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Teleosts exhibit the highest reproductive diversity of all vertebrates, but this diversity has not been extensively analyzed, in part due to a lack of synthesis of life history information. The original STOREFISH (STrategies Of REproduction in FISH) database was published in 2007, and then released online in 2020 to facilitate data visualization and utilization (www.storefish.org). The original database contains information on 50 life history traits from ~1,200 references for 80 freshwater and anadromous species, mostly from Europe. Here, we describe the process and results of an international effort to update and extend the database for 14 egg and larval traits from North American freshwater and anadromous species, and then reassess previous bivari- ate relationships. Students in the United States and France used data from nearly 800 references to increase the STOREFISH database to 8,081 records (70% increase) for 368 species (360% increase) and 41 families (116% increase). We extracted fewer records per species than the original database because we included many species for which relatively little information was known. However, the distribution of records among trait values was similar to the original database. Updating and expanding the database improved the accuracy of the incuba- tion time-temperature relationship below 10°C, and challenged a previous assumption regarding the larval size- egg diameter relationship. Our expansion effort progressed smoothly and quickly via an educational model that emphasized supervised research and collaboration. We are extending this approach to include validators for data curation, and both pure and applied research that demonstrates the utility of the STOREFISH database to biodi- versity research, conservation, assessment, management, and aquaculture.

Resume La curietherapie permet de traiter certaines tumeurs cutanees. Elle utilise des applicateurs personnalises fabriques manuellement. L’integration d’une impression tridimensionnelle des applicateurs lors de la planification d’une curietherapie haut debit pourrait permettre une meilleure conformation au plan cutane et une meilleure reproductibilite du positionnement et du traitement. Nous presentons la mise en œuvre technique de cette methode pour nos deux premieres patientes. Une scanographie de planification previsionnelle etait realisee pour creer un objet numerique « applicateur ». La creation de la forme numerique de l’applicateur utilisait successivement plusieurs logiciels. Le premier, commercial, etait RhinocerosR 3D utilise via Grasshopper, une extension integree open source. L’applicateur tridimensionnel etait ensuite exporte vers le logiciel commercial Simplify3DR. Un fichier de format g-code etait genere a destination de l’imprimante. Une seconde scanographie etait realisee avec applicateur tridimensionnel en place afin de planifier le traitement definitif. Le traitement etait planifie par optimisation inverse. L’applicateur a pu etre concu dans un delai de 15 jours. Pour la patiente A, on notait que 95 % du volume cible anatomoclinique (D95) recevaient au moins 35,4 Gy (63 Gy EQD2, dose equivalente a un traitement de 2 Gy par fraction). Pour la patiente B, 95 % du volume cible anatomoclinique recevaient au moins 36 Gy (64,8 Gy EQD2). Les planimetries previsionnelle et effective respectaient le critere de couverture de la D95. La curietherapie de contact avec bioimpression tridimensionnelle est faisable, apres prise en main logicielle, pour des lesions de traitement complexe. Cette technique pourrait etre etendue a d’autres indications.

Resume La radiotherapie stereotaxique est une technique innovante de radiotherapie externe, permettant de delivrer de fortes doses de rayonnement en une fraction unique ou en quelques fractions, avec une precision maximale. Cette technique peu invasive peut etre proposee pour la prise en charge des metastases de cancer de prostate, permettant d’obtenir un excellent controle local. Differentes situations de cancer de prostate oligometastatique peuvent etre identifiees, selon l’atteinte synchrone ou metachrone, d’une part, et selon le statut d’hormonosensibilite, d’autre part. Les modalites modernes d’imagerie, et particulierement les nouveaux traceurs utilises en medecine nucleaire ont permis de mieux selectionner les patients oligometastatiques. Les donnees de la litterature, bien que preliminaires, suggerent qu’un traitement focal des oligometastases de cancer de prostate par radiotherapie stereotaxique pourrait avoir un impact sur le pronostic des patients et permettre dans certains cas une epargne therapeutique, avec un profil de toxicite favorable. Les indications therapeutiques doivent etre proposees au cas par cas chez des patients rigoureusement selectionnes.

