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Achieving climate targets requires more stringent mitigation policies, including the participation of all economic sectors. However, in a fragmented global climate regime, unilateral mitigation policies affecting sectors’ production costs increase carbon leakage risk. Carbon leakage implies reducing the competitiveness of domestic sectors without achieving the full mitigation objectives. Under such circumstances, generating information about sectors’ vulnerability is essential to increase their acceptance of more stringent climate policies and design anti-leakage mechanisms. Our paper calculates and compares potential carbon leakage risk across sectors and OECD countries under varying climate policy scenarios covering GHG emissions along global supply chains. To measure this risk, we use the emission-intensity and trade-exposure metric and emission data including CO2 and non-CO2 gasses. Our results show that agri-food and transport sectors, usually lagging behind in countries’ national climate mitigation policies, could have an even higher carbon leakage risk than energy-intensive industries. Furthermore, we find that this risk can be higher in many downstream sectors compared to directly regulated sectors and is highly heterogenous across OECD countries.

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.

G-protein-coupled receptors (GPCR) are seven transmembrane proteins that convert extracellular stimuli to cell signaling.Viral genes homologous to cellular GPCR have been described in the genome of Betaherpesvirinae, Gammaherpesvirinae and Poxviridae. The goal of this review is to summarize the knowledge available on viral GPCR (vGPCR) with a special interest for their roles in the biology and the pathogenesis of the infection. This review highlights some properties of vGPCR that are not shared by their cellular homologues and stresses the diversity of their functions in the biology of the infection.

In 2018, the French High Authority of Health (HAS) included a "time-out" phase in the latest version of the checklist for the operating room in order to improve the safety of operated patients. The aim of this study is to evaluate the practice of French urologists concerning the check list (CL) of the operating room.A survey of 30 items was developed by the committee of accreditation of the French Association of Urology (AFU) and other contributors. It was centered on the characteristics of the urologists, the details of application of the CL, and the evaluation of the current version. After validation, the questionnaire was emailed as an online form in July 2021 for all the members of the AFU and AFUF.Overall, 369 form the 1700 contacted urologists responded to the survey. The majority were more than 40 years old (70.11%) and less than 20 year of experience (54.49%). The engagement in individual or team accreditation was observed in 222 (60.7%) and 145 (39.84%) urologists, respectively. Almost half of them were present at the beginning of the CL (47.18%), and prescribed postoperative medication with the anesthesiologist (55.56%). The CL has modified the practice in 47.54%, however, with greater administrative burden, and 80% preferred that the AFU adapts the CL to the urology field.The practice of CL between urologists is variable. On multivariate analysis, the engagement in team accreditation was the only variable to influence the practice of time out.

To assess the morbidity specific of extended pelvic lymphadenectomy during robot-assisted laparoscopic radical prostatectomy in a 8 year retrospective study.We carried out a single-center, single-surgeon retrospective study on 342 consecutive patients who underwent a robot-assisted laparoscopic radical prostatectomy and extended pelvic lymphadenectomy, from July 2010 to March 2018. Postoperative complications were recorded up to 3 months after the operation.Thirty (8.8%) patients had at least one complication related to lymphadenectomy including 1 vascular injury (0.3%), 7 injuries of the obturator nerve (2%), 5 venous thromboembolic complications (1.5%) including 4 pulmonary embolisms, 10 symptomatic lymphoceles (2.9%) and 8 lymphoedemas (2.3%). Of these complications, 13 were classified Clavien 1 (43.3%), 8 Clavien 2 (26.7%), 7 Clavien 3a (23.3%) and 2 Clavien 3b (6.7%). In univariate analysis a high age (P=0.04), high BMI (P0.01) and pT stage (P=0.02) were significantly associated with complication whereas in multivariate analysis, only age (P=0.02) and BMI (P0.01) lived were. In univariate analysis high BMI (P=0.04) and lymph node involvement (P=0.04) were associated with lymphatic complication. We did not find any other specific risk factor for the other complications.With 8.8% of overall complications related to lymphadenectomy and 5% of complication classified Clavien grade 2 or higher, extended pelvic lymphadenectomy was not very morbid. Age and BMI were risk factors for a overall complication. BMI and lymph node involvement were risk factors for lymphatic complications.4.

