Design and methodology of the Swiss Transplant Cohort Study (STCS): a comprehensive prospective nationwide long-term follow-up cohort.

In Switzerland, organ procurement is well organized at the national-level but transplant outcomes have not been systematically monitored so far. Therefore, a novel project, the Swiss Transplant Cohort Study (STCS), was established. The STCS is a prospective multicentre study, designed as a dynamic cohort, which enrolls all solid organ recipients at the national level. The features of the STCS are a flexible patient-case system that allows capturing all transplant scenarios and collection of patient-specific and allograft-specific data. Beyond comprehensive clinical data, specific focus is directed at psychosocial and behavioral factors, infectious disease development, and bio-banking. Between May 2008 and end of 2011, the six Swiss transplant centers recruited 1,677 patients involving 1,721 transplantations, and a total of 1,800 organs implanted in 15 different transplantation scenarios. 10 % of all patients underwent re-transplantation and 3% had a second transplantation, either in the past or during follow-up. 34% of all kidney allografts originated from living donation. Until the end of 2011 we observed 4,385 infection episodes in our patient population. The STCS showed operative capabilities to collect high-quality data and to adequately reflect the complexity of the post-transplantation process. The STCS represents a promising novel project for comparative effectiveness research in transplantation medicine.

Identifying the preferred subset of enzymatic profiles in nonlinear kinetic metabolic models via multiobjective global optimization and pareto filters

Optimization models in metabolic engineering and systems biology focus typically on optimizing a unique criterion, usually the synthesis rate of a metabolite of interest or the rate of growth. Connectivity and non-linear regulatory effects, however, make it necessary to consider multiple objectives in order to identify useful strategies that balance out different metabolic issues. This is a fundamental aspect, as optimization of maximum yield in a given condition may involve unrealistic values in other key processes. Due to the difficulties associated with detailed non-linear models, analysis using stoichiometric descriptions and linear optimization methods have become rather popular in systems biology. However, despite being useful, these approaches fail in capturing the intrinsic nonlinear nature of the underlying metabolic systems and the regulatory signals involved. Targeting more complex biological systems requires the application of global optimization methods to non-linear representations. In this work we address the multi-objective global optimization of metabolic networks that are described by a special class of models based on the power-law formalism: the generalized mass action (GMA) representation. Our goal is to develop global optimization methods capable of efficiently dealing with several biological criteria simultaneously. In order to overcome the numerical difficulties of dealing with multiple criteria in the optimization, we propose a heuristic approach based on the epsilon constraint method that reduces the computational burden of generating a set of Pareto optimal alternatives, each achieving a unique combination of objectives values. To facilitate the post-optimal analysis of these solutions and narrow down their number prior to being tested in the laboratory, we explore the use of Pareto filters that identify the preferred subset of enzymatic profiles. We demonstrate the usefulness of our approach by means of a case study that optimizes the ethanol production in the fermentation of Saccharomyces cerevisiae.

Two different epidemiological scenarios of border disease in the populations of Pyrenean chamois (Rupicapra p. pyrenaica) after the first disease outbreaks

Since 2001 several outbreaks of a new disease associated with Border disease virus (BDV) infection have caused important declines in Pyrenean chamois (Rupicapra pyrenaica) populations in the Pyrenees. The goal of this study was to analyze the post-outbreak BDV epidemiology in the first two areas affected by disease with the aim to establish if the infection has become endemic. We also investigated if BDV infected wild and domestic ruminants sharing habitat with chamois. Unexpectedly, we found different epidemiological scenarios in each population. Since the disease outbreaks, some chamois populations recuperated quickly, while others did not recover as expected. In chamois from the first areas, prevalence was high (73.47%) and constant throughout the whole study period and did not differ between chamois born before and after the BDV outbreak; in all, BDV was detected by RT-PCR in six chamois. In the other areas, prevalence was lower (52.79%) and decreased during the study period; as well, prevalence was significantly lower in chamois born after the disease outbreak. No BDV were detected in this population. A comparative virus neutralisation test performed with four BDV strains and one Bovine viral diarrhoea virus (BVDV) strain showed that all the chamois had BDV-specific antibodies. Pestivirus antibodies were detected in all the rest of analyzed species, with low prevalence values in wild ruminants and moderate values in domestic ruminants. No viruses were detected in these species. These results confirm the hypothesis that outbreaks of BDV infection only affect the Pyrenean chamois, although other wild ruminants can occasionally be infected. In conclusion, two different scenarios have appeared since the first border disease outbreaks in Pyrenean chamois: on the one hand frequent BDV circulation with possible negative impact on population dynamics in some areas and on the other, lack of virus circulation and quick recovery of the chamois population.