Tropical forests are experiencing increasing impacts from a multitude of anthropogenic activities, such as logging and conversion to agricultural use. These perturbations are expected to have strong impacts on ecological interactions and on the transmission dynamics of infection diseases. To date, no clear picture of the effects of deforestation on vector-borne disease transmission has emerged. This is associated with the challenge of studying complex systems where many vertebrate hosts and vectors co-exist. To overcome this problem, we focused on an innately-simplified system – a small oceanic island (São Tomé, Gulf of Guinea). We analyzed the impacts of human land-use on host-parasite interactions by sampling the bird community (1735 samples from 30 species) in natural and anthropogenic habitats at different elevations and screened individuals for haemosporidian parasites from three genera (Plasmodium, Haemoproteus, Leucocytozoon). Overall, Plasmodium had the highest richness but the lowest prevalence, while Leucocytozoon diversity was the lowest despite having the highest prevalence. Interestingly, co-infections (i.e. intra-host diversity) involved essentially Leucocytozoon lineages (69%). We also found marked differences between bird species and habitats. Some bird species showed low prevalence but harbored high diversity of parasites, while others showed high prevalence but were infected with fewer lineages. These infection dynamics are most likely driven by host specificity of parasites and intrinsic characteristics of hosts. In addition, Plasmodium was more abundant in disturbed habitats and at lower elevations, while Leucocytozoon was more prevalent in forest areas and at higher elevations. These results likely reflect the ecological requirements of their respective vectors: mosquitoes and black flies, respectively.

Introduction: In breast cancer the androgen receptor (AR) is the most abundantly expressed steroid receptor with 75-95% of estrogen receptor (ER)-positive and 40-70% of ER-negative breast cancers expressing the AR. Historically, advanced breast cancer has been treated with androgens, resulting in significant clinical response. However, the use of steroidal androgens fell from favor as a result of their virilizing side effects. Nonsteroidal, tissue selective androgen receptor modulators (SARMs) will provide a novel targeted approach to exploit the therapeutic benefits of androgens in breast cancer. Aims: To test the effects of enobosarm (a first-in-class SARM) and enzalutamide (AR antagonist) on the growth of patient-derived breast cancer xenografts (PDX) and to discern the mechanism of action of AR-targeted therapies in AR-positive breast cancer. Materials and Methods: AR-positive PDXs with varying receptor expression (ER, progesterone receptor (PR), and HER2) were implanted in immunecompromised mice. Mice carrying PDXs were treated with vehicle, 10 mg/kg/day (mpk) enobosarm (GTx, Inc., Memphis, TN), or 20 mpk enzalutamide (Medivation Inc.), orally. Tumor volume was measured twice or thrice weekly. Tumors that received enobosarm were further analyzed to determine the mechanism of action. Results: Enobosarm significantly (p Conclusion: These results indicate that AR-positive breast cancers are highly heterogeneous and that enobosarm has promise as novel targeted therapy to treat AR-positive breast cancer. Enobosarm is currently in phase II clinical trial in both ER-positive breast cancer and in TNBC patients. Citation Format: Narayanan R, Ponnusamy S, Fan M, Yang CH, Grimes BL, Fleming MD, Pritchard EF, Berry MP, Oswaks RM, Fine RE, Loiseau J-C, Schwartzberg LS, Pfeffer LM. Nonsteroidal, tissue selective androgen receptor modulator (SARM), enobosarm, reduces growth of androgen receptor-positive breast cancer in patient-derived preclinical models [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-12-06.

Background Stereotactic irradiation (SBRT) is a standard of care for inoperable stage I lung cancer and brain oligometastases from lung cancer but is controversial for extracranial oligometastases. We assessed outcomes of lung cancer patients with extracranial metastases in oligometastatic, oligorecurrent, oligopersistent and oligoprogressive settings (“oligometastatic spectrum”) under strategies using SBRT +/− systemic treatments. Methods A retrospective multicentric study of consecutive lung cancer adult patients with 1–5 extracranial metastases treated with SBRT was conducted. Results Of 91 patients (99 metastases, median age 63, 64.8% adenocarcinomas, 19.8% molecular alterations), 11% had oligometastases, 49.5% oligorecurrence, 19.8% oligopersistence and 19.8% oligoprogression. Of 36% of patients under systemic treatments at initiation of SBRT, systemic treatment interruption was performed in 58% of them. With median follow up of 15.3 months, crude local control at irradiated metastases was 91%, while median distant progression-free survival (dPFS) and overall survival were 6.3 and 28.4 months (2-year survival 54%). Initial nodal stage and oligometastatic spectrum were prognostic factors for dPFS; age, initial primary stage and oligometastatic spectrum were prognostic factors for survival on multivariate analysis. Patients with oncogene-addicted tumors more frequently had oligoprogressive disease. Repeat ablative irradiations were preformed in 80% of patients who had oligorelapses. Worst acute toxicities consisted of 5.5% and one late toxic death occurred. Conclusion The oligometastatic spectrum is a strong prognosticator in patients undergoing SBRT for extracranial metastases. Median survival was over two years but dPFS was about 6 months. Continuation of systemic therapy in oligoprogressive patients should be investigated.