Metastatic prostate cancer (mPCa) is an heterogeneous disease. Metachronous mPCa (MM) seems to have a better prognosis than synchronous mPCa (SM). However, it is difficult to analyze their specificities from national registries. Data from the so-called "sentinel multidisciplinary meeting" (SMDM) would represent a "real life" data collection. The objective of this national pilot study was to evaluate the concept of SMDM through the description and comparison of the diagnosis, management and follow-up of patients with synchronous or metachronous mPCa in 2018.A survey covering clinical, biological, radiological data as well as treatment initiated and follow-up at 3 and 6 months was sent to the SMDM. All patients diagnosed with metastatic disease (SM or MM) between 01/01/2018 and 11/30/2018 were included.In total, 780 patients from 39 centers were included, 408 SM and 372 MM. SM were more symptomatic and had a higher metastatic burden than MM. PET were mostly performed in MM without a prior standard staging. SM patients received more chemotherapy than MM patients whereas new generation androgen deprivation therapy was mostly given to MM patients. At 6 months, there were no more significant difference in clinical presentation between the two groups.Specificities of SM and MM patients in terms of clinical presentation, metastatic burden and management were described, validating the concept of SMDM as a source of reliable informations.

Surgical activity contributes to global warming though the production of greenhouse gases and consumption of resources. To date, no clinical practice guidelines have been made to promote and implement climate-smart actions.To perform a systematic review of the available actions that could limit COMEDLINE and Cochrane databases were searched from January 1, 1990 to April 2021. We included studies assessing carbon footprint (CF) in the OR and articles detailing actions that limit or reduce CF.Thirty-eight studies met the inclusion criteria. We identified six core climate-smart actions: (1) waste reduction by segregation; (2) waste reduction by recycling, reuse, and reprocessing; (3) sterilisation; (4) anaesthesia gas management; and (5) improvement of energy use. Quantitative analysis regarding the CF was not possible due to the lack of homogeneous data. For climate-smart actions, the analysis was limited by discrepancies in study scope and in the methodology of COThis review provides arguments for many climate-smart actions that could be implemented in our daily practice. Improving awareness and education are important to act collectively in a sustainable way. Further studies are mandatory to assess the impact of these climate-smart actions in the OR.We performed a systematic review of the available scientific literature to reference all the climate-smart actions proposed to improve the sustainability of surgical activities. Waste segregation, waste reduction and recycling, reuse and reprocessing, sterilisation, anaesthesia gas changes, and improvement of energy use in the operating room were found to be the main areas of research. There is still a long way to go to homogenise and improve the quality of our climate-smart actions.

The French population is facing the COVID-19 pandemic and the health system have been reoriented in emergency for the care of patients with coronavirus. The management of cancers of the urinary and male genital tracts must be adapted to this context.An expert opinion documented by a literature review was formulated by the Cancerology Committee of the French Association of Urology (CCAFU).The medical and surgical management of patients with any cancers of the urinary and male genital tracts must be adapted by modifying the consultation methods, by prioritizing interventions according to the intrinsic prognosis of cancers, taking into account the patient's comorbidities. The protection of urologists from COVID-19 must be considered.The CCAFU issues an expert opinion on the measure to be taken to adapt the management of cancers of the male urinary and genital tract to the context of pandemic by COVID-19.

There is substantial evidence on the effectiveness of short-time work on reducing unemployment. However, no study looks at its role during natural disasters. This article exploits the exogenous nature of the 2013 European floods to assess if the impact depends on the quality of the short-time work mechanism across affected counties. We use regression discontinuity designs to show that unemployment does not increase in regions with robust programs while rising up to seventeen percent in areas with less robust mechanisms. Our results are relevant to the literature on how institutional quality influences recovery and suggests that short-time work programs are useful against unforeseeable productivity shocks besides financial crises.

Conservation of the three-dimensional aspect of bitemarks optimizes their analysis. Although bitemarks could be recorded with a surface scanner, in clinical dentistry, intraoral scanners are used as an alternative to conventional dental impressions. Here we assess the reproducibility and the reliability of a three-dimensional bitemark analysis protocol using an intraoral scanner. Twenty-seven volunteers bit on different materials: dental wax, hard cheese, chocolate and apple. Then, bitemarks and dentitions were scanned with the PlanMeca® Emerald intraoral scanner and the scans obtained were exported into the mesh comparison software, CloudCompare®, which can generate overlays automatically. For this purpose, dentitions were aligned and compared with the indentations. The meshing and non-meshing areas were visualized using a colorimetric scale. First, the same blinded observer compared the bitten materials by analyzing 256 meshing areas for each. Secondly, comparisons of bitemarks from wax were analyzed in a randomized blinded study involving four observers (dentist, dental student, forensic scientist and police officer) and predictive values were calculated. The wax support obtained the best result and apple the worst. The rate of correct classifications was high and misclassification was rare. For the all observers, negative predictive values were near 100%. Positive predictive values were more variable. Moreover, the work clearly highlighted the importance of experience in odontology.

