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Induction Nivolumab Before Chemoradiation in High-Risk Human Papillomavirus–Driven Oropharynx Cancers: IMMUNEBOOST-HPV, a Multicenter Randomized Phase II Trial
No full textInternational audiencePURPOSE Patients with human papillomavirus (HPV)–positive oropharyngeal cancer (OPC) and advanced stage and/or significant smoking history are at higher risk of relapse. Induction immunotherapy before chemoradiation (CRT) may improve outcomes. This randomized phase II trial assessed the feasibility and safety of induction nivolumab before CRT in this high-risk population. METHODS Eligible patients had HPV-positive OPC with either T4 and/or N2/N3 disease or a smoking history >10 pack-years. Patients were randomly assigned 1:2 to receive either standard CRT (70 Gy with cisplatin, control arm [CA], n = 20) or two infusions of nivolumab followed by CRT (experimental arm [EA], n = 41). The primary end point was the rate of patients who received full treatment in due time (FTDT), defined as (1) two nivolumab infusions on days 1 and 13-17, (2) CRT started between days 27-37 after the first nivolumab infusion, (3) no radiotherapy break ≥7 days, (4) >95% of theoretical/prescribed RT dose, and (5) cisplatin dose received ≥200 mg/m 2. If two patients or less in the EA failed FTDT, the strategy would be considered feasible. Secondary end points included oncologic outcomes and toxicity. RESULTS Between July 2019 and September 2021, 62 patients were randomly assigned. Median follow-up was 37.5 months. The primary end point was not met: four of 41 patients in EA received <200 mg/m 2 cisplatin. Grade 4 to 5 acute adverse events occurred only in EA, in seven patients. The 2-year cumulative incidence (95% CI) of relapse was 7.3% (1.9 to 18.0) in EA versus 15.0% (3.6 to 34.0) in CA. CONCLUSION Induction nivolumab before CRT did not meet the predefined feasibility threshold because of reduced cisplatin dosing after toxicity in 10% of patients. The relapse incidence was numerically lower in the EA but this finding is exploratory and requires confirmation
Benefit and risk associated with interleukin-6 receptor inhibitor administration during severe COVID-19: a retrospective multicentric study
No full textInternational audienceDuring severe and critical COVID-19, therapeutic options remain scarce. Among interventions, the use of interleukin-6 receptor inhibitor (IL-6Ri) is especially controversial due to persistent uncertainty about their efficacy and safety. To compare the occurrence of secondary infections, digestive and hematological complication function of the administration of IL-6Ri we conducted a multicentric retrospective French observational study. All severe or critical COVID-19 requiring hospital admission were included. Among 2587 patients requiring hospital admission, 1603 had a severe COVID-19 and 984 a critical one requiring ICU admission. 224 received at least one dose of tocilizumab or sarilumab. Incidence of secondary infection was 29.5% in the IL-6Ri group vs. 19.5% without IL-6Ri (p = 0.0004) in the whole population. This result remained consistent after adjustment, without multiple imputation (MI) and after MI (adjusted OR: 1.47 [1.25; 1.72]; p < 0.0001)). Incidence of hematological or digestive complication were similar between groups. Mortality of patients admitted in ward was higher in the IL-6Ri group (18.7% vs 10.5%, p = 0.0155). No difference in 28 days, ICU, hospital of 90 days mortality was noticed among ICU patients.Clinical trial registration: This study was registred on ClinicalTrial.gov: NCT05017441
Adherence to the Mediterranean and Mediterranean‐Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay ( <scp>MIND</scp> ) Diets and Parkinson's Disease Incidence in Women: Results from the Prospective <scp>E3N</scp> Cohort
No full textInternational audienceObjective The evidence regarding adherence to dietary patterns and Parkinson's disease (PD) risk is inconsistent. Because of the long prodromal PD phase, reverse causation represents a major threat to investigations of diet in relation to PD. We examined whether adherence to the Mediterranean (MED) and Mediterranean‐Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diets is associated with PD incidence, while considering reverse causation, in a large cohort of women with a 25‐year follow‐up. Methods Participants from the E3N (Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l'Education Nationale) study were prospectively followed‐up from 1993 to 2018. PD diagnoses were validated using medical records and drug claim databases. Baseline MED and MIND scores were computed using a validated food questionnaire. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable Cox regression models. Exposures were lagged by 5 years in main analyses and longer lags in sensitivity analyses. We performed age‐stratified analyses and adjusted for prodromal symptoms. Results Analyses (5‐year–lag) are based on 71,542 women (845 PD patients). Higher adherence to MED and MIND diets was not associated with PD overall, but was associated with lower PD incidence in women <71 years old (MED, HR high vs. low+medium = 0.76 [0.58–1.00], p ‐Age × MED interaction = 0.038; MIND, HR high vs. low+medium = 0.75 [0.58–0.97], p ‐Age × MIND interaction = 0.035). Legumes and high unsaturated to saturated fat ratio had the strongest contribution for the MED diet, while beans and olive oil had the strongest contribution for the MIND diet. Results were consistent after adjustment for constipation/depression and in analyses with lags up to 20 years. Interpretation Adherence to the MED and MIND diets was associated with lower PD incidence <71 years in women. These findings are important for planning preventative interventions. ANN NEUROL 202
