Introduction. Les circuits courts alimentaires : regards croisés entre l’Amérique latine et l’Europe occidentale

Depuis plus de deux décennies, les initiatives alimentaires qui se veulent alternatives par rapport aux filières basées sur l’agriculture fortement consommatrice d’intrants d’origine industrielle, sur la transformation par l’industrie des produits et sur leur commercialisation par le biais de la grande distribution se sont multipliées. Ainsi, les circuits courts sont censés assurer aux producteurs agricoles, en particulier aux exploitants familiaux, des revenus plus élevés en renforçant leur ..

Formation continue sur la prise en charge de la clientèle pédiatrique pour les infirmières de l’urgence générale

Rapport de stage présenté à la Faculté des sciences infirmières en vue de l'obtention du grade de Maître ès sciences (M.Sc.) en sciences infirmières option formationAu Canada, 85 % des visites pédiatriques se font à l’extérieur d’un centre pédiatrique spécialisé et 20 % de ces enfants reçoivent un traitement qui ne serait pas bénéfique, voire nocif pour eux (TREKK, 2019). Afin de remédier à cette problématique, plusieurs auteurs suggèrent que la formation continue serait la pierre angulaire pour améliorer la prise en charge de la clientèle pédiatrique par les infirmières des urgences générales (Jain et al., 2019; Klig et al., 2018; Remick et al., 2018). Malheureusement, ces dernières ont relevé un manque de formations disponibles sur les soins d’urgence pédiatrique (Crockett et al., 2018). Le but de l’intervention éducationnelle présentée dans cet article clinique était de développer, mettre à l’essai une formation continue sur les soins d’urgence pédiatrique infirmiers et en apprécier la satisfaction. Celle-ci a été dispensée aux infirmières de deux urgences générales. Un questionnaire pour établir le profil des participantes et un questionnaire sur l’évaluation de la formation ont été utilisés. Cette formation a été basée sur deux cadres de références : la formation par compétences de Lasnier (2014) et le guide clinique sur les soins d’urgence pédiatrique de l’American Academy of Pediatrics et al. (2009). La formation d’une durée de 75 minutes a été offerte sous forme d’étude de cas et jumelée à un aide-mémoire. Les participantes se sont dites satisfaites de cette activité et la recommanderaient à leurs collègues. Enfin, au terme de cette intervention éducationnelle, le milieu a souhaité ajouter cette formation au programme d’orientation des infirmières de l’urgence.In Canada, 85% of pediatric visits are made outside of a specialized pediatric center and 20% of these children receive treatment that are suboptimal and perhaps even harmful to them (TREKK, 2019). To address this problem, several authors have suggested that continuing education should be the cornerstone for improving the management of pediatric patients by general emergency nurses (Jain et al., 2019; Klig et al., 2018; Remick et al., 2018). Unfortunately, the latter have noted a lack of training available on pediatric emergency care (Crockett et al., 2018). The purpose of this educational intervention presented in this practicum dissertation was to develop and provide an educational session on pediatric emergency nursing care. This session was offered to nurses in two general emergencies. Questionnaires were distributed to nurses before and after the educational session to establish a profile and verify their satisfaction on the session offered. This training was based on two frameworks: Educational competencies from Lasnier (2014) and the Clinical guidelines for the care of children presenting to the emergency department from the American Academy of Pediatrics et al. (2009). The 75-minutes training was offered through the analysis of a case-study combined and a pocketcard was distributed to them. Overall, participants mentioned that they were satisfied of the session offered and would recommend it to their colleagues. Finally, nursing administration of the setting concerned by this practicum decided to add the content of this educational intervention to their emergency nurses training program

THE SMALL FATAL CHOROIDAL MELANOMA STUDY A Survey by the European Ophthalmic Oncology Group

