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Évaluation d’une proposition systématique du test HPV par auto prélèvement vaginal (APV-HPV) chez les femmes précaires en PASS de 30 à 65 ans non dépistées ou insuffisamment dépistées pour le cancer du col de l’utérus
No full textIntroduction: cervical cancer (CC) is a major public health issue, particularly affecting women in vulnerable situations. HPV screening is essential for CC prevention. Vaginal self-sampling for HPV (VS-HPV) has been shown to increase screening rates among underscreened women. Objective: To evaluate the impact of a systematic offer of VS-HPV on CC screening among patients at the PASS clinic in Libourne, regardless of the reason for consultation. Material and Methods: an observational study was conducted over two periods at the Libourne PASS clinic: G1 (pre-intervention, January 1, 2023 – July 22, 2024, n=83) and G2 (intervention, July 23, 2024 – April 30, 2025, n=30). In G1, screening was offered based on the consultation; in G2, VS-HPV was systematically offered to women aged 30– 65 who were underscreened. Screening results, complementary cytology, and follow-up of HPVpositive patients were analyzed. Barriers to refusal in G2 were assessed. Results: screening was offered and performed in 100 % of cases in G2, versus 34.9 % offered and 25.3 % performed in G1 (significant differences). Pathological results were observed in 23.8 % of G1 patients and 16.7 % of G2 patients (p=0.722). Two ASCUS cytologies were detected in G1 versus five in G2 (p=0.685). Complete diagnostic follow-up was achieved in 100 % of G1 and 93.3 % of G2 patients (p=0.5). No barriers were identified in G2. Conclusion: systematic VS-HPV significantly improves CC screening uptake among vulnerable populations. Diagnostic follow-up remains satisfactory, allowing access to women outside the routine healthcare system, contributing to earlier diagnosis and reducing health inequities.Introduction : le cancer du col de l’utérus (CCU) constitue un enjeu majeur de santé publique, et touche particulièrement les femmes en situation de précarité. Le dépistage de l’HPV est essentiel dans la prévention du CCU. L’auto-prélèvement vaginal pour HPV (APV-HPV) améliore le taux de dépistage chez les femmes insuffisamment dépistées. Objectif : Évaluer l’impact d’une proposition systématique par APV-HPV sur le dépistage du CCU auprès des patientes de la PASS de Libourne, indépendamment du motif de consultation. Matériel et méthodes : étude sur deux périodes à la PASS de Libourne : G1 (préintervention, 1er janvier 2023–22 juillet 2024, n=83), G2 (intervention, 23 juillet 2024–30 avril 2025, n=30). Dans G1, la proposition de dépistage dépendait de la consultation alors que dans G2, un APV-HPV était systématiquement proposé aux patientes de 30 à 65 ans insuffisamment dépistées. Les résultats du dépistage, la cytologie complémentaire et le suivi des patientes positives ont été analysés ; et enfin les éventuels freins au dépistage étaient recherchés dans G2. Résultats : le dépistage a été proposé et réalisé dans 100 % des cas dans G2, contre 34,9 % proposés et 25,3 % réalisés dans G1, (différences significatives). Des résultats pathologiques étaient retrouvés dans 23,8 % des patientes de G1, et 16,66 % dans G2 (p=0,722). Deux cytologies ASCUS ont été retrouvées dans G1, contre cinq dans G2 (p=0,685). La réalisation omplète du diagnostic était de 100 % dans G1 et 93,3 % des dans G2 (p=0,5). Aucun obstacle n’a été identifié dans G2. Conclusion : la proposition systématique d’APV-HPV améliore significativement la réalisation du dépistage du CCU dans les populations précaires. Le suivi diagnostic reste satisfaisant, permettant d’atteindre des femmes en marge du système de soins et de prévention, contribuant ainsi à un diagnostic plus précoce et à une réduction des inégalités en santé
We Don’t Put All Our Eggs in One Basket": Multipositioning strategies of Malian andComoran Diaspora Leaders in Parisian political landscape
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L'entreprise familiale résiliente : paradoxe ou évidence ?
