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Poster-Abstract

Conflict and fragility are increasing in many areas of the world. This context has been referred to as the ‘new normal’ and affects a billion people. Fragile and conflict-affected states have the worst health indicators and the weakest health systems. This presents a major challenge to achieving universal health coverage. The evidence base for strengthening health systems in these contexts is very weak and hampered by limited research capacity, challenges relating to insecurity and apparent low prioritisation of this area of research by funders. This article reports on findings from a multicountry consortium examining health systems rebuilding post conflict/crisis in Sierra Leone, Zimbabwe, northern Uganda and Cambodia. Across the ReBUILD consortium's interdisciplinary research programme, three cross-cutting themes have emerged through our analytic process: communities, human resources for health and institutions. Understanding the impact of conflict/crisis on the intersecting inequalities faced by households and communities is essential for developing responsive health policies. Health workers demonstrate resilience in conflict/crisis, yet need to be supported post conflict/crisis with appropriate policies related to deployment and incentives that ensure a fair balance across sectors and geographical distribution. Postconflict/crisis contexts are characterised by an influx of multiple players and efforts to support coordination and build strong responsive national and local institutions are critical. The ReBUILD evidence base is starting to fill important knowledge gaps, but further research is needed to support policy makers and practitioners to develop sustainable health systems, without which disadvantaged communities in postconflict and postcrisis contexts will be left behind in efforts to promote universal health coverage.

The loss of carbon dioxide (CO2) to the environmentduring microalgae cultivation is undesirable for both environmentaland economic reasons. In this study, a phototrophic biofilm growthmodel was developed and validated with the objective to maximizeboth CO2 utilization efficiency and production of microalgae inbiofilms. The model was validated in growth experiments with CO2as the limiting substrate. The CO2 utilization and biomassproductivity were maximized by changing the gas flow rate, thenumber of biofilm reactors in series and gas composition. Based onsimulations, the maximum CO2 utilization efficiency that wasreached was 96% based on a process employing flue gas. Thecorresponding drop in productivity was only 2% in comparison tothe non-CO2 limited reference situation. In order to achieve this, 25biofilm reactors units, or more,must be operated in series. Based onthese results, it was concluded that concentrated CO2 streams andplug flow behavior of the gaseous phase over the biofilm surface areessential for high productivity and CO2 utilization efficiency.

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Endothelin-1 (ET-1), a potent vasoconstrictor, is widely distributed in the central nervous system. This article demonstrates the spatio-temporal expression of mouse preproendothelin-1 (mPPET-1) gene in pre- and perinatal mouse brain by in situ hybridization using a probe specific for mPPET-1. mPPET-1 mRNA expression was first observed in medulla at embryonic age 11.5 (E11.5) and the level became increasingly stronger toward later stages of development. At E18.5 and postnatal day 0.5 (D0.5), mPPET-1 mRNA was found in discrete nucleus group in ventrolateral medulla. mPPET-1 mRNA was also detected in thalamic reticular nucleus at E16.5, E18.5, and D0.5. These results showed that mPPET-1 mRNA is present in neurons of central cardiorespiratory region and drastically increased during the transition from episodic fetal breathing to continuous postnatal respiration (E18.5 to D0.5), implicating the important role of ET-1 in central cardiorespiratory control regulating the onset of respiration during this critical period.

It is generally believed that too high or low levels of endothelin-1 (ET-1), a strong vasoconstrictor, may be detrimental to animals. Therefore, in order to understand the in vivo function of ET-1, we used a conditional transgenic approach, Cre/loxP recombination system, to generate transgenic mice that over-express ET-1 in a tissue-specific manner. In such a strategy a single transgenic mouse line, ELSE, was initially generated where a general promoter, human elongation factor 1alpha (hEF1alpha) promoter, was used to drive the expression of a loxP-flanked sequence containing the lacZ reporter gene and a STOP cassette before the ET-1 cDNA, the recombinational competency of which was confirmed in an Escherichia coli test system. In ELSE mice, expression of the reporter lacZ was limited to spermatozoa and spermatogonia as well as Sertoli, Leydig and endothelial cells in the testis, thus confirming the suitability of these mice for the generation of testes-limited ET-1 expression. To generate transgenic progeny with ET-1 over-expression in the testis (successful recombination, ELSE/ELT), ELSE mice were mated with EIIa-cre mice expressing Cre recombinase in pre-implantation mouse embryos. These ELSE/ELT mice exhibiting testis-specific ET-1 over-expression had normal reproductive function and showed no obvious alterations in gross testicular morphology. Although over-expression of ET-1 leads to reduction of testicular blood flow, young adult ELSE/ELT mice showed no obvious signs of inflammation, fibrosis or abnormal proliferation of cells in the testes of young ELSE/ELT mice by histochemical analyses.

