The impact of patients’ and physicians’ characteristics on surgery decision for head and neck cancer: Results of a national survey

Background: Population’s aging leads to an increased diagnosis of head and neckcancer (HNC) in older patients (pts). Treatment can involve surgery, radiation, sys-temic therapy or multimodal therapy. Due to heterogeneity of older pts, thecomprehensive geriatric assessment (CGA) is considered the gold standard tool toclassify pts according to frailty profile. Multidisciplinary approach including a geria-trician is essential. CGA may be helpful to personalize treatment plan and to detectgeriatric conditions that can be reversible through geriatric interventions. We aim toevaluate the impact of CGA on therapeutic decision

Mars’ Surface Radiation Environment Measured with the Mars Science Laboratory’s Curiosity Rover

The Radiation Assessment Detector (RAD) on the Mars Science Laboratory’s Curiosity rover began making detailed measurements of the cosmic ray and energetic particle radiation environment on the surface of Mars on 7 August 2012. We report and discuss measurements of the absorbed dose and dose equivalent from galactic cosmic rays and solar energetic particles on the martian surface for ~300 days of observations during the current solar maximum. These measurements provide insight into the radiation hazards associated with a human mission to the surface of Mars and provide an anchor point with which to model the subsurface radiation environment, with implications for microbial survival times of any possible extant or past life, as well as for the preservation of potential organic biosignatures of the ancient martian environment.</jats:p

Mise en place et suivi d'une mission humanitaire, rôles et responsabilités du pharmacien

STRASBOURG ILLKIRCH-Pharmacie (672182101) / SudocSudocFranceF

Anaerobic oxidation of n-alkenes by sulphate-reducing bacteria from the genus Desulfatiferula: n-Ketones as potential metabolites

International audienceTwo alkene-degrading sulphate-reducing bacteria from the genus Desulfatiferula (Desulfatiferula olefinivorans strain LM2801(T) and Desulfatiferula sp. strain BE2801) were investigated for their 1-alkene metabolism. Their total cellular fatty acids were predominantly C-even when they were grown on C-even 1-alkene (1-hexadecene), whereas a mixture of fatty acids with C-odd or C-even carbon chains predominated when cells were grown on C-odd 1-alkene (1-pentadecene). This is consistent with the fatty acid composition of other sulphate-reducing strains previously reported to grow on n-alkenes. Linear and 3-OH-fatty acids appear to be the main fatty acids produced by the two Desulfatiferula strains. The analysis of their neutral lipids led to identifying several n-alkanols and n-ketones with the same number of carbon atoms as the alkene growth substrate and with functionality located between C-1 and C-5. Growth of strains LM2801(T) and BE2801 on (per) deuterated 1-alkenes provided direct evidence of their anaerobic transformation to corresponding 1-alkanols, n-ketones and linear (3-OH-) fatty acids. These results demonstrate that Desulfatiferula strains oxidize a 1-alkene by oxidation of the double bond at C-1, but also at C-2 to C-5 (after eventual isomerization of the double bond) yielding the corresponding C-2 to C-5 n-ketones (via the corresponding n-alkanols). The formation of specific 3-OH-fatty acids by elongation of shorter chain fatty acids was also demonstrated. Based on our observations, pathways for anaerobic 1-alkene metabolism in sulphate-reducing bacteria from the genus Desulfatiferula are proposed. They indicate that n-ketones can constitute new metabolites of the biodegradation of n-alkenes in anaerobic environment

The impact of patients’ and physicians’ characteristics on surgery decision for head and neck cancer: Results of a national survey.

e14151 Background: The choice between surgical or medical treatments in head and neck cancer is a function of many patient-related and disease-related factors. We investigated how physicians' behavioral characteristics and patients’ socioeconomic status could affect medical decision-making. Methods: A nationwide cross-sectional online survey of surgeons and (radiation) oncologists specialized in head and neck oncology collected data on medical decision-making for 7 clinical vignettes involving head and neck squamous cell carcinoma patients that were representative of routine practice. Questionnaires elicited physicians' demographic and occupational characteristics along with their individual behavioral characteristics according to the decision theory framework. Patients’ gender and socioeconomic position were distributed across vignettes using a Latin square design. Results: We obtained 206 assessable answers. A multivariate analysis shows that surgeons suggested surgery more often than other professionals, which is mostly related to vignettes corresponding to clinical cases for which there is no consensus, so oncologists are 68% less likely than surgeons to choose surgery. For clinical vignette with an absence of consensus, physicians with lower risk aversion recommend more often surgery compared to those with higher risk aversion (OR = 1.88, p = 0.052). When the vignette corresponds to a clinical case for which there is a surgical consensus decision the isolated male blue-collar worker has a 75% lower chance of being offered surgery compared to the married male small business owner (OR = 0.25, p = 0.024). We did not observe any differences based on the patient's gender. Conclusions: Patients’ socioeconomic status did affect our clinical management decisions in head and neck oncology. The significant association between medical decision and individual behavioral characteristics of the physician documented still understudied mechanisms that involved nonbiological factor to explain clinical practices variations. </jats:p

Photo-oxidation in an 18O2 atmosphere: a powerful tool to elucidate the mechanism of UV-visible light oxidation of polymers – Application to the photodegradation of MDMO-PPV.