Systematic review of the measurement properties of patient-reported outcome measures (PROMs) of eHealth literacy in adult populations
No full textInternational audiencePROSPERO CRD42021232765
Mercury concentrations within Peruvian mangrove sediments
No full textInternational audienceAbstract The assessment of mercury (Hg) contamination in Peruvian mangrove sediments was conducted across two contrasting environments: the anthropogenically impacted mangrove forest of “Puerto Pizarro” (PP), affected by shrimp aquaculture, mining activities, and urban expansion, and the relatively pristine Mangrove Sanctuary of Tumbes (MS). In PP, Hg concentrations ranged from 291 to 177 ng g⁻ 1, yielding a Pollution Index (PI) of 1.6 and exceeding the sediment quality guideline defined by the Effect Range Low (ERL; 150 ng g⁻ 1 ), indicative of potential Hg toxicity. In contrast, Hg concentrations in MS ranged from 135 to 17 ng g⁻ 1, remaining below the ERL and within natural background levels reported for Peruvian marine sediments. Using the estimated mean background concentration in MS sediments (70 ng g⁻ 1 ), enrichment factors of up to 3.2 were observed in PP sediments. Mercury concentrations in MS exhibited significant positive correlations with fine-grained sediments (silt and clay; r = 0.66) and reactive iron phases (r = 0.70), reflecting natural geochemical controls on Hg accumulation. Conversely, no significant correlations were detected in PP, suggesting that anthropogenic inputs override sedimentological and geochemical processes. This study provides the first assessment of Hg concentrations in mangrove ecosystems located at the eastern South Pacific distributional limit and highlights the role of mangroves as effective biogeochemical barriers that mitigate Hg transfer to adjacent coastal ecosystems
Brick Kilns Across India: A Temporal Analysis of Brick Kiln Distribution and Technology Types
No full textInternational audienceOverview The MuTBriK dataset contains multispectral Sentinel-2 image patches prepared for multi-class semantic segmentation of brick kiln types. Each image consists of 8 channels: six original Sentinel-2 spectral bands and two derived indices (NDVI and NDBI). All bands are normalized. Each image has a corresponding pixel-wise annotation mask. The dataset has been used to generate a national-scale map of brick kiln distribution and technology types across India. Dataset Contents Input images: 8-band multispectral GeoTIFF patches Label images: Pixel-wise segmentation masks One-to-one correspondence between each image and its label Image sizes: Training images: 263 × 263 pixels Validation/Test images: 256 × 256 pixels Spectral Bands Each image contains the following channels: Band Description Resolution -------- -------------------------------- -------------------------- B2 Blue 10 m B3 Green 10 m B4 Red 10 m B8 Near Infrared (NIR) 10 m B11 Shortwave Infrared 1 (SWIR1) 20 m → resampled to 10 m B12 Shortwave Infrared 2 (SWIR2) 20 m → resampled to 10 m Band 7 NDVI = (B8 − B4) / (B8 + B4) Derived Band 8 NDBI = (B11 − B8) / (B11 + B8) Derived Normalization All bands are normalized. Sentinel-2 reflectance values were scaled by dividing by 10,000. Classes and Labels Each label mask contains six classes: Class ID Class name ---------- ------------ 0 Background 1 FCBTK 2 Zigzag 3 CBTK 4 RBTK 5 DDK Labels are encoded as integer pixel values in the mask files. Preprocessing Steps - Sentinel-2 band selection (B2, B3, B4, B8, B11, B12) - Resampling of 20 m bands (B11, B12) to 10 m - Normalization (÷ 10,000) - Computation of NDVI and NDBI - Band stacking into 8-channel images - Patch extraction from larger Sentinel-2 tiles File Format Images: GeoTIFF (.tif) Labels: GeoTIFF (.tif) Fully compatible with open-source tools. Software Compatibility The dataset can be used with open-source software such as QGIS, Python (rasterio, NumPy, PyTorch, etc.) Geographic Coverage India Inference Results The full maps of India, showing all detected brick kilns and their corresponding technology classification, are available in the Maps_GeoJSON.zip file (2019-2025). Related Code Repository https://github.com/ssugandh01/MuTBri
Systematic review of direct access physiotherapy for musculoskeletal conditions in primary care: consequences for general practitioner workload, resource use, and organisation of care
No full textInternational audienceOSF (ID 897ub; registered 15 August 2024; https://osf.io/897ub/)