transtornos psiquiátricos menores foram positivamente associados ao desfecho em ambos os sexos. Tabagismo e intoxicação por agrotóxicos foram associados ao desfecho entre as mulheres, enquanto escolaridade e passar varas com folhas de tabaco foram associados aos homens. Conclusões: reestruturação ergonômica, redução das cargas de trabalho, trocas de posição durante o turno de trabalho e mecanização do processo de trabalho são estratégias importantes para reduzir a exposição à nicotina, agrotóxicos e carga de trabalho ergonômica.

Published
2020
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27. Hypothermic Oxygenated Perfusion Versus Normothermic Regional Perfusion in Liver Transplantation From Controlled Donation After Circulatory Death: First International Comparative Study

Author

Muller, Xavier, Mohkam, Kayvan, Mueller, Matteo, Schlegel, Andrea, Dondero, Federica, Sepulveda, Ailton, Savier, Eric, Scatton, Olivier, Bucur, Petru, Salame, Ephrem, Jeddou, Heithem, Sulpice, Laurent, Pittau, Gabriella, Allard, Marc-Antoine, Mabrut, Jean-Yves, Dutkowski, Philipp, Clavien, Pierre-Alain, and Lesurtel, Mickael

Published
2020
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30. In situ normothermic regional perfusion versus ex situ normothermic machine perfusion in liver transplantation from donation after circulatory death

Author

Mohkam, Kayvan, Nasralla, David, Mergental, Hynek, Muller, Xavier, Butler, Andrew, Jassem, Wayel, Imber, Charles, Monbaliu, Diethard, Perera, M Thamara PR, Laing, Richard W, García-Valdecasas, Juan Carlos, Paul, Andreas, Dondero, Federica, Cauchy, François, Savier, Eric, Scatton, Olivier, Robin, Fabien, Sulpice, Laurent, Bucur, Petru, Salamé, Ephrem, Pittau, Gabriella, Allard, Marc-Antoine, Pradat, Pierre, Rossignol, Guillaume, Mabrut, Jean-Yves, Ploeg, Rutger J, Friend, Peter J, Mirza, Darius F, Lesurtel, Mickaël, Consortium For Organ Preservation In Europe (COPE), Mohkam, Kayvan [0000-0002-9695-0902], Mergental, Hynek [0000-0001-5480-9380], Muller, Xavier [0000-0002-8849-5495], Savier, Eric [0000-0003-4131-2222], Rossignol, Guillaume [0000-0002-9896-4144], Mabrut, Jean-Yves [0000-0002-5701-3588], Lesurtel, Mickaël [0000-0003-2397-4599], and Apollo - University of Cambridge Repository

Subjects
End Stage Liver Disease, Perfusion, Carcinoma, Hepatocellular, Graft Survival, Liver Neoplasms, Humans, Aspartate Aminotransferases, Organ Preservation, Severity of Illness Index, Liver Transplantation
Abstract

In situ normothermic regional perfusion (NRP) and ex situ normothermic machine perfusion (NMP) aim to improve the outcomes of liver transplantation (LT) using controlled donation after circulatory death (cDCD). NRP and NMP have not yet been compared directly. In this international observational study, outcomes of LT performed between 2015 and 2019 for organs procured from cDCD donors subjected to NRP or NMP commenced at the donor center were compared using propensity score matching (PSM). Of the 224 cDCD donations in the NRP cohort that proceeded to asystole, 193 livers were procured, resulting in 157 transplants. In the NMP cohort, perfusion was commenced in all 40 cases and resulted in 34 transplants (use rates: 70% vs. 85% [p = 0.052], respectively). After PSM, 34 NMP liver recipients were matched with 68 NRP liver recipients. The two cohorts were similar for donor functional warm ischemia time (21 min after NRP vs. 20 min after NMP; p = 0.17), UK-Donation After Circulatory Death risk score (5 vs. 5 points; p = 0.38), and laboratory Model for End-Stage Liver Disease scores (12 vs. 12 points; p = 0.83). The incidence of nonanastomotic biliary strictures (1.5% vs. 2.9%; p > 0.99), early allograft dysfunction (20.6% vs. 8.8%; p = 0.13), and 30-day graft loss (4.4% vs. 8.8%; p = 0.40) were similar, although peak posttransplant aspartate aminotransferase levels were higher in the NRP cohort (872 vs. 344 IU/L; p < 0.001). NRP livers were more frequently allocated to recipients suffering from hepatocellular carcinoma (HCC; 60.3% vs. 20.6%; p < 0.001). HCC-censored 2-year graft and patient survival rates were 91.5% versus 88.2% (p = 0.52) and 97.9% versus 94.1% (p = 0.25) after NRP and NMP, respectively. Both perfusion techniques achieved similar outcomes and appeared to match benchmarks expected for donation after brain death livers. This study may inform the design of a definitive trial.