International audience; In a previous work, a PENELOPE Monte Carlo model of a Cyberknife system equipped with fixed collimator was developed and validated for in-field dose evaluation. The aim of this work is to extend it to evaluate peripheral doses and to determine the precision of the treatment planning system (TPS) Multiplan in evaluating the off-axis doses. The Cyberknife® head model was completed with surrounding components based on manufacturer drawings. The contribution of the different head parts on the out-of-field dose was studied. To model the attenuation and the modification of particle energy caused by components not modelled, the photon transport was modified in one of the added components. The model was iteratively adjusted to fit dose profiles measured with EBT3 films and an ionization chamber for several collimator sizes. Finally, dose profiles were calculated using the two Multiplan TPS algorithms and were compared to our simulations. The contributions to out-of-field dose were identified as scattered radiation from the phantom and head leakage and scatter originating at the secondary collimator level. Particle transport in the additional pieces was modified to model this radiation. The maximum differences between simulated and measured doses are of 20.4%. Regarding the detector responses away from axis, EBT3 films and the Farmer chamber give similar response (less than 20% difference). The TPS Monte Carlo algorithm underestimates the doses away from axis more importantly for the smaller field sizes (up to 98%). Besides, RayTracing simplifies peripheral dose to a constant value with no inclusion of particle transport. A Monte Carlo model of a Cyberknife system for the determination of out-of-field doses up to 14 cm off-axis was successfully developed and validated for different depths and field sizes in comparison with measurements. This study also confirms that TPS algorithms do not model peripheral dose properly. © 2019 Institute of Physics and Engineering in Medicine.

In a previous work, a PENELOPE Monte Carlo model of a Cyberknife system equipped with fixed collimator was developed and validated for in-field dose evaluation. The aim of this work is to extend it to evaluate peripheral doses and to determine the precision of the treatment planning system (TPS) Multiplan in evaluating the off-axis doses. The Cyberknife

PURPOSE Correct tandem implantation for cervix cancer intracavitary brachytherapy may be challenging. We investigated whether suboptimal implantation can be related to patient and disease characteristics and may result in subsequent underutilization of brachytherapy in cervical cancer. METHODS AND MATERIALS Consecutive cervix cancer patients referred for intracavitary brachytherapy after external beam radiation therapy performed in several general hospitals from 2013 to 2017 were included. Results In 172 patients having 301 procedures, 95 implantations were suboptimal (15% inadequate tandem insertions, 10% subserosal insertion, and 6% uterine perforation on postimplant CT scan). Risk factors were age, myometrium invasion, and uterine retroversion. Median followup was 21 months. Three-year local control and survival rates were 72% and 85%, respectively. Forty-seven patients (27%) failed to receive brachytherapy. Failure to perform brachytherapy was associated with poorer local control (OR = 0.34 [0.17–0.67], p = 0.001). By contrast, suboptimal implantation did not increase local failure or toxicity rates in patients undergoing brachytherapy. No peritoneal carcinomatosis occurred after uterine perforation in our cohort. CONCLUSIONS Suboptimal implantation was frequent. In the absence of image guidance during implantation, conversion to other treatment modalities (including external beam radiation therapy) due to insertion difficulties resulted in worse local control. With optimization, however, suboptimal brachytherapy implantation did not result in suboptimal dose coverage or poorer local control. Failure to perform a brachytherapy boost correlates with increased local failure risk in patients with cervix cancer, whereas tandem malposition does not. Real-time intraoperative ultrasound guidance may be useful to reduce uterine perforation rates and thus increase brachytherapy use.

Brachytherapy of skin tumours uses custom applicators that are manufactured manually. The integration of 3D printing customization of applicators during hidh dose rate brachytherapy planning could allow a better skin conformation and a better reproducibility of the positioning and treatment. We present the technical implementation of this method for our first two patients. A provisional planning scanner was carried out to create a digital applicator. The creation of the digital applicator used successively several software programs. The first, commercial, was RhinocerosR 3D used via Grasshopper, an integrated open source plug-in. The 3D applicator was then exported to the commercial software Simplify3DR. A g-code format file was generated for the printer. A second scanner was made with a 3D applicator in place to plan the final treatment. The treatment was planned by reverse optimization. The applicator could be designed within 15 days. For patient A, it was noted that 95 % of the clinical target volume received at least 35.4Gy (63Gy EQD2). For patient B, 95 % of the clinical target volume received at least 36Gy (64.8Gy EQD2). The forecast and actual planimetry met the coverage criteria of D95. Contact brachytherapy with 3D bioimpression is feasible, after software training, for complex treatment lesions. This technique could be extended to other indications.

