Analyse des facteurs cliniques et structurels associés à l'acuité visuelle post-opératoire des trous maculaires ayant subi une vitrectomie

Le trou maculaire (TM) est un défaut dans la rétine au niveau de la zone centrale de la macula (fovéa). Typiquement, les patients atteints de cette pathologie auront une diminution de leur acuité visuelle (AV) et de la métamorphopsie. Le traitement pour ces patients consistera en une vitrectomie par la pars plana (VPP) dans laquelle le vitré est retiré et remplacé par une tamponnade (SF6, C3F8, air ou huile de silicone). Après cette chirurgie, le succès chirurgical, soit de fermeture anatomique du TM, est très élevé. Toutefois, plus récemment, on s'aperçoit que malgré un taux de fermeture anatomique élevé, les résultats visuels après l'intervention chirurgicale ne sont pas aussi importants, d'où la nécessité d'identifier les facteurs pronostiques liés à la VPP dans les TM qui ont fermé chirurgicalement et de tenter de prédire les résultats visuels suivant la VPP. En ce qui concerne les TM qui n'ont pas fermé lors d'une première VPP, il est intéressant d'évaluer les résultats fonctionnels et anatomiques à la suite d'une VPP de reprise. Nos travaux ont démontré que les yeux avec une durée du TM plus courte, une taille du TM plus petite et une AV préopératoire plus élevée ont obtenu de meilleurs résultats visuels après une première chirurgie réussie. Nous avons par la suite produit un modèle hybride basé sur des données cliniques et des tomographies par cohérence optique haute définition (HD-OCT) préopératoires de TM, et ce, à l'aide de l'intelligence artificielle, afin de tenter de mieux prédire les résultats visuels. Les modèles basés sur les données cliniques ou les HD-OCT ont obtenu de bonnes performances discriminantes individuellement. Toutefois, la combinaison des deux modèles dans un modèle hybride n'a pas significativement amélioré les performances. Enfin, les TM qui subissaient une VPP de révision (non-fermeture chirurgicale à la première VPP) montraient une fermeture anatomique dans 85% des cas et avaient une amélioration de l'AV au fil du temps.Idiopathic full thickness macular hole (MH) is a defect of all layers of the fovea. Typically, patients with this condition will experiment decreased visual acuity (VA) and metamorphopsia. Treatment for these patients will consist in a pars plana vitrectomy in which the vitreous is removed and replaced by a tamponade (SF6, C3F8, air or silicone oil). After this surgery, the surgical success, or anatomical closure of the MH, is very high. However, more recently, it has been noticed that despite a high anatomical closure rate, the visual results after the surgery are not quite as important, hence the need to identify the prognostic factors related to vitrectomy in patients with closed MH and to predict visual results following vitrectomy. For MH that did not close during the primary vitrectomy, it is interesting to assess the functional and anatomical results following a revision vitrectomy. Our works provided that eyes with shorter MH duration, smaller MH size and higher preoperative VA achieved better visual outcomes after successful MH surgery. We then produced a hybrid model based on clinical data and preoperative MH high-definition optical coherence tomography (HD-OCT), using artificial intelligence to try to better predict visual results. Both the clinical data and HD-OCT models had good discriminative performances. Combining both into a hybrid model did not significantly improve performance. Finally, MH that underwent revision vitrectomy (nonsurgical closure at primary vitrectomy) showed anatomical closure in 85% of cases and had VA improvement over the time

Automatic Text Simplification of News Articles in the Context of Public Broadcasting

This report summarizes the work carried out by the authors during the Twelfth Montreal Industrial Problem Solving Workshop, held at Universit\'e de Montr\'eal in August 2022. The team tackled a problem submitted by CBC/Radio-Canada on the theme of Automatic Text Simplification (ATS)

