Summary Objectives To estimate the prevalence and factors associated with Human Papillomavirus (HPV) infection, HPV genotypes and cytological/histological high-grade (HSIL+/CIN2+) lesions. Methods We ...conducted a cross-sectional study within a prospective cohort of HIV-infected women on combination antiretroviral therapy (cART). Cervical specimens were collected for cytology and HPV genotyping (Papillocheck® ). Any women with High-Risk-HPV (HR-HPV), and/or potentially HR-HPV (pHR-HPV) and/or ASC-US or higher (ASC-US+) lesions were referred for colposcopy. Factors associated with HR-HPV infection and with HSIL+/CIN2+ lesions were investigated using mixed-effects logistic regression models. Results 829 women were enrolled: median age 40.4 years, on cART for a median of 6.9 years, median CD4 cell-count 536 cells/mm3, and 788 (96%) with HIV-viral load<50copies/mL. Of 214 (26%) infected with HPV: 159 (19%) had ≥1 HR-HPV, of whom 38 (5%) HPV52, 22 (3%) HPV16, 9 (1%) HPV18; 21 (3%) had pHR-HPV, 34 (4%) low risk-HPV infection, and 56 (26%) had multiple genotypes. Younger age, low CD4 cell-counts and low education were independently associated with HR-HPV infection. 72 women (9%) had ASC-US+ and 28 (3%) HSIL+/CIN2+ lesions. HR-HPV infection was independently associated with HSIL+/CIN2+ lesions. Conclusion The prevalence of HPV infection and of cervical lesions was low. The HPV genotype distribution supports the use of 9-valent vaccine in Thailand.
Background
Patients with inflammatory bowel disease (IBD) may have a modified immune response to SARS-CoV-2. The objectives were to evaluate the prevalence of COVID-19 in patients treated with ...infliximab or vedolizumab, to analyze the factors associated with the infection, the impact of treatments and trough levels.
Methods
Patients with IBD treated with intravenous biologics in 14 French centers were included between March and June 2020 and followed-up for 6 months. Blood samples were collected for serologies and trough levels. The analysis of factors associated with COVID-19 was conducted in a matched 1:1 case-control sub-study with positive patients.
Results
In total, 1026 patients were included (74.9% infliximab). Over the follow-up period, 420 patients reported the occurrence of COVID-19 symptoms; 342 had been tested of whom 18 were positive. At the end of follow-up, 38 patients had a positive serology. Considering both nasal tests and serologies together, 46 patients (4.5%) had been infected. The risk of COVID-19 was related neither to the use of treatments (whatever the trough levels) nor to disease activity. Infections were more frequent when using public transport or living in flats in urban areas.
Conclusions
The prevalence rate of COVID-19 in this IBD population treated with intravenous infliximab or vedolizumab was the same as the one in the French population before the start of the vaccination campaign. The risk was increased by urban living and was not influenced by disease activity or biologics. Sanitary barrier measures remain the best way to protect against SARS-CoV-2 in patients with IBD in biological therapy.
Lithium isotopic analysis is of interest in various fields from biology to energy. In addition to analytical methods commonly used for that purpose, a new complementary method for determining the ...spatial resolution of isotopic ratio in solid samples was previously developed: laser induced self-reversal isotopic spectrometry (LIBRIS), derived from laser-induced breakdown spectroscopy (LIBS). In this paper, we present a proof of concept of fast spatially-resolved quantitative isotopic analysis of lithium by LIBS both in depth (z resolution) and in configuration of high-resolution surface mapping (x and y resolution). First, a depth profile measurement where a 9% relative uncertainty on the 6Li isotopic ratio and 0.74 μm depth resolution is obtained. Then, we introduce the first high-resolution lithium isotopic mapping obtained by LIBS with a 3.3 μm lateral resolution and a typical 40% relative uncertainty on the 6Li isotopic ratio is obtained. Those results could be applied in the future to a large number of solid samples where fast information on the lithium isotopic distribution are needed, for instance in solid-state batteries development.
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•First spatially-resolved isotopic measurements of Li by LIBS.•Analysis of epoxy samples containing Li2CO3.•Depth-resolved and surface mapping quantitative analysis of 6Li isotopic abundance.•9% shot-to-shot uncertainty on the isotopic abundance for depth profile measurements.•40% shot-to-shot uncertainty on the isotopic abundance with a 3.3 μm resolution.
