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

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

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

Acid phosphatase activity in the rhizosphere: how a cereal and a legume create local hotspots

Phosphorus is a poorly mobile, essential nutrient in terrestrial ecosystems. Phosphorus can be of greater local availability in the rhizosphere where greater biological activity can increase enzymatic activities and induce chemical changes such as to pH. However, many rhizosphere processes occur at the very fine-scale (millimetric) while sampling is difficult to do at less than the cm-scale. Using rhizoboxes with 2D access to the soil profile, we mapped and monitored acid phosphatase activity in situ in chickpea and durum wheat, sole and intercropped, as well as in bare soil rhizoboxes over 5 weeks, from small plants to post seed set for the legume. The soil originated from the nill treatment of a long-term fertilizer trial that had not received phosphorus application over 40 years, and thus had low phosphorus availability. We also monitored pH at a very fine scale several times a week using novel noninvasive optical sensors (optodes) to understand fluctuations as well as development of pH shifts in the soil over time and with plant root passage. Greater acid phosphatase activity was frequently observed near roots, especially chickpea roots, some root apices, and root nodules. We also observed heterogeneity of hotspots of acid phosphatase activity within the soil and investigated the size and frequency of these hotspots using geostatistics. We combine these results with data on pH and inorganic phosphorus to try to understand how rhizosphere processes impact local phosphorus availability and how these processes may shift when different plant species interact with each other

Effectiveness of a Therapeutic Educational Oral Health Program for Persons with Schizophrenia: A Cluster Randomized Controlled Trial and Qualitative Approach

International audienceBACKGROUND: The oral health of people with schizophrenia (PWS) is very poor, suggesting a need for oral health promotion programmes with a high level of evidence. The aim of the EBENE study (Clinicaltrials.gov: NCT02512367) was to develop and evaluate the effectiveness of a multidisciplinary therapeutic educational programme in oral health (TEPOH) for PWS. METHODS: A multicentre cluster randomised controlled trial, with outpatient psychiatry centres as the unit of randomisation, was designed to compare the effectiveness of TEPOH (intervention group) versus standard care (control group). The trial was conducted in 26 outpatient psychiatry centres in France (14 in the intervention group, 12 in the control group). Eligible patients with a diagnosis of schizophrenia were enroled between 2016 and 2020 and followed for 6 months. The TEPOH group received a multicomponent intervention (comprising an introductory session, three educational sessions, and a debriefing session). The primary endpoint was the evaluation of periodontal disease as a community periodontal index (CPI) score ≥ 3 at Month 6. The trial was completed using a qualitative approach based on semi-structured interviews with caregivers conducted between July 2018 and December 2019. The trial was stopped early due to difficulties in recruiting patients. RESULTS: Overall, 81 patients (of 250 planned) were included, and 54 patients completed the trial: 40 in the TEPOH group and 14 in the control group. At baseline, the percentage of CPI ≥ 3 was 42.5% in the TEPOH group and 9.1% in the control group. At Month 6, the percentage of CPI ≥ 3 was 20% in the TEPOH group and 14.3% in the control group. The qualitative evaluation underlined that the professionals emphasised the &quot;seriousness&quot; and &quot;assiduity&quot; of the patients’ participation in this programme and that the TEPOH reinforced carers’ investment in oral hygiene. It also highlighted structural factors (lack of resources for professionals, lack of teeth in PWS, COVID-19 pandemic) that may have exacerbated the difficulties with enrolment and follow-up. CONCLUSIONS: The effectiveness of this TEPOH, developed for PWS as part of the EBENE study, has not been demonstrated. Certain aspects of the programme’s content and implementation need to be reconsidered. In particular, an adapted subjective measurement scale should be developed

Physician practice variation in head and neck cancer therapy: Results of a national survey

International audienceObjectives: Choice between surgical or medical treatments in head and neck cancer depends of many patient-related and disease-related factors. We investigated how patients' socioeconomic status and practitioners' specialty could affect medical decision-making.Materials and methods: We conducted a cross-sectional online, nationwide survey, send to surgeons, oncologists and radiotherapists specialized in head and neck oncology. We collected data on medical decision-making for seven clinical scientific scenarios involving head and neck carcinoma and physicians' demographic data. Patients' gender and socioeconomic position were distributed across scientific scenarios using a Latin square design. The scientific scenarios were grouped into several categories according to the prognostic and functional impact of the therapeutic choice.Results: We obtained 206 assessable answers. Surgeons seemed to propose surgery in 49% of cases, whereas oncologists and radiotherapists opted for it in 34% of cases only. This was particularly relevant when the oncological result of surgery and the medical approach were equivalent, and when the surgery appeared to be superior in terms of curative potential but was burdened by a large functional impact. Patient's socioeconomic position also influence therapeutic decision. Among surgeons, the "single male manager" had significantly more chance of being offered surgery than the "married male blue-collar worker". Among oncologists and radiotherapists, the "single male blue-collar worker" had the lowest probability of being proposed surgery. Regarding gender, surgeons tended to offer surgical management more to women regardless of their clinical profile.Conclusions: Patients' sex, marital status, socioeconomic status, practitioners' specialty affect therapeutic management decisions in head and neck oncology

Perspectives of injectable long acting antiretroviral therapies for HIV treatment or prevention: understanding potential users’ ambivalences

International audienc