International audienceThis article describes a new approach to improve the analysis of the chemical modifications that result from the degradation of polymers under UV-visible light exposure in the presence of oxygen. The tool which is used consists of an irradiation chamber whose atmosphere is composed of 18O2. The 18O2 pressure inside the chamber and the hygrometry can be adjusted. In this study, particular attention was paid to the photo-oxidation of poly[2-methoxy-5-(3′,7′-dimethyloctyloxy)-1,4-phenylenevinyl ene] (MDMO-PPV). Using infrared spectroscopy, irradiation under the oxygen 18 atmosphere allowed discrimination between compounds formed via fixation of oxygen from the atmosphere and those formed by reorganisation of the matrix. In addition, irradiation of MDMO-PPV in an 18O2 wet atmosphere allowed for detection of the presence of phenyl formate and aromatic ketone functions. This permitted validating the mechanism of photo-oxidation previously proposed. Additionally, with regard to blends made with MDMO-PPV and methano-fullerene[6,6]-phenyl C61-butyric acid methyl ester ([60] PCBM), it was demonstrated that this technique facilitates the identification of the photo-oxidation products formed

Optimization of PVA clay nanocomposite for ultra-barrier multilayer encapsulation of organic solar cells.

International audienceThe lifetime of organic solar cells (OSCs) is a key point that has to be addressed to allow their commercial development. Ultra-barrier organic/inorganic multilayer encapsulation therefore has to be developed to improve OSC stability. Polymer nanocomposites are good candidates to be used as the organic layer in the multilayered structure. We report here an optimization of MMt-Na+ content up to 10 wt% in PVA nanocomposite to obtain the properties required for organic solar cell encapsulation, namely an exfoliated structure that has high gas barrier properties, transparency, wettability and planarity of the surface. The elaboration of these nanocomposites was performed through an environmentally friendly process in aqueous solution. The distribution of MMt-Na+ in PVA was first investigated, and the results showed that the transparency of the nanocomposite films was not affected by the presence of the clay in the visible region (400-700 nm). The morphology of nanocomposites was also investigated. A good distribution of the MMt-Na+ in PVA, with intercalated and exfoliated structures, was observed, especially for concentrations up to 5 wt%. Surface properties were also explored and it was shown that PVA/MMt-Na+ 5% nanocomposite permitted to obtain an improvement in wettability without increasing too much the surface roughness. Subsequently, the permeability of the nanocomposites was investigated and it was shown that 5 wt% of MMt-Na+ improved the helium permeability (by 70%) and also oxygen and water permeability. Finally, PVA/MMt-Na+ 5 wt% nanocomposite layer was used as encapsulation for organic solar cells and the improvement of the OSCs stability was evidenced. This work allowed selecting optimized nanocomposites with clay content up to 5 wt%, which will be incorporated into multilayer encapsulation structure to have the best compromise between the different required properties and to enhance organic solar cells stability

Diagnosis, risk factors and management of diabetes mellitus in HIV-infected persons in France: A real-life setting study

International audienceBackground: Diabetes mellitus (DM) is a major and increasing public health problem that may be underdiagnosed and undertreated among persons living with HIV (PLWH).Objective: To describe the diagnosis, treatment and follow-up of DM among PLWH.Methods: This study was performed inside a monocentric cohort of 1494 PLWH. DM was defined as having a FG ≥126 mg/dL twice or a HbA1c ≥6.5%, or a history of diabetes, or receiving antidiabetic treatment. The first visit mentioning a diagnosis of DM was considered as the baseline visit. Chi-Square or Fisher exact test were used to examine the association between categorical variables and DM, Wilcoxon or Student t-test were used for continuous variables.Results: 156 PLWH with DM were included. Compared to non-diabetic participants, they were more likely to be native of Sub Saharan Africa (31.6% vs. 22.4%, p = 0.027) and older (54.6 vs. 49.9 years, p 25 for 46.1% vs. 35.3%, p = 0.020) and a poorer control of HIV (HIV RNA<50 copies/mL: 80.1% vs. 89.5%, p<0.001). The diagnosis of DM was missed in 37.8% of PLWH, and 47.2% of PLWH treated for DM did not reach a HbA1c<7%. PLWH with DM were more frequently on antihypertensive and/or lipid-lowering medications: 94.2% had a LDL-cholesterol <70 mg/dL and 60.9% had a blood pressure <140/90 mmHg.Conclusion: In a setting of HIV-control, HIV care providers should focus on metabolic issues. The management of DM and associated risk factors is mandatory to prevent cardiovascular disease in PLWH

Diagnosis, risk factors and management of diabetes mellitus in HIV-infected persons in France: A real-life setting study

Background Diabetes mellitus (DM) is a major and increasing public health problem that may be underdiagnosed and undertreated among persons living with HIV (PLWH). Objective To describe the diagnosis, treatment and follow-up of DM among PLWH. Methods This study was performed inside a monocentric cohort of 1494 PLWH. DM was defined as having a FG ≥126 mg/dL twice or a HbA1c ≥6.5%, or a history of diabetes, or receiving antidiabetic treatment. The first visit mentioning a diagnosis of DM was considered as the baseline visit. Chi-Square or Fisher exact test were used to examine the association between categorical variables and DM, Wilcoxon or Student t-test were used for continuous variables. Results 156 PLWH with DM were included. Compared to non-diabetic participants, they were more likely to be native of Sub Saharan Africa (31.6% vs. 22.4%, p = 0.027) and older (54.6 vs. 49.9 years, p&lt;0.001), to have a higher BMI (&gt; 25 for 46.1% vs. 35.3%, p = 0.020) and a poorer control of HIV (HIV RNA&lt;50 copies/mL: 80.1% vs. 89.5%, p&lt;0.001). The diagnosis of DM was missed in 37.8% of PLWH, and 47.2% of PLWH treated for DM did not reach a HbA1c&lt;7%. PLWH with DM were more frequently on antihypertensive and/or lipid-lowering medications: 94.2% had a LDL-cholesterol &lt;70 mg/dL and 60.9% had a blood pressure &lt;140/90 mmHg. Conclusion In a setting of HIV-control, HIV care providers should focus on metabolic issues. The management of DM and associated risk factors is mandatory to prevent cardiovascular disease in PLWH. </jats:sec