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Bioinspired bi- or trinuclear FeMoS model complexes for the partial region of FeMo cofactor of nitrogenase
No full textInternational audienceSulfur-rich {FeMo} complexes of low nuclearity ({Fe2Mo}, {FeMo}) can be considered as simple truncated models of the cofactor of Mo‑nitrogenase. They are suitable to address questions concerning the role of the still unclear FeMo cooperativity in the biological N2-reduction process performed by this metallo-enzyme. This review affords a state of the art of the chemistry of di- and tri-heterometallic {FeMoS} complexes. Although well-defined synthetic procedures have been evidenced for the design of such compounds, very few investigations on their activity towards N2 and related substrates have been reported. This shows the interest to develop new light bio-inspired {FeMoS} molecules and to study their reactivity, as well as their redox behaviours, to help to better understand the biological N2-fixation. This approach involving di- and tri- heterometallic {FeMoS} species is a promising field of investigation
Clinical Phenotypes of Critically Ill Patients with COVID-19 Infected with Omicron: A Nationwide Prospective Cohort Study
No full textInternational audienceINTRODUCTION: The clinical presentation of critically ill patients with coronavirus disease 2019 (COVID-19) has evolved significantly with the emergence of the Omicron variant. Current intensive care unit (ICU) admissions involve patients with diverse comorbidities and immune statuses, highlighting the need to redefine homogeneous phenotypic subgroups within this population. This study aimed to characterize distinct clinical phenotypes among critically ill patients with COVID-19 and acute respiratory failure. METHODS: This multicenter prospective substudy of the SEVARVIR cohort included adult patients from 39 French ICUs between December 2021 and October 2024 with acute respiratory failure and infected with the Omicron variant. Clustering analysis was conducted using Kohonen’s self-organizing maps (SOMs) and validated with ClinTrajan, two unsupervised clustering methods, to identify homogeneous patient phenotypes. RESULTS: During the study period, 777 patients with Omicron infection were included, and 7 distinct clinical clusters were identified. Clusters 1 and 2 included patients with metabolic and cardiovascular comorbidities. Cluster 3 featured younger, mildly ill patients with isolated chronic respiratory failure, while cluster 4 comprised older male patients with isolated respiratory failure. Cluster 5 included patients with isolated hematologic malignancies, cluster 6 patients with multiorgan failure, and cluster 7 organ transplant recipients, with high severity scores and impaired renal function. ICU management varied substantially across clusters. Patients in clusters 5 and 7 had the highest requirements for organ support, with frequent use of invasive mechanical ventilation, vasopressors (cluster 6), and renal replacement therapy (cluster 7). Dexamethasone and tocilizumab were most commonly prescribed in cluster 4 (91.3% and 30.2%, respectively). Mortality at day 28 varied significantly across clusters, ranging from 13.1% in cluster 3 to 41.1% in cluster 6. CONCLUSIONS: This clustering analysis highlights, for the first time, the clinical heterogeneity of critically ill patients infected with Omicron, identifying seven distinct clusters with varying clinical presentations, management strategies and outcomes. These findings underscore the relevance of a phenotype-driven approach to support personalized treatment strategies and guide future clinical trials. TRIAL REGISTRATION: Clinicaltrials.gov, NCT05162508. A Graphical Abstract is available for this article
Robotic nipple-sparing mastectomy with immediate prosthetic reconstruction: A prospective study about 138 consecutive procedures
No full textInternational audienceBackground and purpose. -Robotic nipple-sparing mastectomy (RNSM) is becoming popular for the treatment of breast cancers because of the absence of scars on the breasts. The aim of this study is to assess the feasibility and the safety of RNSM with immediate prosthetic breast reconstruction (IPBR). Methods. -In this single-arm, monocentric and prospective study, RNSM with IPBR was offered, in case of prophylactic or therapeutic surgery of breast cancers, to patients with breast cup C and moderate ptosis. The primary goal was the rate of full thickness skin or areola necrosis. As a second objective we meant to assess the rate of conversion to open technique and postoperative complications. We also analysed pre-and postoperative BREAST-Q scores and aesthetic out-</div
Ultramafic float rocks at Jezero crater (Mars): excavation of lower crustal rocks or mantle peridotites by impact cratering?