Does ear C sink strength contributes to the overcoming of photosynthetic acclimation of wheat plants exposed to elevated CO2?

Wheat plants (Triticum durum Desf., cv. Regallo) were grown in the field to study the effects of contrasting [CO2] conditions (700 versus 370 μmol mol−1) on growth, photosynthetic performance, and C management during the post-anthesis period. The aim was to test whether a restricted capacity of sink organs to utilize photosynthates drives a loss of photosynthetic capacity in elevated CO2. The ambient 13C/12C isotopic composition (δ13C) of air CO2 was changed from-10.2 in ambient [CO2] to-23.6 under elevated [CO2] between the 7th and the 14th days after anthesis in order to study C assimilation and partitioning between leaves and ears. Elevated [CO2] had no significant effect on biomass production and grain filling, and caused an accumulation of C compounds in leaves. This was accompanied by up-regulation of phosphoglycerate mutase and ATP synthase protein content, together with down-regulation of adenosine diphosphate glucose pyrophosphatase protein. Growth in elevated [CO2] negatively affected Rubisco and Rubisco activase protein content and induced photosynthetic down-regulation. CO2 enrichment caused a specific decrease in Rubisco content, together with decreases in the amino acid and total N content of leaves. The C labelling revealed that in flag leaves, part of the C fixed during grain filling was stored as starch and structural C compounds whereas the rest of the labelled C (mainly in the form of soluble sugars) was completely respired 48 h after the end of labelling. Although labelled C was not detected in the δ13C of ear total organic matter and respired CO2, soluble sugar δ13C revealed that a small amount of labelled C reached the ear. The 12CO2 labelling suggests that during the beginning of post-anthesis the ear did not contribute towards overcoming flag leaf carbohydrate accumulation, and this had a consequent effect on protein expression and photosynthetic acclimation.

Suicide par sulfure d'hydrogène et délai post mortem long : à propos d'un cas. [Suicide by hydrogen sulfide inhalation and significant post mortem delay: A case report].

