The ion-gas-neutral interactions with surfaces-2 (IGNIS-2) facility for the study of plasma-material interactions.

The Ion-Gas-Neutral Interactions with Surfaces-2 (IGNIS-2) surface science facility has been designed at the Pennsylvania State University with the specific purpose of enabling experiments to study plasma-material interactions. This in situ surface modification and characterization facility consists of multiple reconfigurable substations that are connected through a central transfer chamber. This fully connected vacuum system ensures that the physical and chemical properties of samples are not altered between surface modification and analysis. The modification techniques in IGNIS-2 include a low-energy (<300 eV), high-flux (up to 1016 cm-2 s-1) broad-beam ion source, a liquid metal dropper, a lithium injection system, an RF sputter source, and an evaporator. Its characterization techniques include charged particle-based techniques, such as low-energy ion scattering (enabled by two <5 keV ion sources) and x-ray photoelectron spectroscopy, and photon and light-based techniques, such as x-ray fluorescence, multi-beam optical stress sensors, and optical cameras. All of these techniques can be utilized up to mTorr pressures, allowing both in situ and in operando studies to be conducted. Results are presented on lithium wetting experiments of argon-irradiated tungsten-based composites, surface stress measurements of tungsten films during deuterium ion irradiation, and temperature-programmed desorption of deuterium-irradiated graphite to demonstrate the in situ capabilities of this new facility.

Enhancing silk fibroin structures and applications through angle-dependent Ar+ plasma treatment.

This study tackles limitations of Silk Fibroin (SF), including availability of sites for modification. This is achieved by Direct Plasma Nanosynthesis (DPNS), an Ar+ bombardment method, to generate and modify nanostructures and nanoscale properties on the SF surface. SF samples were treated with DPNS at incidence angles of 45o and 60o, with specific ion dose and energy parameters (1 × 1018 ions/cm2 and 500 eV, respectively) maintained throughout the process. Fourier-transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) primarily underscored transformations in SF's nitrogenous components. Specifically, treatment produced a boost in C-NH2, particularly pronounced in the 45o-treated samples, suggesting changes were more superficial than alterations to the secondary structure. The DPNS treatment gave rise to periodic nanocone structures on the SF surface, with a scale increase correlated to a higher angle of incidence. This resulted in a decrease in surface stiffness and significant changes in the motility of J774 macrophages interacting with the transformed SF. Furthermore, the SF samples treated at a 60o incidence showcased a confinement effect, moderating the macrophages' motility, morphology, and inflammatory response. The DPNS-induced alterations not only mitigate SF's limitations but also affect cellular behavior, expanding potential for SF in biomaterials.

Ion-bombardment-driven surface modification of porous magnesium scaffolds: Enhancing biocompatibility and osteoimmunomodulation.

Porous Mg scaffolds are promising for bone repair but are limited by high corrosion rates and challenges in preserving coating integrity. We used Directed Plasma Nanosynthesis (DPNS) at 400 eV and a fluence of 1 × 1018 cm-2 to augment the bioactivity and corrosion resistance of porous Mg scaffolds, maintaining their overall material integrity. DPNS creates nanostructures that increase surface area, promote apatite nucleation, and enhance osseointegration, improving the bioactivity and corrosion resistance of porous Mg scaffolds without compromising their structure. Our findings indicate a decrease in surface roughness, with pre-irradiated samples having Rq = 60.4 ± 5.3 nm andRa = 48.2 ± 3.1 nm, and post-DPNS samples showing Rq = 36.9 ± 0.3 nm andRa = 28.6 ± 0.8 nm. This suggests changes in topography and wettability, corroborated by the increased water contact angles (CA) of 129.2 ± 3.2 degrees. The complexity of the solution influences the CA: DMEM results in a CA of 120.4 ± 0.1 degrees, while DMEM + SBF decreases it to 103.6 ± 0.5 degrees, in contrast to the complete spreading observed in non-irradiated samples. DPNS-treated scaffolds exhibit significantly reduced corrosion rates at 5.7 × 10-3 ± 3.8 × 10-4 mg/cm²/day, compared to the control's 2.3 × 10-2 ± 3.2 × 10-4 mg/cm²/day over 14 days (P < 0.01). The treatment encourages the formation of a Ca-phosphate-rich phase, which facilitates cell spreading and the development of focal adhesion points in hBM-MSCs on the scaffolds. Additionally, J774A.1 murine macrophages show an enhanced immune response with diminished TNF-α cytokine expression. These results offer insights into nanoscale modifications of Mg-based biomaterials and their promise for bone substitutes or tissue engineering scaffolds.