Resume Le traitement de l’hypertrophie benigne de la prostate (HBP) par photovaporisation au laser Greenlight XPS™ necessite un apprentissage specifique compte tenu des caracteristiques du materiel utilise et des effets tissulaires du laser. Deux tranchees anterieure et posterieure sont creees, permettant d’isoler, puis de vaporiser les lobes lateraux a forte puissance. Les orifices ureteraux doivent etre systematiquement reperes, en particulier en cas de lobe median. Au niveau de l’apex la vaporisation a 80 W de par et d’autre du veru montanum associee a l’introduction de l’extremite de l’endoscope dans le plan de clivage de l’HBP permet d’isoler l’apex de l’uretre sphincterien. La qualite des resultats fonctionnels depend du caractere complet de la vaporisation, facilement apprecie par l’echographie endorectale peroperatoire. L’apprentissage de la technique peut etre facilite par l’utilisation du simulateur GreenSim ® . Le respect des conditions de realisation techniques specifiques au laser Greenlight permet d’assurer l’efficacite et la securite de la procedure.

Resume L’analyse des traces de morsures est une specialite de l’odontologie legale. Une morsure peut contenir des elements tels que la salive ou des indentations permettant d’identifier un individu. But de l’etude Cet article decrit la mise en place d’un protocole photographique et l’analyse semiologique des morsures ainsi photographiees au sein de l’UMJ de Toulouse. Materiels et methodes Plusieurs criteres des morsures ont ete etudies : le delai, l’exploitabilite, la classe de severite, le diametre et la description des indentations. Resultats De fevrier a octobre 2016, 58 cas de morsures ont ete observes. Le delai moyen est de 3,5 jours entre la morsure et la photographie. Dans 17 % des cas, les morsures presentaient un fort interet en odontologie legale par la presence d’indentations caracteristiques. Conclusion Un protocole photographique peut etre facilement mis en place au sein d’une UMJ. La photographie facilite la description et la semiologie de la morsure. Elle est essentielle dans l’analyse de la morsure en apportant rapidement des informations aussi bien morphologiques que metriques.

La prostatectomie totale et la nephrectomie partielle robot-assistees sont les interventions les plus pratiquees en onco-urologie. En dix ans, la robotique s’est imposee pour la prostatectomie dans les centres equipes, du fait de l’amelioration technique apportee a la realisation de cette intervention. Les resultats carcinologiques et fonctionnels sont comparables ou superieurs a ceux de la prostatectomie laparoscopique ou par voie ouverte. L’assistance robotique est particulierement utile en cas de patient obese et de necessite de dissection precise (conservation des nerfs caverneux, anastomose vesico-uretrale). Les resultats de la nephrectomie partielle sont egalement en faveur de l’assistance robotique si l’on prend en compte les parametres perioperatoires, les resultats fonctionnels et carcinologiques.

This article analyzes the spatio-temporal effect of the 2013 floods on freight traffic in Germany by using automatic traffic counter data. The methodology uses a proven time-series outlier detection and identification technique to endogenously determine if a counter was affected during the flood and estimate the magnitude and duration of the change in the number of vehicles passing through it. This is the first paper able to quantify climate-related variations in traffic across all the counters of a national network. Results show variations on 10% of all counters and 23% of all main roads. Results allow us to trace the configuration of disrupted and detour routes, recovery times, and the total effect on the network. Our findings serve as an input to other studies on the impact of exogenous events on the transport system and contribute towards the formulation of public policies to improve road resilience.

