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Background and study aims Incomplete resection of 4- to 20-mm colorectal polyps occur frequently (> 10 %), putting patients at risk for post-colonoscopy colorectal cancer. We hypothesized that routine use of wide-field cold snare resection with submucosal injection (CSP-SI) might reduce incomplete resection rates (IRRs). Patients and methods Patients aged 45 to 80 years undergoing elective colonoscopies were enrolled in a prospective clinical study. All 4- to 20-mm non-pedunculated polyps were resected using CSP-SI. Post-polypectomy margin biopsies were obtained to determine IRRs through histopathology assessment. The primary outcome was IRR, defined as remnant polyp tissue found on margin biopsies. Secondary outcomes included technical success and complication rates. Results A total of 429 patients (median age 65 years, 47.1 % female, adenoma detection rate 40 %) with 204 non-pedunculated colorectal polyps 4 to 20 mm removed using CSP-SI were included in the final analysis. CSP-SI was technical successful in 97.5 % (199/204) of cases (5 conversion to hot snare polypectomy). IRR for CSP-SI was 3.8 % (7/183) (95 % confidence interval [CI] 2.7 %-5.5 %). IRR was 1.6 % (2/129), 16 % (4/25), and 3.4 % (1/29) for adenomas, serrated lesions, and hyperplastic polyps respectively. IRR was 2.3 % (2/87), 6.3 % (4/64), 4.0 % (6/151), and 3.1 % (1/32) for polyps 4 to 5 mm, 6 to 9 mm, Conclusions Use of CSP-SI results in lower IRRs compared to what has previously been reported in the literature for hot or cold snare polypectomy when not using wide-field cold snare resection with submucosal injection. CSP-SI showed an excellent safety and efficacy profile, however comparative studies to CSP without SI are required to confirm these results.

Inside the Marine Atmospheric Boundary Layer (MABL) turbulence drives a large amount of physical processes through a dynamical coupling. Understanding this coupling is a key issue in weather and climate modeling, but an adapted statistical representation is still lacking. A strong limitation comes from the non-Gaussianities existing inside the MABL. We seek an approach to describe statistically the couplings across scales, which is poorly measured by the power spectrum. Recent developments in data science provide new tools as the Wavelet Scattering Transform (WST), which gives a low-variance statistical description of non-Gaussian processes and offers to go beyond the power spectrum representation.We proposes to apply WST technique on turbulent moments recorded during the EUREC4A campaign in trade-wind cloud regimes. Using WST analysis on both fluctuating time series and realistic Large-Eddy Simulations (LES), we study how the different scales in turbulent flows interact between each other in the MABL. Are the turbulent flows organised or purely random in the MABL ? Do the couplings change for different cloud organisations ? Do the models show evidence of such scale couplings ?In this presentation, we first look at the expected WST coefficients law for turbulent flows in the inertial subrange. Second, we present what are the WST coefficients for the measured turbulent moments and how they evolve for different cloud organizations.

Volcano seismology is essential for understanding, monitoring, and forecasting eruptive events. The use of distributed acoustic sensing (DAS) technology can be particularly useful for this purpose because of its high temporal and spatial resolution, which may help to overcome the challenges of deploying and maintaining seismic arrays on volcanoes.Between 2020 and 2022, we installed 4 km of optical fibre on Stromboli volcano, Italy, whose persistent activity is well-suited for investigating the related dynamic strain rate. The cable was buried at a depth of 30 cm and the layout geometry was designed to provide wide coverage while being constrained by natural obstacles and topographical features. Seismometers were also installed along the fibre. DAS data were collected using a Febus A1-R interrogator, and the acquisition period increased from one week in 2020 to over four months in 2022. We recorded volcanic tremor, ordinary explosions (several per hour), two major explosions in 2021 and 2022, and the entire sequence of a pyroclastic flow in 2022. DAS and seismic data show good agreement in both time and frequency domains after converting strain rate to velocity and vice versa using different methodologies. Beamforming of DAS data shows a dominant signal in the 3-5 Hz frequency band coming from the active craters. We will also present preliminary results of major explosions and pyroclastic flow. This experiment demonstrates that DAS can be used for monitoring volcanic activity.

A widely applicable parameterization of turbulent heat and momentum fluxes at sea has been developed for the SURFEX v8.1 surface model. This wave-age dependent stress parameterization (WASP) combines a close fit to available in situ observations at sea up to wind speed of 60 m s-1 with the possibility of activating the impact of wave growth on the wind stress. It aims in particular at representing the effect of surface processes that depend on the surface wind according to the state of the art. It can be used with the different atmospheric models coupled with the surface model SURFEX, including the CNRM-CM climate model, the operational (numerical weather prediction) systems in use at Météo-France and the research model Meso-NH. Designed to be used in coupled or forced mode with a wave model, it can also be used in atmosphere-only configuration. It has been validated in several case studies covering different surface conditions known to be sensitive to the representation of surface turbulent fluxes: i) the impact of a Sea Surface Temperature (SST) front on low-level flow by weak wind; ii) the simulation of a Mediterranean heavy precipitating event where waves are known to influence the low-level wind and displace precipitation; iii) several tropical cyclones; and iv) a climate run over 35 years. It shows skills comparable to or better than the different parameterizations in use in the SURFEX v8.1 so far.

Background and aims Identification and photo-documentation of the ileocecal valve (ICV) and appendiceal orifice (AO) confirm completeness of colonoscopy examinations. We aimed to develop and test a deep convolutional neural network (DCNN) model that can automatically identify ICV and AO, and differentiate these landmarks from normal mucosa and colorectal polyps. Methods We prospectively collected annotated full-length colonoscopy videos of 318 patients undergoing outpatient colonoscopies. We created three nonoverlapping training, validation, and test data sets with 25,444 unaltered frames extracted from the colonoscopy videos showing four landmarks/image classes (AO, ICV, normal mucosa, and polyps). A DCNN classification model was developed, validated, and tested in separate data sets of images containing the four different landmarks. Results After training and validation, the DCNN model could identify both AO and ICV in 18 out of 21 patients (85.7%). The accuracy of the model for differentiating AO from normal mucosa, and ICV from normal mucosa were 86.4% (95% CI 84.1% to 88.5%), and 86.4% (95% CI 84.1% to 88.6%), respectively. Furthermore, the accuracy of the model for differentiating polyps from normal mucosa was 88.6% (95% CI 86.6% to 90.3%). Conclusion This model offers a novel tool to assist endoscopists with automated identification of AO and ICV during colonoscopy. The model can reliably distinguish these anatomical landmarks from normal mucosa and colorectal polyps. It can be implemented into automated colonoscopy report generation, photo-documentation, and quality auditing solutions to improve colonoscopy reporting quality.