Identification of PCPE-2 as the endogenous specific inhibitor of human BMP-1/tolloid-like proteinases.

BMP-1/tolloid-like proteinases (BTPs) are major players in tissue morphogenesis, growth and repair. They act by promoting the deposition of structural extracellular matrix proteins and by controlling the activity of matricellular proteins and TGF-ß superfamily growth factors. They have also been implicated in several pathological conditions such as fibrosis, cancer, metabolic disorders and bone diseases. Despite this broad range of pathophysiological functions, the putative existence of a specific endogenous inhibitor capable of controlling their activities could never be confirmed. Here, we show that procollagen C-proteinase enhancer-2 (PCPE-2), a protein previously reported to bind fibrillar collagens and to promote their BTP-dependent maturation, is primarily a potent and specific inhibitor of BTPs which can counteract their proteolytic activities through direct binding. PCPE-2 therefore differs from the cognate PCPE-1 protein and extends the possibilities to fine-tune BTP activities, both in physiological conditions and in therapeutic settings.

Ion Bombardment-Induced Nanoarchitectonics on Polyetheretherketone Surfaces for Enhanced Nanoporous Bioactive Implants.

In spite of the biocompatible, nontoxic, and radiolucent properties of polyetheretherketone (PEEK), its biologically inert surface compromises its use in dental, orthopedic, and spine fusion industries. Many efforts have been made to improve the biological performance of PEEK implants, from bioactive coatings to composites using titanium alloys or hydroxyapatite and changing the surface properties by chemical and physical methods. Directed plasma nanosynthesis (DPNS) is an atomic-scale nanomanufacturing technique that changes the surface topography and chemistry of solids via low-energy ion bombardment. In this study, PEEK samples were nanopatterned by using argon ion irradiation by DPNS to yield active nanoporous biomaterial surface. PEEK surfaces modified with two doses of low and high fluence, corresponding to 1.0 × 1017 and 1.0 × 1018 ions/cm2, presented pore sizes of 15-25 and 60-90 nm, respectively, leaving exposed PEEK fibers and an increment of roughness of nearly 8 nm. The pores per unit area were closely related for high fluence PEEK and low fluence PEEK surfaces, with 129.11 and 151.72 pore/µm2, respectively. The contact angle significantly decreases in hydrophobicity-hydrophilicity tests for the irradiated PEEK surface to ∼46° from a control PEEK value of ∼74°. These super hydrophilic substrates had 1.6 times lower contact angle compared to the control sample revealing a rough surface of 20.5 nm only at higher fluences when compared to control and low fluences of 12.16 and 14.03 nm, respectively. These super hydrophilic surfaces in both cases reached higher cell viability with ∼13 and 34% increase, respectively, compared to unmodified PEEK, with an increased expression of alkaline phosphatase at 7 days on higher fluences establishing a higher affinity for preosteblasts with increased cellular activity, thus revealing successful and improved integration with the implant material, which can potentially be used in bone tissue engineering.

Analysis of Antibacterial Efficacy and Cellular Alignment Regulation on Plasma Nanotextured Chitosan Surfaces.

