Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma

Introduction The conservative management of upper tract urothelial carcinoma (UTUC) has historically been offered to patients with imperative indications. The recent International Consultation on Urologic Diseases (ICUD) publication on UTUC stratified treatment allocations based on high- and low-risk groups. This report updates the conservative management of the low-risk group. Methods The ICUD for low-risk UTUC working group performed a thorough review of the literature with an assessment of the level of evidence and grade of recommendation for a variety of published studies in this disease space. We update these publications and provide a summary of that original report. Results There are no prospective randomized controlled studies to support surgical management guidelines. A risk-stratified approach based on clinical, endoscopic, and biopsy assessment allows selection of patients who could benefit from kidney-preserving procedures with oncological outcomes potentially similar to radical nephroureterectomy with bladder cuff excision, with the added benefit of renal function preservation. These treatments are aided by the development of high-definition flexible digital URS, multi-biopsies with the aid of access sheaths and other tools, and promising developments in the use of adjuvant topical therapy. Conclusions Recent developments in imaging, minimally invasive techniques, multimodality approaches, and adjuvant topical regimens and bladder cancer prevention raise the hope for improved risk stratification and may greatly improve the endoscopic treatment for low-risk UTUC

SLICEE: A Service oriented middleware for intensive scientific computation

International audienceWith the growth of computational power and storage demand from bioinformatics applications, cluster computing has emerged as a good answer. Bioinformatics applications are often structured as workflows that are composed of a set of operations to perform on large data sets. These workflows are deployed as complex script that handles the sequence of program calls with their relevant inputs and try to take advantage of a computer cluster using a scheduler. Their performance rely on the user ability to analyze the potential parallelism in the workflow. SLICEE (Service Layer for Intensive Computation Execution Environment) proposes to abstract the calls to the cluster scheduler by handling command submission and data management. A workflow client is used to orchestrate the SLICEE services, that takes care of exploiting the data parallelism, and data routing between tasks to take advantage of the cluster architecture. A storage management layer takes care of optimizing data transfer with a reference passing mechanism. More-over SLICEE handles multi site command submission and data storage in a way that makes it transparent to the end-user. This tool enables an easy to maintain and to share implementation of bioinformatics workflows using intensive computation resources

Acute effect of tendon vibration applied during isometric contraction at two knee angles on maximal knee extension force production.

The aim of the current study was to investigate the effect of a single session of prolonged tendon vibration combined with low submaximal isometric contraction on maximal motor performance. Thirty-two young sedentary adults were assigned into two groups that differed based on the knee angle tested: 90° or 150° (180° = full knee extension). Participants performed two fatigue-inducing exercise protocols: one with three 10 min submaximal (10% of maximal voluntary contraction) knee extensor contractions and patellar tendon vibration (80 Hz) another with submaximal knee extensor contractions only. Before and after each fatigue protocol, maximal voluntary isometric contractions (MVC), voluntary activation level (assessed by the twitch interpolation technique), peak-to-peak amplitude of maximum compound action potentials of vastus medialis and vastus lateralis (assessed by electromyography with the use of electrical nerve stimulation), peak twitch amplitude and peak doublet force were measured. The knee extensor fatigue was significantly (P<0.05) greater in the 90° knee angle group (-20.6% MVC force, P<0.05) than the 150° knee angle group (-8.3% MVC force, P = 0.062). Both peripheral and central alterations could explain the reduction in MVC force at 90° knee angle. However, tendon vibration added to isometric contraction did not exacerbate the reduction in MVC force. These results clearly demonstrate that acute infrapatellar tendon vibration using a commercial apparatus operating at optimal conditions (i.e. contracted and stretched muscle) does not appear to induce knee extensor neuromuscular fatigue in young sedentary subjects

Measurement of the effective gamma/gamma' lattice mismatch during high temperature creep of Ni-based single crystal superalloy