Background The risk of advanced pathology increases with polyp size, as does the potential for mismanagement when optical diagnosis is used. This study aimed to evaluate the proportion of patients who would be assigned inadequate surveillance intervals when different size cutoffs are adopted for use of optical diagnosis. Methods In a post hoc analysis of three prospective studies, the use of optical diagnosis was evaluated for three polyp size groups: 1–3, 1–5, and 1–10 mm. The primary outcome was the proportion of patients in whom advanced adenomas were found and optical diagnosis resulted in delayed surveillance. Secondary outcomes included agreements between surveillance intervals based on high confidence optical diagnosis and pathology outcomes, reduction in histopathological examinations, and proportion of patients who could receive an immediate surveillance recommendation. Results We included 3374 patients (7291 polyps ≤ 10 mm) undergoing complete colonoscopies (median age 66.0 years, 75.2 % male, 29.6 % for screening). The percentage of patients with advanced adenomas and either 2- or 7-year delayed surveillance intervals (n = 79) was 3.8 %, 15.2 %, and 25.3 % for size cutoffs of 1–3, 1–5, and 1–10 mm polyps, respectively (P Conclusion A 3-mm cutoff for clinical implementation of optical diagnosis resulted in a very low risk of delayed management of advanced neoplasia while showing high surveillance interval agreement with pathology and a one-third reduction in overall requirement for pathology examinations.

Satellite observations of significant wave height (Hs) have recently reached 30 years of continuous record. Is this length sufficient to detect the effect of anthropogenically forced climate change on wave height trends? Wave height decadal variability is influenced by a combination of internal variability and forced variability caused by both anthropogenic and natural forcing. Using a statistical model to derive Hs from sea level pressure field and exploiting ERA-5 reanalysis data as well as 80 members of the Community Earth System Model v2 large ensemble, we show that, over the North Atlantic (NA), altimetry-based Hs trends are mostly caused by internal variability. This suggests that Hs changes computed over the satellite era are not yet controlled by anthropogenic climate change. Starting from 1993, the date of emergence, defined as the date when the forced signal becomes dominant over the internal variability, is later than 2050 for Hs in the NA. Plain Language Summary Satellite observations of significant wave height will soon reach 30 years of continuous record. Changes in significant wave height over this period can either be attributed to both anthropogenic or “natural” climate forcing or to the intrinsic variability of the climate system. In this article, we show that the intrinsic variability effect largely dominates the significant wave height changes in the North Atlantic (NA) over the 30 years of satellite observations. We further estimate that the significant wave height changes associated with anthropogenically forced climate change will become dominant over those due to the intrinsic variability after 2050 in most of the NA region.

Double-stranded RNA produced during viral replication and transcription activates both protein kinase R (PKR) and ribonuclease L (RNase L), which limits viral gene expression and replication through host shutoff of translation. In this study, we find that APOBEC3B forms a complex with PABPC1 to stimulate PKR and counterbalances the PKR-suppressing activity of ADAR1 in response to infection by many types of viruses. This leads to translational blockage and the formation of stress granules. Furthermore, we show that APOBEC3B localizes to stress granules through the interaction with PABPC1. APOBEC3B facilitates the formation of protein-RNA condensates with stress granule assembly factor (G3BP1) by protecting mRNA associated with stress granules from RNAse L-induced RNA cleavage during viral infection. These results not only reveal that APOBEC3B is a key regulator of different steps of the innate immune response throughout viral infection but also highlight an alternative mechanism by which APOBEC3B can impact virus replication without editing viral genomes.

Background Serrated lesions are potential colorectal cancer precursors. This study evaluated the presence of total metachronous advanced neoplasia (T-MAN) at follow-up in patients with index serrated lesions compared with a matched cohort without serrated lesions. Methods Patients aged 45–74 years with serrated lesions were matched 2:1 by sex, age, synchronous polyps, and timing of index colonoscopy, to patients without serrated lesions. The primary outcome was T-MAN (advanced adenoma or high-risk serrated lesion) at follow-up. Secondary outcomes included presence of T-MAN stratified by synchronous polyps and serrated lesion characteristics. Results 1425 patients were included (475 patients, 642 serrated lesions; 950 controls; median follow-up 2.9 versus 3.6 years). Patients with serrated lesions had greater risk of T-MAN than those without (hazard ratio [HR] 6.1, 95 %CI 3.9–9.6). Patients with serrated lesions and high-risk adenoma (HRA) had higher risk of T-MAN than those with HRA alone (HR 2.6, 95 %CI 1.4–4.7); similarly, patients with serrated lesions plus low-risk adenoma (LRA) had higher risk than those with LRA alone (HR 7.0, 95 %CI 2.8–18.4), as did patients with serrated lesions without adenoma compared with no adenoma (HR 14.9, 95 %CI 6.5–34.0). Presence of proximal sessile serrated lesion (SSL; HR 9.3, 95 %CI 5.4–15.9), large SSL (HR 17.8, 95 %CI 7.4–43.3), and proximal large SSL (HR 25.0, 95 %CI 8.8–71.3), but not distal SSL, were associated with greater risk for T-MAN. Conclusion Patients with serrated lesions had higher risk for T-MAN regardless of synchronous adenomas. Patients with serrated lesions and HRA, and those with large or proximal SSLs, were at greatest risk.

Introduction: Upon BMP-2 stimulation, the osteoblastic lineage commitment in C2C12 myoblasts is associated with a microenvironmental change that occurs over several days. How does BMP-2 operate a switch in adhesive machinery to adapt to the new microenvironment and to drive bone cell fate is not well understood. Here, we addressed this question for BMP-2 delivered either in solution or physically bound of a biomimetic film, to mimic its presentation to cells via the extracellular matrix (ECM).Methods: Biommetics films were prepared using a recently developed automated method that enable high content studies of cellular processes. Comparative gene expressions were done using RNA sequencing from the encyclopedia of the regulatory elements (ENCODE). Gene expressions of transcription factors, beta chain (1, 3, 5) integrins and cadherins (M, N, and Cad11) were studied using quantitative PCR. ECM proteins and adhesion receptor expressions were also quantified by Western blots and dot blots. Their spatial organization in and around cells was studied using immuno-stainings. The individual effect of each receptor on osteogenic transcription factors and alkaline phosphatase expression were studied using silencing RNA of each integrin and cadherin receptor. The organization of fibronectin was studied using immuno-staining and quantitative microscopic analysis.Results: Our findings highlight a switch of integrin and cadherin expression during muscle to bone transdifferentiation upon BMP-2 stimulation. This switch occurs no matter the presentation mode, for BMP-2 presented in solution or via the biomimetic film. While C2C12 muscle cells express M-cadherin and Laminin-specific integrins, the BMP-2-induced transdifferentiation into bone cells is associated with an increase in the expression of cadherin-11 and collagen-specific integrins. Biomimetic films presenting matrix-bound BMP-2 enable the revelation of specific roles of the adhesive receptors depending on the transcription factor.Discussion: While β3 integrin and cadherin-11 work in concert to control early pSMAD1,5,9 signaling, β1 integrin and Cadherin-11 control RunX2, ALP activity and fibronectin organization around the cells. In contrast, while β1 integrin is also important for osterix transcriptional activity, Cadherin-11 and β5 integrin act as negative osterix regulators. In addition, β5 integrin negatively regulates RunX2. Our results show that biomimetic films can be used to delinate the specific events associated with BMP-2-mediated muscle to bone transdifferentiation. Our study reveals how integrins and cadherins work together, while exerting distinct functions to drive osteogenic programming. Different sets of integrins and cadherins have complementary mechanical roles during the time window of this transdifferentiation.

