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    Multicenter Analysis of General presentations and Imaging features in Cerebral MUCORmycosis (MAGICMUCOR): towards different entities

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    International audienceCentral nervous system mucormycosis (CNS-M) is a severe disease with difficult and often delayed diagnosis, leading to high mortality. The aim of this new study was to assess clinical and radiological presentation according to underlying conditions and dissemination routes, to optimize diagnostic strategies. We conducted a retrospective national study including 54 CNS-M cases diagnosed between 2005 and 2020, with brain imaging reviewed by two neuroradiologists. CNS-M resulted from presumed hematogenous dissemination in 29 patients (54%) and from direct extension in 25 (46%), known as rhino-orbito-cerebral mucormycosis (ROCM). No neurological symptoms were found in 10/54 (19%), regardless of dissemination route. Hematogenous CNS-M mainly affected highly immunocompromised (HM or SOT) patients (90%), including 43% neutropenic. Radiology showed abscesses (87%) and small vessel disease (39%). In ROCM, two patterns emerged depending on osteolysis (19/25, 76%) or its absence (6/25, 24%). ROCM without bone lysis, mostly in severely immunosuppressed patients, caused meningitis without abscess, whereas osteolytic ROCM led to abscess formation (11/18, 60%). Without osteolysis, perineural spread along the optic nerve occurred in 2/3 cases. Serum Mucorales PCR was positive in 91% of hematogenous and 64% of ROCM cases. Fungal co-infections occurred in 26%. This study underscores distinct invasion patterns and the need for extensive workup in CNS-M, highlighting the diagnostic value of MRI with gadolinium and serum Mucorales qPCR based on dissemination route and underlying condition. MRI is particularly useful in ROCM for detecting meningitis (80%), large vessel disease (30%), and perineural involvement (8%)

    Design and synthesis of first-in-class stapled peptides targeting the E3 ligase MuRF1 to potentially prevent muscle wasting

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    International audienceThis study focuses on developing stapled peptides that target the E3 ubiquitin ligase MuRF1 (TRIM63), a key player in muscle protein degradation and muscle wasting. MuRF1 is so far the only E3 involved in the degradation of contractile proteins in muscle tissue, making it a potential therapeutic target for conditions like cachexia, sarcopenia, and chronic disease-related muscle atrophy. We designed two stapled decapeptides mimicking a helical segment of MuRF1's coiled-coil domain, aiming at perturbating its structural organization. To enhance their α-helical structure, these peptides were stabilized using hydrocarbon stapling and were prepared using solid-phase peptide synthesis. Their binding affinities to MuRF1 were assessed using spectral shift and microscale thermophoresis (MST) assays. Stapled peptides bound efficiently to MuRF1 with equilibrium dissociation constants KD in the range 1.5–1.8 μM, whereas their unstapled counterparts showed little or no binding. This work represents an early promising step in targeting MuRF1, thus offering a potential therapeutic approach to prevent or reduce muscle wasting

    Results of the Randomized Phase 3 AFU-GETUG-20 Trial Evaluating Adjuvant Leuprorelin Acetate After Radical Prostatectomy in Men with High-risk Localized Prostate Cancer

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    International audienceBACKGROUND AND OBJECTIVE: Androgen-deprivation therapy survival benefits after radical prostatectomy (RP) in nonmetastatic high-risk prostate cancer (PCa) patients with an undetectable prostate-specific antigen (PSA) level are unclear. The AFU-GETUG-20 study assessed the benefit of leuprorelin immediately after RP in this population. METHODS: This open-label, randomized, phase 3 trial is conducted at 37 French centers. Participants undergoing RP for nonmetastatic PCa were aged ≥18 yr, with a postoperative Gleason score of ≥7 and PSA <0.1 ng/ml. Participants were randomly assigned (1:1) to the observation or leuprorelin (45 mg subcutaneous Q6M, 24 mo) arm. The primary endpoint was metastasis-free survival in the intent-to-treat population (n = 322). The secondary objectives PSA and testosterone level evolution, PCa-specific survival, overall survival, safety, and quality of life. KEY FINDINGS AND LIMITATIONS: From 2011 to 2017, 325 patients were randomized to the observation (n = 163) or leuprorelin (n = 162) arm. The 10-yr risk of metastasis occurrence was similar between arms (hazard ratio [HR] 0.63 [95% confidence interval {CI} 0.30-1.30]; p = 0.204) with no differences in PSA rise-free survival (HR 0.74 [95% CI 0.47-1.16]; p = 0.187), overall survival (HR 1.24 [95% CI 0.56-2.76]; p = 0.596), or PCa-specific survival (HR 0.57 [95% CI 0.10-3.17]; p = 0.512). Leuprorelin-treated patients had lower testosterone level after surgery (p < 0.001), shorter time to global health degradation (p = 0.0019), fatigue (p < 0.001), pain (p < 0.001), and additional adverse events, mainly hot flashes (83.6% vs 6.2%), pain (57.2% vs. 17.1%), fatigue (45.4% vs 16.3%), and psychiatric disorders (25.0% vs 2.3%). Insufficient enrollment affected the trial power but permitted pertinent comparison. CONCLUSIONS AND CLINICAL IMPLICATIONS: Leuprorelin treatment immediately after RP in high-risk nonmetastatic PCa patients with an undetectable PSA level does not improve survival, but increases adverse events, leading to poorer quality of life compared with observation