The main objectives of the project have been addressed by combining a European modelling approach with case study analysis and regional (local) knowledge of water demand and water availability considering climate change as well as socio-economic developments. An integrated assessment for entire Europe was performed under the consideration of different scenarios and cli-mate change projections. This large-scale perspective allows indicating regions which are po¬ten-tially vulnerable to climate change and furthermore to identify regional adaptation measures which could be promoted at the EU level. Additionally three case studies were selected across Europe to in¬vestigate changes in hydrologic regimes, water availability and sectoral water use. These case stu¬dies are focusing on three different water management issues in three different regions. In the first case study, the influence of climate change on the hydromorphological conditions according to the WFD were evaluated for a section of the Eder River (Germany). The objective of this case study was to examine whether the environmental WFD objectives can be achieved in a typical river section considering climate change impacts. The second case study investigated water management, especially drinking water provision, and flood alleviation in the Seine river basin (France), which is partly based on the operation of artificial reservoirs. Scenarios were developed linking the impact of climate change on water resources and changes in water demand and its management. The third case study assesses the quantitative effects of climate change on water balance components and water use in the agricultural sector of the Italian Apulia region, in order to support the adoption of adaptation measures. Actually, in the Apulia region agriculture still remains the primary user of water and the primary economical resource.; Les principaux objectifs du projet ont été adressés en combinant une approche de modélisation européenne avec une analyse de cas d'études et la connaissance régionale (locale) des demandes et disponibilités en eau en considérant le changement climatique ainsi que les développements socio-économiques. Une estimation intégrée pour l'Europe entière a été entreprise en considérant différents scénarios et projections de changement climatique. Cette perspective à large échelle permet d'identifier des régions qui sont potentiellement vulnérables au changement climatique mais aussi d'identifier les mesures d'adaptation qui pourraient être développées au niveau européen. De plus, trois cas d'étude ont été sélectionnés à travers l'Europe pour étudier les changements dans les régimes hydrologiques, la disponibilité en eau, et les usages de l'eau. Ces cas d'étude concernent trois différents problèmes de gestion de l'eau dans trois régions différentes. Dans le premier cas d'étude, l'influence du changement climatique sur les conditions hydromorphologiques selon la DCE ont été évaluées pour une section de la rivière Eder (Allemagne). L'objectif de ce cas d'étude était d'examiner si l'objectif environnemental de la DCE peut être rempli dans une section typique de la rivière en considérant le changement climatique. Le second cas d'étude s'est penché sur la gestion de l'eau, plus spécialement de la fourniture en eau potable, et sur la mitigation des crues sur le bassin de la Seine (France), qui est partiellement basée sur l'exploitation de réservoirs artificiels. Des scénarios ont été développés pour évaluer l'impact du changement climatique sur les ressources en eau en testant différents modes de gestion des réservoirs. Le troisième cas d'étude a évalué les effets quantitatifs du changement climatique sur les composantes du bilan en eau et sur l'utilisation de l'eau sur le secteur agricole de la région des Pouilles en Italie, afin de soutenir l'adoption de mesures d'adaptation. En fait, la région des Pouilles l'agriculture reste le principal utilisateur d'eau et la principale ressource économique.

Context The 'Standards, Options and Recommendations' (SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French cancer centres and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Objectives To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for the management of stage I and II non small cell lung carcinoma treated by radiotherapy alone. Methods Data were identified by searching Medline and personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to independent reviewers, and to the medical committees of the 20 French cancer centres. Results The main recommendations for the management of stage I and II non small cell lung carcinoma treated by radiotherapy alone are: 1) The curative external irradiation with a continual course is an alternative to surgery only in the case of medically inoperable tumors or because the patient refuses surgery; 2) The external irradiation of the primary tumor only without the mediastinum could be proposed in peripheral stage IA. In proximal stage IA and IB, external irradiation should be carried out only as part of prospective randomised controlled trials comparing a localised irradiation of the primary tumor with a large irradiation of the mediastinum and the primary tumor. The treated volume must include the macroscopic tumoral volume with or without the microscopic tumoral volume and with a security margin from 1.5 to 2 cm; 3) There is a benefit to delivering a total dose in the primary tumor higher than 60 Gy in so far as the proposed irradiation, taking into account the respiratory function, does not increase the likelihood of severe adverse events due to radiation; and 4) The change in fractionation, the radiochemotherapy combination, the endobronchial brachytherapy with high dose rate alone or with external irradiation could be proposed only as part of prospective controlled trials for tumors classified as stage IB or II.

