Reconstructive complications and early toxicity in breast cancer patients treated with proton-based postmastectomy radiation therapy

BackgroundPostmastectomy radiation therapy (PMRT) decreases the risk of locoregional recurrence and increases overall survival rates in patients with high-risk node positive breast cancer. While the number of breast cancer patients treated with proton-based PMRT has increased in recent years, there is limited data on the use of proton therapy in the postmastectomy with reconstruction setting. In this study, we compared acute toxicities and reconstructive complications in patients treated with proton-based and photon-based PMRT.MethodsA retrospective review of our institutional database was performed to identify breast cancer patients treated with mastectomy with implant or autologous reconstruction followed by PMRT from 2015 to 2020. Baseline clinical, disease, and treatment related factors were compared between the photon-based and proton-based PMRT groups. Early toxicity outcomes and reconstructive complications following PMRT were graded by the treating physician.ResultsA total of 11 patients treated with proton-based PMRT and 26 patients treated with photon-based PMRT were included with a median follow-up of 7.4 months (range, 0.7-33 months). Six patients (55%) in the proton group had a history of breast cancer (3 ipsilateral and 3 contralateral) and received previous RT 38 months ago (median, range 7-85). There was no significant difference in mean PMRT (p = 0.064) and boost dose (p = 0.608) between the two groups. Grade 2 skin toxicity was the most common acute toxicity in both groups (55% and 73% in the proton and photon group, respectively) (p = 0.077). Three patients (27%) in the proton group developed grade 3 skin toxicity. No Grade 4 acute toxicity was reported in either group. Reconstructive complications occurred in 4 patients (36%) in the proton group and 8 patients (31%) in photon group (p = 0.946).ConclusionsAcute skin toxicity remains the most frequent adverse event in both proton- and photon-based PMRT. In our study, reconstructive complications were not significantly higher in patients treated with proton- versus photon-based PMRT. Longer follow-up is warranted to assess late toxicities

Pathologies infectieuses des poissons d'ornement et traitements

AMIENS-BU Santé (800212102) / SudocSudocFranceF

Restauration de parcours sahéliens au Sénégal. Etude thématique (Rapport de fin d'étude)

Au cours de la saison des pluies 1988, des essais de réhabilitation de parcours dégradés à dénudés sur terrains sableux, limoneux et parfois salés, ont été effectués par travail du sol en associant raies de sous-solage et segments de sillons-billons disposés en quinconce, ménageant des portions de terrain colmaté faisant office d'impluvium. Après réception en janvier 1989, de l'appareil australien de sursemis, le Camel Pitter, cet instrument a été testé pendant la saison des pluies sur sols salés et sur sols sablonneu x . Un bilan des introductions d'espèces locales ou exotiques, herbacées et ligneuses a été effectué en novembre 1989

SIMoNe: Statistical Inference for MOdular NEtworks.

International audienceSUMMARY: The R package SIMoNe (Statistical Inference for MOdular NEtworks) enables inference of gene-regulatory networks based on partial correlation coefficients from microarray experiments. Modelling gene expression data with a Gaussian graphical model (hereafter GGM), the algorithm estimates non-zero entries of the concentration matrix, in a sparse and possibly high-dimensional setting. Its originality lies in the fact that it searches for a latent modular structure to drive the inference procedure through adaptive penalization of the concentration matrix. AVAILABILITY: Under the GNU General Public Licence at http://cran.r-project.org/web/packages/simone

Texture, Color and Frequential Proxy-Detection Image Processing for Crop Characterization in a Context of Precision Agriculture

The concept of precision agriculture consists to spatially manage crop management practices according to in-field variability. This concept is principally dedicated to variable-rate application of inputs such as nitrogen, seeds and phytosanitary products, allowing for a better yield management and reduction on the use of pesticides, herbicides … In this general context, the development of ICT techniques has allowed relevant progresses for Leaf Area Index (LAI) (Richardson et al., 2009), crop density (Saeys et al., 2009), stress (Zygielbaum et al., 2009) … Most of the tools used for Precision Farming utilizes optical and/or imaging sensors and dedicated treatments, in real time or not, and eventually combined to 3D plant growth modeling or disease development (Fournier et al., 2003 ; Robert et al., 2008). To evaluate yields or to better define the appropriated periods for the spraying or fertilizer input, to detect crop, weeds, diseases …, the remote sensing imaging devices are often used to complete or replace embedded sensors onboard the agricultural machinery (Aparicio et al., 2000). Even if these tools provide sufficient accurate information, they get some drawbacks compared to “proxy-detection” optical sensors: resolution, easy-to-use tools, accessibility, cost, temporality, precision of the measurement … The use of specific image acquisition systems coupled to reliable image processing should allow for a reduction of working time, a lower work hardness and a reduction of the bias of the measurement according to the operator, or a better spatial sampling due to the rapidity of the image acquisition (instead of the use of remote sensing). The early evaluation of yield could allow farmers, for example, to adjust cultivation practices (e.g., last nitrogen (N) input), to organize harvest and storage logistics. The optimization of late N application could lead to significant improvements for the environment, one of the most important concerns that precision agriculture aims to address. We propose in this chapter to explore the proxy-detection domain by focusing first on the development of robust image acquisition systems, and secondly on the use of image processing for different applications tied on one hand to wheat crop characterization, such as the detection and counting of wheat ears per m² (in a context of yield prediction) and the weed detection, and on the other hand to the evolution of seed development/germination performance of chicory achenes. Results of the different processing are presented in the last part just before a conclusion

Calcul du sens et contexte

La question du contexte occupe une place centrale pour l’analyse du langage, aussi bien en linguistique, en philosophie qu’au sein des sciences cognitives. En effet, le sens d’une expression linguistique varie fortement d’un contexteà l’autre et d’une situation donnée à une autre. Mais que faut-il entendre exactement par contexte ? Comment le définir ? Le contexte est- il assimilable à la notion de situation ? à la notion d’usage ? Ce sont quelques-unes des questions qui ont été abordées au sein du groupe de travail sur « la construction du sens en contexte », mêlant des linguistes et des philosophes de l’Ecole Normale Supérieure de Paris durant l’année 2011/2012

Transoral robotic surgery hypopharyngectomy (TORSH): feasibility and outcomes.

With the development of minimal invasive procedure, trans-oral robotic surgery (TORS) is expanding in the field of ENT. Most reviews focus on oropharyngeal and laryngeal (supra-glottic) localization. We report here the feasibility and outcomes of TORS hypopharyngectomy (TORSH) for selected patients with hypopharyngeal tumor. Between September 2009 and July 2017, 22 patients, retrospectively included, underwent TORSH with curative intent. From 22 successful hypopharyngectomy, no conversion to open procedure was needed. Three patients (13%) presented a post-operative bleeding and were managed by surgical revision. No fistula was encountered. The 3-year overall survival and disease-specific survival rates were 54 and 92%, respectively. Patients started oral feeding after an average of 7 days. Naso-gastric feeding tubes were removed after a median period of 16 days. Two patients (9%) needed a transient gastrostomy (< 1 year). Three patients (13%) received a transient tracheostomy (< 2 months). Median hospitalization stay was 13 days. TORSH is a safe technique. Patients' outcomes are favorable and the post-operative morbidity is reduced compared to open neck approach. Hospitalization length and safe swallowing time are reduced