Cost-effectiveness of a bone substitute delivering gentamicin in the treatment of chronic osteomyelitis of long bones: Protocol for the CONVICTION randomized multicenter study

IntroductionChronic osteomyelitis is a serious osteoarticular infection that most often occurs in the long bones, responsible for significant morbidity with the risk of fracture and amputation. Despite advances in both antibiotics and surgical treatment, the probability of recurrence of infection remains at around 20%. Cerament-G (BONESUPPORT AB, Sweden) is a synthetic bone substitute that fills the bone void left by surgery, prevents infection and promotes bone regeneration within this space. Cerament-G also provides the local delivery of high doses of gentamicin over several weeks. Two prospective observational studies described a number of infectious recurrences of 4 and 5% after the use of Cerament-G. Although available in France, Cerament-G is currently not reimbursed and its high cost constitutes a barrier to its use. We hypothesize that the use of Cerament-G will lead to fewer costs to the collectivity while improving patient utility and, as an innovative strategy, will be superior to standard of care on recurrence of infection.Methods and analysisThe Conviction Study is a prospective, multicenter, randomized, single blind study conducted in 14 French Reference Centers for Complex Osteoarticular infections. The main objective is to evaluate the cost-effectiveness of using Cerament-G in the treatment of chronic long bone osteomyelitis by comparing this innovative strategy to standard of care. A cost-utility analysis from the collective perspective will be conducted over a 24-month time horizon after the initial surgery. The outcome for the main medico-economic evaluation will be Quality Adjusted Life Years (QALYs).DiscussionThe study is being conducted throughout the CRIOAc network in France, in referral centers for the management of complex infections which will facilitate patient recruitment. This study has several limitations: the investigators have to be trained to handle the device, and it was impossible to blind the surgeon.ConclusionIf the use of Cerament-G is demonstrated to be superior to leaving the dead space empty during surgery for patients with stage III chronic long bone osteomyelitis, its use will be recommended to improve the prognosis of such patients, and this device may eventually qualify for reimbursement through the French Health Insurance scheme.Ethics and disseminationThis protocol received authorization from the Ethics Committee CPP Sud Méditerranée V on April 27, 2021 (21.03.10.77652) and the French National Agency for Medicines and Health Products on May 6, 2021 (2020-A02299-30). Results will be disseminated to the scientific community through congresses and publication in peer-reviewed journals

Lysine Methylation Regulators Moonlighting outside the Epigenome

Landmark discoveries made nearly two decades ago identified known transcriptional regulators as histone lysine methyltransferases; since then the field of lysine methylation signaling has been dominated by studies of how this small chemical posttranslational modification regulates gene expression and other chromatin-based processes. However, recent advances in mass spectrometry-based proteomics have revealed that histones are just a subset of the thousands of eukaryotic proteins marked by lysine methylation. As the writers, erasers, and readers of histone lysine methylation are emerging as a promising therapeutic target class for cancer and other diseases, a key challenge for the field is to define the full spectrum of activities for these proteins. Here we summarize recent discoveries implicating non-histone lysine methylation as a major regulator of diverse cellular processes. We further discuss recent technological innovations that are enabling the expanded study of lysine methylation signaling. Collectively, these findings are shaping our understanding of the fundamental mechanisms of non-histone protein regulation through this dynamic and multi-functional posttranslational modification

Root-emitted volatile organic compounds: can they mediate belowground plant-plant interactions?

peer reviewedBackground Aboveground, plants release volatile organic compounds (VOCs) that act as chemical signals between neighbouring plants. It is now well documented that VOCs emitted by the roots in the plant rhizosphere also play important ecological roles in the soil ecosystem, notably in plant defence because they are involved in interactions between plants, phytophagous pests and organisms of the third trophic level. The roles played by root-emitted VOCs in between- and within-plant signalling, however, are still poorly documented in the scientific literature. Scope Given that (1) plants release volatile cues mediating plant-plant interactions aboveground, (2) roots can detect the chemical signals originating from their neighbours, and (3) roots release VOCs involved in biotic interactions belowground, the aim of this paper is to discuss the roles of VOCs in between- and within-plant signalling belowground. We also highlight the technical challenges associated with the analysis of root-emitted VOCs and the design of experiments targeting volatile-mediated root-root interactions. Conclusions We conclude that root-root interactions mediated by volatile cues deserve more research attention and that both the analytical tools and methods developed to study the ecological roles played by VOCs in interplant signalling aboveground can be adapted to focus on the roles played by root-emitted VOCs in between- and within-plant signalling

Relationship between rheology, mouthfeel and flavour perception in starch pastes

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Les mécomptes de la sollicitude. Cinq mois dans une classe de transition

Ferry Gilles, Chaix Marie-Laure. Les mécomptes de la sollicitude. Cinq mois dans une classe de transition. In: Bulletin de psychologie, tome 24 n°292, 1971. pp. 722-736

