Salivary gland-sparing other than parotid-sparing in definitive head-and-neck intensity-modulated radiotherapy does not seem to jeopardize local control.

International audienceBACKGROUND: The objective was to analyze locoregional (LR) failure patterns in patients with head-and-neck cancer (HNC) treated using intensity-modulated radiotherapy (IMRT) with whole salivary gland-sparing: parotid (PG), submandibular (SMG), and accessory salivary glands represented by the oral cavity (OC). METHODS: Seventy consecutive patients with Stage I-II (23%) or III/IV (77%) HNC treated by definitive IMRT were included. For all LR failure patients, the FDG-PET and CT scans documenting recurrence were rigidly registered to the initial treatment planning CT. Failure volumes (Vf) were delineated based on clinical, radiological, and histological data. The percentage of Vf covered by 95% of the prescription isodose (Vf-V95) was analyzed. Failures were classified as "in-field" if Vf--V95 >= 95%, "marginal" if 20% < Vf-V95 < 95%, and "out-of-field" if Vf-V95 <=20%. Correlation between Vf-V95 and mean doses (Dmean) in the PG, SMG, and OC was assessed using Spearman's rank-order correlation test. The salivary gland dose impact on the LR recurrence risk was assessed by Cox analysis. RESULTS: The median follow-up was 20 months (6--35). Contralateral and ipsilateral PGs were spared in 98% and 54% of patients, respectively, and contralateral and ipsilateral SMG in 26% and 7%, respectively. The OC was spared to a dose <=40 Gy in 26 patients (37%). The 2-year LR control rate was 76.5%. One recurrence was "marginal", and 12 were "in-field". No recurrence was observed in vicinity of spared structures. Vf-V95 was not significantly correlated with Dmean in PG, SMG, and OC. The LR recurrence risk was not increased by lower Dmean in the salivary glands, but by T (p = 0.04) and N stages (p = 0.03). CONCLUSION: Over 92% of LR failures occurred "in-field" within the high dose region when using IMRT with a whole salivary gland-sparing strategy. Sparing SMG and OC in addition to PG thus appears a safe strategy

Dispersal of Seeds by Red Deer (Cervuselaphus) During the Hunting Season – Setting Up an Experimentat the National Estate of Chambord

Les populations d’herbivores sauvages sont en nette augmentation depuis plusieurs décennies dans l’hémis- phère Nord en raison du changement des pratiques agricoles et des plans de gestion environnementaux. Cet essor est à l’origine de surpâturage, de perturbations physiques du sol par piétinement et labour du sol et de dégâts aux écorces et aux bourgeons d’essences objectif. Ces animaux contribuent aussi au fonctionne- ment des écosystèmes forestiers par la dispersion des plantes ou la redistribution des nutriments à l’échelle de leurs domaines vitaux. L’épizoochorie, transport externe de graines qui s’accrochent dans les phanères (par exemple pelage, plumage) des animaux, est un des principaux modes de dispersion des graines. Dans cette étude, nous nous sommes intéressés au transport des diaspores pourvues de crochets de Xanthium struma- rium L. par le cerf élaphe (Cervus elaphus) dans un domaine soumis à la chasse. L’expérimentation s’appuie sur l’analyse des données de localisation de biches capturées, équipées de colliers GPS et relâchées au sein du Domaine national de Chambord.Populations of wild herbivores have significantly increased in the last decades in the Northern hemisphere due to changes in farming practises and environmental management plans. This expansion has caused over- grazing, disruption of the physical properties of soil arising from animals stamping and standing and damage to bark and buds of target species. These animals also contribute to the functioning of forest ecosystems by dispersing plants and redistributing nutrients throughout their range. Epizoochory, the external transportation of seeds attached to skin appendages of animals (e.g., fur, feathers) is one of the main vehicles for seed dispersal. In this study, we examined the transportation of Xanthium strumarium L. diaspores with hook appendages by red deer (Cervus elaphus) on a hunting estate. The experimentation relies on the analysis of location data for hinds that have been captured and equipped with GPS collars and then released again in the National Estate of Chambord

Risk factors associated with early and late free flap complications in head and neck osseous reconstruction

International audiencePURPOSE: This study was designed to identify risk factors for post-operative complications in micro-anastomosed osteomyocutaneous free flaps (MOFF) and analyzed their consequences in long term. METHODS: A retrospective review of 100 MOFF realized between May 2007 and October 2019 was performed. Demographic data, perioperative management and postoperative complications were enrolled and analyzed in a multivariate model. Patients were followed for ≥ 6 months. RESULTS: Major surgical complication rate was 20% with 5% of overall free flap failure rate and 6% of anastomosis salvage surgery. Risk identified for major surgical complication was alcohol consumption (p = 0.0054). Minor surgical complications occurred in 26% of patients mostly due to infections (19%). No significant risk factor was associated to minor surgical complications. Major and minor medical complication rates were, respectively, 10% and 10%. Risk identified for major medical complication were age over 70 (p = 0.0253) and history of chemotherapy (p = 0.0277). Risk identified for minor medical complication were alcohol consumption p = 0.0232) and a history of radiotherapy (p = 0.0329). CONCLUSIONS: Alcoholism is an independent risk factor for the surgical complication of MOFF that must be taken into account before surgery. Patients with a history of chemotherapy, radiotherapy or who are over 70 years of age are at greater risk of postoperative medical complications and require special attention

