Interventional radiology in the management of complications after liver transplantation

The arrival of new surgical transplantation techniques, such as split living donor or auxiliary liver transplantation, have increased the incidence of vascular and biliary complications. The causes, symptoms, and diagnostic modalities of arterial, portal caval, and biliary complications are detailed. Interventional techniques, such as balloon angioplasty and stent placement in the arterial and portal tree, as well as biliary interventional techniques, are discusse

Multidetector CT enteroclysis: comparison of the reading performance for axial and coronal views

The purpose of this study was to compare the diagnostic performance of axial and coronal views in multidetector CT enteroclysis (MDCTE). We retrospectively evaluated 48 patients with pathological correlation investigated by MDCTE for small bowel disorders. After nasojejunal administration of 2l of 5% methylcellulose axial arterial and venous acquisition of MDCTE was followed by coronal reconstructions using equal slice thicknesses of 2.5mm with 2mm increments. Spatial resolution of both planes was evaluated by phantom. Three radiologists independently read axial and coronal images concerning 12 pathological features. The interobserver agreement and time of reading was calculated. Sensitivity and specificity resulted from comparison with histopathology (n=39) or follow-up (n=9). Phantom study revealed higher spatial resolution for axial than coronal views, whatever reconstruction interval was used. However, spatial frequency always remained high. Most pathological signs, such as bowel wall thickening (BWT), bowel wall enhancement (BWE) and intraperitoneal fluid (IPF), showed better interobserver agreement on axial than coronal views (BWT: 0.61 vs. 0.44; BWE: 0.56 vs. 0.5; IPF:0.53 vs. 0.43). The Wilcoxon signed-rank test revealed significantly higher sensitivity for axial than coronal views (P=0.0453); the time of reading was significantly shorter for the latter (P=0.0146). The diagnostic value of axial slices is superior to coronal reconstructions despite the reduced data volume and display of the physiological course of bowel loops on the coronal plan

The opposite of Dante's hell? The transfer of ideas for social housing at international congresses in the 1850s–1860s

With the advent of industrialization, the question of developing adequate housing for the emergent working classes became more pressing than before. Moreover, the problem of unhygienic houses in industrial cities did not stop at the borders of a particular nation-state; sometimes literally as pandemic diseases spread out 'transnationally'. It is not a coincidence that in the nineteenth century the number of international congresses on hygiene and social topics expanded substantially. However, the historiography about social policy in general and social housing in particular, has often focused on individual cases because of the different pace of industrial and urban development and is thus dominated by national perspectives. In this paper, I elaborate on transnational exchange processes and local adaptations and transformations. I focus on the transfer of the housing model of SOMCO in Mulhouse, (a French house building association) during social international congresses. I examine whether cross-national networking enabled and facilitated the implementation of ideas on the local scale. I will elaborate on the transmission and the local adaptation of the Mulhouse-model in Belgium. Convergences, divergences, and different factors that influenced the local transformations (personal choice, political situation, socioeconomic circumstances) will be taken into accoun

Organic carbon decomposition rates with depth under an agroforestry system in a calcareous soil

The aims of this study were: (i) assess soil organic carbon (SOC) mineralisation potential as a function of soil depth in an agroforestry (AF) plot compared to an agricultural plot (ii) estimate the contribution of soil inorganic carbon (SIC) to CO2 emissions at different depths. Soils were collected in an 18-year-old AF (tree rows and alleys) and in an adjacent agricultural plot. The incubation comprised four soil replicates per location (control, tree row, alley) and per depth (0-10, 10-30, 70-100 and 160-180 cm). Soil samples were moistened to reach field capacity, at pF 2.5, and were then incubated at 20°C in the dark. The CO2 concentration and the δ13C of the CO2 were measured after 1, 3, 7, 14, 21, 28, 35 and 44 days. The microbial biomass was measured at the end of the incubation. Decomposition rates were calculated, as well as the metabolic quotient. The cumulated total CO2, SIC-derived CO2 and SOC-derived CO2 emissions were only significantly higher in tree row than in the alley or in the control plot at 0-10 cm. SOC decomposition rates decreased with increasing depth. Contributions of SIC to total CO2 emissions according were comprised between 0.15 and 0.30 in topsoil layers and between 0.50 and 0.70 in subsoil layers. The higher emission in the tree row at 0-10 cm was related to a large amount of labile particulate organic matter. SOC did not seem to be more stabilized in AF compared to the control. SIC-derived CO2 must be taken into account on calcareous soils

