Planning oncologists of ambulatory care units

International audienceThis paper addresses the problem of determining the work schedule, called medical planning, of oncologists for chemotherapy of oncology patients at ambulatory care units. A mixed integer programming (MIP) model is proposed for medical planning in order to best balance bed capacity requirements under capacity constraints of key resources such as beds and oncologists. The most salient feature of the MIP model is the explicit modeling of specific features of chemotherapy such as treatment protocols. The medical planning problem is proved to be NP-complete. A three-stage approach is proposed for determining good medical planning in reasonable computational time. From numerical experiments based on field data, the three-stage approach takes less than 10 min and always outperforms the direct application of MIP solvers with 10 h CPU time. Compared with the current planning, the three-stage approach reduces the peak daily bed capacity requirement by 20 h to 45 h while the maximum theoretical daily bed capacity is 162 h

High-Throughput Drug Screening Identifies Pazopanib and Clofilium Tosylate as Promising Treatments for Malignant Rhabdoid Tumors

Summary: Rhabdoid tumors (RTs) are aggressive tumors of early childhood characterized by SMARCB1 inactivation. Their poor prognosis highlights an urgent need to develop new therapies. Here, we performed a high-throughput screening of approved drugs and identified broad inhibitors of tyrosine kinase receptors (RTKs), including pazopanib, and the potassium channel inhibitor clofilium tosylate (CfT), as SMARCB1-dependent candidates. Pazopanib targets were identified as PDGFRα/β and FGFR2, which were the most highly expressed RTKs in a set of primary tumors. Combined genetic inhibition of both these RTKs only partially recapitulated the effect of pazopanib, emphasizing the requirement for broad inhibition. CfT perturbed protein metabolism and endoplasmic reticulum stress and, in combination with pazopanib, induced apoptosis of RT cells in vitro. In vivo, reduction of tumor growth by pazopanib was enhanced in combination with CfT, matching the efficiency of conventional chemotherapy. These results strongly support testing pazopanib/CfT combination therapy in future clinical trials for RTs. : Rhabdoid tumors (RTs) are aggressive pediatric tumors characterized by SMARCB1 inactivation. Chauvin et al. identify two SMARCB1-dependent targeted therapies for RT: pazopanib, which inhibits PDGFR and FGFR2, and the potassium channel inhibitor clofilium tosylate, which induces endoplasmic reticulum stress. Combining both drugs induces cell apoptosis and reduces PDX tumor growth. Keywords: rhabdoid tumors, SMARCB1, pazopanib, clofilium tosylate, high-throughput drug screening, tyrosine kinase inhibitor

Imaging and multi-omics datasets converge to define different neural progenitor origins for ATRT-SHH subgroups

Atypical teratoid rhabdoid tumors (ATRT) are divided into MYC, TYR and SHH subgroups, suggesting diverse lineages of origin. Here, we investigate the imaging of human ATRT at diagnosis and the precise anatomic origin of brain tumors in the Rosa26-Cre$^{ERT2}$::Smarcb1$^{flox/flox}$ model. This cross-species analysis points to an extra-cerebral origin for MYC tumors. Additionally, we clearly distinguish SHH ATRT emerging from the cerebellar anterior lobe (CAL) from those emerging from the basal ganglia (BG) and intra-ventricular (IV) regions. Molecular characteristics point to the midbrain-hindbrain boundary as the origin of CAL SHH ATRT, and to the ganglionic eminence as the origin of BG/IV SHH ATRT. Single-cell RNA sequencing on SHH ATRT supports these hypotheses. Trajectory analyses suggest that SMARCB1 loss induces a de-differentiation process mediated by repressors of the neuronal program such as REST, ID and the NOTCH pathway

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Implication des médecins libéraux dans un programme local d'éducation pour la santé (intérêt de la formation à l'entretien motivationnel)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Appointment scheduling of oncology outpatients

International audienceThis paper addresses the problem of appointment scheduling of patients of an oncology outpatient unit. Each patient is first seen by his oncologist, and then the drug is prepared and injected to the patient. Two major resources including oncologists for consultation and beds for injection are considered. Idle times of oncologists are not allowed. The problem consists in scheduling the appointment time of each patient and the starting time of the injection in order to minimize the total weighted cost incurred by patient waiting times and the makespan. A Lagrangian relaxation-based heuristic and a local optimization heuristic are proposed. Numerical results show that the Lagrangian relaxation-based heuristic always outperforms the local optimization heuristic

Facteurs prédictifs d'une restriction d'aptitude ou d'inaptitude au poste de travail antérieur en visite de reprise : élaboration d'un score

The objective is to study factors bound to the decision of capacity given by the occupational doctor during the visit of return to work of an employee after a sick leave for disease.L'objectif est d'étudier les facteurs liés à la décision d'aptitude du médecin du travail lors de la visite de reprise d'un salarié après un arrêt de travail pour maladie. Une enquête descriptive multicentrique transversale a été réalisée auprès de 402 salariés suivis par des services de santé au travail (SST) de l'agglomération stéphanoise. La reprise du travail au poste antérieur est significativement liée à certains facteurs professionnels et médicaux. Un score prédictif d'un avis d'aptitude autre que " apte " a été construit en renseignant quatre variables explicatives de l'avis d'aptitude identifiées dans l'analyse multivariée. Ce score pourrait être utilisé pour identifier en amont les situations difficiles de reprise du travail, de manière à mieux anticiper la mise en place des procédures de maintien dans l'emploi

Factors influencing return to work after illness in France

Few studies have been published about the factors influencing return to work after sickness absence.Aims To identify medical and occupational factors influencing the type of fitness certificate given by occupational physicians before employees return to work after sickness absence.Peu d'études ont été publiées des facteurs influençant la reprise du travail après l'absence de maladie.Des buts d'identifier des facteurs médicaux et professionnels influençant le type de certificat de santé(d'aptitudes) donné par des médecins professionnels avant la reprise du travail de salariés après l'absence de maladie

Facteurs prédictifs d'une restriction d'aptitude ou d'inaptitude au poste de travail antérieur en visite de reprise : élaboration d'un score

The objective is to study factors bound to the decision of capacity given by the occupational doctor during the visit of return to work of an employee after a sick leave for disease.L'objectif est d'étudier les facteurs liés à la décision d'aptitude du médecin du travail lors de la visite de reprise d'un salarié après un arrêt de travail pour maladie. Une enquête descriptive multicentrique transversale a été réalisée auprès de 402 salariés suivis par des services de santé au travail (SST) de l'agglomération stéphanoise. La reprise du travail au poste antérieur est significativement liée à certains facteurs professionnels et médicaux. Un score prédictif d'un avis d'aptitude autre que " apte " a été construit en renseignant quatre variables explicatives de l'avis d'aptitude identifiées dans l'analyse multivariée. Ce score pourrait être utilisé pour identifier en amont les situations difficiles de reprise du travail, de manière à mieux anticiper la mise en place des procédures de maintien dans l'emploi