In order to improve the safety of Li-ion batteries, solid-state electrolytes have been studied for many years. However, lithium is known to have lower diffusion coefficients in these materials. ...Various methods can be used to investigate lithium transport mechanisms; one of them relies on isotopic tracing. This method often used in environmental sciences, medicine and biology has been developed since 2011 by Lu et al. in the battery field. In addition to the techniques commonly used for isotopic analysis of lithium in battery materials, such as nuclear magnetic resonance (NMR) and mass spectrometry techniques, a new complementary method for determining the spatial distribution of the lithium isotopic ratio in solid electrolytes has been developed: laser induced self-reversal isotopic spectrometry (LIBRIS) proposed by Touchet et al. in 2020. In this paper, a proof of concept of LIBRIS analysis of a solid electrolyte composed of poly(ethylene oxide) (POE) containing 6Li enriched lithium bis(trifluoromethylsulphonyl)imide (LiTFSI) was first achieved. Then, the lateral resolution of LIBRIS measurements was improved from 250 μm down to 7 μm. Such lateral resolution is well adapted to future studies of lithium transport mechanisms in a solid electrolyte composed of a dispersion of ceramic microparticles in a polymer matrix. This material design is used as a trade-off to improve Li diffusion compared to polymer-based electrolytes. The sources of signal fluctuations were discussed, and a calibration curve of the 6Li isotopic abundance in POE/LiTFSI samples was finally obtained, with a relative uncertainty of 25%. The results demonstrate the feasibility of high resolution isotopic analysis by the LIBRIS technique and could be applied in the future to the characterization of the lithium mobility in battery materials.
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•Isotopic tracing for the study of lithium mobility in solid battery electrolytes•LIBRIS measurements with 250 and 7 μm lateral resolution in Li2CO3 and POE/LiTFSI•A 5–10% uncertainty on the 6Li isotopic abundance is reached with a 250 μm resolution•A 25–30% uncertainty on the 6Li isotopic abundance is reached with a 7 μm resolution•Opens the way to the analysis of particles/polymer interfaces in hybrid electrolytes
Prophylactic administration of tranexamic acid has been associated with reduced postpartum blood loss after cesarean delivery in several small trials, but evidence of its benefit in this clinical ...context remains inconclusive.
In a multicenter, double-blind, randomized, controlled trial, we assigned women undergoing cesarean delivery before or during labor at 34 or more gestational weeks to receive an intravenously administered prophylactic uterotonic agent and either tranexamic acid (1 g) or placebo. The primary outcome was postpartum hemorrhage, defined as a calculated estimated blood loss greater than 1000 ml or receipt of a red-cell transfusion within 2 days after delivery. Secondary outcomes included gravimetrically estimated blood loss, provider-assessed clinically significant postpartum hemorrhage, use of additional uterotonic agents, and postpartum blood transfusion.
Of the 4551 women who underwent randomization, 4431 underwent cesarean delivery, 4153 (93.7%) of whom had primary outcome data available. The primary outcome occurred in 556 of 2086 women (26.7%) in the tranexamic acid group and in 653 of 2067 (31.6%) in the placebo group (adjusted risk ratio, 0.84; 95% confidence interval CI, 0.75 to 0.94; P = 0.003). There were no significant between-group differences in mean gravimetrically estimated blood loss or in the percentage of women with provider-assessed clinically significant postpartum hemorrhage, use of additional uterotonic agents, or postpartum blood transfusion. Thromboembolic events in the 3 months after delivery occurred in 0.4% of women (8 of 2049) who received tranexamic acid and in 0.1% of women (2 of 2056) who received placebo (adjusted risk ratio, 4.01; 95% CI, 0.85 to 18.92; P = 0.08).
Among women who underwent cesarean delivery and received prophylactic uterotonic agents, tranexamic acid treatment resulted in a significantly lower incidence of calculated estimated blood loss greater than 1000 ml or red-cell transfusion by day 2 than placebo, but it did not result in a lower incidence of hemorrhage-related secondary clinical outcomes. (Funded by the French Ministry of Health; TRAAP2 ClinicalTrials.gov number, NCT03431805.).
Abstract Telomeres protect chromosome ends and control cell division and senescence. During organogenesis, telomeres need to be long enough to ensure the cell proliferation necessary at this stage of ...development. Previous studies have shown that telomere shortening is associated with growth retardation and congenital malformations. However, these studies were performed in newborns or postnatally, and data on telomere length (TL) during the prenatal period are still very limited. We measured TL using quantitative PCR in amniotic fluid (AF) and chorionic villi (CV) samples from 69 control fetuses with normal ultrasound (52 AF and 17 CV) and 213 fetuses (165 AF and 48 CV) with intrauterine growth retardation (IUGR) or congenital malformations diagnosed by ultrasound. The samples were collected by amniocentesis at the gestational age (GA) of 25.0 ± 5.4 weeks and by CV biopsy at 18.1 ± 6.3 weeks. In neither sample type was TL influenced by GA or fetal sex. In AF, a comparison of abnormal versus normal fetuses showed a significant telomere shortening in cases of IUGR (reduction of 34%, P < 10−6), single (29%, P < 10−6) and multiple (44%, P < 10−6) malformations. Similar TL shortening was also observed in CV from abnormal fetuses but to a lesser extent (25%, P = 0.0002; 18%, P = 0.016; 20%, P = 0.004, respectively). Telomere shortening was more pronounced in cases of multiple congenital anomalies than in fetuses with a single malformation, suggesting a correlation between TL and the severity of fetal phenotype. Thus, TL measurement in fetal samples during pregnancy could provide a novel predictive marker of pathological development.
