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Rosuvastatin for intracranial aneurysms treated with flow diverters: preclinical study in rabbits
No full textInternational audienceBackground Flow diverters (FDs) revolutionized cerebral aneurysm treatment by promoting aneurysm sac sealing but have limitations, including thromboembolic complications and incomplete occlusion. Rosuvastatin enhances endothelialization via endothelial progenitor cell mobilization and nitric oxide bioavailability, potentially improving FD healing. This study assessed the effect of rosuvastatin on FD endothelialization in a rabbit aneurysm model. Methods Twenty-two rabbits with elastase-induced aneurysms underwent FD implantation in the right subclavian artery. In the same animals, FDs were placed in the descending aorta to assess side branch patency. Thirteen rabbits received rosuvastatin plus aspirin (Rosu+ASA; 10 mg/kg/day each) and nine received aspirin alone (ASA; 10 mg/kg/day). Two weeks post-implantation, aneurysm occlusion (O’Kelly-Marotta scale), side branch patency (high frequency optical coherence tomography), and histological/MPM strut coverage were evaluated. Rosuvastatin serum concentration was correlated with endothelial cell coverage. Results Complete aneurysm occlusion (OKM D) occurred in 11/13 (84.6%) of Rosu+ASA vs 6/9 (66.6%) of ASA animals. Patency of branches ≥1 mm was higher with Rosu+ASA (17/18 (94.4%) vs 9/13 (46.1%), PP=0.007), as was patency of branches <1 mm (21/22 (95.4%) vs 11/15 (73.4%), P=0.036). The composite outcome (complete occlusion+patent branches) favored Rosu+ASA (10/13 (76.9%) vs 2/9 (22.2%), P=0.011). Histology showed a trend toward greater strut coverage and neointimal thickness in Rosu+ASA (P=0.1). Rosuvastatin serum concentration strongly correlated with endothelial cell coverage (r=0.92, P=0.02). Conclusion In rabbit FD models, rosuvastatin therapy seems to improve aneurysm occlusion, preserving side branch patency. We also found an association between drug levels and endothelial cells covering the FD. These findings support further investigations
Treatment and outcomes of chronic coronary syndromes: the EORP EURECA imaging registry
No full textInternational audienc
Exercise Right Ventricular‐Pulmonary Arterial Coupling and Functional Outcome in Patients Undergoing Surgery for Secondary Ischemic Mitral Regurgitation
No full textInternational audienceBackground The exercise assessment of the right ventricular‐pulmonary arterial (PA) coupling adds diagnostic and prognostic value in patients with heart failure. In patients with ischemic mitral regurgitation undergoing surgery, data on the exercise assessment of the right ventricular‐PA coupling are not available. Resting and exercise echocardiographic predictors of functional outcome in patients with ischemic mitral regurgitation were tested. Methods Six‐minute walking test and exercise echocarrdiogram performed at baseline, at 1 years, and at a median follow‐up of 6 years (interquartile range, 3.70; range, 4.5–8) on 50 patients (67±8 years; ejection fraction: 35±5%) undergoing valve replacement or repair. Linear mixed models were used to evaluate the predictive value of preoperative echocardiographic parameters on the longitudinal distribution of the 6‐minute walking test. Results Preoperative exercise tricuspid annular plane systolic excursion (TAPSE)/PA systolic pressure strongly correlated with the long‐term 6‐minute walking test (r=0.81, P <0.01). The receiver operating characteristic analysis found a preoperative exercise TAPSE/PA systolic pressure <0.34 predicted the lowest quartile of the 6‐minute walking test in the long term (sensitivity: 79%; specificity: 100%) as well as a composite outcome of heart failure and death from any cause (positive predictive value: 91.3%, negative predictive value: 100%). On multivariable analysis, TAPSE and TAPSE/PA systolic pressure were significantly associated with a better long‐term 6‐minute walking test. Conclusions A preoperative exercise TAPSE/PA systolic pressure <0.34 predicts a poor functional performance and a higher likelihood of clinical adverse events. In patients with ischemic mitral regurgitation the exercise right ventricular ‐PA coupling could improve risk stratification. Larger studies are needed
L’ETP (en pratique) est-elle promotrice de santé ? Retour sur le congrès de la SETE de mai 2024