Artificial urinary sphincter (AUS) is the treatment of last resort of stress urinary incontinence (UI) due to intrinsic sphincter deficiency (IS). The implantation procedure has been described by open surgery and laparoscopy with a significative rate of complication by Lucas et al. (2012) and Costa et al. (2001). We report our experience of implantation of SUA by robotic-assisted laparoscopy (R-SUA) in 17 patients among 3 revisions.Between 2012 and 2017, 17 patients have been consecutively included. The surgical technique was described by Fournier et al. The continence was defined by the absence of urine leakage.The median age at implantation was 66,8±7 years, in the primo-implantation (PI) group, one patient had a neurological acontractile bladder, and bladder was open in 11 patients (78,6%) to ensure the bladder neck dissection. In the revision group (R) 3 patients had a complete replacement of SUA for mechanical failure. One vaginal bound was reported, but did not compromise the implantation, and the survival of SUA. Duration of intervention, size of cuff, postoperative catheterization and hospitalization time were respectively 205±34 and 112±8min; 7,7±0.9 and 5.2±0.8cm; 5.9±2.1 and 4.3±4 days; 6.6±1.5 and 7±3.6 days for PI and R groups. At the end of a mean follow-up of 24.6±18.4 and 59±5 months, continence was respectively 86% and 100%, for the PI and R groups.The implantation of R-SUA was feasible and safe with encouraging results. Other studies must evaluate the place of R-SUA among the different enabled surgical techniques.4.

International audience; Severe combined immunodeficiency (SCID) is characterized by a major T cell deficiency. Infants with SCID are asymptomatic at birth but die from infections in the first year of life if not treated. Survival rates are better for early treatment. SCID therefore meets criteria for newborn screening (NBS). T cell receptor excision circle (TREC) quantification is a reliable marker of T cell deficiency and can be performed using Guthrie cards. The DEPISTREC project was designed to study the feasibility, clinical utility, and cost-effectiveness of generalized SCID screening in France. About 200,000 babies from all over the country were screened at birth with a commercial kit. We determined assay performance and proposed a cutoff for classification of results. Our findings suggest that, given clearly established validation rules and decision-making procedures, the TREC assay is a suitably specific and sensitive method for high-throughput SCID screening. Clinical Trials: NCT02244450.

Part of the ERCOFTAC Series book series (ERCO, volume 24); International audience; In the aeronautical and aerospace industries, the flow configurations where an incident oblique shock wave impinges upon a boundary layer are very common. The supersonic flow around an aircraft, in a rocket nozzle or in a supersonic inlet are some examples among others.

Objectif de l’etude La chirurgie reste l’option therapeutique privilegiee chez les patients atteints d’un cancer de la prostate. La radiotherapie adjuvante des cancers de la prostate a haut risque a montre son efficacite sur la survie sans recidive biochimique et la survie globale dans plusieurs essais randomises, mais ce traitement est peu realise en routine, au profit d’une radiotherapie de rattrapage precoce en cas de recidive biochimique averee. Une meilleure selection des patients permettrait de modifier le paradigme actuel. Notre objectif etait d’evaluer la valeur pronostique de la radiomique de l’IRM pretherapeutique sur la recidive biochimique. Materiel et methode Nous avons identifie les patients pris en charge par prostatectomie radicale et eligibles a une radiotherapie adjuvante selon les recommandations actuelles : pT3a ou pT3b, N0, R1 avec antigene specifique de la prostate postoperatoire indetectable. Les donnees cliniques ont ete recueillies, les parametres de texture extraits a partir des IRM prostatiques pretherapeutiques. Une analyse unifactorielle (courbes ROC [receiver operating characteristic]) puis multifactorielle par regression logistique (modele de Cox) a ete realisee. Resultats Parmi les 195 patients eligibles pris en charge au centre hospitalier universitaire de Brest entre 2010 et 2017, 91 patients, dont 14 ont ete atteints d’une reactive biochimique, avaient une IRM analysable. Le suivi median etait de 70 mois. En analyse unifactorielle, parmi les parametres cliniques (concentration preoperatoire d’antigene specifique de la prostate, âge, score de Gleason, stade tumoral, envahissement des berges), seul le score de Gleason etait correle significativement au risque de recidive biochimique. De meme, 14 parametres de textures etaient correles significativement au risque de recidive biochimique. En analyse multifactorielle, seuls deux parametres de texture restaient predictifs du risque de recidive biochimique : le ngldm_Fngl_hdlge (AUC [area under curve] : 0,951 ; p Conclusion Deux parametres de texture apparaissent fortement predictifs du risque de recidive biochimique. Une meilleure selection des patients basee sur ces parametres pourrait permettre d’identifier les patients qui beneficieraient alors d’une radiotherapie adjuvante.