L'hydrogène sulfuré (H2S) est un gaz toxique retrouvé à l'état naturel et dans certains milieux industriels, à l'origine d'intoxication accidentelle, mais pouvant être également et facilement synthétisé de manière domestique. Des cas de suicide par hydrogène sulfuré ont ainsi été décrits à partir de produits ménagers dans la littérature depuis 2009, aux États-Unis et au Japon. La plupart présentait des délais post mortem (DPM) courts (moins de 72 heures). En France, les intoxications aiguës à l'H2S demeurent rares et sont le plus souvent liées à des accidents du travail. Nous rapportons ici le cas d'un homme âgé de 37 ans découvert à son domicile, en état de décomposition avancée avec un DPM de deux mois. Compte tenu de la présence d'une importante signalétique avisant du danger potentiel d'exposition à l'H2S, des mesures de précaution ont été mises en oeuvre dès la découverte du corps et poursuivies jusqu'aux opérations d'autopsie. Les analyses toxicologiques ont confirmé la présence d'H2S au niveau des prélèvements de cerveau et de muscle. Le cas présenté constitue le premier cas de suicide avec un délai post mortem long à l'H2S rapporté en France. Dans la littérature, les constatations macroscopiques à l'autopsie ne sont pas spécifiques tandis que les analyses toxicologiques reposent essentiellement sur la recherche et la quantification d'H2S. En raison de leur redistribution post mortem, les résultats de ces analyses doivent être interprétés avec prudence, et encore plus en cas de délai post mortem long et de phénomènes de putréfaction qui peuvent également être une source de génération d'H2S post mortem. Hydrogen sulfide (H2S) which is a poisonous gas found either in the natural state or in industrial environments and potentially linked with accidental intoxication, can also be easily handmade. Several cases of suicide by inhaling H2S produced by mixing household products have been reported in the literature since 2009 in USA and Japan. Most of them involved short post mortem delays up to 72 hours. In France, acute H2S poisoning remains rare and mostly accidental. We report the case of a 37-year-old man found at home, in an advanced stage of decomposition with a 2-month post mortem delay. As numerous warning signs about a high risk of H2S exposure were present, some precautionary measures were taken from the discovery of the cadaver to the autopsy. Toxicological analyses confirmed the presence of H2S in brain and muscle samples. This observation is the first French case with a long post mortem delay. As macroscopic findings in such cases are described to be unspecific in literature, toxicological analysis must focus on the detection and the quantification of H2S. However, due to the phenomena of post mortem drug redistribution and neo-formation, their results should be interpreted with much more caution when the post mortem delay is long. The potential increase in such voluntary-intoxication-related-deaths in France, similar to the recent Japanese and American waves of suicides, requires for forensic scientists, a good knowledge of both thanatological and toxicological pictures, and precautionary measures to adopt in such situations.

Europeanisation and Conflict Resolution: The Case of Cyprus

This paper investigates the example of Cyprus as a case study for the Europeanisation of conflict resolution. The argument advanced is that the European Union (EU) impacts the positions of the parts of the conflict (here, Greek Cypriots, Turkish Cypriots and Turkey) but not always towards the resolution of the dispute and compliance with EU conditionality. Conformity with EU conditionality depends on its credibility, which is decreased by the internalisation of the conflict into the EU. In this context, this work contributes to the discussion on Europeanisation and the aptitude of the EU in conflict resolution as well as the role of the EU in the Cyprus conflict during the post-accession years.

Satisfaction with pregnancy and delivery services: The quality of maternity care services as experienced by women

Objective: The objective of this study was to investigate the opinions of women regarding the satisfaction about the quality of maternity care received. We hope to establish whether health care technology increases satisfaction or whether it actually interferes with the construction of personal satisfaction in the process of care. Design and setting: Information was gathered using the focus group technique. The area of study comprised the post-natal groups run as part of the Sexual and Reproductive Health Programme of the Catalan Health Authority. (Spain) Participants: Five focus groups were held between May 2006 and July 2007. Findings: Quality of care is a complex concept in which a number of independent core features can be identified. We have grouped these core features into three basic categories. Safety: the hospital and its technological facilities, and the technical expertise of health professionals. The other two main pillars of quality of care are the human dimension of the relationship between the carers and the patient, and finally the structural aspects that determine the context in which the heath care is provided. Key conclusions and implications for practice: The mothers of our study feel satisfied with healthcare technology and view it as a source of security; technology become indispensable features in order to reduce the anxiety provoked by the perceived lack of confidence in their ability as mothers. In this study, women, both during pregnancy and especially when giving birth, believe their feelings and values should be understood by professionals, from whom they seek empathy and a personal commitment, and not just information.