Revision Surgery for Idiopathic Macular Hole after Failed Primary Vitrectomy

Purpose. To investigate the anatomical and functional outcomes of revision surgery after failed primary surgery for idiopathic macular hole (MH). Methods. All consecutive patients with MH were identified from a cohort of patients operated between 2014 and 2018 at the CHU de Québec-Université Laval (Québec). The clinical and anatomical features of patients with unclosed MH after primary surgery were retrospectively collected. Our primary outcome was MH nonclosure rate after revision surgery. Our secondary outcomes were best-corrected visual acuity (BCVA) with ETDRS scale and MH size of eyes with revision surgery preoperatively and at 3 and 12 months after revision surgery. Results. In our cohort of 1085 eyes, 926 eyes met inclusion criteria and were analyzed in the study. We identified 22 eyes with failed primary surgery (2.4%), of which 20 underwent revision surgery. We had no bilateral MH in these 22 eyes. The nonclosure rate of MH after revision surgery was 15%. The mean final BCVA for closed MH after revision surgery was 55 ± 19 letters. Compared to the initial presentation, the mean change in visual acuity (VA) for closed MH was +4 ± 31 letters and +16 ± 17 letters at 3 and 12 months after the revision surgery, respectively. At initial presentation, patients with failed primary surgery had a baseline MH size of 665 ± 226 μm. The mean MH size after failed primary surgery was 607 ± 162 μm and 546 ± 156 μm for the three unclosed MHs one month after revision surgery. Conclusion. The success rate of revision surgery in eyes with unclosed MH is 85%. After successful revision surgery, eyes demonstrated an improvement in VA and closure of the MH

Pathological investigation of placentas in preeclampsia (the PEARL study)

INTRODUCTION: Preeclampsia (PE), but mainly preterm PE, is associated with deep placentation disorders. We aimed to compare placental pathologies in pregnancies affected by term and preterm PE compared to normal pregnancies. METHODS: We performed a prospective case-cohort study. Low-risk nulliparous women were recruited in the first trimester and women who developed PE were recruited at diagnosis. Placental pathologies were reported according to the Amsterdam Placental Workshop Group Consensus Statement and were compared between cases and controls. PE cases stratified as term (≥37 weeks) and preterm PE (<37 weeks). Our primary outcome was maternal vascular malperfusion (MVM). RESULTS: Twenty-four women who developed preterm PE were compared to 10 women who developed term PE and 41 women without PE. Preterm PE (92%) was associated with more MVM than term PE (10%, p < 0.01) and controls (4%, p < 0.01), but the rate of MVM was similar between term PE and controls (p = 0.56). Preterm PE was also associated with more placental infarcts (65% vs. 20% vs. 15%); advanced villous maturation (91% vs. 30% vs. 1%); and hypoplastic villous maturation (70% vs. 10% vs. 3%); and moderate to severe decidual vasculopathy (56% vs. 10% vs. 3%) than term PE and controls (all p < 0.05). CONCLUSION: Most cases of preterm PE are associated with MVM, placental infarcts, advanced and/or hypoplastic villous maturation, and moderate to severe decidual vasculopathy, while it is infrequent in term PE and pregnancies without PE. Preterm and term preeclampsia have a different pathologic process that should be considered for their prevention and clinical management

Preparation of phenylethylbenzamide derivatives as modulators of DNMT3 activity

International audienceDNA-methyltransferases (DNMTs) are a class of epigenetic enzymes that catalyze the transfer of a methyl moiety from the methyl donor S-adenosyl-L-methionine onto the C5 position of cytosine in DNA. This process is dysregulated in cancers and leads to the hypermethylation and silencing of tumor suppressor genes. The development of potent and selective inhibitors of DNMTs is of utmost importance for the discovery of new therapies for the treatment of cancer. We report herein the synthesis and DNMT inhibitory activity of 29 analogues derived from NSC 319745. The effect of selected compounds on the methylation level in the MDA-MB-231 human breast cancer cell line was evaluated using a luminometric methylation assay. Molecular docking studies have been conducted to propose a binding mode for this serie

Frontières de la fiction

L'étude renouvelée de genres frontières tels que la biographie, l'autobiographie, l'essai, le journal intime et le récit de voyage, a fait émerger ces dernières années dans le débat critique une question que la poétique n'avait jamais explicitée en tant que telle : celle des frontières externes de l'espace littéraire et, corrélativement, celle des frontières de la fiction. Les théoriciens contemporains ont cherché à définir des critères de littérarité et de fictionalité permettant de se prononcer sur la référence problématique du texte narratif, de distinguer les usages de la fiction de ses conséquences sur le statut des textes, voire de faire le partage entre littérature et philosophie, entre littérature et pratiques intimes ou sociales du langage. Quel crédit accorder à ces hypothèses en regard des renouvellements subis par la théorie littéraire, réinventée à la lumière des récentes propositions pragmatiques ou philosophiques sur la fiction, des relectures de l'histoire de la littérature et des avancées nouvelles de la réflexion sur le genre ? En quels termes articuler littérarité et fictionalité ? Que nous apprennent et quelles interrogations soulève l'histoire de la poétique et de la notion de fiction elle-même