Andreev reflection of fractional quantum Hall quasiparticles

Electron correlation in a quantum many-body state appears as peculiar scattering behaviour at its boundary, symbolic of which is Andreev reflection at a metal-superconductor interface. Despite being fundamental in nature, dictated by the charge conservation law, however, the process has had no analogues outside the realm of superconductivity so far. Here, we report the observation of an Andreev-like process originating from a topological quantum many-body effect instead of superconductivity. A narrow junction between fractional and integer quantum Hall states shows a two-terminal conductance exceeding that of the constituent fractional state. This remarkable behaviour, while theoretically predicted more than two decades ago but not detected to date, can be interpreted as Andreev reflection of fractionally charged quasiparticles. The observed fractional quantum Hall Andreev reflection provides a fundamental picture that captures microscopic charge dynamics at the boundaries of topological quantum many-body states.

Renormalization flow of a weak extended backscattering Hamiltonian in a non-chiral Tomonaga-Luttinger liquid

We consider a non-chiral Luttinger liquid in the presence of a backscattering Hamiltonian which has an extended range. Right/left moving fermions at a given location can thus be converted as left/right moving fermions at a different location, within a specific range. We perform a momentum shell renormalization group treatment which gives the evolution of the relative degrees of freedom of this Hamiltonian contribution under the renormalization flow, and we study a few realistic examples of this extended backscattering Hamiltonian. We find that, for repulsive Coulomb interaction in the Luttinger liquid, any such Hamiltonian contribution evolves into a delta-like scalar potential upon renormalization to a zero temperature cutoff. On the opposite, for attractive couplings, the amplitude of this kinetic Hamiltonian is suppressed, rendering the junction fully transparent. As the renormalization procedure may have to be stopped because of experimental constraints such as finite temperature, we predict the actual spatial shape of the kinetic Hamiltonian at different stages of the renormalization procedure, as a function of the position and the Luttinger interaction parameter, and show that it undergoes structural changes. This renormalized kinetic Hamiltonian has thus to be used as an input for the perturbative calculation of the current, for which we provide analytic expressions in imaginary time. We discuss the experimental relevance of this work by looking at one-dimensional systems consisting of carbon nanotubes or semiconductor nanowires.

Properties of Heavy Secondary Fluorine Cosmic Rays: Results from the Alpha Magnetic Spectrometer

Precise knowledge of the charge and rigidity dependence of the secondary cosmic ray fluxes and the secondary-to-primary flux ratios is essential in the understanding of cosmic ray propagation. We report the properties of heavy secondary cosmic ray fluorine F in the rigidity R range 2.15 GV to 2.9 TV based on 0.29 million events collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. The fluorine spectrum deviates from a single power law above 200 GV. The heavier secondary-to-primary F/Si flux ratio rigidity dependence is distinctly different from the lighter B/O (or B/C) rigidity dependence. In particular, above 10 GV, the F/Si/B/O ratio can be described by a power law R^{δ} with δ=0.052±0.007. This shows that the propagation properties of heavy cosmic rays, from F to Si, are different from those of light cosmic rays, from He to O, and that the secondary cosmic rays have two classes.

Impact of the COVID-19 pandemic on clinical research in hospitals: observational study in the first epicenter of the epidemic during the general lockdown in France

OBJECTIVE

The COVID-19 epidemic has had a strong impact on the entire healthcare sector in France with priority being given to research for new therapeutic options for COVID-19. Nevertheless, continuity of care for patients suffering from other diseases represents a crucial challenge, and clinical research is no exception in this respect. This study aims to assess the impact of the strict Covid-19 lockdown on non-Covid-19 clinical research in the French University Hospital of Strasbourg.

MATERIALS AND METHODS

Clinical research activity (non-Covid-19) from the point of view of pharmacy department was estimated and compared to the pre-lockdown period. The impact of lockdown was assessed through five indicators: site initiation visits, the initiation of experimental therapies in non-Covid-19 patients, the delivery of non-Covid-19 investigational medical products, the number of drug shipments to patients' homes, and the number of monitoring or closure visits.

RESULTS

During the study period, the number of site initiation visits decreased by 90%, total inclusions by 72%, and delivery of investigational medical products by 30%. During the lockdown period, 15 treatments were sent to patients' homes. Monitoring activity decreased by 98%.

CONCLUSIONS

Although the COVID-19 outbreak has created an incredible momentum in the field of clinical research, research not focused on SaRS-CoV-2 has suffered greatly from this situation. The impact on patients is difficult to estimate but should be further investigated.