Data from: Epizoochorous dispersal by ungulates depends on fur, grooming and social interactions

The transport phase of the animal-mediated plant dispersal process is critical to dispersal effectiveness as it determines the spatial distribution of the diaspores released and their chance for further recruitment. Assessing this specific phase of the dispersal process generally requires combining diaspore retention times with the associated distances covered. Here, we specifically tested the effect of grooming behavior, interindividual contacts and ungulate fur on diaspore retention times and associated dispersal distances for the hooked diaspores of Xanthium strumarium L. experimentally attached to tamed individuals of three ungulate species. We used a comparative approach based on differing fur quality on different body zones of these three ungulates. During 6-hr sessions, we monitored for grooming and social interactions that may induce intended or inadvertent diaspore detachment. Additionally, we proposed innovative approaches to directly assessing diaspore dispersal distances by red deer in situ. Fat-tailed functions fitted diaspore retention time, highlighting the potential for long-distance dispersal events. The longer the hair, the higher the retention capacity of diaspores in the animal's fur. As predicted, donkey retained diaspores longer than red deer and dwarf goat; and we also confirmed that diaspores attached to the short hair of the head fell off more quickly than did those on the other body zones. Dwarf goat groomed more often than both red deer and donkey, but also when it carried diaspores. Up to 14% of the diaspores detached from animal fur after specific grooming behavior. We observed, in controlled conditions, for the first time and for each ungulate species, interindividual transfers of diaspores, representing 5% of the diaspores attached to animals’ fur. Our results militate for incorporating animal behavior into plant dispersal modeling approaches

One-step nucleic acid amplification for detecting lymph node metastasis of head and neck squamous cell carcinoma

International audienceBackground - In head and neck squamous cell carcinoma (HNSCC) 30% of cN0 patients have occult metastasis. LN invasion is a major prognostic factor. Sentinel lymph node (SLN) is an option for cN0 neck management. One-step nucleic acid amplification (OSNA) used to analyze SLN in breast cancer is also a candidate to get more reliable intraoperative HNSCC lymph node (LN) staging. Objective - To compare OSNA analysis to pathological analysis in cN0 HNSCC. Materials and methods - 157 LN from 26 cN0 HNSCC patients were prospectively analyzed (6.3LN/patient). Exclusion criteria were previous surgery or radiotherapy. Each node was cut into 4 equal pieces alternatively sent to pathological analysis and OSNA technique. IHC CK19 was performed on the primary tumor biopsy and RT-qPCR of CK19, PVA and EPCAM on the LN lysate of discordant cases. Results - OSNA was able to provide intraoperative result in all patients. OSNA detected 21 metastases. There were 139 concordant LN (88.5%). There were 18 initial discordant LN (11.5%), 13 (8.3%) were OSNA positive/pathological analysis negative, 5 (3.2%) were OSNA negative/pathological analysis positive. After elimination of allocation bias, false negative rate was 1.3%, sensitivity and specificity were 90% and 95.6%, PPV and NPV were 75% and 98.5%. Conclusion - Our results suggest that OSNA should be considered to improve SNB analysis both for increasing micro metastasis diagnosis and offer extemporaneous results. Study registered under clinicaltrials.gov database number NCT02852343

Dataset

This dataset comprises 3 sheets : 1) counts and causes of diaspore detachment per animal species 2) paired grooming monitoring data and 3) diaspore retention time and dispersal distance for the 756 monitored diaspores

Fiberoptic endoscopic validation of a clinical screening test of swallowing function in critically ill patients performed within 24 h after extubation

International audienceBACKGROUND: A bedside screening tool of swallowing dysfunction (SD) (BSSD) after extubation would be useful to identify patients who are at risk of SD. We aimed to evaluate the accuracy of our BSSD in comparison with fiberoptic endoscopic evaluation of swallowing (FEES) in critically ill patients after extubation. METHODS: We conducted a 1-year prospective monocentric study to evaluate the accuracy of our BSSD to diagnose SD following endotracheal intubation in comparison with FEES (gold standard). Patients intubated for longer than 48 h were included. Both tests were assessed within 24 h after extubation. Primary endpoint was the accuracy of the BSSD. Secondary endpoint was to assess risk factors of SD. RESULTS: Seventy-nine patients were included in the study. Thirty-three patients (42%) presented with a SD. The BSSD showed a sensitivity of 88% (95% CI 0.72-0.97) and a specificity of 91% (95% CI 0.79-0.98), a positive predictive value of 88% (95% CI 0.72-0.97) and a negative predictive value of 91% (95% CI 0.79-0.97). The AUC reached 0.83 (95% CI 0.74-0.92). CONCLUSION: Our study describes an accurate clinical screening tool to detect SD after extubation in critically ill patients. Screening-positive cases should be confirmed by instrumental tests, ideally using FEES