To address implant-related infections, antibacterial solutions specific to biomaterials are required to prevent bacterial proliferation. Traditional antibiotic usage has been found insufficient, motivating researchers to investigate alternative strategies such as surface modification and the application of antifouling or infection-resistant properties. A developing interest lies in designing surfaces that mimic natural antibacterial nanotopographies. In this study, we conducted a quantitative analysis of the outcomes from plasma nanotexturing, with particular emphasis on how the organization of topography influences antibacterial efficacy and the regulation of cell alignment. Plasma nanotexturing was applied to chitosan surfaces, which gradually transformed from nanopores to pillars and eventually into tilted pillars, as the plasma parameters (fluence and angle) increased. We used directed plasma nanosynthesis, a plasma-based technique that primarily induces topographical alterations on the surfaces. The surfaces were systematically characterized, incorporating methods such as scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS). A comprehensive comparison of the nanotextures was executed by utilizing a trapezoidal method to calculate aspect ratios and assess texture orientation by examining the gaps in the nanostructures. We evaluated antibacterial properties against E. coli and S. aureus strains and assessed the survival and alignment of human bone marrow mesenchymal stem cells. Our findings reveal a significant reduction in bacterial adhesion (>80%) and growth on nanotextured surfaces, underscoring their potential for clinical applications. Moreover, we measured cell alignment, presenting the results in both a color-coded and numerical format to demonstrate the preferential alignment orientation induced specially by the tilted nanotexture. These insights highlight the profound impacts of plasma nanotexturing, indicating its potential for innovative biomedical applications such as advanced wound healing and tissue engineering.

Development and qualification of clinical grade decellularized and cryopreserved human esophagi.

Tissue engineering is a promising alternative to current full thickness circumferential esophageal replacement methods. The aim of our study was to develop a clinical grade Decellularized Human Esophagus (DHE) for future clinical applications. After decontamination, human esophagi from deceased donors were placed in a bioreactor and decellularized with sodium dodecyl sulfate (SDS) and ethylendiaminetetraacetic acid (EDTA) for 3 days. The esophagi were then rinsed in sterile water and SDS was eliminated by filtration on an activated charcoal cartridge for 3 days. DNA was removed by a 3-hour incubation with DNase. A cryopreservation protocol was evaluated at the end of the process to create a DHE cryobank. The decellularization was efficient as no cells and nuclei were observed in the DHE. Sterility of the esophagi was obtained at the end of the process. The general structure of the DHE was preserved according to immunohistochemical and scanning electron microscopy images. SDS was efficiently removed, confirmed by a colorimetric dosage, lack of cytotoxicity on Balb/3T3 cells and mesenchymal stromal cell long term culture. Furthermore, DHE did not induce lymphocyte proliferation in-vitro. The cryopreservation protocol was safe and did not affect the tissue, preserving the biomechanical properties of the DHE. Our decellularization protocol allowed to develop the first clinical grade human decellularized and cryopreserved esophagus.

Factitious disorder imposed on self: A retrospective study of 2232 cases from health insurance databases.

OBJECTIVE: Patients with factitious disorder imposed on self (FDIS) seek medical care for deliberately falsified problems. Although a large amount of work has been published, the scientific literature lacks robust data on FDIS. The present study aimed to estimate the annual mean of in-hospital FDIS codings in France, describe the sociodemographic characteristics of subjects with FDIS, assess healthcare utilisation and medical nomadism, and describe the pathologies most frequently associated with FDIS. METHOD: Subjects with at least one coding of FDIS in French health insurance databases between January 1, 2009, and December 31, 2017 were included. Subjects younger than 18 years of age at the time of first coding were excluded from the study. Sociodemographic data of subjects and diagnoses associated with the first coding of FDIS were collected. Healthcare utilisation and medical nomadism were analysed descriptively from one year before to one year after the first FDIS coding. RESULTS: 2232 subjects were included, representing an average of 248 new in-hospital FDIS codings per year. The subjects included were 58.2% female. The mean age at diagnosis was 48.5 years. In the year following the first coding of FDIS, 1268 subjects (56.8%) were re-hospitalised at least once, including 159 (7.1%) with at least one new coding for FDIS. From one year before to one year after the first coding of FDIS, 66% of the subjects included had received at least one prescription for benzodiazepines, 58.3% for antidepressants, and 42.6% for antipsychotics. CONCLUSIONS: Our findings bring new data working towards a better understanding of FDIS. The consumption of psychotropic drugs is particularly frequent in patients with FDIS.

