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Mediastinal lymph node enlargement is common in the follow-up of patients with previously treated malignancies. The aim of this study is to assess the role of endobronchial ultrasound (EBUS) transbronchial needle aspiration (TBNA) for cyto-histological evaluation of positron emission tomography with 18fluorodeoxyglucose (PET) positive mediastinal and hilar lymph nodes developed in patients with previous malignancies. All EBUS-TBNA cases performed from January 2012 to May 2016 were retrospective reviewed. Results of EBUS-TBNA in patients with mediastinal and/or hilar lymphadenopathies were analysed. Non-malignant cytopathologies were confirmed with surgical procedures or clinical and radiological follow-up. Among 1780 patients, 176 were included in the analysis. 103 of these (58.5%) had a diagnosis of tumour recurrence whereas 73 (41.5%) had a different diagnosis: 63 (35.8%) had a non-neoplastic diagnosis and 8 patients (4.6%) had a different cell type malignancy. Samples were false-negative in 5 (2.8%) out of 176 patients. The overall sensitivity, specificity, negative predicted value and diagnostic accuracy were 95.7% (95% CI 90.2–98.6%), 100% (95% CI 94.0–100%), 92.3% (95% CI 83.2–96.7%) and 97.2% (95% CI 93.5–98.8%), respectively. EBUS-TBNA demonstrated a pathological diagnosis different from the previous tumour in a large percentage of patients, confirming its strategic role in the management of patients with previously treated malignancies.

A range of preventive practices are recommended to reduce the burden of chronic diseases. The aim of our study was to describe the preventive practices of French-speaking primary care physicians.A cross-sectional survey was conducted in 2015 in a randomly selected sample of 1100 primary care physicians (700 in Switzerland, 400 in France). The physicians were asked how often they performed the following recommended preventive practices: blood pressure, weight and height measurements, screening for dyslipidemia, screening for alcohol use and brief intervention, screening for smoking (and brief advice for smokers), colon and prostate cancer screening, and influenza immunization. Response options on the five points Likert scale were never, rarely, sometimes, often, always. The physicians were considered to be performing the preventive practice regularly if they declared performing it often or always.518 participants (47%) returned the questionnaire. The most commonly reported preventive practices were: blood pressure measurement (99%), screening for smoking (95%) and brief advice for smokers (95%). The least frequently reported practices were annual influenza immunization for at-risk patients

Free living amoebae (FLA) including Acanthamoeba castellanii, are protozoa that feed on different microorganisms including viruses. These microorganisms show remarkable similarities with macrophages in cellular structures, physiology or ability to phagocyte preys, and some authors have therefore wondered whether Acanthamoeba and macrophages are evolutionary related. It has been considered that this amoeba may be an in vitro model to investigate relationships between pathogens and macrophagic cells. So, we intended in this study to compare the interactions between a human adenovirus strain and A. castellanii or THP-1 macrophagic cells. The results of molecular and microscopy techniques following co-cultures experiments have shown that the presence of the adenovirus decreased the viability of macrophages, while it has no effect on amoebic viability. On another hand, the viral replication occurred only in macrophages. These results showed that this amoebal model is not relevant to explore the relationships between adenoviruses and macrophages in in vitro experiments.

A multichromophoric glucopyranoside 2 bearing three dicyanomethylenepyran (DCM) fluorophores and one diarylethene (DAE) photochrome has been prepared by Cu(I)-catalyzed alkyne–azide cycloaddition reaction. The fluorescence of 2 was switched off upon UV irradiation, in proportion with the open to closed form (OF to CF) conversion extent of the DAE moiety. A nearly 100% Förster-type resonance energy transfer (FRET) from all three DCM moieties to a single DAE (in its CF) moiety was achieved. Upon visible irradiation, the initial fluorescence intensity was recovered. The observed photoswiching is reversible, with excellent photo resistance.