This contribution deals with $\mathrm L^2$ hypocoercivity methods for kinetic Fokker-Planck equations with integrable local equilibria and a \emph{factorisation} property that relates the Fokker-Planck and the transport operators. Rates of convergence in presence of a global equilibrium, or decay rates otherwise, are estimated either by the corresponding rates in the diffusion limit, or by the rates of convergence to local equilibria, under moment conditions. On the basis of the underlying functional inequalities, we establish a classification of decay and convergence rates for large times, which includes for instance sub-exponential local equilibria and sub-exponential potentials.

Group B enteroviruses, including coxsackievirus B3 (CVB3), can persistently infect cardiac tissue and cause dilated cardiomyopathy. Persistence is linked to 5’ terminal deletions of viral genomic RNAs that have been detected together with minor populations of full-length genomes in human infections. In this study, we explored the functions and interactions of the different viral RNA forms found in persistently-infected patients and their putative role(s) in pathogenesis. Since enterovirus cardiac pathogenesis is linked to the viral proteinase 2A, we investigated the effect of different terminal genomic RNA deletions on 2A activity. We discovered that 5’ terminal deletions in CVB3 genomic RNAs decreased the proteinase activity of 2A but could not abrogate it. Using newly-generated viral reporters encoding nano-luciferase, we found that 5’ terminal deletions resulted in decreased levels of viral protein and RNA synthesis in singly-transfected cardiomyocyte cultures. Unexpectedly, when full-length and terminally deleted forms were co-transfected into cardiomyocytes, a cooperative interaction was observed, leading to increased viral RNA and protein production. However, when viral infections were carried out in cells harboring 5’ terminally deleted CVB3 RNAs, a decrease in infectious particle production was observed. Our results provide a possible explanation for the necessity of full-length viral genomes during persistent infection, as they would stimulate efficient viral replication compared to that of the deleted genomes alone. To avoid high levels of viral particle production that would trigger cellular immune activation and host cell death, the terminally deleted RNA forms act to limit the production of viral particles, possibly as trans-dominant inhibitors.ImportanceEnteroviruses like coxsackievirus B3 are able to initiate acute infections of cardiac tissue and, in some cases, to establish a long-term persistent infection that can lead to serious disease sequelae, including dilated cardiomyopathy. Previous studies have demonstrated the presence of 5’ terminally-deleted forms of enterovirus RNAs in heart tissues derived from patients with dilated cardiomyopathy. These deleted RNAs are found in association with very low levels of full-length enterovirus genomic RNAs, an interaction that may facilitate continued persistence while limiting virus particle production. Even in the absence of detectable infectious virus particle production, these deleted viral RNA forms express viral proteinases at levels capable of causing viral pathology. Our studies provide mechanistic insights into how full length and deleted forms of enterovirus RNA cooperate to stimulate viral protein and RNA synthesis without stimulating infectious viral particle production. They also highlight the importance of targeting enteroviral proteinases to inhibit viral replication while at the same time limiting the long-term pathologies they trigger.

Background: Cold snare polypectomy (CSP) is increasingly used for polypectomy and is recommended as first-line modality for small (

SUMMARYThe brutal onset of seismicity offshore Mayotte island North of the Mozambique Channel, Indian Ocean, that occurred in May 2018 caught the population, authorities and scientific community off guard. Around 20 potentially felt earthquakes were recorded in the first 5 d, up to magnitude Mw 5.9. The scientific community had little pre-existing knowledge of the seismic activity in the region due to poor seismic network coverage. During 2018 and 2019, the MAYOBS/REVOSIMA seismology group was progressively built between four French research institutions to improve instrumentation and data sets to monitor what we know now as an on-going exceptional submarine basaltic eruption. After the addition of 3 medium-band stations on Mayotte island and 1 on Grande Glorieuse island in early 2019, the data recovered from the Ocean Bottom Seismometers were regularly processed by the group to improve the location of the earthquakes detected daily by the land network. We first built a new local 1-D velocity model and established specific data processing procedures. The local 1.66 low VP/VS ratio we estimated is compatible with a volcanic island context. We manually picked about 125 000 P and S phases on land and sea bottom stations to locate more than 5000 events between February 2019 and May 2020. The earthquakes outline two separate seismic clusters offshore that we named Proximal and Distal. The Proximal cluster, located 10 km offshore Mayotte eastern coastlines, is 20–50 km deep and has a cylindrical shape. The Distal cluster start 5 km to the east of the Proximal cluster and extends below Mayotte's new volcanic edifice, from 50 to 25 km depth. The two clusters appear seismically separated, however our data set is insufficient to firmly demonstrate this.

Background Clinical implementation of the resect-and-discard strategy has been difficult because optical diagnosis is highly operator dependent. This prospective study aimed to evaluate a resect-and-discard strategy that is not operator dependent. Methods The study evaluated a resect-and-discard strategy that uses the anatomical polyp location to classify colonic polyps into non-neoplastic or low risk neoplastic. All rectosigmoid diminutive polyps were considered hyperplastic and all polyps located proximally to the sigmoid colon were considered neoplastic. Surveillance interval assignments based on these a priori assumptions were compared with those based on actual pathology results and on optical diagnosis. The primary outcome was ≥ 90 % agreement with pathology in surveillance interval assignment. Results 1117 patients undergoing complete colonoscopy were included and 482 (43.1 %) had at least one diminutive polyp. Surveillance interval agreement between the location-based strategy and pathological findings using the 2020 US Multi-Society Task Force guideline was 97.0 % (95 % confidence interval [CI] 0.96–0.98), surpassing the ≥ 90 % benchmark. Optical diagnoses using the NICE and Sano classifications reached 89.1 % and 90.01 % agreement, respectively (P Conclusion The location-based resect-and-discard strategy achieved very high surveillance interval agreement with pathology-based surveillance interval assignment, surpassing the ≥ 90 % benchmark and outperforming optical diagnosis in surveillance interval agreement and the number of pathology examinations avoided.

The western Mediterranean Sea area is frequently affected in autumn by heavy precipitation events (HPEs). These severe meteorological episodes, characterized by strong offshore low-level winds and heavy rain in a short period of time, can lead to severe flooding and wave-submersion events. This study aims to progress towards an integrated short-range forecast system via coupled modeling for a better representation of the processes at the air–sea interface. In order to identify and quantify the coupling impacts, coupled ocean–atmosphere–wave simulations were performed for a HPE that occurred between 12 and 14 October 2016 in the south of France. The experiment using the coupled AROME-NEMO-WaveWatchIII system was notably compared to atmosphere-only, coupled atmosphere–wave and ocean–atmosphere simulations. The results showed that the HPE fine-scale forecast is sensitive to both couplings: the interactive coupling with the ocean leads to significant changes in the heat and moisture supply of the HPE that intensify the convective systems, while coupling with a wave model mainly leads to changes in the low-level dynamics, affecting the location of the convergence that triggers convection over the sea. Result analysis of this first case study with the AROME-NEMO-WaveWatchIII system does not clearly show major changes in the forecasts with coupling and highlights some attention points to follow (ocean initialization notably). Nonetheless, it illustrates the higher realism and potential benefits of kilometer-scale coupled numerical weather prediction systems, in particular in the case of severe weather events over the sea and/or in coastal areas, and shows their affordability to confidently progress towards operational coupled forecasts.