Previous studies in humans with breast, colorectal or liver cancer showed that neoplasia was associated with a modification of the blood ratio between 65Cu and 63Cu (∂Cu). The aim of the present study was to compare the blood ∂Cu of dogs with cancer to healthy controls or dogs with non-oncologic disease. One hundred and seventeen dogs were included in the study (35 dogs with cancer, 33 dogs with non-neoplastic disease, and 49 healthy controls). The ∂Cu of dogs with cancer was significantly lower than the ratio of healthy controls (P

International audience; Gafchromic™ films have become popular due to their ease of use and their near water equivalence. This last property is crucial for stereotactic small beam dosimetry as demonstrated in recent papers. An accurate bi-dimensional dose measurement with Gafchromic™ films is very challenging mainly because of the non-uniformity response of flatbed scanners (used for films digitalization) and their own non-uniformity. The first proposal of this work is to develop bi-dimensional protocol for small beams and evaluate the associated uncertainty. The second proposal is to validate this protocol for the bi-dimensional measurements of treatment plans performed with the CyberKnife® system. First, the uniformity of an Epson V700 flatbed scanner and a batch of EBT3 Gafchromic™ films has been investigated. A "four films" dosimeter was designed to reduce the errors (statistic and systematic) due to their non-uniformity. Then, the "four films" dosimeter protocol in both a homogeneous (RW3 material) and heterogeneous (RW3, lung-like and bone-like materials) phantoms has been used to measure the bi-dimensional dose distributions of three simple CyberKnife® treatment plans. Two tumor locations (middle of the lung and near lung/bone interface) were considered for the heterogeneous phantom. These plans were achieved with the 10 mm fixed collimator and modeled with the PENELOPE Monte Carlo code in order to calculate accurate dose distributions. Finally, the "four films" bi-dimensional dose distributions were compared to the PENELOPE Monte Carlo simulations. Regarding the uncertainty associated to the bi-dimensional dose measurement protocol, the relative standard deviation σD on the dose was 1.2% in the range from 0.5 to 4.0 Gy. Regarding the protocol validation on CyberKnife® treatment plans, a very good agreement was found with all measurement points passing the {3% - 3 mm} Gamma Index criteria. © 2016 Elsevier Ltd. All rights reserved.

International audience; PurposeStereotactic radiosurgery and hypofractionated stereotactic radiotherapy are standard treatments for brain metastases when they are small in size (at the most 3 cm in diameter) and limited in number, in patients with controlled extracerebral disease and a good performance status. Large inoperable brain metastases usually undergo hypofractionated stereotactic radiotherapy while haemorrhagic brain metastases have often been contraindicated for both stereotactic radiosurgery or hypofractionated stereotactic radiotherapy. The objective of this retrospective study was to assess a six 6 Gy-fractions hypofractionated stereotactic radiotherapy scheme in use at our institution for haemorrhagic brain metastases, large brain metastases (size greater than 15 cm3) or brain metastases located next to critical structures.Material and methodsPatients with brain metastases treated with the 6 × 6 Gy scheme since 2012 to 2016 were included. Haemorrhagic brain metastases were defined by usual criteria on CT scan and MRI. Efficacy, acute and late toxicity were evaluated.ResultsSixty-two patients presenting 92 brain metastases were included (32 haemorrhagic brain metastases). Median follow up was 10.1 months. One-year local control rate for haemorrhagic brain metastases, large brain metastases, or brain metastases next to critical structures were 90.7%, 73% and 86.7% respectively. Corresponding overall survival rates were 61.2%, 32% and 37.8%, respectively. Haemorrhagic complications occurred in 5.3% of patients (N = 5), including two cases of brain metastases with pretreatment haemorrhagic signal. Tolerance was good with only one grade 3 acute toxicity.ConclusionThe 6 × 6 Gy hypofractionated stereotactic radiotherapy scheme seems to yield quite good results in patients with haemorrhagic brain metastases, which must be confirmed in a prospective way.; Objectif de l’étudeLa radiochirurgie et la radiothérapie stéréotaxique sont le standard de traitement des métastases cérébrales lorsqu’elles sont peu nombreuses, de petite taille, chez les patients en bon état général et à la maladie extracérébrale contrôlée. Les métastases plus volumineuses sont souvent acceptées en stéréotaxie, tandis que les métastases hémorragiques restent plutôt contre-indiquées pour ce type de traitement. L’objectif de cette étude rétrospective était de rapporter les résultats obtenus par un schéma de fractionnement 6 × 6 Gy utilisé dans notre centre pour les métastases hémorragiques, de plus de 15 cm3 ou situées proches de structures à risque.Matériel et méthodesLes patients traités par ce schéma dans notre centre de 2012 à 2016 ont été inclus. Le caractère hémorragique était défini sur l’imagerie scanographique et IRM. L’efficacité et la tolérance ont été évaluées.RésultatSoixante-deux patients atteints de 92 métastases (32 hémorragiques) ont été inclus. Le suivi médian était de 10,1 mois. Le taux de contrôle local à 1 an pour les métastases hémorragiques, les grosses métastases, et les métastases proches de structure à risque étaient respectivement de 90,7 %, 73 % et 86,7 %. Les taux correspondants de survie globale étaient de 61,2 %, 32 % et 37,8 %. Des complications hémorragiques ont été observées chez 5,3 % des patients (deux lésions hémorragiques avant le traitement). Un seul cas de toxicité aiguë de grade 3 a été observé, résolutif après traitement symptomatique.ConclusionLe Schéma 6 × 6 Gy semble réalisable et plutôt efficace en traitement des métastases hémorragiques, ce qui reste à confirmer en prospectif.