No full textInternational audienceBased on observation and data from meteorites and in situ scientific missions, experiments as well as models, the Martian mantle is assumed to share some compositional and mineralogical affinity with the terrestrial mantle. However, there might be subtle differences like the Martian mantle being more ferroan. Yet, we do not have any direct analysis of a Martian mantle rock to confirm this assumption. NASA’s Perseverance rover found olivine-rich boulder-sized float rocks on the upper Jezero fan (Mars). These boulders have an ultramafic composition and their mineralogy is dominantly composed of Fo73±3 olivine with high-Mg orthopyroxene, Cr-rich Ti-Fe oxides and minor plagioclase and high-Ca pyroxene. Microtextural and petrological analysis reveals that these minerals crystallized at equilibrium. In addition, these boulders are different from all the bedrocks analyzed by Perseverance along its traverse which are crustal igneous rocks and sediments. Comparing our data to Martian meteorites and available Mars bulk silicate models (BSM), we discuss that these boulders could represent primitive melts and/or lower crustal material, and we specifically hypothesize that they could be mantle peridotites. We propose that these putative mantle rocks could have been excavated by the succession of impacts from the shallow mantle or lower crust in the Isidis region where Jezero crater is located. These olivine-rich boulders could thereby constitute the first direct analysis of a Martian mantle rock
Real-world 5-year outcomes with durvalumab after chemoradiotherapy in unresectable stage III NSCLC
No full textInternational audiencePACIFIC-R provides mature data on OS and rwPFS from a large, real-world cohort, supporting consolidation durvalumab as a standard of care in this setting
Real-life impact of clinical metagenomics in the intensive care unit: a multicenter retrospective study in greater paris area hospitals
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High rates of return-to-sport and work in military personnel after arthroscopic posterior capsuloplasty of the wrist
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Carbon-11 Isotopic Radiolabeling of CP31398 and Development of a Fluorine-18 Derivative to Target Protein p53 with PET Imaging
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Relevance of Clinical High-Risk of Psychotic Transition Conceptto Avoid Misdiagnosis Risk in an Unaccompanied Minor Refugeewith Complex Trauma: A Case Report
No full textInternational audienceIntroduction: Unaccompanied refugee minors face a heightened risk of mental health disorders due to cumulative traumatic exposures and sociocultural displacement. Psychotic-like symptoms are common and frequently misdiagnosed as primary psychotic disorders, often overlooking trauma-related or culturally-influenced presentations. Case Presentation: We report the case of “Moussa”, a 15-year-old URM from Cameroon, who presented with transient psychotic symptoms during an acute stress episode. Following the CAARMS assessment, he was initially diagnosed with a Clinical High-Risk for psychosis state (CHRp), then later labeled as schizophreniform by another provider. However, his rapid remission and trauma history led to a revised diagnosis of complex PTSD. Conclusion: This case underscores the risks of early psychiatric labeling in traumatized migrant youth. Greater use of CHRp frameworks—if combined with cultural and ethical caution—may help delay premature diagnoses and favor tailored care. However, the CHRp construct itself remains debated, and its application should not obscure broader systemic biases. Main limitations include the single-case design and the absence of standardized trauma assessments. Therefore, longitudinal research is needed
ALTOPANC: Local ablative therapies in oligometastatic pancreatic adenocarcinoma—A bi-national French-Belgian retrospective study.
No full textInternational audience728 Background: Oligometastatic disease (OMD) in pancreatic ductal adenocarcinoma (PDAC) is an emerging clinical entity. The limited extension of the disease prompt to explore the role of metastases-directed therapies (MDT); however, their actual survival and clinical benefits remain uncertain. Additional studies with larger effectives are needed to clarify the role of MDT in clinical practice. Methods: We conducted a retrospective multicenter, observational French-Belgian study to evaluate the impact of MDT on event-free survival (EFS) and overall survival (OS) in patients with OMD-PDAC. OMD was defined as metastases (mets) involving no more than 2 organ and ≤5 mets (Leonhardt CS. ESMO Open 2023). Eligible patients were adults with histologically confirmed PDAC who underwent a resection of the primary tumor, with concurrent or subsequent MDT of MDT. OS was defined as the delay from MDT to death from any cause; EFS was calculated from the date of MDT until radiologically confirmed disease progression, recurrence or death. The ALTOPANC score—based on known prognostic factors (CA 19-9 >90 U/mL, > 1 met, and non-pulmonary mets)—was correlated with OS and EFS. Results: Between 01/2011 and 12/2024, 155 patients with OMD-PDAC were included; 138 had metachronous metastases. Sites of mets included liver (n=71, 45%), lung (n=61, 39%), periaortic lymph nodes (n=13, 8%) and peritoneum (n=5, 3%). At time of the met's diagnosis, 107 patients (71%) had a single met, and 25 (17%) patients had presented two mets. After a median follow-up of 4.42 years, median EFS and median OS in the entire population were of 0.8 and 3,4 years respectively. MDT modalities consisted in surgery (n=69, 45%), radiotherapy (n=50, 32%), and thermoablation (n=36, 23%). In the multivariate Cox model, higher CA 19-9 level (HR = 1.29, 95% CI: 1.13–1.48, p = 0.0002) and the presence of 2 (HR = 2.54, 95% CI: 1.32–4.88, p <0.0001) or ≥3 treated mets (HR = 4.39, 95% CI: 2.18–8.84, p <0.0001) were independent adverse prognostic factors for OS. Thermoablation was independently associated with an improved OS compared to other technics (HR=0.51, 95%CI: 0.27–0.96, p =0.0127). The ALTOPANC score was significantly associated with EFS :2-year EFS rates were 53.1%, 23.8%, 8.3%, and 0% in patients with scores of 0, 1, 2, and 3, respectively (p < 0.001). A similar trend was observed for OS. Conclusions: 1) This real-world, study shows promising results of MDT in patients with OMD-PDAC, particularly thermoablation ; 2) among patients with favorable prognostic profile (low ALTOPANC score) may have the higher benefit. A prospective randomized study is warranted to confirm these results