Contexte. - La Federation nationale des centres de lutte contre le cancer (FNCLCC) et les Centres regionaux de lutte contre le cancer (CRLCC), en collaboration avec des partenaires des secteurs public (CHU, CHG), prive et certaines societes savantes ont entrepris depuis 1993 d'elaborer des recommandations pour la pratique clinique en cancerologie: les « Standards, Options et Recommandations » (SOR). L'objectif de l'operation SOR est d'ameliorer la qualite et l'efficience des soins aux patients atteints de cancer en fournissant aux praticiens une aide a la decision facilement utilisable. La methodologie d'elaboration des SOR repose sur une revue et une analyse critique des donnees de la litterature scientifique par un groupe d'experts pluridisciplinaire, permettant de definir, sur la base du niveau de preuve scientifique et du jugement argumente des experts, des « Standards », des « Options » et des « Recommandations ». Avant publication, les SOR sont revus par des experts independants. Objectifs. - Definir, sur la base d'une revue de la litterature et de l'accord d'experts, des Standards, Options et Recommandations pour la prise en charge des patients atteints de cancer broncho-pulmonaire primitif de stade I ou Il traites par irradiation exclusive. Methodes. - Un groupe de travail multidisciplinaire mis en place par la Federation nationale des centres de lutte contre le cancer (FNCLCC) a revu les donnees scientifiques disponibles concernant la prise en charge des patients atteints de cancer broncho-pulmonaire primitif non a petites cellules de stade I et Il traites par irradiation exclusive. Apres selection des articles, synthese des resultats et redaction des SOR, le document a ete soumis pour relecture et approbation a des relecteurs. Resultats.- Les principales recommandations sont: 1) l'irradiation externe exclusive continue a visee curative, avec un fractionnement conventionnel, n'est une alternative a la chirurgie d'exerese qu'en cas de contre-indications a un acte chirurgical liees au terrain medical ou de refus du malade de tout acte chirurgical; 2) l'irradiation externe du volume tumoral primitif seul, sans le mediastin, peut etre proposee dans les formes classees stade IA, de topographie peripherique. Dans les formes classees stade IA proximal et IB, elle ne peut se concevoir que dans le cadre d'un essai therapeutique prospectif randomise et controle comparant une irradiation localisee au volume tumoral et une irradiation large mediastino-tumorale. Le volume traite doit inclure le volume tumoral macroscopique avec ou sans le volume tumoral microscopique, avec une marge de securite de 1,5 a 2 cm; 3) il y a un benefice a delivrer une dose totale dans le volume tumoral superieure a 60 Gy dans la mesure ou la technique d'irradiation proposee tenant compte de la fonction respiratoire du malade, n'augmente pas la probabilite de risque de complications severes radio-induites; 4) les modifications du fractionnement, l'association radiochimiotherapie concomitante, la curietherapie endoluminale a haut debit de dose seule ou en association a une irradiation externe, ne peuvent etre proposees que dans le cadre d'essais prospectifs controles pour des formes classees de stade IB ou II.

Endothelin-1 (ET-1) is a peptide implicated in a wide variety of functions involving vascular and non-vascular systems. We have cloned the cDNA encoding the mouse preproendothelin-1 (PPET-1) and determined its nucleotide sequence. The putative PPET-1 peptide processing sites are, all conserved and the deduced 21-amino-acid mature ET-1 peptide is identical to that of the rat, human, bovine, porcine and rabbit. Using the cloned cDNA as a probe for in suit hybridization, we detected PPET-1 mRNA in different tissues at different stages of mouse embryonic development. Embryos at a stage as early as 9.5 days postcoitum (E9.5) have very strong expression in the branchial epithelium, optic vesicle and the endothelial cells of large blood vessels, including the dorsal aorta and aortic arches. While the expression level in the branchial epithelium was decreasing towards the later stage of embryogenesis, the expression in the endothelial cells increased with age. At E10.5, PPET-1 mRNA was also detected in the otic vesicle as well as in the developing gut epithelium. At later stage of development, the expression of PPET-1 was primarily found in the vascular endothelial cells, cochlea, eye and the gut, with the highest level of PPET-I mRNA in the endothelial cells of the lung. These data will be useful for analyzing the function of ET-1 in these organs.