Computer-assisted access to the kidney

OBJECTIVES: The aim of this paper is to introduce the principles of computer-assisted access to the kidney. The system provides the surgeon with a pre-operative 3D planning on computed tomography (CT) images. After a rigid registration with space-localized ultrasound (US) data, preoperative planning can be transferred to the intra-operative conditions and an intuitive man-machine interface allows the user to perform a puncture. MATERIAL AND METHODS: Both CT and US images of informed normal volunteer were obtained to perform calculation on the accuracy of registration and punctures were carried out on a kidney phantom to measure the precision of the whole of the system. RESULTS: We carried out millimetric registrations on real data and guidance experiments on a kidney phantom showed encouraging results of 4.7 mm between planned and reached targets. We noticed that the most significant error was related to the needle deflection during the puncture. CONCLUSION: Preliminary results are encouraging. Further work will be undertaken to improve efficiency and accuracy, and to take breathing into account

Corps sans visage

International audienceSi la greffe du visage a fait couler tant d'encre, c'est qu'elle est, d'un point de vue anthropologique et au-delà de toute considération technique et médicale, irréductible à toute autre transplantation. La vision d'un visage ravagé provoque horreur et répulsion, bientôt suivies de pitié. La défiguration touche en effet directement au soi, dans sa relation à autrui et à lui-même. La destruction du visage signe la désertion de l'individu, atteint au cœur de son identité et de sa relation aux autres. Cette absence l'éloigne tant de lui-même que de la sphère sociale. Paradoxalement, il est pourtant des corps sans visage qui attisent le désir : corps masqués, corps cagoulés, où l'interface du rapport à soi et aux autres disparaît, oblitérée et absente. Comment alors ce qui cause l'horreur d'un côté peut-il être objet du désir de l'autre ? Comment celui ou celle qui n'a plus de visage devient objet attirant, et non pas repoussant comme le défiguré ? Existent en effet un type de pratiques et de représentations qui mettent en scène une individualité sans visage. Elles sont habituellement qualifiées - en un sens non clinique du terme - de " sadomasochistes " ou " fétichistes " par beaucoup, leurs acteurs y compris. L'étrangeté de cette absence de visage constitue alors, par contraste, le lieu d'un questionnement sur celui-ci. Puisque l'identification d'autrui passe de manière privilégiée par son visage, que nous apprend l'oblitération délibérée de ce visage sur l'identité du sujet quand ce dernier est objet de désir

Ethical Issues in U.S. Trademark Prosecution and TTAB Practice, 10 J. Marshall Rev. Intell. Prop. L. 365 (2011)

The conduct of practitioners and agents before the U.S. Patent and Trademark Office (“USPTO” or “Office”) is subject to regulation by the Office under 35 U.S.C. § 2(b)(2)(D). This provision grants the Under Secretary of Commerce for Intellectual Property and the Director of the USPTO the authority to establish regulations to govern the conduct of agents, attorneys, or other representatives before the Office, including establishing disciplinary measures for non-compliance with those regulations. The USPTO regulations governing conduct include the Patent and Trademark Office Code of Professional Responsibility. This article summarizes the key canons and disciplinary rules applicable to trademark practitioners and authorized representatives; outlines common ethical issues for practitioners and other authorized representatives that arise in ex parte and inter partes trademark proceedings before the USPTO. This article also discusses the case law that has developed relating to these issues. Although the practice of law is generally regulated by State ethics rules and regulations, trademark practitioners and authorized representatives should be equally familiar with the separate set of USPTO regulations governing their conduct before the Office. Additionally, although the USPTO canons and disciplinary rules are based on the Model Code of Professional Responsibility of the American Bar Association (like some State ethics codes), there are a number of ethical issues unique to the conduct of trademark practitioners and agents before the Office. Failure to adhere to these unique rules and regulations can result in disciplinary action by the USPTO that compounds or even exceeds any disciplinary action by the State

Mention de la démission de M. Dourthe au procès-verbal, lors de la séance du 17 novembre 1789

Mention de la démission de M. Dourthe au procès-verbal, lors de la séance du 17 novembre 1789. In: Archives Parlementaires de 1787 à 1860 - Première série (1787-1799) Tome X - Du 12 novembre au 24 décembre 1789. Paris : Librairie Administrative P. Dupont, 1878. p. 82

Mention de la démission de M. Dourthe au procès-verbal, lors de la séance du 17 novembre 1789

Mention de la démission de M. Dourthe au procès-verbal, lors de la séance du 17 novembre 1789. In: Archives Parlementaires de 1787 à 1860 - Première série (1787-1799) Tome X - Du 12 novembre au 24 décembre 1789. Paris : Librairie Administrative P. Dupont, 1878. p. 82

Avelumab maintenance in advanced urothelial carcinoma: biomarker analysis of the phase 3 JAVELIN Bladder 100 trial

In a recent phase 3 randomized trial of 700 patients with advanced urothelial cancer (JAVELIN Bladder 100; NCT02603432), avelumab/best supportive care (BSC) significantly prolonged overall survival relative to BSC alone as maintenance therapy after first-line chemotherapy. Exploratory biomarker analyses were performed to identify biological pathways that might affect survival benefit. Tumor molecular profiling by immunohistochemistry, whole-exome sequencing and whole-transcriptome sequencing revealed that avelumab survival benefit was positively associated with PD-L1 expression by tumor cells, tumor mutational burden, APOBEC mutation signatures, expression of genes underlying innate and adaptive immune activity and the number of alleles encoding high-affinity variants of activating Fc gamma receptors. Pathways connected to tissue growth and angiogenesis might have been associated with reduced survival benefit. Individual biomarkers did not comprehensively identify patients who could benefit from therapy; however, multi-parameter models incorporating genomic alteration, immune responses and tumor growth showed promising predictive utility. These results characterize the complex biologic pathways underlying survival benefit from immune checkpoint inhibition in advanced urothelial cancer and suggest that multiple biomarkers might be needed to identify patients who would benefit from treatment

Supplementary Material for: Adherence and Patients' Attitudes to Oral Anticancer Drugs: A Prospective Series of 201 Patients Focusing on Targeted Therapies

<b><i>Objectives:</i></b> Patient adherence is a challenge in oncology and hematology practice. Hormone therapy data in breast cancer suggest insufficient adherence and poor persistence. Limited data are available for targeted therapies (TT) including tyrosine kinase and mammalian target of rapamycin inhibitors. <b><i>Methods:</i></b> We performed a prospective survey using a 15-item questionnaire in patients with solid tumors and hematologic malignancies receiving oral anticancer therapy. Treatment duration, setting (adjuvant vs. metastatic), cancer type, age, and comedication were recorded. <b><i>Results:</i></b> 201 patients (median age 65.5 years) participated, 102 with TT and 99 with hormone therapy or chemotherapy (HC). The median time of drug intake was 11.0 months. Written information was more frequently given to TT patients (68.6 vs. 23.2%, p < 0.0001). TT and HC patients showed equal adherence to therapy (72.5 vs. 69.6%, p = n.s.) despite TT patients experiencing more side effects (p < 0.0001) and taking more concomitant oral medication (p = 0.0042). Forgotten doses were the leading cause of nonadherence in HC patients (83%, as compared to 54% in the TT group), whereas dose reduction by the patient was higher in the TT group (32 vs. 17%). <b><i>Conclusions:</i></b> Despite advances in providing information to patients leading to better adherence among TT patients, efforts towards better patient education are warranted including dedicated staff for monitoring outpatient anticancer oral therapy