    La preuve par tout moyen de la cause étrangère en matière de communication par voie électronique

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    Communauté de pratique en santé : engagement des membres et posture de praticienne-chercheure

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    La communication se propose d'explorer les grandes lignes d'une recherche menée pour la réalisation d'un mémoire de master 2 en sciences de l'éducation et de la formation. En alternance dans un organisme de formation dédié aux métiers de la rééducation-réadaptation, nous avons œuvré à la mise en place d'une communauté de pratique intentionnelle, dispositif répondant à quatre grands enjeux du secteur : l’interdisciplinarité, le travail ensemble, l'amélioration des pratiques et la formation continue des professionnel·les. Pour mettre en place cette communauté de pratique, les conditions ont dû être pensées pour favoriser l’engagement des membres présent·es aux rencontres. En mobilisant le cadre théorique de l'environnement capacitant, nous interrogeons les facteurs à l’œuvre dans le processus d’engagement des membres de cette communauté de pratique. Grâce à une méthodologie qualitative avec des entretiens individuels et collectifs auprès de certains membres, nous mettrons en lumière les différents facteurs individuels, sociaux et environnementaux et leur articulation individuelle et collective. L’ancrage dans le terrain de cette recherche sera l'occasion de revenir : d'une part, sur la posture de praticien·ne-chercheur·e éprouvée, et d'autre part, sur des préconisations à quatre niveaux : le secteur de la santé, l'organisme de formation, la communauté et ses membres et enfin, la recherche

    Statistical Consistency of Discrete-to-Continuous Limits of Determinantal Point Processes

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    Determinantal point processes (DPPs) are finding an increasing amount of applications in data science and statistics. Typically, practitioners tend to distinguish between “discrete” DPPs that subsample a finite set and “continuous” DPPs that sample a continuous space, the former being generally much more algorithmically tractable than the latter. In this paper, we examine the following question: what is the limiting behavior of discrete DPPs when the sizeof the set to sample from goes to infinity? In particular, if this set is itself formed of identically and independently distributed data, is there a connection with an underlying continuous DPP? This natural question has scarcely been studied in the literature.We propose a non-asymptotic characterization of this limit in terms of the concentration of statistics associated to the process, which we refer to as “weak coherency”. In particular, these statistics and their moments play a crucial role in many practical use-cases of DPPs, and weak coherency naturally allows us to translate certain statistical guarantees from the limiting process to the discrete process.Our main result is to provide various sufficient conditions for weak coherency to hold. In particular, we show that it holds even when the continuous kernel and its underlying space are inaccessible, and the discrete kernel is a (very) noisy version of its continuous counterpart, possibly constructed by the user, which is the case in several important examples.We then illustrate our theory on several such examples, and obtain byproduct results that are interesting in their own rights. We first prove that a discrete multivariate orthogonal polynomial ensemble can be used to produce coresets strictly smaller than independent sampling. We then propose a process achieving repulsive sampling on an unknown manifold from a set of points sampled from a density that is also unknown. Finally, we show that continuous DPPs can be obtained as limits on random graphs with independent Bernoulli edges, even when only observing the graph structure

    Multifaceted role of goethite in metal(loid) adsorption and mobility across environmental systems

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    International audienceGoethite, the most prevalent iron oxide mineral in aquatic and terrestrial environments, possesses exceptional thermodynamic stability and well-defined structural properties. These characteristics make it a highly valuable model system for researchers to investigate the adsorption and fate of toxic metal(loid)s in the environment. However, to our knowledge, no comprehensive review has yet focused exclusively on this topic. This review addresses this gap by comprehensively evaluating the knowledge on metal(loid) adsorption onto goethite across diverse environmental settings with an emphasis on the effect of goethite's surface properties and underlying adsorption mechanisms. We summarize recent advances in understanding how diverse metal(loid)s interact with goethite and its modified forms, such as metal-substituted variants and composites with adsorbents, organic matter, and microbes as in natural systems. The review also explores key factors affecting metal(loid) binding, including metal speciation, pH, ionic strength, adsorption kinetics, isotherms, thermodynamics, and the impact of co-existing environmental components (natural organic matter, inorganic substances, and organic contaminants). Finally, we outline future research directions to deepen insights into goethite's environmental role in controlling pollutant fate and inform strategies to mitigate metal contamination

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