Microrheology and structural quantification of hypercoagulable clots.

Hypercoagulability is a pathology that remains difficult to explain today in most cases. It is likely due to a modification of the conditions of polymerization of the fibrin, the main clot component. Using passive microrheology, we measured the mechanical properties of clots and correlated them under the same conditions with structural information obtained with confocal microscopy. We tested our approach with known alterations: an excess of fibrinogen and of coagulation Factor VIII. We observed simultaneously a rigidification and densification of the fibrin network, showing the potential of microrheology for hypercoagulability diagnosis.

Effects of transition metal carbide dispersoids on helium bubble formation in dispersion-strengthened tungsten.

The formation of helium bubbles and subsequent property degradation poses a significant challenge to tungsten as a plasma-facing material in future long-pulse plasma-burning fusion reactors. In this study, we investigated helium bubble formation in dispersion-strengthened tungsten doped with transition metal carbides, including TaC, ZrC, and TiC. Of the three dispersoids, TaC exhibited the highest resistance to helium bubble formation, possibly due to the low vacancy mobility in the Group VB metal carbide and oxide phases. Under identical irradiation conditions, large helium bubbles formed at grain boundaries in tungsten, while no bubbles were observed at the interfaces between the carbide dispersoid and tungsten matrix. Moreover, our results showed the interfaces could suppress helium bubble formation in the nearby tungsten matrix, suggesting that the interfaces are more effective in trapping helium as tiny clusters. Our research provided new insights into optimizing the microstructure of dispersion-strengthened tungsten alloys to enhance their performance.

Clinical features and long-term outcomes of patients with systemic polyarteritis nodosa diagnosed since 2005: Data from 196 patients.

BACKGROUND: The landscape of polyarteritis nodosa (PAN) has substantially changed during the last decades. Recent data regarding causes, characteristics, and prognosis of systemic PAN in the modern era are lacking. METHODS: This retrospective study included patients with systemic PAN referred to the French Vasculitis Study Group between 2005 and 2019. Characteristics, associated conditions and outcomes were collected, and predictors of relapse and death were analyzed. RESULTS: 196 patients were included. Main clinical symptoms were constitutional (84%), neurological (59%), skin (58%) and musculoskeletal (58%) manifestations. Secondary PAN accounted for 55 (28%) patients, including myelodysplastic syndrome (9%), solid cancer (7%), lymphoma (4%) and autoinflammatory diseases (4%). No patient had active HBV infection. All treated patients (98.5%) received glucocorticoids (GCs), alone (41%) or in combination with immunosuppressants (59%), with remission achieved in 90%. Relapses were independently associated with age >65 years (HR 1.85; 95% CI1.12-3.08), gastrointestinal involvement (1.95; 95% CI1.09-3.52) and skin necrotic lesions (HR 1.95; 95%CI 1.24-3.05). One-, 5- and 10-year overall survival rates were 93%, 87% and 81%, respectively. In multivariate analyses, age >65 years (HR 2.80; 95%CI 1.23-6.37), necrotic purpura (HR 4.16; 95%CI 1.62-10.70), acute kidney injury (HR 4.89; 95% 1.71-13.99) and secondary PAN (HR 2.98; 95%CI 1.29-6.85) were independently associated with mortality. CONCLUSION: Landscape of PAN has changed during the last decades, with the disappearance of HBV-PAN and the emergence of secondary PAN. Relapse rate remains high, especially in aged patients with gastrointestinal and cutaneous necrosis, as well as mortality.

Nanotextured porous titanium scaffolds by argon ion irradiation: Toward conformal nanopatterning and improved implant osseointegration.