No full textInternational audienceIntroduction : L’Éducation Thérapeutique du Patient (ETP) s’est développée pour pallier les contraintes imposées par les maladies chroniques, en permettant aux patients de devenir acteurs de leur santé. Pour ce faire, elle cherche à dépasser une vision préventive souvent réduite à une simple transmission d’informations pour s’inscrire dans une vision promotrice de santé. Cependant, les pratiques actuelles de l’ETP traduisent-elles une véritable ouverture vers la promotion de la santé, ou bien reconduisent-elles encore, sous des formes renouvelées, une logique préventive centrée sur le contrôle des comportements ?Méthode : Pour répondre à ces questions, nous nous sommes appuyés sur l’étude des 44 résumés des communications orales soumises lors du Xième congrès de la Société d’Éducation Thérapeutique Européenne (SETE) qui s’est déroulé en mai 2024 à Liège (Belgique). Résultats – Discussion : Les résumés montrent l’importance du soutien des politiques publiques. Ils montrent également le renforcement des actions communautaires, notamment grâce à la place faite aux patients partenaires ainsi que l’importance de définir de nouveaux cadres soutenant la réorientation des services de santé. Cependant les acquisitions d’aptitude concernent moins les aptitudes collectives que les aptitudes individuelles et les inégalités sociales de santé ainsi que la littératie sont peu évoquées. Conclusion : Le Xème congrès de la SETE qui s’est tenu en mai 2024 à Liège, a montré que si cette transition a été engagée, elle doit être plus franche
Atypie-Friendly: the French program to improve inclusivity of universities
No full textInternational audienceIn 2015, only 500 autistic students were formally identified in French universities, reflecting both a lack of diagnosis and systemic invisibility of neurodivergent individuals in higher education. The "Aspie-Friendly" project, launched in 2018, aimed to transform this landscape by creating a network of universities committed to inclusive practices. In 2022, the project expanded to include all neurodevelopmental disorders (NDDs) and was renamed as "Atypie-Friendly." As of September 2025, the program involves 25 active institutions and continues to grow, with the ambition of making higher education accessible to all neurodivergent students.Atypie-Friendly adopts a strength-based, participatory approach, providing comprehensive support from the transition to university through to employment. It offers training for staff and students, promotes pedagogical innovation, and develops digital tools. The creation of a Charter and a Label has established a national quality framework, ensuring that all participating institutions meet some standards of inclusivity. The program's impact is evident in the six-fold increase in the number of neurodivergent students identifying themselves and seeking support over six years. This article explores the origins, evolution, and impact of the Atypie-Friendly program, as well as its future challenges, particularly in terms of research and international collaboration
Rectal versus colonic submucosal cancer rates and procedural outcomes in large non-pedunculated polyps: French ESD registry data
No full textInternational audienceBackground For large non-pedunculated rectal polyps, en bloc resection via endoscopic submucosal dissection (ESD) is typically recommended due to presumed higher risk of submucosal invasive cancer (SMIC) compared with the colon; however, data on cancer risk by location remain controversial. Objective Using the French ESD registry, we compared SMIC rates in large non-pedunculated colorectal polyps in the rectum versus colon. Procedural outcomes were also compared. Design From September 2019 to September 2022, all large non-pedunculated polyps resected by ESD in 13 centres were included. Oncological and procedural outcomes were analysed using propensity score matching (PSM) and inverse probability weighting, accounting for relevant influencing factors. A subgroup analysis was performed on cases from the three largest centres, where such polyps were exclusively treated with ESD. Results Among 3770 lesions, 3310 were analysed. Rectal lesions were larger (56.0 (40; 75) mm vs 47.0 (37; 62) mm), more often granular (80.0% vs 59.4%) and mixed nodular (54.0% vs 32.5%) (p<0.001). After PSM, submucosal cancer rates were not significantly different between rectal and colonic lesions of similar size and morphology (9.8% vs 8.9%, p=0.52). En bloc (97.7% vs 97.3%, p=0.757) and R0 resection rates (89.7% vs 89.5%, p=0.937) were also comparable. Perforation (5.5% vs 