Prevalence of pulmonary tuberculosis and HIV infections and risk factors associated to tuberculosis in detained persons in Antananarivo, Madagascar

The incidence rate of tuberculosis in prisons is estimated to be 8 times greater than that in the general population in Madagascar. Our objectives were to estimate the prevalence of pulmonary tuberculosis and HIV infection among prisoners and to identify risk factors associated with tuberculosis. We conducted a cross-sectional study at the central prison of Antananarivo from March to July 2021. Individual male and female inmates aged ≥ 13 years who had lived in the prison for at least three months prior to the study period were included as participants. Acid-fast bacilli detection by microscopy and/or culture, an intradermal tuberculin test, a chest X-ray, and a rapid diagnostic orientation test for HIV were performed. Among 748 participants, 4 (0.5%) were confirmed to have pulmonary tuberculosis. Overall, 14 (1.9%) patients had “confirmed” or “probable” tuberculosis [0.90–2.84, 95% CI]. The proportion of participants with latent tuberculosis infection was 69.6% (517/743) based on a positive tuberculin test without clinical symptoms or radiography images indicating tuberculosis. Out of 745 HIV screening tests, three showed reactive results (0.4%). Age (OR = 4.4, 95% CI [1.4–14.0]) and prior tuberculosis treatment (or episodes) were found to be associated with confirmed and probable tuberculosis

40Ar/39Ar ages of the sill complex of the Karoo large igneous province: implications for the Pliensbachian-Toarcian climate change.

Reliable geochronological results gathered so far (n = 76) have considerably constrained the timing of the emplacement of the Karoo large igneous province (LIP). Yet strikingly missing from this dating effortis the huge southern sill complex cropping out in the >0.6 x 10(6) km2 Main Karoo sedimentary basin. We present 16 new 40Ar/39Ar analyses carried out on fresh plagioclase and biotite separates from 15 sill samples collected along a N-S trend in the eastern part of the basin. The results show a large range of plateau and miniplateau ages (176.2 +- 1.3 to 183.8 +- 2.4 Ma), with most dates suggesting a -3 Ma (181-184 Ma) duration for the main sill events. The available age database allows correlation of the Karoo LIP emplacement with the Pliensbachian-Toarcian second-order biotic extinction, the global warming, and the Toarcian anoxic event (provided that adequate calibration between the 40K and 238U decay constant ismade). The mass extinction and the isotopic excursions recorded at the base of the Toarcian appear to be synchronous with both the increase of magma emission of the Karoo LIP and the emplacement of the sills.The CO2 and SO2 derived from both volcanic emissions as well as carbon-rich sedimentary layers intrudedby sills might be the main culprits of the Pliensbachian-Toarcian climate perturbations. We propose that the relatively low eruption rate of the Karoo LIP is one of the main reasons explaining why its impact on thebiosphere is relatively low contrary to, e.g., the CAMP (Triassic-Jurassic) and Siberia (Permo-Triassic) LIPs

Effectiveness of Chest Physiotherapy in Infants Hospitalized with Acute Bronchiolitis: A Multicenter, Randomized, Controlled Trial

Vincent Gajdos and colleagues report results of a randomized trial conducted among hospitalized infants with bronchiolitis. They show that a physiotherapy technique (increased exhalation and assisted cough) commonly used in France does not reduce time to recovery in this population