Published
2022

39. Utilization of livers donated after circulatory death for transplantation - An international comparison

Author

Eden, J, Da Silva, R, Cortes-Cerisuelo, M, Croome, K, De Carlis, R, Hessheimer, A, Muller, X, de Goeij, F, Banz, V, Magini, G, Compagnon, P, Elmer, A, Lauterio, A, Panconesi, R, Widmer, J, Dondossola, D, Muiesan, P, Monbaliu, D, de Rosner van Rosmalen, M, Detry, O, Fondevila, C, Jochmans, I, Pirenne, J, Immer, F, Oniscu, G, de Jonge, J, Lesurtel, M, De Carlis, L, Taner, C, Heaton, N, Schlegel, A, Dutkowski, P, Eden, Janina, Da Silva, Richard Sousa, Cortes-Cerisuelo, Miriam, Croome, Kristopher, De Carlis, Riccardo, Hessheimer, Amelia J, Muller, Xavier, de Goeij, Femke, Banz, Vanessa, Magini, Giulia, Compagnon, Philippe, Elmer, Andreas, Lauterio, Andrea, Panconesi, Rebecca, Widmer, Jeannette, Dondossola, Daniele, Muiesan, Paolo, Monbaliu, Diethard, de Rosner van Rosmalen, Marieke, Detry, Olivier, Fondevila, Constantino, Jochmans, Ina, Pirenne, Jacques, Immer, Franz, Oniscu, Gabriel C, de Jonge, Jeroen, Lesurtel, Mickaël, De Carlis, Luciano G, Taner, C Burcin, Heaton, Nigel, Schlegel, Andrea, Dutkowski, Philipp, Eden, J, Da Silva, R, Cortes-Cerisuelo, M, Croome, K, De Carlis, R, Hessheimer, A, Muller, X, de Goeij, F, Banz, V, Magini, G, Compagnon, P, Elmer, A, Lauterio, A, Panconesi, R, Widmer, J, Dondossola, D, Muiesan, P, Monbaliu, D, de Rosner van Rosmalen, M, Detry, O, Fondevila, C, Jochmans, I, Pirenne, J, Immer, F, Oniscu, G, de Jonge, J, Lesurtel, M, De Carlis, L, Taner, C, Heaton, N, Schlegel, A, Dutkowski, P, Eden, Janina, Da Silva, Richard Sousa, Cortes-Cerisuelo, Miriam, Croome, Kristopher, De Carlis, Riccardo, Hessheimer, Amelia J, Muller, Xavier, de Goeij, Femke, Banz, Vanessa, Magini, Giulia, Compagnon, Philippe, Elmer, Andreas, Lauterio, Andrea, Panconesi, Rebecca, Widmer, Jeannette, Dondossola, Daniele, Muiesan, Paolo, Monbaliu, Diethard, de Rosner van Rosmalen, Marieke, Detry, Olivier, Fondevila, Constantino, Jochmans, Ina, Pirenne, Jacques, Immer, Franz, Oniscu, Gabriel C, de Jonge, Jeroen, Lesurtel, Mickaël, De Carlis, Luciano G, Taner, C Burcin, Heaton, Nigel, Schlegel, Andrea, and Dutkowski, Philipp

Abstract

Background and aim: Liver graft utilization rates are a hot topic due to the worldwide organ shortage and an increasing number of transplant candidates on waiting lists. Liver perfusion techniques have been introduced in several countries, and may help to increase the organ supply, as they potentially allow the assessment of livers before use. Methods: Liver offers were counted from donation after circulatory death (DCD) donors (Maastricht-type-III) arising during the past decade in eight countries, including Belgium, France, Italy, the Netherlands, Spain, Switzerland, UK, and US. Initial DCD-type-III liver offers were correlated with accepted, recovered and implanted livers. Results: A total number of 34`269 DCD livers were offered, resulting in 9`780 liver transplants (28.5%). The discard rates were highest in UK and US, ranging between 70 and 80%. In contrast, much lower DCD liver discard rates, e.g., between 30-40%, were found in Belgium, France, Italy, Spain and Switzerland. In addition, large differences were recognized in the use of various machine perfusion techniques, and in terms of risk factors in the cohorts of implanted livers. For example, the median donor age and functional donor warm ischemia were highest in Italy, e.g., >40minutes, followed by Switzerland, France, and the Netherlands. Importantly, such varying risk profiles of accepted DCD livers between countries did not translate into large differences in five-year graft survival rates, which ranged between 60-82% in this analysis. Conclusions: We highlight a significant number of discarded and consequently unused DCD liver offers. Countries with more routine use of in- and ex-situ machine perfusion strategies showed better DCD utilization rates without compromised outcome. Impact and implications: A significant number of Maastricht type III DCD livers are discarded across Europe and North America today. The overall utilization rate among eight Western countries is 28.5%, but varies significant