Stress shielding and osseointegration are two main challenges in bone regeneration, which have been targeted successfully by chemical and physical surface modification methods. Direct irradiation synthesis (DIS) is an energetic ion irradiation method that generates self-organized nanopatterns conformal to the surface of materials with complex geometries (e.g., pores on a material surface). This work exposes porous titanium samples to energetic argon ions generating nanopatterning between and inside pores. The unique porous architected titanium (Ti) structure is achieved by mixing Ti powder with given amounts of spacer NaCl particles (vol % equal to 30%, 40%, 50%, 60%, and 70%), compacted and sintered, and combined with DIS to generate a porous Ti with bone-like mechanical properties and hierarchical topography to enhance Ti osseointegration. The porosity percentages range between 25% and 30% using 30 vol % NaCl space-holder (SH) volume percentages to porosity rates of 63%-68% with SH volume of 70 vol % NaCl. Stable and reproducible nanopatterning on the flat surface between pores, inside pits, and along the internal pore walls are achieved, for the first time on any porous biomaterial. Nanoscale features were observed in the form of nanowalls and nanopeaks of lengths between 100 and 500 nm, thicknesses of 35-nm and heights between 100 and 200 nm on average. Bulk mechanical properties that mimic bone-like structures were observed along with increased wettability (by reducing contact values). Nano features were cell biocompatible and enhanced in vitro pre-osteoblast differentiation and mineralization. Higher alkaline phosphatase levels and increased calcium deposits were observed on irradiated 50 vol % NaCl samples at 7 and 14 days. After 24 h, nanopatterned porous samples decreased the number of attached macrophages and the formation of foreign body giant cells, confirming nanoscale tunability of M1-M2 immuno-activation with enhanced osseointegration.

Occult Hepatitis B Virus Infection and Liver Fibrosis in Chinese Patients.

BACKGROUND: The impact of hepatitis B surface antigen (HBsAg)-negative/hepatitis B virus (HBV) DNA-positive occult HBV infection (OBI) on the severity of liver fibrosis remains unclear. METHODS: A total of 1772 patients negative for HBsAg but positive for antibody to hepatitis B core antigen (HBcAg), stratified by the presence or absence of OBI, were selected for long-term carriage leading to elevation of ≥2 of 4 liver fibrosis indexes-hyaluronic acid (HA), laminin, type III procollagen peptide (PCIII), and type IV collagen (CIV)-at testing in a Chinese hospital. Patients were tested for serum viral load, HBV markers, and histopathological changes in liver biopsy specimens. RESULTS: OBI was identified in 148 patients with liver fibrosis (8.4%), who had significantly higher levels of HA, laminin, PCIII, and CIV than 1624 fibrotic patients without OBI (P < .05). In 36 patients with OBI who underwent liver biopsy, significant correlations were observed between OBI viral load and serum HA levels (P = .01), PCIII levels (P = .01), and pathological histological activity index (HAI) scores (P < .001), respectively; HAI scores and PCIII levels (P = .04); HBcAg immunohistochemical scores and HA levels (P < .001); and HBcAg immunohistochemical scores and PCIII levels (P = .03). Positive fluorescent in situ hybridization results were significantly more frequent in patients with OBIs (80.6% vs 37.5% in those without OBIs). Among patients with OBIs, HBcAg was detected in the liver tissue in 52.8% and HBsAg in 5.6%. CONCLUSIONS: OBI status appears to be associated with liver fibrosis severity.

Early Phase of Specific Cellular Immune Status Associates with HCV Infection Outcomes in Marmosets.

The major mechanism for determination of HCV infection outcomes has not been fully described, particularly in the early phase of the "window-period" of infection. Based on two groups of marmosets infected with HCV-CE1E2p7/GBV-B chimeric virus (HCV chimera) or GBV-B, the immune mechanism correlating with the different outcomes of virus infections was explored in this study. HCV chimera containing the entire HCV core and envelope proteins (CE1E2p7) and GBV-B RNA were intrahepatically injected into four marmosets in each group, respectively. Blood samples were taken from individual animals in an interval of 2 weeks. Viral load and specific T cell responses were detected in two groups of HCV chimera- and GBV-B-infected marmosets. HCV chimera-infected marmosets appeared to have a virally persistent infection over 6 months post inoculation of the virus. Of these, the specific IFN-γ-secretion T cell response slowly developed over 13 to 19 weeks and was maintained at a relatively low level with 40-70 SFC/106 PBMCs, while the specific Treg cell response was rapidly activated over 3 weeks and was maintained at a high level around 5% among lymphocytes. In contrast, GBV-B-infected marmosets presented spontaneous viral clearance within 6 months; the specific IFN-γ-secretion T cell response was quickly established over 5 to 7 weeks and was maintained at a high level with 50-130 SFC/106 PBMCs, while the specific Treg cell response was inactivated and maintained at a baseline below 3% among lymphocytes. In conclusion, the HCV structural proteins inducing immune suppression in the early phase of HCV infection contributed to the viral persistence, of which the activation of Treg cells might play an important role in the inhibition of an effective T cell antiviral response.