Satisfaction with pregnancy and delivery services: The quality of maternity care services as experienced by women

Objective: The objective of this study was to investigate the opinions of women regarding the satisfaction about the quality of maternity care received. We hope to establish whether health care technology increases satisfaction or whether it actually interferes with the construction of personal satisfaction in the process of care. Design and setting: Information was gathered using the focus group technique. The area of study comprised the post-natal groups run as part of the Sexual and Reproductive Health Programme of the Catalan Health Authority. (Spain) Participants: Five focus groups were held between May 2006 and July 2007. Findings: Quality of care is a complex concept in which a number of independent core features can be identified. We have grouped these core features into three basic categories. Safety: the hospital and its technological facilities, and the technical expertise of health professionals. The other two main pillars of quality of care are the human dimension of the relationship between the carers and the patient, and finally the structural aspects that determine the context in which the heath care is provided. Key conclusions and implications for practice: The mothers of our study feel satisfied with healthcare technology and view it as a source of security; technology become indispensable features in order to reduce the anxiety provoked by the perceived lack of confidence in their ability as mothers. In this study, women, both during pregnancy and especially when giving birth, believe their feelings and values should be understood by professionals, from whom they seek empathy and a personal commitment, and not just information.

Post-partum persistence of abnormal circadian pattern of blood pressure after preeclampsia [109-POS]

OBJECTIVES: Blunted nocturnal dip of blood pressure (BP) and reversed circadian rhythm have been described in preeclampsia (PE). Non-dipper status and preeclampsia are both associated with an increased risk of cardiovascular disease later in life. Complete recovery of BP in PE is reported to occur over a variable period of time. Twenty-four hours-ambulatory blood pressure measurement (ABPM) in the post-partum follow-up after a PE has not been described. The aim of this study was to assess 24h-ambulatory blood pressure pattern after a PE and to determine the prevalence of non-dipper status, nocturnal hypertension, white coat hypertension and masked hypertension. METHODS: This is an observational, prospective study on women who suffered from a preeclampsia. A 24h-ABPM was done 6 weeks post-partum at the Hypertension Unit of the University Hospitals of Geneva, concomitantly with a clinical and biological evaluation. RESULTS: Forty-five women were included in a preliminary analysis. Mean age was 33±6years, 57.3% were Caucasian, mean BMI before pregnancy was 24±5kg/m(2). Office and ambulatory BP are shown in Table 1. Prevalence of nocturnal hypertension was high and half of the women had no nocturnal dipping. The diagnosis of hypertension based on office BP was discordant with the diagnosis based on ABPM in 25% of women. CONCLUSIONS: The prevalence of increased nighttime BP and abnormal BP pattern is high at 6weeks post-partum in preeclamptic women. Early assessment of BP with ABPM after preeclampsia allows an early identification of women with persistent circadian abnormalities who might be at increased risk. It also provides a more accurate assessment than office BP. DISCLOSURES: A. Ditisheim: None. B. Ponte: None. G. Wuerzner: None. M. Burnier: None. M. Boulvain: None. A. Pechère-Bertschi: None.

Compensatory embryonic response to allele-specific inactivation of the murine X-linked gene Hcfc1.

Early in female mammalian embryonic development, cells randomly inactivate one of the two X chromosomes to achieve overall equal inactivation of parental X-linked alleles. Hcfc1 is a highly conserved X-linked mouse gene that encodes HCF-1 - a transcriptional co-regulator implicated in cell proliferation in tissue culture cells. By generating a Cre-recombinase inducible Hcfc1 knock-out (Hcfc1(lox)) allele in mice, we have probed the role of HCF-1 in actively proliferating embryonic cells and in cell-cycle re-entry of resting differentiated adult cells using a liver regeneration model. HCF-1 function is required for both extraembryonic and embryonic development. In heterozygous Hcfc1(lox/+) female embryos, however, embryonic epiblast-specific Cre-induced Hcfc1 deletion (creating an Hcfc1(epiKO) allele) around E5.5 is well tolerated; it leads to a mixture of HCF-1-positive and -negative epiblast cells owing to random X-chromosome inactivation of the wild-type or Hcfc1(epiKO) mutant allele. At E6.5 and E7.5, both HCF-1-positive and -negative epiblast cells proliferate, but gradually by E8.5, HCF-1-negative cells disappear owing to cell-cycle exit and apoptosis. Although generating a temporary developmental retardation, the loss of HCF-1-negative cells is tolerated, leading to viable heterozygous offspring with 100% skewed inactivation of the X-linked Hcfc1(epiKO) allele. In resting adult liver cells, the requirement for HCF-1 in cell proliferation was more evident as hepatocytes lacking HCF-1 fail to re-enter the cell cycle and thus to proliferate during liver regeneration. The survival of the heterozygous Hcfc1(epiKO/+) female embryos, even with half the cells genetically compromised, illustrates the developmental plasticity of the post-implantation mouse embryo - in this instance, permitting survival of females heterozygous for an X-linked embryonic lethal allele.