Published
2023

40. A multicenter randomized-controlled trial of hypothermic oxygenated perfusion (HOPE) for human liver grafts before transplantation

Author

Schlegel, Andrea; https://orcid.org/0000-0002-9385-9847, Mueller, Matteo; https://orcid.org/0000-0002-1118-156X, Muller, Xavier, Eden, Janina, Panconesi, Rebecca, von Felten, Stefanie; https://orcid.org/0000-0002-5264-6394, Steigmiller, Klaus; https://orcid.org/0000-0002-2527-9234, Sousa Da Silva, Richard X; https://orcid.org/0000-0001-8970-7077, de Rougemont, Olivier, Mabrut, Jean-Yves, Lesurtel, Mickaël, Cerisuelo, Miriam Cortes, Heaton, Nigel D, Allard, Marc Antoine, Adam, Rene, Monbaliu, Diethard, Jochmans, Ina; https://orcid.org/0000-0003-4592-2810, Haring, Martijn P D, Porte, Robert J, Parente, Alessandro; https://orcid.org/0000-0001-5506-224X, Muiesan, Paolo; https://orcid.org/0000-0002-7389-6691, Kron, Philipp, Attia, Magdy, Kollmann, Dagmar, Berlakovich, Gabriela; https://orcid.org/0000-0001-8850-7874, Rogiers, Xavier, Petterson, Karin, Kranich, Anne L, Amberg, Stefanie, Müllhaupt, Beat; https://orcid.org/0000-0002-9020-8192, et al, Schlegel, Andrea; https://orcid.org/0000-0002-9385-9847, Mueller, Matteo; https://orcid.org/0000-0002-1118-156X, Muller, Xavier, Eden, Janina, Panconesi, Rebecca, von Felten, Stefanie; https://orcid.org/0000-0002-5264-6394, Steigmiller, Klaus; https://orcid.org/0000-0002-2527-9234, Sousa Da Silva, Richard X; https://orcid.org/0000-0001-8970-7077, de Rougemont, Olivier, Mabrut, Jean-Yves, Lesurtel, Mickaël, Cerisuelo, Miriam Cortes, Heaton, Nigel D, Allard, Marc Antoine, Adam, Rene, Monbaliu, Diethard, Jochmans, Ina; https://orcid.org/0000-0003-4592-2810, Haring, Martijn P D, Porte, Robert J, Parente, Alessandro; https://orcid.org/0000-0001-5506-224X, Muiesan, Paolo; https://orcid.org/0000-0002-7389-6691, Kron, Philipp, Attia, Magdy, Kollmann, Dagmar, Berlakovich, Gabriela; https://orcid.org/0000-0001-8850-7874, Rogiers, Xavier, Petterson, Karin, Kranich, Anne L, Amberg, Stefanie, Müllhaupt, Beat; https://orcid.org/0000-0002-9020-8192, and et al

Abstract

BACKGROUND & AIMS Machine perfusion is a novel method intended to optimize livers before transplantation. However, its effect on morbidity within a 1-year period after transplantation has remained unclear. METHODS In this multicenter controlled trial, we randomly assigned livers donated after brain death (DBD) for liver transplantation (LT). Livers were either conventionally cold stored (control group), or cold stored and subsequently treated by 1-2 h hypothermic oxygenated perfusion (HOPE) before implantation (HOPE group). The primary endpoint was the occurrence of at least one post-transplant complication per patient, graded by the Clavien score of ≥III, within 1-year after LT. The comprehensive complication index (CCI), laboratory parameters, as well as duration of hospital and intensive care unit stay, graft survival, patient survival, and biliary complications served as secondary endpoints. RESULTS Between April 2015 and August 2019, we randomized 177 livers, resulting in 170 liver transplantations (85 in the HOPE group and 85 in the control group). The number of patients with at least one Clavien ≥III complication was 46/85 (54.1%) in the control group and 44/85 (51.8%) in the HOPE group (odds ratio 0.91; 95% CI 0.50-1.66; p = 0.76). Secondary endpoints were also not significantly different between groups. A post hoc analysis revealed that liver-related Clavien ≥IIIb complications occurred less frequently in the HOPE group compared to the control group (risk ratio 0.26; 95% CI 0.07-0.77; p = 0.027). Likewise, graft failure due to liver-related complications did not occur in the HOPE group, but occurred in 7% (6 of 85) of the control group (log-rank test, p = 0.004, Gray test, p = 0.015). CONCLUSIONS HOPE after cold storage of DBD livers resulted in similar proportions of patients with at least one Clavien ≥III complication compared to controls. Exploratory findings suggest that HOPE decreases the risk of severe liver graft-related events. IMPACT AND IMPLICATIO