Background: Studies have found possible physiologic changes to esophageal motility with aging currently not taken into account in routine high-resolution manometry (HRM) interpretation. We aimed to quantify the relationship between these physiologic changes and aging to improve HRM interpretation. Methods: We conducted a retrospective analysis of patients who underwent HRM at a tertiary hospital center between 2015 and 2019. Inclusion criteria were patients aged >= 18 years with normal HRM. Exclusion criteria were abnormal HRM, abnormal upper digestive endoscopy or imagery. Outcomes were median integrated relaxation pressure (IRP), lower esophageal sphincter (LES) pressure, distal contractal integral (DCI), distal latency (DL), and peristaltic break (PB) according to the v4.0 Chicago classification criteria. Effect of age was examined through univariate and multivariate linear regression analysis. Results: We identified 1,917 patients with HRM and included 722 patients with normal exams (median age 56 years (interquartile range (IQR) 46 - 66), 63.8% female). Indications for HRM included dysphagia (39.6%), gastroesophageal reflux disease (29.5%), and chest pain (11.5%). There was statistically significant relationship between age and IRP (r = 0.20, P < 0.0001) as well as DCI (r = 0.12, P = 0.001) and DL (r = -0.09, P = 0.02). No statistically significant relationship was found between age and LES pressure or PB. Conclusion: We found that IRP, DCI, and to a lesser extent, DL, are significantly correlated with the normal aging process in symptomatic patients. These findings should be taken into consideration when interpreting esophageal HRM. J Clin Med Res. 2021;13(8):413-419 doi: https://doi.org/10.14740/jocmr4576

Background The effectiveness of colonoscopy screening to prevent colorectal cancer (CRC) is directly linked to its procedural quality. An independent observer (Hawthorne effect) can improve colonoscopy procedural quality metrics, including adenoma detection rate (ADR). However, the results of studies are limited or controversial. Purpose We aimed to evaluate the colonoscopy quality metrics in a group of patients undergoing screening or diagnostic colonoscopies under stringent observer conditions. Method In a single-center, case–control study, consecutive patients undergoing routine screening or diagnostic colonoscopy were prospectively enrolled. In the case group, all procedural steps and quality metrics were observed and documented, and the procedure was video recorded by an independent research assistant. In the control group, colonoscopies were performed without independent observation. Colonoscopy quality metrics such as polyp, adenoma, serrated lesions, and advanced adenoma detection rates (PDR, ADR, SLDR, AADR), the mean number of adenomas detected per patient (MAP), and the mean number of adenomas and serrated lesions detected per patient (MASP) were compared. The probabilities of increased quality metrics were evaluated through regression analyses weighted by the inversed probability of observation during the procedure. Result(s) We included a total of 687 patients (327 cases and 360 controls) in the final analyses. The case group had significantly higher PDRs (62.4% vs. 53.1%) and ADRs (39.4% vs. 28.3%) compared with the control group. The SLDR was also higher in the case group than in the control group, but the difference was not significant (7.3% vs. 4.4%; P = 0.14). The AADR was not significantly increased. After adjusting for potential confounders, the ADR and SLDR were 50% (odds ratio [OR] 1.51; 95%CI 1.05–2.17) and more than twofold (OR 2.17; 95%CI 1.05–4.47) more likely to be higher in the case group than in the control group. The MAP and MASP were significantly increased in the case group compared with the control group (P < 0.001). The regression analyses for both metrics demonstrated the direct and significant association between the Hawthorne effect and elevated MAP/MASP. Conclusion(s) The presence of an independent observer documenting colonoscopy quality metrics and video recording the colonoscopy resulted in a significant increase in ADR and other quality metrics. The Hawthorne effect should be considered an alternative strategy to advanced devices to improve colonoscopy quality in routine practice. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest M. Taghiakbari: None Declared, D. Coman: None Declared, M. Takla: None Declared, A. N. Barkun: None Declared, M. Frija-Gruman: None Declared, M. Bouin: None Declared, S. Bouchard: None Declared, E. Deslandres: None Declared, S. Sidani: None Declared, D. von Renteln Grant / Research support from: ERBE, Ventage, Pendopharm, and Pentax, Consultant of: Boston Scientific and Pendopharm

Background Serrated lesions (SLs), including sessile serrated lesions (SSL) and traditional serrated adenomas (TSA) have become subject of increased interest for their role as CRC precursors. Purpose Study aim was to evaluate the risk to develop total metachronous advanced neoplasia (T-MAN) at follow-up in patients with index SL compared to a matched cohort without SL. Method Patients 45-74y with SLs were identified through pathology database search. SL patients were matched 2:1 by sex; age; synchronous polyps (high-risk adenoma [HRA], low-risk adenoma [LRA], no-adenoma); timing of index, to patients without SL. Primary outcome was risk of T-MAN (advanced adenoma or high-risk SL) at follow-up. Secondary outcomes included risk of T-MAN stratified by synchronous polyps and SL characteristics. Result(s) 1425 patients were included (475 patients, 642 SLs; 950 controls (mean follow-up 2.9 vs 3.9y). The SL group had greater risk of T-MAN compared to the non-SL group [Hazard-ratio (HR)=6.12 (95%confidence-interval (CI)3.91-9.58)]. Patients with SL+HRA had higher risk of T-MAN compared to HRA alone [HR=2.62 (95%CI 1.45-4.71)], as well as patients with SL+LRA compared to LRA alone [HR=7.03 (95%CI 2.78-18.44)], and SL without adenoma compared to no-adenoma [HR=14.87 (95%CI 6.51-33.95)]. Presence of proximal SSL (HR=9.30), large SSL (HR=17.87) and proximal large SSL (HR=24.99), but not distal SSL, was associated with greater risk for T-MAN. Conclusion(s) Patients with SLs are at greater risk for developing T-MAN regardless of synchronous adenomas. Patients with SL and HRA, and those with large or proximal SSLs appear to be at greatest risk for T-MAN. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding; ACG Disclosure of Interest R. Djinbachian Grant / Research support from: Grant from the American College of Gastroenterology for the conduction of this project, M.-L. Lafontaine: None Declared, J. Anderson: None Declared, H. Pohl: None Declared, T. Dufault: None Declared, M. Boivin: None Declared, M. Bouin: None Declared, D. von Renteln Grant / Research support from: Daniel von Renteln is supported by a “Fonds de Recherche du Québec Santé” (FRQS) career development award and has received research funding from ERBE, Ventage, Pendopharm, Fujifilm, and Pentax., Consultant of: Boston Scientific and Pendopharm

The spatial organization of cell-surface receptors is fundamental for the coordination of biological responses to physical and biochemical cues of the extracellular matrix. How serine/threonine kinase receptors, ALK3-BMPRII, cooperate with integrins upon BMP2 to drive cell migration is unknown. Whether the dynamics between integrins and BMP receptors intertwine in space and time to guide adhesive processes is yet to be elucidated. We found that BMP2 stimulation controls the spatial organization of BMPRs by segregating ALK3 from BMPRII into β3 integrin-containing focal adhesions. The selective recruitment of ALK3 to focal adhesions requires β3 integrin engagement and ALK3 activation. BMP2 controls the partitioning of immobilized ALK3 within and outside focal adhesions according to single-protein tracking and super-resolution imaging. The spatial control of ALK3 in focal adhesions by optogenetics indicates that ALK3 acts as an adhesive receptor by eliciting cell spreading required for cell migration. ALK3 segregation from BMPRII in integrin-based adhesions is a key aspect of the spatio-temporal control of BMPR signaling.