Global Carbon Budget 2023

Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere in a changing climate is critical to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe and synthesize data sets and methodology to quantify the five major components of the global carbon budget and their uncertainties. Fossil CO2 emissions (EFOS) are based on energy statistics and cement production data, while emissions from land-use change (ELUC), mainly deforestation, are based on land-use and land-use change data and bookkeeping models. Atmospheric CO2 concentration is measured directly, and its growth rate (GATM) is computed from the annual changes in concentration. The ocean CO2 sink (SOCEAN) is estimated with global ocean biogeochemistry models and observation-based fCO2 products. The terrestrial CO2 sink (SLAND) is estimated with dynamic global vegetation models. Additional lines of evidence on land and ocean sinks are provided by atmospheric inversions, atmospheric oxygen measurements, and Earth system models. The resulting carbon budget imbalance (BIM), the difference between the estimated total emissions and the estimated changes in the atmosphere, ocean, and terrestrial biosphere, is a measure of imperfect data and incomplete understanding of the contemporary carbon cycle. All uncertainties are reported as ±1σ. For the year 2022, EFOS increased by 0.9 % relative to 2021, with fossil emissions at 9.9±0.5 Gt C yr−1 (10.2±0.5 Gt C yr−1 when the cement carbonation sink is not included), and ELUC was 1.2±0.7 Gt C yr−1, for a total anthropogenic CO2 emission (including the cement carbonation sink) of 11.1±0.8 Gt C yr−1 (40.7±3.2 Gt CO2 yr−1). Also, for 2022, GATM was 4.6±0.2 Gt C yr−1 (2.18±0.1 ppm yr−1; ppm denotes parts per million), SOCEAN was 2.8±0.4 Gt C yr−1, and SLAND was 3.8±0.8 Gt C yr−1, with a BIM of −0.1 Gt C yr−1 (i.e. total estimated sources marginally too low or sinks marginally too high). The global atmospheric CO2 concentration averaged over 2022 reached 417.1±0.1 ppm. Preliminary data for 2023 suggest an increase in EFOS relative to 2022 of +1.1 % (0.0 % to 2.1 %) globally and atmospheric CO2 concentration reaching 419.3 ppm, 51 % above the pre-industrial level (around 278 ppm in 1750). Overall, the mean of and trend in the components of the global carbon budget are consistently estimated over the period 1959–2022, with a near-zero overall budget imbalance, although discrepancies of up to around 1 Gt C yr−1 persist for the representation of annual to semi-decadal variability in CO2 fluxes. Comparison of estimates from multiple approaches and observations shows the following: (1) a persistent large uncertainty in the estimate of land-use changes emissions, (2) a low agreement between the different methods on the magnitude of the land CO2 flux in the northern extra-tropics, and (3) a discrepancy between the different methods on the strength of the ocean sink over the last decade. This living-data update documents changes in methods and data sets applied to this most recent global carbon budget as well as evolving community understanding of the global carbon cycle. The data presented in this work are available at https://doi.org/10.18160/GCP-2023 (Friedlingstein et al., 2023)

Current use of androgens in bone marrow failure disorders: a report from the Severe Aplastic Anemia Working Party of the European Society of Blood and Marrow Transplantation

Androgens have represented the historical therapeutic backbone of bone marrow failure (BMF) syndromes. However, their role has been rarely analyzed in prospective setting and systematic and long-term data are currently unavailable regarding their usage, effectiveness and toxicity in both acquired and inherited BMF. Here, taking advantage of a unique disease-specific international dataset, we retrospectively analyzed the so far largest cohort of BMF patients who received androgens before or in absence of an allogeneic hematopoietic cell transplantation (HCT), reappraising their current use in these disorders. We identified 274 patients across 82 EBMT affiliated centers, 193 with acquired (median age of 32) and 81 with inherited BMF (median age of 8 years). With a median duration of androgen treatment of 5.6 and 20 months respectively, complete/partial remission rates at 3 months were of 6%/29% in acquired and 8%/29% in inherited disorders. Five-year overall survival and failure free survival (FFS) were respectively 63% and 23% in acquired and 78% and 14% in inherited contexts. Androgen initiation after second line treatments for acquired, and after > 12 months post-diagnosis for inherited group were identified as factors associated with improved FFS in multivariable analysis. Androgen use was associated with a manageable incidence of organ-specific toxicity and low rates of solid and hematological malignancies. Sub-analysis of transplant-related outcomes after exposure to these compounds showed probabilities of survival and complications similar to other transplanted BMF cohorts. This study delivers a unique opportunity to track androgen use in BMF syndromes and represents the basis for general recommendations on their use on behalf of the SAAWP of the EBMT