Abstract
Telomeres protect chromosome ends and control cell division and senescence. During organogenesis, telomeres need to be long enough to ensure the cell proliferation necessary at this stage of ...development. Previous studies have shown that telomere shortening is associated with growth retardation and congenital malformations. However, these studies were performed in newborns or postnatally, and data on telomere length (TL) during the prenatal period are still very limited. We measured TL using quantitative PCR in amniotic fluid (AF) and chorionic villi (CV) samples from 69 control fetuses with normal ultrasound (52 AF and 17 CV) and 213 fetuses (165 AF and 48 CV) with intrauterine growth retardation (IUGR) or congenital malformations diagnosed by ultrasound. The samples were collected by amniocentesis at the gestational age (GA) of 25.0 ± 5.4 weeks and by CV biopsy at 18.1 ± 6.3 weeks. In neither sample type was TL influenced by GA or fetal sex. In AF, a comparison of abnormal versus normal fetuses showed a significant telomere shortening in cases of IUGR (reduction of 34%, P < 10−6), single (29%, P < 10−6) and multiple (44%, P < 10−6) malformations. Similar TL shortening was also observed in CV from abnormal fetuses but to a lesser extent (25%, P = 0.0002; 18%, P = 0.016; 20%, P = 0.004, respectively). Telomere shortening was more pronounced in cases of multiple congenital anomalies than in fetuses with a single malformation, suggesting a correlation between TL and the severity of fetal phenotype. Thus, TL measurement in fetal samples during pregnancy could provide a novel predictive marker of pathological development.
Enterovirus D68 (EV-D68) has emerged as an agent of epidemic respiratory illness and acute flaccid myelitis in the paediatric population but data are lacking in adult patients. We performed a ...4.5-year single-centre retrospective study of all patients who tested positive for EV-D68 and analysed full-length EV-D68 genomes of the predominant clades B3 and D1. Between 1 June 2014, and 31 December 2018, 73 of the 11,365 patients investigated for respiratory pathogens tested positive for EV-D68, of whom 20 (27%) were adults (median age 53.7 years IQR 34.0-65.7) and 53 (73%) were children (median age 1.9 years IQR 0.2-4.0). The proportion of adults increased from 12% in 2014 to 48% in 2018 (
= 0.01). All adults had an underlying comorbidity factor, including chronic lung disease in 12 (60%), diabetes mellitus in six (30%), and chronic heart disease in five (25%). Clade D1 infected a higher proportion of adults than clades B3 and B2 (
= 0.001). Clade D1 was more divergent than clade B3: 5 of 19 amino acid changes in the capsid proteins were located in putative antigenic sites. Adult patients with underlying conditions are more likely to present with severe complications associated with EV-D68, notably the emergent clade D1.
Management of pregnant women at risk of venous thromboembolism (VTE) and placental vascular complications (PVCs) remains complex. Guidelines do not definitively specify optimal strategies.
Our ...objective was to evaluate the impact of employing risk score-driven prophylaxis strategies on VTE and PVC rates in at-risk pregnant women.
This study, conducted in 21 French maternity units, compared VTE and PVC rates before and after implementation of a risk scoring system to determine prophylactic strategies.
A total of 2,085 pregnant women at risk of VTE or PVC were enrolled. Vascular events occurred in 190 (19.2%) patients before and 140 (13.0%) after implementation of risk score-driven prophylaxis (relative risk RR = 0.68 0.55; 0.83). The incidence of deep vein thrombosis during pregnancy was reduced (RR = 0.30 0.14; 0.67). PVC comprised mainly pre-eclampsia, occurring in 79 patients before and 42 patients after risk score implementation (RR = 0.52 0.36; 0.75). Post-partum haemorrhage occurred in 32 patients (3.2%) before and 48 patients (4.5%) after risk score implementation (RR = 1.38 0.89; 2.13,
= 0.15).
Use of a simple risk scoring system, developed by experts in VTE and PVC research to guide prophylaxis, reduced the risk of thrombotic events during pregnancy without any significant increase in bleeding risk.
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