Objectives:To assess the relationship between blood biomarkers of inflammation and lesion growth within the penumbra in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT).Methods:HIBISCUS-STROKE cohort enrolled patients admitted in the Lyon Stroke Center for an anterior circulation AIS treated with MT following MRI. Lesion growth within the penumbra was assessed on day-6 MRI using a voxel-based nonlinear coregistration method and dichotomized into low and high according to the median. C-reactive protein (CRP), interleukin (IL)-6, IL-8, IL-10, monocyte chemoattractant protein-1 (MCP-1), soluble tumor necrosis factor receptor I (sTNF-RI), soluble form suppression of tumorigenicity 2 (sST2), soluble P-selectin (sP-selectin), vascular cellular adhesion molecule-1 (VCAM-1) and matrix metalloproteinase-9 (MMP-9) were measured in sera at 4 timepoints within the first 48 hours. Reperfusion was considered as successful if Thrombolysis in Cerebral Infarction (TICI) score was 2b/2c/3. A multiple logistic regression model was performed to detect any association between area under the curve (AUC) of these biomarkers within the first 48 hours and a high lesion growth within the penumbra.Results:90 patients were included. Median lesion growth within the penumbra was 2.3 [0.7-6.2] mL. On multivariable analysis, a high sST2 AUC (odds ratio (OR) 3.77, 95% confidence interval (CI) 1.36-10.46) as well as a high baseline DWI volume (OR 3.65, 95% CI 1.32-10.12) and lack of successful reperfusion (OR 0.19, 95% CI 0.04-0.92) were associated with a high lesion growth within the penumbra. When restricting analyses to patients with successful reperfusion (n=76), a high sST2 AUC (OR 5.03, 95% CI 1.64-15.40), a high baseline DWI volume (OR 3.74, 95% CI 1.22-11.53) and a high penumbra volume (OR 3.25, 95% CI 1.10-9.57) remained associated with a high lesion growth within the penumbra.Conclusions: sST2 levels within the first 48 hours are associated with a high lesion growth within the penumbra.

Background Standard colonoscopy practice requires removal and histological characterization of almost all detected small ( Methods A post hoc analysis was performed on patients enrolled in a prospective study. The primary outcome was surveillance interval agreement of the PBRD strategy with pathology-based management according to 2020 US Multi-Society Task Force guidelines. Chart analysis also evaluated clinician adherence to pathology-based recommendations. One-sided testing was performed with a null-hypothesis of 90 % agreement with pathology-based surveillance intervals and a two-sided 96.7 % confidence interval (CI) using correction for multiple testing. Results 452 patients were included in the study. Surveillance intervals assigned using the PBRD strategy were correct in 97.8 % (96.7 %CI 96.3–99.3 %) of patients compared with pathology-based management. The PBRD strategy reduced pathology examinations by 58.7 % while providing 87.8 % of patients with immediate surveillance interval recommendations on the day of colonoscopy, compared with 47.1 % when using pathology-based management. Chart analysis of surveillance interval assignments showed 63.3 % adherence to pathology-based guidelines. Conclusion The PBRD strategy surpassed the 90 % agreement with the pathology-based standard for determining surveillance interval, reduced the need for pathology examinations, and increased the proportion of patients receiving immediate surveillance interval recommendations. The PBRD strategy does not require expertise in optical diagnosis and may replace histological characterization of small and diminutive colorectal polyps.

The microbiome is now regarded as one of the hallmarks of cancer and several strategies to modify the gut microbiota to improve immune checkpoint inhibitor (ICI) activity are being evaluated in clinical trials. Preliminary data regarding the upper gastro-intestinal microbiota indicated that Helicobacter pylori seropositivity was associated with a negative prognosis in patients amenable to ICI. In 97 patients with advanced melanoma treated with ICI, we assessed the impact of H. pylori on outcomes and microbiome composition. We performed H. pylori serology and profiled the fecal microbiome with metagenomics sequencing. Among the 97 patients, 22% were H. pylori positive (Pos). H. pylori Pos patients had a significantly shorter overall survival (p = .02) compared to H. pylori negative (Neg) patients. In addition, objective response rate and progression-free survival were decreased in H. pylori Pos patients. Metagenomics sequencing did not reveal any difference in diversity indexes between the H. pylori groups. At the taxa level, Eubacterium ventriosum, Mediterraneibacter (Ruminococcus) torques, and Dorea formicigenerans were increased in the H. pylori Pos group, while Alistipes finegoldii, Hungatella hathewayi and Blautia producta were over-represented in the H. pylori Neg group. In a second independent cohort of patients with NSCLC, diversity indexes were similar in both groups and Bacteroides xylanisolvens was increased in H. pylori Neg patients. Our results demonstrated that the negative impact of H. pylori on outcomes seem to be independent from the fecal microbiome composition. These findings warrant further validation and development of therapeutic strategies to eradicate H. pylori in immuno-oncology arena.

SUMMARYIn spite of growing evidence that many earthquakes are preceded by increased seismic activity, the nature of this activity is still poorly understood. Is it the result of a mostly random process related to the natural tendency of seismic events to cluster in time and space, in which case there is little hope to ever predict earthquakes? Or is it the sign that a physical process that will lead to the impending rupture has begun, in which case we should attempt to identify this process. With this aim we take a further look at the nucleation of two of the best recorded and documented strike-slip earthquakes to date, the 1999 Izmit and Düzce earthquakes which ruptured the North Anatolian Fault over ∼200 km. We show the existence of a remarkable mechanical logic linking together nucleation characteristics, stress loading, fault geometry and rupture speed. In both earthquakes the observations point to slow aseismic slip occurring near the ductile-to-brittle transition zone as the motor of their nucleation.

Andre Carel propose de differencier trois modes de transformation de la crise dans la psyche, individuelle et collective: l’epreuve, la nevrose traumatique, la catastrophe. Chacune appelle des formes specifiques de traitement psychique, notamment dans le registre de l’historisation. Ces trois modalites peuvent etre associees dans la meme psyche. La perinatalite psychique offre une clinique precieuse quant a cette diversite. A propos de la catastrophe, l’accent est mis sur le negativisme dans la rencontre. Il menace le traitement, mais il est le passage oblige pour fonder l’alliance et mener vers le travail du negatif et la reconnaissance mutuelle.

