To buy or not to buy-evaluating commercial AI solutions in radiology (the ECLAIR guidelines).

Artificial intelligence (AI) has made impressive progress over the past few years, including many applications in medical imaging. Numerous commercial solutions based on AI techniques are now available for sale, forcing radiology practices to learn how to properly assess these tools. While several guidelines describing good practices for conducting and reporting AI-based research in medicine and radiology have been published, fewer efforts have focused on recommendations addressing the key questions to consider when critically assessing AI solutions before purchase. Commercial AI solutions are typically complicated software products, for the evaluation of which many factors are to be considered. In this work, authors from academia and industry have joined efforts to propose a practical framework that will help stakeholders evaluate commercial AI solutions in radiology (the ECLAIR guidelines) and reach an informed decision. Topics to consider in the evaluation include the relevance of the solution from the point of view of each stakeholder, issues regarding performance and validation, usability and integration, regulatory and legal aspects, and financial and support services. KEY POINTS: • Numerous commercial solutions based on artificial intelligence techniques are now available for sale, and radiology practices have to learn how to properly assess these tools. • We propose a framework focusing on practical points to consider when assessing an AI solution in medical imaging, allowing all stakeholders to conduct relevant discussions with manufacturers and reach an informed decision as to whether to purchase an AI commercial solution for imaging applications. • Topics to consider in the evaluation include the relevance of the solution from the point of view of each stakeholder, issues regarding performance and validation, usability and integration, regulatory and legal aspects, and financial and support services

Netrin-1 regulates somatic cell reprogramming and pluripotency maintenance

The generation of induced pluripotent stem (iPS) cells holds great promise in regenerative medicine. The use of the transcription factors Oct4, Sox2, Klf4 and c-Myc for reprogramming is extensively documented, but comparatively little is known about soluble molecules promoting reprogramming. Here we identify the secreted cue Netrin-1 and its receptor DCC, described for their respective survival/death functions in normal and oncogenic contexts, as reprogramming modulators. In various somatic cells, we found that reprogramming is accompanied by a transient transcriptional repression of Netrin-1 mediated by an Mbd3/Mta1/Chd4-containing NuRD complex. Mechanistically, Netrin-1 imbalance induces apoptosis mediated by the receptor DCC in a p53-independent manner. Correction of the Netrin-1/DCC equilibrium constrains apoptosis and improves reprogramming efficiency. Our work also sheds light on Netrin-1s function in protecting embryonic stem cells from apoptosis mediated by its receptor UNC5b, and shows that the treatment with recombinant Netrin-1 improves the generation of mouse and human iPS cells

Étude des facteurs de risque des troubles musculosquelettiques des membres supérieurs à La Poste

International audienceObjective. To identify risk factors related to occupational musculoskeletal disorders of the upper limbs in the French Post office workers. Methods. Between 2008 and 2010, 45 occupational physicians gathered during consultation anonymous information relating to the organization and the working environment of 703 post office workers with musculoskeletal disorders. A control group of 466 workers free of musculoskeletal disorders was formed from the same medical consultations. Variables related to physical effort and psychosocial factors were grouped into scores. Results. A bad biomechanical score (OR = 4.3,95% CI = (2.3, 7.8), a poor psychosocial score (OR = 3.5, 95% CI = (2.5, 5.1)), female gender (OR = 2.9,95% CI = (2.2, 4.0)), age over 50 years (OR = 3.0, 95% CI = (2.1, 4.4)) are the main risk factors identified. The sorting work including manual sorting, handling and working on machine are associated with high risk of MSDs as well as bicycle and pedestrian distribution. Shoulder lesions are more frequent than those of wrist and elbow. Conclusion. This descriptive study explores individual factors and others work-related organizational and environmental factors that are associated with the risk of MSDs. An etiological analysis of the case control type should be conducted to test these hypotheses. However, ways to strengthen prevention efforts are already definable. (C) 2013 Published by Elsevier Masson SAS

Netrin-1 blockade inhibits tumour growth and EMT features in endometrial cancer

Netrin-1 is upregulated in cancers as a protumoural mechanism1. Here we describe netrin-1 upregulation in a majority of human endometrial carcinomas (ECs) and demonstrate that netrin-1 blockade, using an anti-netrin-1 antibody (NP137), is effective in reduction of tumour progression in an EC mouse model. We next examined the efficacy of NP137, as a first-in-class single agent, in a Phase I trial comprising 14 patients with advanced EC. As best response we observed 8 stable disease (8 out of 14, 57.1%) and 1 objective response as RECIST v.1.1 (partial response, 1 out of 14 (7.1%), 51.16% reduction in target lesions at 6 weeks and up to 54.65% reduction during the following 6 months). To evaluate the NP137 mechanism of action, mouse tumour gene profiling was performed, and we observed, in addition to cell death induction, that NP137 inhibited epithelial-to-mesenchymal transition (EMT). By performing bulk RNA sequencing (RNA-seq), spatial transcriptomics and single-cell RNA-seq on paired pre- and on-treatment biopsies from patients with EC from the NP137 trial, we noted a net reduction in tumour EMT. This was associated with changes in immune infiltrate and increased interactions between cancer cells and the tumour microenvironment. Given the importance of EMT in resistance to current standards of care2, we show in the EC mouse model that a combination of NP137 with carboplatin-paclitaxel outperformed carboplatin-paclitaxel alone. Our results identify netrin-1 blockade as a clinical strategy triggering both tumour debulking and EMT inhibition, thus potentially alleviating resistance to standard treatments