Published
2023

41. Benchmarks in Pancreatic Surgery: A Novel Tool for Unbiased Outcome Comparisons

Author

Sánchez-Velázquez, Patricia, Muller, Xavier, Malleo, Giuseppe, Park, Joon-Seong, Hwang, Ho-Kyoung, Napoli, Niccolò, Javed, Ammar A., Inoue, Yosuke, Beghdadi, Nassiba, Kalisvaart, Marit, Vigia, Emanuel, Walsh, Carrie D., Lovasik, Brendan, Busquets, Juli, Scandavini, Chiara, Robin, Fabien, Yoshitomi, Hideyuki, Mackay, Tara M., Busch, Olivier R., Hartog, Hermien, Heinrich, Stefan, Gleisner, Ana, Perinel, Julie, Passeri, Michael, Lluis, Nuria, Raptis, Dimitri A, Tschuor, Christoph, Oberkofler, Christian E., DeOliveira, Michelle L., Petrowsky, Henrik, Martinie, John, Asbun, Horacio, Adham, Mustapha, Schulick, Richard, Lang, Hauke, Koerkamp, Bas Groot, Besselink, Marc G., Han, Ho-Seong, Miyazaki, Masaru, Ferrone, Cristina R., Fernández-del Castillo, Carlos, Lillemoe, Keith D., Sulpice, Laurent, Boudjema, Karim, Del Chiaro, Marco, Fabregat, Joan, Kooby, David A., Allen, Peter, Lavu, Harish, Yeo, Charles J., Barroso, Eduardo, Roberts, Keith, Muiesan, Paolo, Sauvanet, Alain, Saiura, Akio, Wolfgang, Christopher L., Cameron, John L., Boggi, Ugo, Yoon, Dong-Sup, Bassi, Claudio, Puhan, Milo A., and Clavien, Pierre-Alain

Published
2019
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46. Urinary cotinine in tobacco farmers in Southern Brazil

Author

Anaclaudia Gastal Fassa, Rodrigo Dalke Meucci, Nadia Spada Fiori, Maria Laura Vidal Carrett, and Neice Muller Xavier Faria

Subjects
Farmers, Cotinine, urine, Tobacco, adverse effects, Sectional Studies, Public aspects of medicine, RA1-1270
Abstract

ABSTRACT OBJECTIVE To describe urinary cotinine levels in tobacco farmers. METHODS A cross-sectional study was conducted in 2,570 tobacco farmers. All participants that reported green tobacco sickness in the week prior to the interview plus a subsample of 492 pesticide applicators were included. We collected urinary samples and information about sociodemographic, behavioral, dietary, occupational characteristics, and pesticide poisoning during their lifetime. Stratification by sex and smoking was performed and the Wilcoxon and Kruskal-Wallis non-parametrical tests were used to analyze cotinine means. RESULTS This study included 582 individuals. There was no difference in urinary cotinine means between green tobacco sickness symptomatic and asymptomatic individuals. Among non-smokers, having picked tobacco in the previous week was associated with higher cotinine means in both genders. Cotinine levels were higher on the first day of symptoms and reduced exponentially with each day in female non-smokers. Male non-smokers had higher levels on the second day and a more gradual reduction. The cotinine level rose up to 15 cigarettes/day of consumption. CONCLUSIONS The urinary cotinine measures exposure to nicotine up to its saturation point; while green tobacco sickness, affected by tolerance, indicates nicotine poisoning. Strategies to reduce nicotine exposure in tobacco production are needed. Mechanization could be an alternative, as long as it overcame the challenge of irregular terrain and did not affect the quality of the leaf. More studies are needed to evaluate the chronic effect of nicotine exposure.