The KrasG12D/+;LSL-Trp53R172H/+;Pdx-1-Cre (KPC) mouse model is frequently employed for preclinical therapeutic testing, in particular in regard to antistromal therapies. Here, we investigate the prognostic implications of histopathological features that may guide preclinical trial design. Pancreatic tumor tissue from n = 46 KPC mice was quantitatively analyzed using immunohistochemistry and co-immunofluorescence for proliferation (Ki67), mitotic rate (phospho-Histone 3, PHH3), apoptosis (cleaved caspase-3, CC3), collagen content, secreted protein acidic and rich in cysteine (SPARC), hyaluronic acid (HA), and α-smooth muscle actin (α-SMA). Furthermore, mean vessel density (MVD), mean lumen area (MLA), grading, activated stroma index (ASI), and fibroblast-proliferation rate (α-SMA/Ki67) were assessed. Univariate analysis using the Kaplan−Meier estimator and Cox regression model for continuous variables did not show association between survival and any of the analyzed parameters. Spearman correlation demonstrated that desmoplasia was inversely correlated with differentiated tumor grade (ρ = −0.84). Ki67 and PHH3 synergized as proliferation markers (ρ = 0.54), while SPARC expression was positively correlated with HA content (ρ = 0.37). MVD and MLA were correlated with each other (ρ = 0.31), while MLA positively correlated with CC3 (ρ = 0.45). Additionally, increased MVD was correlated with increased fibroblast proliferation rate (α-SMA + Ki67; ρ = 0.36). Our pilot study provides evidence that individual histopathological parameters of the primary tumor of KPC mice are not associated with survival, and may hint at the importance of systemic tumor-related effects such as cachexia.

Introduction: Since reliable information is scarce to describe continuing medical education (CME) and revalidation in Europe, we carried out a survey in 5 selected countries (France, Germany, Italy, Spain, and the United Kingdom). Methods: A tested questionnaire was sent to 2 experts per country (except in Germany), during August-September 2004. Results: In the analyzed countries medical societies, medical associations, and employers are the main CME providers. Pharmaceutical industry sponsorship accounts on the average for more than 50% of the CME financing in those countries. In all 5 countries, CME accreditation systems exist; the national health authorities and medical associations are mainly responsible for them. In France, Italy, and Germany CME is mandatory; in Spain and the United Kingdom it is voluntary. CME credits/points are mainly used for professional career purposes. Revalidation systems have not been introduced in any of these countries, although in the United Kingdom it is being introduced as part of a relicensing process. Discussion: Recommendations for the implementation of a European system of CME/CPD harmonization are made by the authors. (Contains 3 tables.)

Introduction: Little data on the educational needs and practices of French hospital physicians have been obtained through surveys. Given that continuing medical education (CME) information is now available on http://www.cnfmc.fr and providers are accredited, we investigated CME practices and knowledge of the CME system with the use of a representative sample of hospital physicians. Methods: A questionnaire was prepared during 2 work sessions organized by TNS Healthcare Sofres in July 2007. A sample of 300 physicians was selected to represent hospital physicians throughout 5 main regions and hospital types. Telephone numbers were dialed automatically in order to meet quota objectives. Questionnaires were administered by telephone between August 30 and September 7, 2007 by trained operators. Results: Among the 300 interviewed physicians, 218 (73%) were from general or specialized hospitals and 82 (27%) were from university hospitals. They were located equally all over France. Their specialties were: medicine, 130 (43%); laboratory, 51 (17%); pharmacy, 45 (15%); surgery, 15 (5%); psychiatry, 9 (3%); and others, 49 (17%), including emergency and radiology. One hundred twenty-five of the physicians (42%) stated that they took part in continuing education programs for more than 10 days per year, 122 (41%) between 6 and 10 days per year, and 51 (17%) less than 5 days; 2 (less than 1%) did not answer. Two hundred fourteen of the physicians subscribed to either specialized or general medical journals; 86 (29%) did not subscribe to any journal. For live in-class events, approximately 65% of the educational, travel, and lodging expenses were paid for by physicians and hospitals. The pharmaceutical industry paid for 25% of these expenses. In response to the question "Did you participate in a performance improvement program in your hospital?", 75 (25%) said that they had (16% for the 82 physicians in university hospitals, and 29% for the 211 physicians in general hospitals), 210 (70%) said that they had not, including the 134 (45% of the 300) who said that it was scheduled, and 15 (5%) did not answer. Seminars were preferred for continuing education programs, and interactive workshops and e-learning methods were requested for the future. Among the 300 physicians, 246 (82%) expressed difficulties following up on CME events, and 54 (18%) had no difficulty with their education. Discussion: This telephone survey of 300 hospital physicians showed that although they took part in many educational programs, they had organizational, personal, and financial issues. E-learning could make it easier for physicians to continue their education. (Contains 4 tables.)