Detecting Detection: International Perspectives on the Uses of a Plot

One of the problems with books which are relatively general in nature is that many of the individual contributions tend to be so narrow and specialised that only the author has any knowledge of (or interest in) the issues under discussion. At first sight this appears to be the case with Detecting Detection. Fortunately, however, first impressions are deceiving. Although the essays in the volume deal with writers as diverse and disparate as the Catalano-Spanish writer Juan Marse, the Bulgarian-French philosopher Julia Kristeva and the once-vaunted giant of English literature,Graham Greene, among numerous others, there is much to be enjoyed and learnt, even if some of the works under discussion are unfamiliar to the crime fiction reader and/or scholar to whom the book initially appears to be directed.

Another Look at the Null of Stationary Real Exchange Rates: Panel Data with Structural Breaks and Cross-section Dependence

This paper re-examines the null of stationary of real exchange rate for a panel of seventeen OECD developed countries during the post-Bretton Woods era. Our analysis simultaneously considers both the presence of cross-section dependence and multiple structural breaks that have not received much attention in previous panel methods of long-run PPP. Empirical results indicate that there is little evidence in favor of PPP hypothesis when the analysis does not account for structural breaks. This conclusion is reversed when structural breaks are considered in computation of the panel statistics. We also compute point estimates of half-life separately for idiosyncratic and common factor components and find that it is always below one year.

Evolución de los conocimientos acerca de los trastornos del comportamiento alimentario, a través de una intervención educativa en estudiantes de enseñanza post-obligatoria

Introducción: A pesar de ser considerados eventos infrecuentes en comparación a otros estados patológicos relacionados con la alimentación, en los últimos años y en diferentes países, se constata un incremento de las tasas de incidencia y prevalencia de los Tras - tornos del Comportamiento Alimentario; la mayoría de estudios que analizan los factores que pueden influir en su aparición, suelen implicar a jóvenes y adolescentes de poblaciones pre-mórbidas o mórbidas, siendo menos frecuentes los realizados sobre población sana y estándar. Objetivos: Evaluar el nivel de conocimientos acerca de los Trastornos del Comportamiento Alimentario y comprobar la eficacia de una intervención educativa, en jóvenes de una población presumiblemente sana. Métodos: Estudio de intervención con evaluación pre y post intervención, a través de un cuestionario previamente validado de 10 preguntas cerradas y abiertas, en estudiantes de Fisioterapia, Educación Infantil y Hostelería. Resultados: Respondieron el cuestionario inicial 154 estu diantes, 85 universitarios y 39 de ciclo formativo en Hostelería, mayoritariamente mujeres (68%) y con una edad media de 20,8 años. Los estudiantes demostraron un nivel medio de conocimientos inicial, mayor en las mujeres y en los estudiantes universitarios que en los de formación profesional. Los factores de riesgo y las manifestaciones clínicas fueron los aspectos menos conocidos por los estudiantes. La intervención educativa realizada en los 35 estudiantes de Hostelería que participaron en el taller y respondieron el cuestionario post-intervención, consiguió elevar el nivel de conocimientos hasta una calificación media superior a la inicial y a la de los grupos en que no se realizó la intervención. Discusión y conclusiones: A pesar de que la intervención realizada resultó eficaz para mejorar el nivel de conocimientos en muchos de los participantes, los resultados del cuestionario post-intervención revelan la necesidad de educar a los jóvenes en los rasgos que definen y caracterizan un Trastorno del Compor tamiento Alimen - tario, adaptando el abordaje de los mismos a su realidad social. La inclusión de temas relacionados con la nutrición y la salud en los programas curriculares de los estudios post-obligatorios mejoraría el nivel de conocimientos entre los futuros profesionales de los ámbitos de la salud, la educación y la hostelería/restauración.