L’assistance robotique par le robot Da Vinci® a profondement modifie la pratique chirurgicale du fait des caracteristiques techniques et egalement par le cout eleve de l’instrument. Le changement principal est de ne plus etre au contact direct du patient. Cela a conduit a deleguer a l’assistant des fonctions visant a assurer la securite. L’autre changement est la perte du toucher du fait de l’absence de retour de force des instruments. La vision en trois dimensions du champ operatoire constitue une tres grande amelioration, plus proche de la vision naturelle, et la mobilite articulee de l’extremite des instruments procure une aisance superieure a celle de la laparoscopie manuelle... Ces ameliorations ont amplifie les possibilites chirurgicales de la coelioscopie. L’existence d’un simulateur permet de reduire la courbe d’apprentissage du nouveau chirurgien. D’autres changements sont apparus du fait du cout eleve, creant des etablissements de sante avec et sans robots, avec des consequences inevitables en termes de recrutement des patients et d’activite chirurgicale.

We demonstrate numerically and experimentally the feasibility of an ultra-thin invisibility cloak for low frequency antenna applications. We consider a monopole antenna mounted on a ground plane and a metallic obstacle located in its near-field. We simulate the real antenna radiation scenario considering the finite size of the obstacle, its cylindrical form, as well as the non-negligible influence of the ground plane. To restore the radiation patterns of the antenna perturbed by an obstacle we propose here an electromagnetic cloak that consists simply of metallic patches separated from the obstacle by a dielectric substrate. We show that the radiation patterns of the monopole antenna can be restored completely owing resonant electromagnetic modes localized under the patch. The thickness of the coverage of the obstacle is close to λ/240. The dimensions of the patch are determined by the frequency and the dielectric permittivity of the substrate. To demonstrate experimentally the concept, we fabricate and characterize a prototype at 125MHz using classical printed board technology. The measurements are in excellent agreement with the simulations and demonstrate the efficiency of the cloak.

Purpose: Circulating hormone concentrations are associated with breast cancer risk, with well-established associations for postmenopausal women. Biomarkers may represent minimally invasive measures to improve risk prediction models. Experimental Design: We evaluated improvements in discrimination gained by adding serum biomarker concentrations to risk estimates derived from risk prediction models developed by Gail and colleagues and Pfeiffer and colleagues using a nested case–control study within the EPIC cohort, including 1,217 breast cancer cases and 1,976 matched controls. Participants were pre- or postmenopausal at blood collection. Circulating sex steroids, prolactin, insulin-like growth factor (IGF) I, IGF-binding protein 3, and sex hormone–binding globulin (SHBG) were evaluated using backward elimination separately in women pre- and postmenopausal at blood collection. Improvement in discrimination was evaluated as the change in concordance statistic (C-statistic) from a modified Gail or Pfeiffer risk score alone versus models, including the biomarkers and risk score. Internal validation with bootstrapping (1,000-fold) was used to adjust for overfitting. Results: Among women postmenopausal at blood collection, estradiol, testosterone, and SHBG were selected into the prediction models. For breast cancer overall, model discrimination after including biomarkers was 5.3 percentage points higher than the modified Gail model alone, and 3.4 percentage points higher than the Pfeiffer model alone, after accounting for overfitting. Discrimination was more markedly improved for estrogen receptor–positive disease (percentage point change in C-statistic: 7.2, Gail; 4.8, Pfeiffer). We observed no improvement in discrimination among women premenopausal at blood collection. Conclusions: Integration of hormone measurements in clinical risk prediction models may represent a strategy to improve breast cancer risk stratification. ©2017 AACR.

The most efficient method to investigate nucleation phenomena is to measure the undercooling temperature at the beginning of the solidification process since it gives information about whether or not a certain substrate favors the heterogeneous nucleation. In this work a suitable experimental setup has been designed and developed for the study of nucleation phenomena, where a silicon droplet is directly placed and melted on a substrate. The melting-solidification process was filmed and the undercooling temperature was simultaneously measured by monochromatic and bichromatic pyrometers. For all the studied substrates the melting process started from the bottom of the sample where there was a contact with the substrate. In the case of zyarock and fused silica substrates, on which we focalize in the present paper, the temperature profile of the silicon sample presented a temperature plateau during melting and a typical cooling curve showing undercooling, recalescence and a plateau denoting that solidification occurred under isothermal conditions. It was also found that the nature of the substrates influences the measured undercooling values and the shape of the solidified silicon droplets.