Introduction: During the past decade, the public, health care professionals, and governments have shown much interest in ensuring that professionals, specifically physicians, are skilled in their work and competent in managing health care organizations. The need to assess competence in the health care sector was explored, with the aim of proposing a policy for monitoring and assessing competence during active professional life. Methods: A literature search and semistructured interviews were conducted. The 16 health care professions listed in the French health care code were included. The main questions were: What is your organization's definition of competence? What are the principal elements that define competence in health care activities? How can a system for assessing competence be implemented? Which methods for such a system are most appropriate, based on foreign experiences? Who are the players in the field of competence? And how can organizations participate in monitoring competence? Results: 265 people representing 148 French organizations were interviewed. Competence in health care should be defined as follows: "professional competence is based on the initial diploma, the implementation of effective continuing education, a minimal professional activity and a regular peer review process." There was an agreement on the basic elements of competence, on the responsibilities of public institutions and professional organizations, and on the need to work together. Discussion: We have shown that in France health care professionals would like to have a better system that allows them to exchange more information on the main health care issues; this is a serious requirement for most professionals.

This manuscript is dedicated to the literature on vegetable oil-based polyurethanes via the isocyanate/alcohol route. A lot of efforts have been made to replace petroleum-based resources. Among renewable resources, vegetable oils present various advantages going from their availability to the large range of possible chemical modifications they permit. Firstly, the vegetable oil chemical composition and the main commercially available vegetable oil precursors are exposed. Concerning vegetable oils-based polyurethanes, research groups first focused on cross-linked systems directly from triglycerides then on thermoplastic ones from fatty acids or fatty acid methyl esters. This manuscript focuses on thermoplastic PUs and underlines the literature about the introduction of hydroxyl groups and isocyanate functions onto triglycerides and fatty acid derivatives. Besides, in a view to the isocyanate/alcohol approach, vegetable oil-based thermoplastic PUs and corresponding diols and diisocyanates are described in details.

The shape optimisation involving complex flows, and based on direct CFD approaches, has now become very possible within industrial contexts, thanks to recent advances in optimal design technologies. However, one key remaining issue is related with the way the shape deformations are modelled. This paper presents the development of such an optimisation procedure, applied to a car engine air intake port, and compares two alternative methods for the shape deformation modelling. Global port variations are defined through a set of shape parameters. The first option consists in building a CAD model (Catia v5) to allow deformations, followed by a grid generation stage with tools enabling to generate and adapt the mesh to shape variations (Gridgen). The second option consists in starting from a grid done for a given shape, and defining parametric deformations on this grid, with a morphing tool (Sculptor). Then, after both modelling methods, the flow calculation is carried out with a CFD solver (Fluent). The resulting fields are processed by a flow post-processor (Fieldview) and by a Matlab procedure to extract the global criteria involved as optimisation objectives: the flow rate and the tumble. All this process is bundled within the modeFRONTIER multi-objective design environment. Similar optimisation approaches were led on both cases, involving mixed response surfaces – direct calculation evaluations of the designs, and a multi-objective genetic algorithm. The paper presents the main results, highlights the advantages and shortcomings of both modelling methods, and provides guidelines for their use and improvements, in view of practical industrial applications.