Introduction et but de l’etude Dans le contexte de carcinome bronchique oligometastatique, l’irradiation stereotaxique des metastases cerebrales est devenue un standard mais elle reste controversee pour les lesions extracerebrales. Materiel et methodes Cette etude retrospective multicentrique sur quatre centres de lutte contre le cancer francais a inclus de 2012 a 2016 les patients atteints d’un carcinome bronchique oligometastatique, oligorecurrent, oligoprogressif ou oligopersistant (« spectre oligo ») extracerebral traites par une strategie d’irradiation stereotaxique avec ou sans traitement systemique. Resultats et analyse statistique Sur 91 cancers (99 metastases chez des patients d’âge median de 63 ans, 65 % d’adenocarcinomes, 20 % d’alterations moleculaires), 11 % etaient oligometastatiques, 49 % oligorecurrents, 20 % oligopersistants et 20 % oligoprogresseurs. Parmi les 36 % des patients qui avaient un traitement systemique au moment de la radiotherapie stereotaxique, 58 % ont pu l’arreter. Avec un suivi median de 15,3 mois, le taux de controle local etait de 91 %, la survie sans progression a distance de 6,3 mois et la survie globale de 28,4 mois. Le groupe d’indication dans le « spectre oligo » et la localisation du site metastatique etaient des facteurs pronostiques. Les patients qui ont ete atteints de nouveau des rechutes « oligo » apres la radiotherapie stereotaxique ont pu beneficier de retraitements locaux dans 80 % des cas. La toxicite aigue etait moderee (5,5 % de cas de grade 3) et un deces iatrogenique tardif est survenu. Conclusion Nos resultats en survie globale (28 mois) et a 5 ans (23 %) semblent coherents par rapport a la litterature. Toutefois la survie sans progression a distance etait plus courte que dans l’etude de De Ruysscher ou de Iyengar et al., probablement du fait de l’inclusion dans notre etude de cancers oligoprogresseurs qui avaient un pronostic moins favorable. Le profil de tolerance excellent de la radiotherapie stereotaxique, son potentiel d’epargne therapeutique et sa repetabilite la rend tres competitive dans la strategie de prise en charge multimodale des patients porteurs d’un cancer bronchique oligometastatique. Son impact medicoeconomique et en termes de qualite de vie reste a evaluer.

Introduction et but de l’etude La catheterisation cervicale en vue d’une curietherapie uterovaginale peut s’averer difficile du fait de la distorsion cervicale induite par la tumeur et les remaniements post-therapeutiques. Materiel et methodes Les patientes adressees au centre Francois-Baclesse de 2013 a 2017 en vue d’une curietherapie uterovaginale pour un carcinome du col uterin ont ete incluses. Resultats et analyse statistique Sur 172 patientes pour 301 implantations, 95 implants etaient sous-optimaux (15 % de catheterisations inadequates, avec 10 % de perforations partielles definies comme la penetration de la sonde uterine dans le myometre et 5,8 % de perforations completes definies comme la penetration de la sonde uterine au-dela de la sereuse). Les facteurs de risque etaient l’âge, la retroversion uterine et l’envahissement du myometre. Un quart des patientes ont ete redirigees vers une autre modalite de traitement apres implantation sous-optimale. Avec un suivi median de 21 mois, l’absence de curietherapie etait associee avec un risque accru de rechute locale (odds ratio [OR] = 0,34 [0,17–0,67], p = 0,001) mais l’implantation sous-optimale en soi n’etait pas un facteur de risque de rechute locale ou de toxicite lorsque la patiente etait prise en charge par curietherapie. Les taux de controle local et de survie globale a 3 ans etaient respectivement de 72 % et 85 %. Conclusion Les implantations sous-optimales etaient frequentes et la conversion vers d’autres modalites de traitement (complement de radiotherapie externe ou chirurgie) etait associee a une degradation du pronostic en termes de controle local. Toutefois, avec une optimisation dosimetrique rigoureuse, la plupart des patientes ayant eu une implantation sous-optimale ont pu tout de meme beneficier de la curietherapie, sans degradation du taux de controle local et sans augmentation de la toxicite. L’echographie pendant l’implantation pourrait etre utile pour reduire le taux d’echec.