International audienceThe high temperature effective (constrained) gamma/gamma' lattice mismatch of a Ni-based single crystal superalloy has been measured in a wide temperature range [930 degrees C-1125 degrees C] using three different techniques: in-situ X-ray diffraction under synchrotron radiation, and post-mortem gamma/gamma' interfacial dislocation network mesh size measurements using Transmission Electron Microscopy (TEM) or high resolution Scanning Electron Microscopy (SEM). It is shown that all three techniques are complementary considering precision and spatial distribution of lattice mismatches in the analyzed volume and that they provide a very similar average value of the gamma/gamma' lattice mismatch. Since isothermal creep experiments were performed under variable applied stress, it is deduced that the post-mortem lattice misfit measurements using both TEM and SEM are representative of the very last loading step of the experiments, even if dislocation networks are out of an equilibrium configuration. Contrary to the unconstrained gamma/gamma' lattice mismatch, it is shown that the effective lattice mismatch is a function of the temperature, applied stress and accumulated plastic strain, i.e. of the thermomechanical histories of the samples

Not all species will migrate poleward as the climate warms: The case of the seven baobab species in Madagascar

International audienceIt is commonly accepted that species should move toward higher elevations and latitudes to track shifting isotherms as climate warms. However, temperature might not be the only limiting factor determining species distribution. Species might move to opposite directions to track changes in other climatic variables. Here, we used an extensive occurrence data set and an ensemble modelling approach to model the climatic niche and to predict the distribution of the seven baobab species (genus Adansonia) present in Madagascar. Using climatic projections from three global circulation models, we predicted species’ future distribution and extinction risk for 2055 and 2085 under two representative concentration pathways (RCPs) and two dispersal scenarios. We disentangled the role of each climatic variable in explaining species range shift looking at relative variable importance and future climatic anomalies. Four baobab species (Adansonia rubrostipa, Adansonia madagascariensis, Adansonia perrieri¸ and Adansonia suarezensis) could experience a severe range contraction in the future (>70% for year 2085 under RCP 8.5, assuming a zero-dispersal hypothesis). For three out of the four threatened species, range contraction was mainly explained by an increase in temperature seasonality, especially in the North of Madagascar, where they are currently distributed. In tropical regions, where species are commonly adapted to low seasonality, we found that temperature seasonality will generally increase. It is, thus, very likely that many species in the tropics will be forced to move equatorward to avoid an increase in temperature seasonality. Yet, several ecological (e.g., equatorial limit, or unsuitable deforested habitat) or geographical barriers (absence of lands) could prevent species to move equatorward, thus increasing the extinction risk of many tropical species, like endemic baobab species in Madagascar

Development of new biocompatible 3D printed graphene oxide-based scaffolds

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Nocturia in Patients With Multiple Sclerosis.

International audienceThe prevalence of nocturia in patients with multiple sclerosis (MS) is high, ranging from 20.9% to 48.8% in this population. Its underlying pathophysiology is complex and different from the non-neurogenic population. In the MS population, the pathophysiology may involve neurogenic lower urinary tract dysfunction (NLUTD) such as detrusor overactivity (NDO), detrusor-sphincter dyssynergia, or detrusor underactivity resulting in reduced bladder capacity. Nocturnal polyuria is also a significant contributor to the pathogenesis of nocturia in MS patients and may be the result of specific mechanisms such as nocturnal hypertension through autonomic cardiovascular dysfunction or lack of diurnal variation of antidiuretic hormone production (ADH) due to demyelinating lesions of the spinal cord. Nocturia might be particularly burdensome in MS patients by contributing to fatigue, a common and highly debilitating symptom in this population. There is likely a complex and multidirectional relationship between nocturia, other sleep disorders, and fatigue in the MS population that has yet to be explored. The assessment of nocturia in MS should rely upon a thorough history and physical examination. Urinalysis should be done to rule out urinary tract infection, a frequency-volume chart might help elucidating the underlying mechanisms, and post-void residual volume may be of interest to screen for urinary retention that could be asymptomatic in MS patients. Other tests such as urodynamics or polysomnography are indicated in selected patients. The treatment should be tailored to the underlying cause. The first steps involve behavioral interventions and treatment of cofactors. When possible, the predominant mechanism should be addressed first. In case of predominant NDO, antimuscarinics and beta-3 agonists should be offered as a first-line treatment and intradetrusor injections of botulinum toxin as a second-line treatment. In cases of incomplete bladder emptying, clean-intermittent self-catheterization is often used as part of multiple other interventions. In cases of nocturnal polyuria, desmopressin may be offered, inclusive of use of newer formulations (desmopressin acetate nasal spray, desmopressin orally disintegrated tablet) in countries where they are approved