Performance during post-harvest storage of banana cv. 'prata', 'maçã' and 'nanica' exposed to physical and chemical treatments

Banana is the most consumed fruit in the world and Brazil is the second largest producer. Despite its global position, Brazil has an average of 40% losses during the post-harvest period. So, this experiment aimed at evaluating the efficiency of post-harvest treatments to improve the storage of banana cultivars cv. 'Prata', 'Maçã' and 'Nanica'. The fruits were acquired at CEASA with green peel, and were submitted to six different treatments: T- immersion in drinking water for 3 minutes (control), H3 - hot water (50 °C for 3 minutes), H8 - hot water (50 °C for 8 minutes), HP - immersion in hypochlorite 0.2% for 3 minutes, OS - immersion in soybean oil 10% for 3 minutes, and OM - immersion in mineral oil 10% for 3 minutes. The fruits were stored at room temperature at about 21 °C for 14 days and evaluated in three periods (1, 7 and 14 days) comparing peel color, flesh/peel ratio, titratable acidity (TA), soluble solids (SS), SS/TA ratio, and pH. The fruits of cv. 'Prata' and 'Maçã' submitted to the treatments H3, H8 and HP ripened at the same time as the control for peel color, which showed increased soluble solids, flesh/peel ratio, acidity and a decrease in pH. On the other hand, the cv. 'Nanica' did not respond significantly different when compared to the applied treatments and the control. The fruits treated with OM and OS were kept green for a longer time for the cultivars 'Prata' and 'Nanica', but there were some changes on peel color due dark spots in 'Prata' banana and a softening aspect in 'Nanica', indicating some level of toxicity of these treatments. Fruits of the 'Maçã' cultivar continued green with the application of mineral oil, without toxicity symptoms. In conclusion, the treatments applied did not show any advantage for storage of these fruits.

Performance of UASB reactors in two stages followed by post-treatment with activated sludge in wastewater batch of wet-processed coffee

In this study it was evaluated the efficiency of the treatment of wet-processed coffee wastewater in upflow anaerobic sludge blanket (UASB) reactors in two stages, in bench scale, followed by post-treatment with activated sludge in batch. The first UASB reactor was submitted to an hydraulic retention time (HRT) of 6.2 d and organic loading rates (OLR) of 2.3 and 4.5g CODtotal (L d)-1, and the second UASB reactor to HRT of 3.1 d with OLR of 0.4 and 1.4g CODtotal (L d)-1. The average values of the affluent CODtotal increased from 13,891 to 27,926mg L-1 and the average efficiencies of removal of the CODtotal decreased from 95 to 91%, respectively, in the UASB reactors in two stages. The volumetric methane production increased from 0.274 to 0.323L CH4 (L reactor d)-1 with increment in the OLR. The average concentrations of total phenols in the affluent were of 48 and 163mg L-1, and the removal efficiencies in the UASB reactors in two stages of 92 and 90%, respectively, and increased to 97% with post-treatment. The average values of the removal efficiencies of total nitrogen and phosphorus were of 57 to 80% and 44 to 60%, respectively, in the UASB reactors in two stages and increased to 91 and 84% with the post-treatment.