Purpose The purpose of this study was to analyze the detector responses in non-equilibrium small photon fields. Methods Five detectors (PTW 31014 ionization chamber, PTW 60016, PTW 60017 and Sun Nuclear EDGE diodes and PTW 60003 diamond detector) and one passive dosimeter (Harshaw micro-LiF) as well as a 1000 MU/min CyberKnife were modeled with the PENELOPE Monte Carlo code. Field factors, Ω Q clin , Q msr f clin , f msr were calculated and perturbations due to volume averaging effect, active material effect and coating effect were quantified for the five detectors and passive dosimeter. Results The PTW 31014 ionization chamber under-response is mainly due to the fluence perturbation caused by the presence of air as detecting material. Regarding diodes, the high density materials used in their active volume and in their coating is responsible for their over-response. Regarding the PTW 60003 diamond, its under-response for the 5 mm field size is due to a large volume averaging effect whereas for largest field sizes a nearly perfect compensation between the volume averaging effect and the material effect due to the diamond density occurs. Despite its small size, a volume averaging effect was observed for the micro-LiF for the 5 mm field size. Conclusion Perturbations due to volume averaging effect, active material effect and coating effect were investigated and quantified for five active detectors. Since these perturbations can cause opposite effects, wrong conclusions may be drawn regarding the radiological water-equivalence of detectors. Thus, we recommend performing such a study for each novel detector available on the market.

Previous studies in humans with breast, colorectal or liver cancer showed that neoplasia was associated with a modification of the blood ratio between

Resume But Evaluation de l’apport de la TEMP/TDM basse dose et de la valeur ajoutee d’une acquisition « diagnostique » centree chez les patients presentant un foyer isole suspect ou indetermine sur la scintigraphie osseuse (SO). Materiel et methodes Soixante patients ont beneficie de facon prospective d’acquisitions TEMP/TDM basse dose (30 mAs, epaisseur de coupe de 3 mm), puis « diagnostique » (100 mAs, epaisseur de 1,25 mm) centree sur le foyer. Le premier observateur a successivement examine la SO, puis l’acquisition basse dose, puis celle centree. Une double lecture en aveugle a ete realisee par un second observateur. Resultats La SO a permis d’identifier des foyers isoles de nature indeterminee ou suspecte chez 38 et 22 patients. Les acquisitions TEMP/TDM basse dose ont permis de classer 73 % des foyers. Les acquisitions centrees ont modifie les resultats chez neuf patients. Des foyers additionnels, non presents sur la SO et localises en dehors de la TDM de l’acquisition centree ont ete retrouves chez 20 patients. L’agrement interobservateur etait pour la SO, les TEMP/TDM basse dose et centree respectivement de 0,542, 0,68 et 0,694. L’analyse Roc n’a pas montre de difference significative entre les deux types d’acquisitions TEMP/TDM que ce soit pour l’observateur 1 ou l’observateur 2. Conclusion Cette etude montre que la TEMP/TDM basse dose est suffisante pour preciser le diagnostic chez les patients presentant un foyer isole sur la SO en cancerologie. Le volume explore par la TDM ne devrait pas etre limite au foyer isole en raison des foyers additionnels frequents.

Pneumococcal vaccination of older persons is thought to be cost-effective in preventing pneumococcal pneumonia, but evidence of clinical protection is uncertain. Because there is better evidence of vaccination effectiveness against invasive pneumococcal disease, we determined the cost-effectiveness of pneumococcal vaccination of persons agedor =65 years in preventing hospital admission for both invasive pneumococcal disease and pneumococcal pneumonia in 5 western European countries. In the base case analyses, the cost-effectiveness ratios for preventing invasive disease varied from approximately 11,000 to approximately 33,000 European currency units (ecu) per quality-adjusted life year (QALY). Assuming a common incidence (50 cases per 100,000) and mortality rate (20%-40%) for invasive disease, the cost-effectiveness ratios were12,000 ecu per QALY in all 5 countries. For preventing pneumococcal pneumonia, vaccinating all elderly persons would be highly cost-effective to cost saving. Public health authorities should consider policies for encouraging pneumococcal vaccination for all persons agedor =65 years.

Aquatic toxicity assessments based on inhibition of algal growth have been performed, as described in the French standardized procedure T90-304. The cellular growth was monitored by acoustic micro-sensors (quartz thickness shear mode) instead of the usual optical techniques. These experiments have shown that the real component of the interfacial acoustic impedance, measured by the sensor, displayed a large linear variation along the 3-day algal growth. The acoustic technique appears to have an interesting potential for conducting automatic algal bioassays.