On the structural origin of the anisotropy in the myocardium: Multiscale modeling and analysis.

Due to structural heterogeneities within the tissue, the myocardium displays an orthotropic material behavior. However, the link between the microstructure and the macroscopic mechanical properties is still not fully established. In particular, if it is admitted that the cardiomyocyte organization induces a transversely isotropic symmetry, the relative role in the observed orthotropic symmetry of cardiomyocyte orientation variation and perimysium collagen "sheetlet" structure, two mechanisms occurring at different scales, is still a matter of debate. In order to shed light on this question, we designed a multiscale model of the myocardium, bridging the cell, sheetlet and tissue scales. More precisely, we compared the macroscopic anisotropy obtained by homogenization of different mesostructures consisting in cardiomyocytes and extracellular collageneous layers, also taking into account the variation of cardiomyocyte and sheetlet orientations on the macroscale, to available experimental data. This study confirms the importance of sheetlets layers in assuring the tissue's anisotropic response, as cardiomyocytes-only mesostructures cannot reproduce the observed anisotropy. Moreover, our model shows the existence of a size effect in the myocardial tissue shear properties, which will require further experimental analysis.

Confronting the Business Models of Modern Slavery.

Despite growing attention from companies and regulators looking to eradicate modern slavery, we know little about how slavery works from a business perspective. We address this gap by empirically examining innovations in the business models of modern slavery, focusing on how the business models of slavery in advanced economies have evolved since slavery was legally abolished. While continuities exist, novel business models have emerged based on new actors, activities, and linkages. We categorize these as four innovative models per actors involved (producer/intermediary) and how value is created and captured (revenue generation/cost reduction), and discuss implications for research, policy, and practice.

Comparison between idiopathic and VEXAS-relapsing polychondritis: analysis of a French case series of 95 patients.

OBJECTIVE: A new adult-onset autoinflammatory syndrome has been described, named VEXAS (Vacuoles, E1 Enzyme, X-linked, Autoinflammatory, Somatic). We aimed to compare the clinical characteristics, the laboratory features and the outcomes between idiopathic-relapsing polychondritis (I-RP) and VEXAS-relapsing polychondritis (VEXAS-RP). METHODS: Patients from French retrospective multicentre cohort of RP were separated into two groups: a VEXAS-RP and an I-RP. RESULTS: Compared with patients with I-RP (n=40), patients with VEXAS-RP (n=55) were men (96% vs 30%, p<0.001) and were older at diagnosis (66 vs 44 years, p<0.001). They had a greater prevalence of fever (60% vs 10%, p<0.001), of skin lesions (82% vs 20%, p<0.001), of ocular involvement (57% vs 28%, p=0.01), of pulmonary infiltrates (46% vs 0%, p<0.001), of heart involvement (11% vs 0%, p=0.0336) and with higher median C-reactive protein levels (64 mg/L vs 10 mg/L, p<0.001). Seventy-five per cent of the patients with VEXAS-RP had myelodysplastic syndrome (MDS) versus none in I-RP group. The glucocorticoids use, and the number of steroid sparing agents were similar in both groups, but patients with VEXAS-RP had more frequent refractory disease (remission obtained in 27% vs 90%, p<0001). VEXAS-RP was associated with higher risk of death: six patients (11%) died in the VEXAS-RP group after a median follow-up of 37 months and none in the I-RP group after a median follow-up of 92 months (p<0.05). CONCLUSION: We report the largest cohort of VEXAS-RP, characterised by high prevalence of male sex, fever, skin lesion, ocular involvement, pulmonary infiltration, heart involvement, older age and MDS association.