7.9%, p=0.057) and surgery for complications (0.1% vs 1.1%, p=0.051) showed a non-significant trend towards higher rates in colonic procedures. Subgroup analysis from the three centres exclusively performing ESD for large non-pedunculated polyps confirmed these findings. Conclusion In our multicentre registry, large non-pedunculated polyps do not show a higher prevalence of SMIC in the rectum compared with colon, when adjusted for relevant factors such as size and morphology. Therefore, risk features, rather than location, should guide the choice of resection technique. Technical outcomes were comparable between rectal and colonic ESD, with a trend for higher complication rates in the colon. Trial registration number NCT04592003
Repression of apelin Furin cleavage sites provides antimetastatic strategy in colorectal cancer
No full textInternational audienceThe adipokine apelin has been directly implicated in various physiological processes during embryogenesis and human cancers. Nevertheless, the importance of the conversion of its precursor proapelin to mature apelin in tumorigenesis remains unknown. In this study, we identify Furin as the cellular proprotein convertase responsible for proapelin cleavage. We explore the therapeutic potential of targeting proapelin cleavage sites in metastatic colorectal cancer by introducing apelin-dm, a modified variant resulting from alteration in proapelin cleavage sites. Apelin-dm demonstrates efficacy in inhibiting tumor growth, promoting cell death, suppressing angiogenesis, and early colorectal liver metastasis events. Proteomic analysis reveals reciprocal regulation between apelin and apelin-dm on proteins associated with clinical outcomes in colon cancer patients. Apelin-dm emerges as a modulator of apelin receptor dynamics, influencing affinity, internalization, and repression of apelin signaling linked to various protein kinases. Pharmacokinetic and toxicity assessments confirm the specificity, safety, and stability of apelin-dm, as well as its facile hepatic metabolism. These findings position targeting proapelin cleavage as a promising therapeutic strategy against metastatic colorectal cancer, paving the way for further clinical exploration
Parameter uncertainty and statistical analysis of tyre-pavement interaction under braking
No full textInternational audienceThis study evaluates the influence of uncertain input parameters on pavement responses in a critical braking scenario. Tyre-pavement interaction is simulated using a fast semi-analytical model. The primary objective is to identify the key stochastic variables associated with equivalent strain, a criterion for surface cracking initiation. The investigation follows a two-level full factorial experiment based on several input parameters, such as pavement properties and applied loads. A first-order surrogate model enables localised strain evaluation at each mesh element. The friction coefficient, vertical load, and surface course stiffness are identified as the most critical factors influencing surface damage in the tyre-pavement contact zone. These factors can contribute to an increase of up to 100 microstrains in critical strain magnitude. The study also highlights that base thickness and modulus have a limited impact on maximum surface strain, primarily due to the dominance of shear mechanisms driven by tractive forces
A robust nonsingular Fixed-Time Controller: Application to Robot Manipulators
No full textInternational audienceSliding Mode Control (SMC) techniques allow accurate position tracking, where fixed-time stability has become an area of great interest. A kind of systems which has represented a control challenge for the last decades are robot manipulators due to their highly nonlinear dynamics and the presence of external perturbations. The current contribution introduces a novel singularity free fixed-time SMC scheme for position and velocity tracking of robot manipulators in the presence of external perturbations. The design of the controller and the sliding surface together improves transient performance by avoiding the presence of high-peaks, providing a natural saturation of the control input while at the same time reducing chattering effects. The result holds globally when the robot model is fully known and locally when this is not the case (partially known or completely unknown). Simulation results confirm the effectiveness and the performance improvement of the developed theory with respect to other well-known schemes