Pneumococcal vaccine is effective in preventing invasive pneumococcal disease in adultsor=65 years of age, but it is not widely used in Western Europe. In this study, data from an earlier (1995) cost-effectiveness study on Belgium, France, Scotland, Spain, and Sweden are updated, and data on five new countries--Denmark, the UK (specifically, England and Wales), Germany, Italy and The Netherlands--are added. Epidemiological and economic variables specific for each country were used, and it was assumed that pneumococcal and influenza vaccines would both be administered during the same physician visit. In the base-case analyses, the cost-effectiveness ratios ranged from euro 9239 to euro 23,657 per quality-adjusted life-year. Because the incidence and mortality of invasive pneumococcal disease were underestimated in most countries, a country-by-country analysis was performed, assuming an incidence of 50 cases per 100,000 population and mortality rates of 20, 30 and 40%. For a mortality of 20%, the cost-effectiveness ratios ranged from euro 4,778 to euro 17,093, and for a mortality of 30%, they ranged from euro 3,186 to euro 11,395. Pneumococcal vaccination to prevent invasive pneumococcal disease in elderly adults was very cost-effective in all 10 countries. This evidence justifies the wider use of the vaccine in Western Europe.

Background The congenital central hypoventilation syndrome (CCHS) is a neuro-respiratory disease characterized by an alteration of the CO2/H+ chemosensitivity due to dysfunction of the CO2/H+ chemosensitive/PHOX2b-positive neurons. Works suggest that mechanisms may compensate this dysfunction: we fortuitously observed in two CCHS women that consumption of a potent synthetic progestin (desogestrel) was correlated to a recovery of the CO2/H+ chemosensitivity (Respir Physiol Neurobiol 2010;171:171–4). In this regard, we recently reported in central nervous system preparations from newborn rat that etonogestrel, the main metabolite of desogestrel, potentiate the response to metabolic acidosis by a way involving supramedullary areas (Neurosci Lett 2014;567:63–7). Objective Our aim was to characterize the optimal concentration of etonogestrel and to determine the encephalic region were etonogestrel exercises its influence on the respiratory response to metabolic acidosis in newborn rat. Methods Experiments were conducted on ex vivo central nervous system preparations from newborn rats containing either only the medulla oblongata or medulla oblongata and pontine, mesencephalic or diencephalic regions. The effect of etonogestrel (0.05, 0.5, 1 and 2 μM) on respiratory frequency was analyzed under metabolic acidosis and appreciated in comparison to control preparations (not exposed to etonogestrel). In addition the effect of etonogestrel was examined in case of a preincubation with an antagonist of GABAA receptor, the bicuculline (3 μM). Results Under metabolic acidosis, except at high (2 μM) and very low (0.05 μM) concentration, acute exposure to etonogestrel enhanced the acidosis-induced hyperventilation if and only if diencephalic structures are present. Antagonizing of GABAAergic signalization abolished the effect of etonogestrel and the respiratory response to metabolic acidosis. Conclusions These data suggest that etonogestrel can potentiate the acidosis-induced hyperventilation by interacting with diencephalic structures and GABAAergic signalization. This enhancement of increase in respiratory frequency may involve orexinergic neurons expressing an H+ sensitive channel. Immunohistological incoming data will confirmed or not their implication and will permit to reveal whole of the involved areas.

Liposomes composed of hexadecylphosphocholine/egg phosphatidylcholine/ stearylamine (HePC/EPC/SA) 10:10:0.1, 10:10:0.5 and 10:10:1 (molar ratio) (1-3) were prepared and lyophilized. The liposomes were physicochemically characterized (size and ζ-potential) and they were found stable at 4°C over a period of 4 weeks. In vitro, liposomes 1 and 2 were about twice more active than HePC against Leishmania donovani WT whereas liposomes 3 were about three times more active than HePC on HePC-resistant promastigotes. Although liposomes 1-3 were inactive on the in vitro intramacrophage amastigote model, the ability of the liposomes to accumulate within the liver where parasites are located justifies a further in vivo evaluation. We observed that liposome 1 was twice more active than HePC against Trypanosoma brucei brucei bloodstream forms maintained in vitro. In vivo results showed that liposomal HePC seemed to be less toxic than the free drug despite the absence of significant antitrypanosomal activity. © 2005 Elsevier SAS. All rights reserved.