No full textInternational audienceAncrée dans leur histoire, leurs valeurs et leurs émotions propres, les entreprises familiales démontrent une grande capacité de résilience. A partir du témoignage de 8 dirigeants d'entreprises familiales, nous avons voulu comprendre pourquoi ces entreprises parviennent à surmonter les épreuves au fil du temps
Traitements endodontiques grâce à l’endodontie guidée : rapport de cas de traitements multiples sur un patient complexe
No full textEndodontic treatment of teeth with canal calcifications is complex and carries risks such as instrument fracture or root perforation. Following the acquisition of a cone beam computed tomography (CBCT) scan and an intraoral scan, customized endodontic drilling guides were produced using three dimensions (3D) printing. This approach allowed for time savings and tissue preservation in a patient with a history of psychoactive substance use and high dental anxiety. However, two failures were observed on teeth 11 and 21, highlighting the technique’s sensitivity to guide precision. Furthermore, guided endodontics requires perfect patient immobility, limiting its use in highly anxious patients or those resistant to local anesthesia. Despite these limitations, it remains useful in complex cases, providing safety, precision, and tissue preservation.Le traitement endodontique des dents présentant des calcifications canalaires est complexe et expose à des risques tels que fracture instrumentale ou perforation radiculaire. Après acquisition d’une tomographie volumique à faisceau conique (CBCT) et d’un scan intra-oral, des guides de forages endodontiques personnalisés ont été réalisés en impression trois dimensions (3D). Cette approche a permis un gain de temps et une économie tissulaire chez un patient présentant des antécédents de consommation de substances psychoactives (SPA) et une forte anxiété des soins dentaires. Cependant deux échecs ont été observés sur les 11 et 21, montrant la sensibilité de cette technique à la précision du guide. De plus, l’endodontie guidée nécessite une immobilité parfaite du patient, limitant son usage chez les patients très anxieux ou présentant des résistances à l’anesthésie. Malgré ces limites, elle demeure utile pour les situations complexes, assurant sécurité, précision et préservation tissulaire
III-Nitride MEMS drum resonators on flexible metal substrates
No full textInternational audienceWe present a simple and efficient process for fabricating III-Nitride (III-N) mechanical resonators on flexible metal substrates. This method combines Van der Waals epitaxy of III-N epilayers with the deposition of a thick metal stressor atop the III-N layers. During thermal treatment, the 30 μm thick metal stressor deposited on a 300 nm AlGaN/500 nm GaN layer grown on a 3 nm two-dimensional hexagonal-Boron Nitride (2D h-BN) release layer, initiates a one-step Self-Lift-Off and Transfer (SLOT) process. This process effectively transfers the III-N heterostructure from the h-BN/Sapphire growth wafer to the flexible metal stressor substrate. Additional local etching of the metal stressor and deposition of front electrodes allow for releasing self-standing III-N layers with integrated actuation. Fabricated III-N MEMS drum resonators were analyzed using optical profilometry and laser Doppler vibrometer, enabling the observation of static deflections and distinct vibration modes. Finite element method (FEM) simulations were also performed to further understand experimental observations and assess the mechanical properties of the released III-N layers, particularly enabling the estimation of stress in the GaN and AlGaN released layers. This straightforward approach not only provides a practical solution for cost-effective III-N MEMS resonators but also ensures flexibility, and crack-free structures
LaPDA: Latent-Space Point Cloud Denoising With Adaptivity
No full textInternational audiencePoint cloud denoising is a fundamental yet challenging task in computer graphics. Existing solutions typically rely on supervised training on synthesized noise. However, real-world noise often exhibits greater complexity, causing learning-based methods trained on synthetic noise to struggle when encountering unseen noise–a phenomenon we refer to as noise misalignment. To address this challenge, we propose LaPDA (Latent-space Point cloud Denoising with Adaptivity), a neural network explicitly designed to mitigate noise misalignment and enhance denoising robustness. LaPDA consists of two key stages. First, we adaptively model noise in the latent space, aligning unseen noise distributions with the known training distributions or adjusting them toward distributions with lower noise scales. Training objectives at this stage are formulated based on controlled synthetic noise with varying intensity levels. Second, we introduce a gradual noise removal module that optimizes the spatial distribution of the adaptively adjusted noisy points. Extensive experiments conducted on both synthetic and scanned datasets demonstrate that LaPDA achieves enhanced accuracy and robustness compared to state-of-the-art methods. We will make the source code and test models publicly available
Empirical Results for Adjusting Truncated Backpropagation Through Time while Training Neural Audio Effects
No full textInternational audienceThis paper investigates the optimization of Truncated Backpropagation Through Time (TBPTT) for training neural networks in digital audio effect modeling, with a focus on dynamic range compression. The study evaluates key TBPTT hyperparameters -- sequence number, batch size, and sequence length -- and their influence on model performance. Using a convolutional-recurrent architecture, we conduct extensive experiments across datasets with and without conditionning by user controls. Results demonstrate that carefully tuning these parameters enhances model accuracy and training stability, while also reducing computational demands. Objective evaluations confirm improved performance with optimized settings, while subjective listening tests indicate that the revised TBPTT configuration maintains high perceptual quality
From visualization to education: the role of 3D-Printed and virtual kidney models in training for renal cancer surgery, a systematic review
No full textInternational audienceObjectives: This systematic review on novel 3D technologies aims to discuss the current evidence on the usefulness of 3D printing, virtual reality (VR) and augmented reality (AR) simulators in the education and training of young urologists for kidney cancer surgery, highlighting the modalities employed, their educational impact, and areas for future development.Materials and Methods: We performed a comprehensive literature search limited to the last 10 years across PubMed and Embase libraries, identifying studies evaluating the use of 3D technologies as educational tools in urologist training for kidney cancer surgery. The review followed PRISMA guidelines, and two reviewers independently screened eligible studies. We extracted data on study designs and on urologists' education outcomes, through different subcategories.Results: Seventeen studies were included, mostly small-scale validation or descriptive investigations. Twelve investigated 3D-printed models and five VR/AR platforms. Simulations focused on laparoscopic and robot-assisted partial nephrectomy, often using patient-specific models for rehearsal and skill development. Training outcomes included improved spatial anatomy understanding, increased technical performance, greater procedural confidence, and enhanced familiarity with complex surgical steps. However, considerable heterogeneity in methodology and limited sample sizes across studies underscore the need for standardized evaluation of these educational tools.Conclusion: 3D technologies, including 3D-printed models and VR/AR platforms, show promise in enhancing surgical training for renal cancer by improving anatomical understanding and procedural skills. These technologies demonstrate good precision and can help assess trainee surgical skill. However, evidence remains limited, and further research is needed to validate their effectiveness, cost-efficiency, and integration into standardized urological training curricula
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