Oral bisphosphonates are effective medications for the prevention of fractures in people suffering from osteoporosis. They are associated with gastrointestinal adverse reactions the most severe being an esophageal ulcer. It is unclear if oral bisphosphonates have a similar gastrointestinal safety profile in the hospital setting as in the community setting because hospitalized patients are often bedridden which may hinder proper drug administration. To evaluate the incidence of upper gastrointestinal symptoms in hospitalized patients taking oral bisphosphonate. This single-center prospective cohort study included hospitalized adult patients actively taking risedronate or alendronate. Upper gastrointestinal symptoms were actively assessed at the baseline and 1 to 5 h following the administration of the oral bisphosphonate. A total of 298 patients were included in the study. The mean age was 64 ± 15 years. During the follow-up period, gastric and esophageal symptoms affected 32 patients (10.7%). Epigastric burning, dysphagia, and regurgitation were reported in 4.4% (n = 13), 3% (n = 9), 2.7 (n = 8), and 2.3% (n = 7) patients, respectively. Heartburn, retro-sternal pain, and odynophagia were observed in 1.7% (n = 5), 1.7% (n = 5), and 0.3% (n = 1) patients. The incidence of adverse reaction was similar to that reported in community trials. The administration of oral bisphosphonate in hospitalized patients does not represent an additional risk for upper gastrointestinal adverse events. Treatment should be optimized during the hospital stay to improve the pharmacological management of osteoporosis.

A medicane, or Mediterranean cyclone with characteristics similar to tropical cyclones, is simulated using a kilometre-scale ocean–atmosphere coupled modelling platform. A first baroclinic phase of the cyclone leads to strong convective precipitation, with high potential vorticity anomalies aloft due to an upper-level trough. The deepening and tropicalization of the cyclone is due first to the crossing of the upper-level jet, then to low-level convergence and uplift of conditionally unstable air masses by cold pools, resulting either from rain evaporation or from advection of continental air masses from North Africa. Backtrajectories show that air–sea heat exchanges warm and moisten the low-level inflow feeding the latent heat release during the mature phase of the medicane. However, the impact of ocean–atmosphere coupling on the cyclone track, intensity and lifecycle is very weak, due to a surface cooling one order of magnitude weaker than for tropical cyclones, even on the area of strong enthalpy fluxes. Isolating the influence of the surface parameters on the surface fluxes at sea during the different phases of the cyclone confirms the impact of the cold pools on the surface processes. The evaporation is controlled mainly by the sea surface temperature and wind, with a significant additional impact of the humidity and temperature at first level during the development phase. The sensible heat flux is influenced mainly by the temperature at first level throughout the whole medicane lifetime. This study shows that the tropical transition, in this case, is dependent on processes widespread in the Mediterranean Basin, like advection of continental air, rain evaporation, and dry air intrusion.

This study investigates the mechanisms acting at the air–sea interface during a heavy precipitation event that occurred between 12 and 14 October 2016 over the north-western Mediterranean area and led to large amounts of rainfall (up to 300 mm in 24 h) over the Hérault region (southern France). The study case was characterized by a very strong (>20 m s−1) easterly to south-easterly wind at low level that generated very rough seas (significant wave height of up to 6 m) along the French Riviera and the Gulf of Lion. In order to investigate the role of the waves on air–sea exchanges during such extreme events, a set of numerical experiments was designed using the Météo-France kilometre-scale AROME-France numerical weather prediction model – including the WASP (Wave-Age-dependant Stress Parametrization) sea surface turbulent flux parametrization – and the WaveWatch III wave model. Results from these sensitivity experiments in the forced or coupled modes showed that taking the waves generated by the model into account increases the surface roughness. Thus, the increase in the momentum flux induces a slowdown of the easterly low-level atmospheric flow and a displacement of the convergence line at sea. Despite strong winds and a young sea below the easterly flow, the turbulent heat fluxes upstream of the precipitating system are not significantly modified. The forecast of the heaviest precipitation is finally modified when the sea state is taken into account; notably, in terms of location, this modification is slightly larger in the forced mode than in the coupled mode, as the coupling interactively balances the wind sea, the stress and the wind.

We consider the non-local Fisher-KPP equation modeling a population with individuals competing with each other for resources with a strength related to their distance, and obtain the asymptotics for the position of the invasion front starting from a localized population. Depending on the behavior of the competition kernel at infinity, the location of the front is either 2t − (3/2) log t + O(1), as in the local case, or 2t − O(t β) for some explicit β ∈ (0, 1). Our main tools here are a local-in-time Harnack inequality and an analysis of the linearized problem with a suitable moving Dirichlet boundary condition. Our analysis also yields, for any β ∈ (0, 1), examples of Fisher-KPP type non-linearities f β such that the front for the local Fisher-KPP equation with reaction term f β is at 2t − O(t β). Abstract Dans cet article, nous considerons l'´ equation de Fisher-KPP non locale, qui modelise la dynamique d'une population ou la force de competition pour les ressources depend de la distance entre les individus. Nous obtenons une asymptotique precise en temps long de la position d'une population qui est initialement localisee en espace. Selon la decroissance a l'infini du noyau de competition, la position du front est soit 2t − (3/2) log t + O(1), comme dans le cas de l'´ equation locale, soit 2t − O(t β), pour un β ∈ (0, 1) calcule explicitement. Les outils les plus importants utilises dans cet article sont une version locale en temps d'une inegalite de Harnack parabolique ainsi qu'une analyse fine duprobi eme linearise avec une condition de bord de Dirichlet dynamique. Notre analyse donne aussi, pour tout β ∈ (0, 1), des exemples de non-linearites de type Fisher-KPP pour lesquelles le front se trouve en 2t − O(t β).

As evidence has been linking the oral bacterium Fusobacterium nucleatum (F. nucleatum) to colorectal tumorigenesis, we aimed to produce preliminary data on the expression of F. nucleatum in both oral and colorectal body sites in cases diagnosed with colorectal neoplasms (CRN) and CRN-free controls. We conducted a pilot hospital-based case–control study among patients who underwent colonoscopy examination. Saliva samples and biopsies from healthy colon mucosa from CRN cases and CRN-free controls, and from tumors in cases, were collected, as well as data on periodontal condition and potential CRN risk factors. A total of 22 CRN cases and 21 CRN-free controls participated in this study, with a total of 135 biospecimens collected and analyzed by qPCR for detection and quantification of F. nucleatum. The detection rate of F. nucleatum was 95% in saliva samples and 18% in colorectal mucosa specimens. The median (95% CI) salivary F. nucleatum level was 0.35 (0.15–0.82) and 0.12 (0.05–0.65) in case and control groups, respectively, with a Spearman correlation of 0.64 (95% CI 0.2–0.94) between F. nucleatum level in saliva and healthy colorectal mucosa in controls. Our study results support the need for and the feasibility of further studies that aim to investigate the association between oral and colorectal levels of F. nucleatum in CRN cases and controls.Clinical Relevance: Considering the current evidence linking F. nucleatum to colorectal carcinogenesis, investigating the role of oral F. nucleatum expression in its colorectal enrichment is crucial for colorectal cancer screening and prevention avenues.