Published
2018
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49. Association between workplace bullying and common mental disorders in civil servants from a middle-income country

Author

Fernando Feijo, Neice Muller Xavier Faria, Maitê Peres de Carvalho, Mayte Amazarray, Neil Pearce, Ana Laura Sica Cruzeiro Szortyka, and Anaclaudia Gastal Fassa

Subjects
Workplace bullying, medicine.medical_specialty, business.industry, Mental Disorders, Health, Toxicology and Mutagenesis, media_common.quotation_subject, Public Health, Environmental and Occupational Health, Psychological intervention, Bullying, Logistic regression, Mental health, Occupational safety and health, Occupational Stress, Cross-Sectional Studies, Surveys and Questionnaires, Environmental health, Epidemiology, Prevalence, medicine, Humans, Personality, Workplace, business, Psychosocial, media_common
Abstract

Workplace bullying (WB) is associated with Common mental disorders (CMD) in high-income countries, but there is a lack of evidence relating to this subject in low- and middle-income countries. Therefore, this study aimed to investigate the association between bullying and CMD in Brazil. A cross-sectional study with 907 judicial civil servants from Porto Alegre, southern Brazil, was carried out. WB was measured by the Negative Acts Questionnaire (NAQ-r) and CMD by the Self-Reporting Questionnaire (SRQ-20). Logistic regression was used to analyse data and test hypotheses. The overall prevalence of CMD was 32.8%, while the overall prevalence of bullying was 18.3%. WB was strongly associated with CMD, even after controlling for confounders. After adjustment for sociodemographic, personality and occupational confounders, weekly and daily exposures to negative acts increased 4.32 (95% CI: 2.00-9.33) and 6.80 (95% CI: 3.42-13.51) times the risk of CMD, respectively. Considering the operational definition, bullied workers had a 3.45 (95% CI: 2.26-5.25) higher risk of CMD. The results are consistent with studies from high-income countries. Different ways of categorising exposure to WB and testing association with CMD are suggested. Interventions to prevent bullying, focusing on work processes and psychosocial factors at work, could reduce the risk of mental health problems.

Published
2021

50. Suicidality among South Brazilian tobacco growers

Author

Anaclaudia Gastal Fassa, Neice Muller Xavier Faria, Ana Laura Sica Cruzeiro Szortyka, Rodrigo Dalke Meucci, Nadia Spada Fiori, Maitê Peres de Carvalho, Betina Daniele Flesch, and Fernando Feijó

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Suicide, Attempted, Toxicology, Suicidal Ideation, Nicotine, Young Adult, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Occupational Exposure, Surveys and Questionnaires, Tobacco, medicine, Humans, Poisson regression, Pesticides, Psychiatry, Suicidal ideation, 030304 developmental biology, Asthma, 0303 health sciences, Suicide attempt, business.industry, General Neuroscience, Agriculture, Middle Aged, medicine.disease, Mental health, Chronic low back pain, Cross-Sectional Studies, Socioeconomic Factors, symbols, Female, medicine.symptom, business, Green Tobacco Sickness, Brazil, 030217 neurology & neurosurgery, medicine.drug
Abstract

Objective To assess prevalence of suicidal ideation and suicide attempt among South Brazilian tobacco growers and to analyze the associated factors related to the suicidal ideation. Methods A cross-sectional study was conducted in 2011 with a random sample of 2469 tobacco growers in Sao Lourenco do Sul/RS. Suicidal ideation was characterized by the question “Has the thought of ending your life been on your mind?”. Suicide attempt was assessed by the question “Have you ever tried to kill yourself?”. Investigation of factors associated with suicidal ideation was done by means of Poisson regression. Results Prevalence of suicidal ideation and suicide attempt was 2.5 % and 1.2 % respectively. In the adjusted analysis, suicidal ideation was associated with being female, older age, moderate participation in religious activities and difficulty in paying debts. Those who worked in activities that required inadequate postures (hunched over or other forced positions), as well as farmers who performed 6–9 pesticide-related tasks demonstrated greater risk of suicidal ideation. Regarding health conditions, medical diagnosis of asthma, chronic low back pain, number of lifetime green tobacco sickness episodes and lifetime pesticide poisoning were positively associated with suicidal ideation. Conclusion Suicidal thoughts and attempts are relevant mental health problems among tobacco growers. Reducing pesticide use, as well as exposure to nicotine and improving socio-economic conditions, can reduce suicidal ideation and improve the mental health of exposed workers.

Published
2021

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