Objective To devise and validate a system to categorize GreenLight photoselective vaporization of prostate (PVP) complications according to Clavien score (CS), to report complications of PVP using this categorization, and to determine risk factors. Materials and Methods A survey questionnaire was distributed to all participants of the second meeting of the Group of GreenLight Users. They were asked to grade PVP complications according to CS. We calculated the mode CS for each complication from the survey data to propose a categorization system for complications of PVP. Complications encountered in a large single-center cohort of 370 patients were reported according to this system. We assessed the reproducibility of CS by estimating inter-rater agreement by the Fleiss kappa. We performed univariate and multivariate analyses to determine risk factors for complications. Results Of the 67 meeting participants, 42 (62.7%) completed the survey. Overall agreement between urologists was fair (Fleiss kappa = 0.356). Among the 370 patients, 21 (5.7%) had intraoperative complications, 147 (39.7%) had postoperative complications, and 70 (18.9%) had long-term complications. Among the postoperative complications, 125 patients (33.8%) were classified as Clavien grade I, 58 (15.7%) as Clavien grade II, 4 (1.1%) as Clavien grade IIIb, 5 (1.3%) as Clavien grade IVa, 1 (0.3%) as Clavien grade IVb, and 1 (0.3%) as Clavien grade V. In multivariate analysis, the only predictor of overall complications was a polymicrobial preoperative urine culture. Conclusion The grading of PVP complications by CS is fairly reproducible. We are the first to propose a system for the categorization of PVP complications. PVP complications are frequent but most often minor.

To evaluate the results of GreenLight XPS photovaporization (PVP/XPS) with intraoperative transrectal ultrasonographic monitoring for the treatment of large Benign Prostatic Hyperplasia (BPH) (80mL).Operative and perioperative data of 82 patients were collected prospectively. Complications and functional outcomes (IPSS, quality of life (QoL) score, maximal flow rate and post-void residual (PVR)) were evaluated at 1, 3, 12 months post-operatively prostate volume and PSA were assessed at 3 and 12 months post-operatively.Median patient age was 68.5years (50-85). Twenty percent had an indwelling catheter and 5%/22% were on anticoagulant/antiplatelet therapy. Median prostate volume and PSA were 103mL (80-220) and 6.4ng/mL (0.66-44.0). Median operative time and energy delivered were 107min (46-219) and 581kJ (212-1193). Energy delivered/prostate volume was 5.4kJ/mL (1.6-10.5). Transurethral catheter was removed at day 1 or 2 in 96% of cases. Patients were discharged as outpatient, p.o. day 1 or day 2 in 4%, 55% and 21% of cases, respectively. Transfusion and Clavien≥3 complication rates were 1.2% and 3.7%. Significant improvement of IPSS (4 vs 19.5), QoL (1 vs 5), maximum flow rate (19.1 vs 8.2mL/s) and PVR (26 vs 100mL) was observed (P0.001) at 12-months evaluation. PSA and prostate volume were decreased by 61 and 62%. Late complications were urethral strictures (6%), stress incontinence (1.2%). Eighty-five percent of patients had no antegrade ejaculation.The treatment of large BPH with PVP/XPS is safe and effective, with a long operative time. The functional outcomes are good and stable at mid-term evaluation.4.

Currently, the French High Authority for Health does not recommend mass screening for prostate cancer (PCa), due to the risk of over-treatment, notably of low risk patients. Our study is intended to reflect the therapeutic attitudes for the management of patients classified as low risk of progression in French clinical centers.For all positive prostate biopsies performed during 2012 and 2013 in five French departments of urology, clinicopathological characteristics required to calculate the d'Amico risk group and the Cancer of the Prostate Risk Assessment (CAPRA) score were filled. Information on the first treatment of "low risk" patients was collected.A total of 1035 patients were included, with a median age at diagnosis of 66 years old. According to d'Amico and CAPRA classifications, 30.4% and 35.0% of patients were at low, 34.5% and 33.2% at intermediate, 35.1% and 31.8% at high risk. The diagnosis severity increased with age (P0.0001). The main treatment for low risk patients was radical prostatectomy (41.6% and 42.0% for d'Amico and CAPRA, respectively), but active surveillance was the most frequent treatment if diagnosed after 75 years old. The management of low risk patients varied significantly between centers (P0.0001), according to the therapeutic platforms available within the hospital.In absence of strong progression predictor, the management of low risk PCa remains based on center habits and local therapeutic platforms. New predictive markers, such as multiparametric MRI or molecular tests, are needed to guide rational management of low risk PCa.4.