Purpose: Advanced stereotactic radiotherapy (SRT) treatments require accurate dose calculation for treatment planning especially for treatment sites involving heterogeneous patient anatomy. The purpose of this study was to evaluate the accuracy of dose calculation algorithms, Raytracing and Monte Carlo (MC), implemented in the MultiPlan treatment planning system (TPS) in presence of heterogeneities. Methods: First, the LINAC of a CyberKnife radiotherapy facility was modeled with the PENELOPE MC code. A protocol for the measurement of dose distributions with EBT3 films was established and validated thanks to comparison between experimental dose distributions and calculated dose distributions obtained with MultiPlan Raytracing and MC algorithms as well as with the PENELOPE MC model for treatments planned with the homogenous Easycube phantom. Finally, bones and lungs inserts were used to set up a heterogeneous Easycube phantom. Treatment plans with the 10, 7.5 or the 5 mm field sizes were generated in Multiplan TPS with different tumor localizations (in the lung and at the lung/bone/soft tissue interface). Experimental dose distributions were compared to the PENELOPE MC and Multiplan calculations using the gamma index method. Results: Regarding the experiment in the homogenous phantom, 100% of the points passed for the 3%/3mm tolerance criteria. These criteria include the global error of the method (CT-scan resolution, EBT3 dosimetry, LINAC positionning …), and were used afterwards to estimate the accuracy of the MultiPlan algorithms in heterogeneous media. Comparison of the dose distributions obtained in the heterogeneous phantom is in progress. Conclusion: This work has led to the development of numerical and experimental dosimetric tools for small beam dosimetry. Raytracing and MC algorithms implemented in MultiPlan TPS were evaluated in heterogeneous media.

Objectif Determiner l’incidence et les caracteristiques des NRS hospitalises au cours d’une bronchiolite en reanimation au CHU d’Amiens (2008-2009). Materiel et Methode Recueil des donnees dans les dossiers d’hospitalisation des patients. Resultats (mediane (extremes)) 37 NRS d’âge 36j (9-196), de poids 3,5 kg (1,8-10) ont ete admis pendant la periode automno-hivernale (84%). Antecedents : AG 38SA (28-41), PN 2,8 kg (0,8-4,4), prematurite ( n = 9), cardiopathie ( n = 3), DBP ( n = 1). Signes respiratoires ( n = 36): tirage, cyanose, pauses respiratoires; S. digestifs ( n = 23): refus alimentaire, vomissements, diarrhee; S. generaux : fievre ( n = 15), hypotension arterielle ( n = 11); S. neurologiques ( n = 6): convulsions, alteration de la conscience. Micro-organismes : virus ( n = 35): VRS ( n = 26), Parainfluenzae 3 ( n = 5), Metapneumovirus ( n = 4); bacteries ( n = 17): S. pneumoniae ( n = 7), B.catarrhalis ( n = 4), H. influenzae ( n = 2), autres ( n = 4). Assistance respiratoire (n; duree): O2 nasale (24; 2j (1-69)), VNI (13; 2j (1-11)), ventilation tracheale (12; 3,5j (1-12)), OHF (3; 2j (1-4)), monoxyde d’azote ( n = 2). Duree de sejour: 4j (1-69). Evolution: 2 deces. Conclusion Le sejour en reanimation concerne les cas de bronchiolite a VRS avec surinfection bacterienne, essentiellement chez le nourrisson de moins de 2 mois.

“Prevention is better than cure” and “less expensive” : this new proverb could resume our regional health policy. This study, which partakes of a regional health policy, purposes to evaluate the risk factors, the efficiency of the detection and the effectiveness of the treatment of the intra epithelial carcinoma of the uterus cervix. (IEC).

The stability and sensitivity of two- and three-dimensional global modes developing on steady spanwise-homogeneous laminar separated flows around NACA 4412 swept wings are numerically investigated for different Reynolds numbers ${\textit {Re}}$ and angles of attack $\alpha$ . The wake dynamics is driven by the two-dimensional von Kármán mode whose emergence threshold in the $\alpha \unicode{x2013}{\textit {Re}}$ plane is computed with that of the three-dimensional centrifugal mode. At the critical Reynolds number, the Strouhal number, the streamwise wavenumber of the von Kármán mode and the spanwise wavenumber of the leading three-dimensional centrifugal mode scale as a power law of $\alpha$ . The introduction of a sweep angle attenuates the growth of all unstable modes and entails a Doppler effect in the leading modes’ dynamics and a shift towards non-zero frequencies of the three-dimensional centrifugal modes. These are found to be non-dispersive as opposed to the von Kármán modes. The sensitivity of the leading global modes is investigated in the vicinity of the critical conditions through adjoint-based methods. The growth-rate sensitivity map displays a region on the suction side of the wing, wherein a streamwise-oriented force has a net stabilising effect, comparable to what could have been obtained inside the recirculation bubble. In agreement with the predictions of the sensitivity analysis, a spanwise-homogeneous force suppresses the Hopf bifurcation and stabilises the entire branch of von Kármán modes. In the limit of small amplitudes, passive control via spanwise-wavy forcing produces a stabilising effect similar to that of a spanwise-homogeneous control and is more effective than localised spherical forces.