Earth System Models (ESM) and Numerical Weather Prediction (NWP) systems often have large biases in their representation of surface-atmosphere fluxes when compared to observations. Over sea, these biases are more pronounced due to dynamic non-linear interactions between atmosphere and sea surface waves. This non-linearity is not accurately represented by traditional semi-emiprical models like COARE. To this end, the PASM (Physically derived Air-Sea Momentum flux) model, developed by us, is the first attempt to represent air-sea exchanges by considering the two-way interaction between the ocean-waves and the atmospheric flow. It can simulate (i) the main turbulent eddies of the air-flow, and (ii) the wind-wave interactions including wave growth, transport and breaking. This model has been previously demonstrated to better predict the air-sea fluxes under 10m high wind speeds greater than 20m/s, where traditional approaches like COARE fail. In this study, we evaluate for the first time, the evolution of cyclone IDAI off the coast of Madagascar, using PASM and COARE approaches, to demonstrate the efficiency of our physically based model in better simulating the evolution and trajectory of cyclones, and thus its usefulness in ESM and NWP models.

With the flourishing of offshore wind projects there is a new socio-economic interest to better our knowledge and forecasting ability of winds within the coastal marine atmospheric boundary layer (MABL). Air-sea fluxes of enthalpy and momentum greatly influence the turbulent and mean winds in the MABL. Already at moderate but certainly at high winds, wave breaking is a key driver of air-sea fluxes and the sea spray generated by whitecaps is thought to be a crucial component when modelling air-sea interactions. Most studies so far have focused on the role of sea spray in enhancing tropical cyclone intensity. Here we investigate its impacts on the MABL under strong orographic wind forcing. A coupled model framework was developed within the scope of the CASSIOWPE project aiming at characterizing the physical environment in the Gulf of Lion (NW Mediterranean Sea) in the prospective of future floating wind farms development. It consists of the non-hydrostatic mesoscale atmospheric model of the French research community Meso-NH, the 3rd generation wave model WAVEWATCH III®, and the oceanic model CROCO. Sea-spray physics were incorporated into the Meso-NH’s surface model SURFEX. Added parametrizations will be detailed and a series of test cases will be presented to illustrate how sea spray alters the MABL under Mistral and Tramontane winds. Several sea-state dependent sea spray generation functions (SSGF) are considered in the present study. The variability in simulated fields linked to the choice of wave forcing or coupling will be showcased to evaluate their suitability in varying fetch conditions. Sea spray production remains to be adequately quantified. Existing measurement derived SSGFs span several orders of magnitude resulting in uncertainties in simulated fields which will be discussed.

Ocean plays a key role in regulating climate through the dynamical coupling between sea surface and the atmosphere. Understanding this coupling is a key issue in climate change modeling, but an adapted statistical representation is still lacking. A strong limitation comes from the non-Gaussianities existing inside a wind over waves surface layer, where wind flows are constrained by the sea state and the swell. We seek an approach to describe statistically the couplings across scales, which is poorly measured by the power spectrum. Recent developments in data science provide new tools as the Wavelet Scattering Transform (WST), which gives a low-variance statistical description of non-Gaussian processes and offers to go beyond the power spectrum representation. The latter is blind to position consistency between scales. To find the methodology, we applied the WST on 1D anemometer time series and 2D atmospheric simulations (LES) and compared them with well known statistical information. These analyses were made possible thanks to the development of WOAST (Wavelet Ocean-Atmosphere Scattering Transform) software. Computation of WST is mathematically embarrassingly parallel and the time consumption is mainly dominated by data access and memory management. Our preliminary geophysical analysis using WOAST and its efficiency of extracting unknown properties of intermittent processes will be shown through a jupyter notebook example. This work is part of the Astrocean project supported by 80Prime grants (CNRS).

Stromboli is an open-conduit volcano characterized by mild intermittent explosive activity that produces jets of gas and incandescent blocks. Explosions occur at a typical rate of 3-10 events per hour, VLP signals have dominant periods between 2 and 30 seconds. Seismic activity is also characterized by less energy short-period volcanic tremor related to the continuous out-bursting of small gas bubbles in the upper part of the magmatic column. The high rate of activity as well as the broadband frequency contents of emitted signals make Stromboli volcano an ideal site for testing new techniques of fibre-optic sensing.In September 2020, approximately 1 km of fiber-optic cable was deployed on the Northeast flank of Stromboli volcano, together with several seismometers, to record the seismic signals radiated by the persistent Strombolian activity via both DAS and inertial-seismometers, and to compare their records.The cable was buried manually about 30 cm deep over a relatively linear path at first and in a triangle-shaped array with 30-meters-long sides in the highest part of the deployment. The strain rate was recorded using a DAS interrogator Febus A1-R with a sampling frequency of 2000 Hz, a spatial interval of 2.4 m and a gauge length of 5m. Data were re-sampled at 200 Hz. A network of 22 nodes SmartSolo IGU-16HR 3C geophones (5 Hz) has been distributed over the fibre path. A Guralp digitizer equipped with a CMG CMG-40T 30 sec seismometer and an infrasound sensor were placed in the upper part of the path. The geolocation of the cable was obtained by performing kinematic GPS measurements with 2 Leica GR25 receivers. All equipment recorded simultaneously several hundreds of explosion quakes between September 20 and 23.Data analysis provided the following main results:DAS interrogator clearly recorded the numerous explosion-quakes which occurred during the experiment, as well as lower amplitude tremor and LP events. DAS spectrum exhibits a lower resolution at long periods with a cut-off frequency of approximately 3 Hz. VLP seismic events generated by Strombolian activity are identified only at a few DAS channels belonging to a specific portion of the path, which seems affected by local amplification. At these channels, they display waveforms similar to those sensed by the Güralp CMG-40T. Comparison of DAS strain waveform to particle velocity recorded by co-located seismometers shows a perfect match in phase and a good agreement in amplitude. Beamforming methods have been applied to nodes data located on the upper triangle and to strain rate data, both in the 3-5 Hz frequency band. Slightly different back-azimuths were obtained, values estimated via DAS point more to the southwest with respect to the crater area. Apparent velocities obtained with DAS recordings have lower values compared to those obtained with nodes.

The SARS-CoV-2 pandemic has brought to light the need for expedient diagnostic testing. Cost and availability of large-scale testing capacity has led to a lag in turnaround time and hindered contact tracing efforts, resulting in a further spread of SARS-CoV-2. To increase the speed and frequency of testing, we developed a cost-effective single-tube approach for collection, denaturation, and analysis of clinical samples. The approach utilizes 1 µL microbiological inoculation loops to collect saliva, sodium dodecyl sulfate (SDS) to inactivate and release viral genomic RNA, and a diagnostic reaction mix containing polysorbate 80 (Tween 80). In the same tube, the SDS-denatured clinical samples are introduced to the mixtures containing all components for nucleic acids detection and Tween 80 micelles to absorb the SDS and allow enzymatic reactions to proceed, obviating the need for further handling of the samples. The samples can be collected by the tested individuals, further decreasing the need for trained personnel to administer the test. We validated this single-tube sample-to-assay method with reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) and reverse transcription loop-mediated isothermal amplification (RT-LAMP) and discovered little-to-no difference between Tween- and SDS-containing reaction mixtures, compared to control reactions. This approach reduces the logistical burden of traditional large-scale testing and provides a method of deployable point-of-care diagnostics to increase testing frequency.