Anti-HBc-nonreactive occult hepatitis B infections with HBV genotypes B and C in vaccinated immunocompetent adults.

Absence of anti-HBc reactivity with detectable anti-HBs was observed in blood donors with occult hepatitis B virus (HBV) infection (OBI). The prevalence and mechanisms underlying this uncommon condition were investigated over time in Chinese blood donors with OBI. Isolated anti-HBs OBI status was identified from 466,911 donors from Dalian, China, and monitored in follow-up (range: 2.6-84.3 months). HBV vaccination status was documented, and infecting viral strains were characterized. Of 451 confirmed OBIs (1:1035), 43 (9.5%; 1:10,858) had isolated anti-HBs as only serological marker. Isolated anti-HBs OBIs differed from anti-HBc-reactive OBIs by significantly younger age (median 24 years), higher HBV DNA (median: 20 IU/ml) and anti-HBs (median 60.5 IU/L) levels, paucity of mutations in HBV Core and S proteins, and high vaccination rate (72%). Vaccinated isolated anti-HBs OBIs (n = 31) differed from unvaccinated (n = 11) by significantly younger age (22 vs 38 years), higher anti-HBs level at index (48% vs 9% with anti-HBs >100 IU/L) and higher frequency of anti-HBs immune response (44% vs 20%). Of 15 vaccinated and 5 unvaccinated OBIs follow-up, 65% (8 vaccinated and 5 unvaccinated) became HBV DNA negative suggesting aborted recent infection, while 35% (7 vaccinated) had low persistent viraemia 2 to 65 months post index. In conclusion, isolated anti-HBs OBI in Chinese blood donors appears associated with young, vaccinated, adults exposed to HBV who predominantly develop low level aborted infection revealed by transient HBV DNA and immune anti-HBs response. However, a subset of individuals still experienced low but persistent viral replication whose clinical outcome remains uncertain.

Venous thromboembolism during systemic inflammatory and autoimmune diseases associated with myelodysplastic syndromes, chronic myelomonocytic leukaemia and myelodysplastic/myeloproliferative neoplasms: a French multicentre retrospective case-control study.

OBJECTIVES: Myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML) are associated with systemic inflammatory and autoimmune diseases (SIADs) in 10-30% of cases. The aims of this study were (i) to evaluate the prevalence of venous thromboembolism VTE in patients presenting with both MDS/CMML and SIADs, (ii) to describe risk factors associated with thrombosis, and (iii) to analyse the impact of VTE on overall survival and transformation to acute myeloid leukaemia in comparison to patients with MDS/CMML-associated SIADs without VTE. METHODS: This retrospective multicentre case-control study was conducted among patients with MDS/CMML and dysimmune disorders and featured in the French retrospective database of the French Network of Dysimmune Disorders Associated with Hemopathies (MINHEMON), diagnosed with MDS/CMML and dysimmune disorders. RESULTS: During a median follow-up of 16 months (5-48) VTE occurred in 35 patients (21.6 %) whereas 127 patients did not. Among those with VTE, 8 patients (22.9%) experienced two or more VTE. Common prothrombotic risk factors were not significantly different in patients with or without VTE. CMML was more frequent in patients without VTE (37 % vs. 14.3%, p=0.01), whereas myelodysplasic/myeloproliferative neoplasm (MDS/MPN) was higher in VTE patients (20 % vs. 5.5 %, p=0.01). In a multivariate analysis, only MDS/CMML progression at the time of VTE (odds ratio 28.82, 95 % CI (5.52-530.70) was significantly associated with VTE. When treated with an anticoagulation therapy, bleeding occurred in 19.4% of cases (6/31). Overall survival was not significantly different between patients with and without VTE (p=0.68). Leukaemia-free survival between groups was not significantly different (p=0.83). CONCLUSIONS: VTE is a common complication in MDS/CMML-associated SIADSs with an increased risk of bleeding when treated by anticoagulants. In the MDS/CMML subgroup, SIADS flares and MDS/CMML progression seem to be prothrombotic risk factors.