Alma Consulting Group

Achieving deep remission, encompassing clinical, endoscopic, and biological remission, is the goal in managing Crohn's disease (CD). The role of histological remission (HR) remains unclear. This study aimed to examine the impact of histological inflammation on clinical relapse risk in CD and explore the relationship between histology, endoscopic scores, and biomarkers. Patients from the prospective STORI (Stable Remission on Combined Therapy with Immunosuppressors) cohort underwent ileocolonoscopy with Crohn's Disease Endoscopic Index of Severity calculation and 2 biopsies from the most inflamed or previously inflamed areas. Histological scores (Robarts, Geboes, modified Geboes, Nancy, and IBD-DCA) were determined by 2 independent pathologists in a central reading process. Histological remission was defined by specific score thresholds. Clinical relapse, defined by Crohn's Disease Activity Index (CDAI) > 250 or a CDAI increase of 70 points over 2 weeks, was monitored for at least 1 year. Out of 115 patients included in STORI, 160 biopsies (44 ileal and 116 colonic) from 76 patients were analyzed. Histological remission rates were 46% (Nancy), 55% (Robarts), 61% (Geboes), and 41% (IBD-DCA). During follow-up, 35 patients (46%) experienced a clinical relapse: 37% with HR and 56% without, based on the Nancy score. Among the mucosal healing subgroup (45 patients), 34% with HR, and 44% without relapsed (p = 0.18). Histological scores did not predict clinical relapse. Only fecal calprotectin was a significant predictor in multivariate analysis (p = 0.029). Despite correlations with endoscopy and biomarkers, histological scores did not predict clinical relapse in CD patients in remission. Thus, these scores are not recommended for clinical practice to assess relapse risk in CD.

Currently, there is no short-reach transceiver standard for 800 Gb/s available. The market is only now starting to develop for 400G whereas 800G deployments are expected after 2023 (relevant standards will be ratified). In this rationale leveraging the performances of the new generation of III/V high-power DFB and DML will allow to reach a compact transceiver, providing low loss, high data rates and low cost. In this invited presentation, we will show our recent achieving of high-performance Si-BH technology for HP-DFB and DMLs. This technology is expected to exhibit low propagation loss and high coupling efficiency for photonic integrations specifications

Objectives: Blood perfusion quality of a flap is the main prognostic factor for success. Microvascular evaluation remains mostly inaccessible. We aimed to evaluate the microflow imaging mode, MV-Flow, in assessing flap microvascularization in a pig model of the fascio-cutaneous flap.Methods: On five pigs, bilateral saphenous fascio-cutaneous flaps were procured on the superficial femoral vessels. A conventional ultrasound evaluation in pulsed Doppler and color Doppler was conducted on the ten flaps allowing for the calculation of the saphenous artery flow rate. The MV-Flow mode was then applied: for qualitative analysis, with identification of saphenous artery collaterals; then quantitative, with repeated measurements of the Vascularity Index (VI), percentage of pixels where flow is detected relative to the total ultrasound view area. The measurements were then repeated after increasing arterial flow by clamping the distal femoral artery.Results: The MV-Flow mode allowed a better follow-up of the saphenous artery’s collaterals and detected microflows not seen with the color Doppler. The VI was correlated to the saphenous artery flow rate (Spearman rho of 0.64; p = 0.002) and allowed to monitor the flap perfusion variations.Conclusion: Ultrasound imaging of microvascularization by MV-Flow mode and its quantification by VI provides valuable information in evaluating the microvascularization of flaps.

En este artículo se presentará una de las experiencias docentes, la de la kitá Pardé Alef, que cada domingo tiene lugar en el Majón Albert Einstein, en sus sedes del Patronato de la Casa de la Comunidad Hebrea de Cuba y en el Centro Hebreo Sefaradí, la que ha provocado la transformación del ser humano e incidido en su capacidad de hacer tikún olam.

The development of suitable analytical tools is required to study the stability, manufacturability and bio-performance of peptide conjugate therapeutics. Mass spectrometric analysis provides essential knowledge for understanding and building the critical quality attributes and regulatory specifications of peptides. The purpose of this chapter is to provide an overview/update of mass spectrometric techniques (e.g. ion stripping and isotopic labelling) that are employed for the analytical characterization and quantitation of peptides and their conjugates such as PEGylated peptides and antibody–drug conjugates. Advances in high-resolution mass spectrometry (HRMS) have considerably increased the quality of analytical data on antibody–peptide drug conjugates [e.g. average drug-to-antibody ratio (DAR), drug loading distribution, unconjugated drug and impurity characterization via peptide mapping] that can be used for product and process development, lot release and stability testing. Similarly, the quality of PEGylated peptides can be evaluated via qualitative and quantitative mass spectrometric analysis to ensure that the PEGylated therapeutics have the desired properties such as molecular mass and polydispersity. In addition, relative or absolute mass spectrometric-based quantitation of peptides/peptide conjugates is very useful for assessing stability, label claim and batch-to-batch variability. Different strategies exploiting stable isotope labelling and isotope dilution are possible, each having specific strengths and weaknesses. Inductively coupled plasma mass spectrometry (ICP-MS) has recently emerged as a complementary technique to the previous methods allowing absolute protein quantification using suitable elemental-based tags.

We present a flip-chip integration process in which the vertical alignment is guaranteed by a mechanical contact between pedestals defined in a recess etched into a silicon photonics chip and a laser or semiconductor optical amplifier. By selectively etching up to the active region of the III-V materials, we can make the accuracy of vertical alignment independent on the process control applied to layer thicknesses during silicon photonics or III-V chip fabrication, enabling alignment tolerances below ±10 nm in the vertical (Z-)direction.