PURPOSE: To determine the size at which choroidal melanomas can metastasize and to report the characteristics of small fatal choroidal melanomas (SFCM). DESIGN: Retrospective case series. METHODS: Ten ocular oncology services submitted 45 patients with a choroidal melanoma 3 mm or less in thickness and 9 mm or less in largest basal diameter (LBD), when treated, who developed metastases. RESULTS: Median tumor thickness was 2.4 mm (range, 1.0-3.0 mm) and LBD 7.3 mm (range, 3.0-9.0 mm). Of 14 (31%) tumors that were first observed, 12 grew a median of 0.5 mm (range, 0.1-1.2 mm) in thickness and 1.0 mm (range, 0-3.0 mm) in LBD within a median of 7 months; 3 were initially smaller than 3 mm in LBD. Number of risk factors for growth and metastasis was 0 for 4% of the tumors; 60% were over 2 mm in thickness, 63% had subretinal fluid, 84% caused symptoms, 57% had orange pigment, and 92% were within 3 mm of the disc. Local recurrence occurred in 8 of 31 eyes (26%) treated conservatively. Median metastasis-free survival was 4.5 years (range, 0.8-15.7 years). Kaplan-Meier estimate of metastasis developing was 15% (95% confidence interval [CI], 7-26), 51% (95% CI, 36-64) and 85% (95% CI, 71-92) by 2, 5, and 10 years, respectively. By the time of analysis, 37 patients had died of metastasis after a median of 7 months. CONCLUSIONS: Choroidal melanomas less than 3.0 mm in LBD are highly unlikely to metastasize. Risk factors of an SFCM are similar to those for all choroidal melanomas of similar size. (C) 2019 The Author(s). Published by Elsevier Inc.Peer reviewe

Retinoblastoma

Retinoblastoma is a rare eye tumor of childhood that arises in the retina. It is the most common intraocular malignancy of infancy and childhood; with an incidence of 1/15,000–20,000 live births. The two most frequent symptoms revealing retinoblastoma are leukocoria and strabismus. Iris rubeosis, hypopyon, hyphema, buphthalmia, orbital cellulites and exophthalmia may also be observed. Sixty per cent of retinoblastomas are unilateral and most of these forms are not hereditary (median age at diagnosis two years). Retinoblastoma is bilateral in 40% of cases (median age at diagnosis one year). All bilateral and multifocal unilateral forms are hereditary. Hereditary retinoblastoma constitutes a cancer predisposition syndrome: a subject constitutionally carrying an RB1 gene mutation has a greater than 90% risk of developing retinoblastoma but is also at increased risk of developing other types of cancers. Diagnosis is made by fundoscopy. Ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT) scans may contribute to diagnosis. Management of patients with retinoblastoma must take into account the various aspects of the disease: the visual risk, the possibly hereditary nature of the disease, the life-threatening risk. Enucleation is still often necessary in unilateral disease; the decision for adjuvant treatment is taken according to the histological risk factors. Conservative treatment for at least one eye is possible in most of the bilateral cases. It includes laser alone or combined with chemotherapy, cryotherapy and brachytherapy. The indication for external beam radiotherapy should be restricted to large ocular tumors and diffuse vitreous seeding because of the risk of late effects, including secondary sarcoma. Vital prognosis, related to retinoblastoma alone, is now excellent in patients with unilateral or bilateral forms of retinoblastoma. Long term follow-up and early counseling regarding the risk of second primary tumors and transmission should be offered to retinoblastoma patients

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment

Placenta Imaging Workshop 2018 report:Multiscale and multimodal approaches

The Centre for Medical Image Computing (CMIC) at University College London (UCL) hosted a two-day workshop on placenta imaging on April 12th and 13th 2018. The workshop consisted of 10 invited talks, 3 contributed talks, a poster session, a public interaction session and a panel discussion about the future direction of placental imaging. With approximately 50 placental researchers in attendance, the workshop was a platform for engineers, clinicians and medical experts in the field to network and exchange ideas. Attendees had the chance to explore over 20 posters with subjects ranging from the movement of blood within the placenta to the efficient segmentation of fetal MRI using deep learning tools. UCL public engagement specialists also presented a poster, encouraging attendees to learn more about how to engage patients and the public with their research, creating spaces for mutual learning and dialogue