The objective of this study was to assess the relationship between blood biomarkers of inflammation and lesion growth within the penumbra in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT).The HIBISCUS-STROKE cohort enrolled patients admitted in the Lyon Stroke Center for an anterior circulation AIS treated with MT after brain MRI assessment. Lesion growth within the penumbra was assessed on day 6 MRI using a voxel-based nonlinear coregistration method and dichotomized into low and high according to the median value. C-reactive protein, interleukin (IL)-6, IL-8, IL-10, monocyte chemoattractant protein-1, soluble tumor necrosis factor receptor I, soluble form suppression of tumorigenicity 2 (sST2), soluble P-selectin, vascular cellular adhesion molecule-1, and matrix metalloproteinase-9 were measured in sera at 4 time points within the first 48 hours. Reperfusion was considered as successful if Thrombolysis in Cerebral Infarction score was 2b/2c/3. A multiple logistic regression model was performed to detect any association between area under the curve (AUC) of these biomarkers within the first 48 hours and a high lesion growth within the penumbra.Ninety patients were included. The median lesion growth within the penumbra was 2.3 (0.7-6.2) mL. On multivariable analysis, a high sST2 AUC (OR 3.77, 95% CI 1.36-10.46), a high baseline DWI volume (OR 3.65, 95% CI 1.32-10.12), and a lack of successful reperfusion (OR 0.19, 95% CI 0.04-0.92) were associated with a high lesion growth within the penumbra. When restricting analyses to patients with successful reperfusion (n = 76), a high sST2 AUC (OR 5.03, 95% CI 1.64-15.40), a high baseline DWI volume (OR 3.74, 95% CI 1.22-11.53), and a high penumbra volume (OR 3.25, 95% CI 1.10-9.57) remained associated with a high lesion growth within the penumbra.High sST2 levels within the first 48 hours are associated with a high lesion growth within the penumbra.

Post-polypectomy surveillance intervals are currently determined based on pathology results.To evaluate a polyp-based resect and discard model that assigns surveillance intervals based solely on polyp number and size.Patients undergoing elective colonoscopies at the Montreal University Medical Center were enrolled prospectively. The polyp-based strategy was used to assign the next surveillance interval using polyp size and number. Surveillance intervals were also assigned using optical diagnosis for small polyps (10 mm). The primary outcome was surveillance interval agreement between the polyp-based model, optical diagnosis, and the pathology-based reference standard using the 2020 United States Multi-Society Task Force guidelines. Secondary outcomes included the proportion of reduction in required histopathology evaluations and proportion of immediate post-colonoscopy recommendations provided to patients.Of 944 patients (mean age 62.6 years, 49.3% male, 933 polyps) were enrolled. The surveillance interval agreement for the polyp-based strategy was 98.0% [95% confidence interval (CI): 0.97-0.99] compared with pathology-based assignment. Optical diagnosis-based intervals achieved 95.8% (95%CI: 0.94-0.97) agreement with pathology. When using the polyp-based strategy and optical diagnosis, the need for pathology assessment was reduced by 87.8% and 70.6%, respectively. The polyp-based strategy provided 93.7% of patients with immediate surveillance interval recommendationsThe polyp-based strategy achieved almost perfect surveillance interval agreement compared with pathology-based assignments, significantly reduced the number of required pathology evaluations, and provided most patients with immediate surveillance interval recommendations.

In this paper we focus on a spatially extended FitzHugh-Nagumo model with interactions. In the regime where strong and local interactions dominate, we quantify how the probability density of neurons concentrates into a Dirac distribution. Previous work investigating this question have provided relative bounds in integrability spaces. Using a Hopf-Cole framework, we derive precise $L^\infty$ estimates using subtle explicit sub- and super- solutions which prove, with rates of convergence, that the blow up profile is Gaussian.

Predicting the adaptation of populations to a changing environment is crucial to assess the impact of human activities on biodiversity. Many theoretical studies have tackled this issue by modeling the evolution of quantitative traits subject to stabilizing selection around an optimum phenotype, whose value is shifted continuously through time. In this context, the population fate results from the equilibrium distribution of the trait, relative to the moving optimum. Such a distribution may vary with the shape of selection, the system of reproduction, the number of loci, the mutation kernel or their interactions. Here, we develop a methodology that provides quantitative measures of population maladaptation and potential of survival directly from the entire profile of the phenotypic distribution, without any a priori on its shape.We investigate two different models of reproduction (asexual and infinitesimal sexual models of inheritance), with general forms of selection.In particular, we recover that fitness functions such that selection weakens away from the optimum lead to evolutionary tipping points, with an abrupt collapse of the population when the speed of environmental change is too high. Our unified framework furthermore allows highlighting the underlying mechanisms that lead to this phenomenon. More generally, it allows discussing similarities and discrepancies between the two reproduction models, the latter being ultimately explained by different constraints on the evolution of the phenotypic variance. We demonstrate that the mean fitness in the population crucially depends on the shape of the selection function in the sexual infinitesimal model, in contrast with the asexual model.In the asexual model, we also investigate the effect of the mutation kernel and we show that kernels with higher kurtosis tend to reduce maladaptation and improve fitness, especially in fast changing environments.

Background Replacing histopathology evaluation of diminutive polyps with optical polyp diagnosis is considered a cost-effective approach. However, the widespread use of optical diagnosis is limited due to concerns about making incorrect optical diagnoses and the requirements of training, credentialing and auditing of performance. Aims This prospective study aimed to evaluate a simplified resect and discard strategy that is not operator dependent. Methods The study evaluated a resect and discard strategy that uses anatomical polyp location to classify colon polyps into non-neoplastic or low-risk neoplastic. All rectosigmoid diminutive polyps were considered hyperplastic and all polyps located proximally to the sigmoid colon were considered neoplastic. Surveillance interval assignments based on these a priori assumptions were compared with those based on actual pathology results and optical diagnosis, respectively. The primary outcome was ≥90% agreement with pathology in surveillance interval assignment. Results Overall, 1117 patients undergoing complete colonoscopy were included and 482 (43.1%) had at least one diminutive polyp. Surveillance interval agreement between the location-based resect and discard strategy and pathological findings using the 2020 US Multi-Society Task Force guideline was 97.0% (95% CI = 0.96 - 0.98), surpassing the ≥90% benchmark. Optical diagnoses using NICE and Sano classifications reached 89.1% and 90.01% agreement, respectively (p Conclusions The location-based resect and discard strategy achieved very high surveillance interval agreement with pathology-based surveillance interval assignment, surpassing the ≥90% quality benchmark and outperforming optical diagnosis in surveillance interval agreement and the number of pathology examinations avoided. Funding Agencies None