TRAITEMENT DES DYSKINESIES TARDIVES INDUITES PAR LES NEUROLEPTIQUES (USAGE DE LA TETRABENAZINE DANS UN SERVICE DE NEUROLOGIE (HOPITAL NEUROLOGIQUE DE LYON))

LYON1-BU Santé (693882101) / SudocSudocFranceF

Archéologie d'une place, Sous les pas de Stanislas, Nancy XVIe-XVIIIe siècle

Ouvrage édité à l'occasion de l'exposition présentée par la Ville de Nancy au Musée lorrain du 7 mai au 5 septembre 2005 sous le titre "Sous les pavés, la place ; archéologie et histoire de la place Stanislas". Numéro hors série de La Gazette Lorraine, juin 200

Les communications dans la classe. Étude des communications entre les élèves et le professeur dans une classe de sixième

Ferry Gilles, Blouet Christine, Chaix Marie-Laure, Leger Yannette. Les communications dans la classe. Étude des communications entre les élèves et le professeur dans une classe de sixième. In: Bulletin de psychologie, tome 22 n°272, 1968. pp. 81-95

Cost-effectiveness of a bone substitute delivering gentamicin in the treatment of chronic osteomyelitis of long bones: Protocol for the CONVICTION randomized multicenter study

International audienceIntroduction Chronic osteomyelitis is a serious osteoarticular infection that most often occurs in the long bones, responsible for significant morbidity with the risk of fracture and amputation. Despite advances in both antibiotics and surgical treatment, the probability of recurrence of infection remains at around 20%. Cerament-G (BONESUPPORT AB, Sweden) is a synthetic bone substitute that fills the bone void left by surgery, prevents infection and promotes bone regeneration within this space. Cerament-G also provides the local delivery of high doses of gentamicin over several weeks. Two prospective observational studies described a number of infectious recurrences of 4 and 5% after the use of Cerament-G. Although available in France, Cerament-G is currently not reimbursed and its high cost constitutes a barrier to its use. We hypothesize that the use of Cerament-G will lead to fewer costs to the collectivity while improving patient utility and, as an innovative strategy, will be superior to standard of care on recurrence of infection. Methods and analysis The Conviction Study is a prospective, multicenter, randomized, single blind study conducted in 14 French Reference Centers for Complex Osteoarticular infections. The main objective is to evaluate the cost-effectiveness of using Cerament-G in the treatment of chronic long bone osteomyelitis by comparing this innovative strategy to standard of care. A cost-utility analysis from the collective perspective will be conducted over a 24-month time horizon after the initial surgery. The outcome for the main medico-economic evaluation will be Quality Adjusted Life Years (QALYs). Discussion The study is being conducted throughout the CRIOAc network in France, in referral centers for the management of complex infections which will facilitate patient recruitment. This study has several limitations: the investigators have to be trained to handle the device, and it was impossible to blind the surgeon. Conclusion If the use of Cerament-G is demonstrated to be superior to leaving the dead space empty during surgery for patients with stage III chronic long bone osteomyelitis, its use will be recommended to improve the prognosis of such patients, and this device may eventually qualify for reimbursement through the French Health Insurance scheme. Ethics and dissemination This protocol received authorization from the Ethics Committee CPP Sud Méditerranée V on April 27, 2021 (21.03.10.77652) and the French National Agency for Medicines and Health Products on May 6, 2021 (2020-A02299-30). Results will be disseminated to the scientific community through congresses and publication in peer-reviewed journals

Segregated versus Disordered Stacking in Two Low Bandgap Alternated Copolymers for Photovoltaic Applications: Impact of Polymorphism on Optical Properties

Structure–property correlations are often hampered by insufficient structural insight into the crystal packing of polymer semiconductors widely used in electronic devices such as organic solar cells. Herein, both the semicrystalline morphology and the crystalline structures of two high performance polymer semiconductors showing more than 9% efficiencies, namely PDTBT-TT and PBT4T, are established by a combination of oriented crystallization and transmission electron microscopy. PDTBT-TT and PBT4T form layered structures with alternation of π-stacked backbones and layers of disordered alkyl side chains. π-Stacking is such that benzothiadiazole and the comonomer (quaterthiophene or thienothiophene–bithiophene) segregate to form distinct stacks. This segregated stacking is preferentially obtained in thin films aligned by high-temperature rubbing at T = 200–230 °C. However, the two polymers show different stabilities of this polymorph versus temperature. The segregated stacking of PDTBT-TT is stable up to near the melting temperature, whereas for PBT4T it transforms to a layered structure with significant intrastack disorder at T ≥ 250 °C. The intensity of the 0–0 component of the vibronic progression in the absorption spectrum is enhanced for the polymorph with long-range segregated π-stacks. The structural models determined for the two polymers suggest that both the position of alkyl side chains and the preferential π-stacking interactions between comonomers determine the polymorphism and corresponding thermal stability