Properties of Iron Primary Cosmic Rays: Results from the Alpha Magnetic Spectrometer

We report the observation of new properties of primary iron (Fe) cosmic rays in the rigidity range 2.65 GV to 3.0 TV with 0.62×10^{6} iron nuclei collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. Above 80.5 GV the rigidity dependence of the cosmic ray Fe flux is identical to the rigidity dependence of the primary cosmic ray He, C, and O fluxes, with the Fe/O flux ratio being constant at 0.155±0.006. This shows that unexpectedly Fe and He, C, and O belong to the same class of primary cosmic rays which is different from the primary cosmic rays Ne, Mg, and Si class.

A systematic review of the impact of cigarettes and electronic cigarettes in otology

BACKGROUND

The detrimental systemic effects of cigarette smoking are well established. Though less pronounced in the field of otology, they are proposed to contribute to the global burden of unaddressed hearing loss. Recently, in efforts to stop smoking, individuals have used electronic cigarettes of which the long-term safety data are largely unknown. This study aimed to conduct a systematic review of cigarette smoking and electronic cigarette effects in the field of otology.

METHOD

Relevant articles were identified by a National Institute for Health and Care Excellence healthcare database literature search and by scanning the references of relevant articles and reviews.

RESULTS

A total of 473 articles were identified, with 43 articles included in the review after trials were excluded.

CONCLUSION

Cigarette smoking is associated with recurrent otitis media, otitis media with effusion and sensorineural hearing loss in children exposed to second-hand smoke. In adults, it is associated with active and aggressive chronic suppurative otitis media, worse tympanoplasty success rates, increased post-operative complications and sensorineural hearing loss that is more pronounced in the long term and at high frequencies. The effects of e-cigarettes in otology are largely unknown.

BDNF activates TrkB/PLCγ1 signaling pathway to promote proliferation and invasion of ovarian cancer cells through inhibition of apoptosis

OBJECTIVE

Abnormal expression and activation of tropomyosin-related kinase receptor B (TrkB) are observed in many pathological conditions, including many types of cancer. We try to explore the relationship between ovarian cancer and Brain-derived neurotrophic factor (BDNF), a ligand of TrkB.

MATERIALS AND METHODS

Human ovarian cancer cell line SKOV-3 was used in this study. qPCR, immunohistochemistry, and immunoblot were used to assay BDNF and TrkB expression level. Scratch assay was used to test the cell motility, and transwell assay was used to test the cell migration ability.

RESULTS

We found that BDNF promotes the proliferation and invasion of human ovarian cancer SKOV-3 cells depend on the activation of TrkB. To illuminate the downstream pathway of BDNF/TrkB, we silenced AKT1 and PLCγ1 by siRNA. The functional assay showed that activated PLCγ1 signaling pathway is necessary for the proliferation and invasion of cancer cells other than the AKT pathway. Further study showed that PLCγ1 could inhibit the apoptosis of cancer cells.

CONCLUSIONS

BDNF triggers TrkB/PLCγ1 signaling pathway to promote proliferation and invasion of ovarian cancer cells through inhibition of apoptosis.

Negative Delta-T Noise in the Fractional Quantum Hall Effect

We study the current correlations of fractional quantum Hall edges at the output of a quantum point contact subjected to a temperature gradient. This out-of-equilibrium situation gives rise to a form of temperature-activated shot noise, dubbed delta-T noise. We show that the tunneling of Laughlin quasiparticles leads to a negative delta-T noise, in stark contrast with electron tunneling. Moreover, varying the transmission of the quantum point contact or applying a voltage bias across the Hall bar may flip the sign of this noise contribution, yielding signatures that can be accessed experimentally.

Free clinic oversight and outcomes in the United States: a scoping review protocol

OBJECTIVE

The objective of this review is to explore existing literature related to free clinic oversight, and patient and health outcomes reported with the use of free clinics in the United States, to examine and conceptually map the evidence, and to identify any gaps.

INTRODUCTION

Free clinics serve a unique role in American health care; however, little is known about clinic oversight and the outcomes seen in uninsured and under-insured patients who are treated at free health clinics.

INCLUSION CRITERIA

The review will consider studies that include hospital or privately owned and operated community free clinics, and adults and children who utilize free clinics in the United States. In addition to information about clinic oversight, patient outcomes to be considered include disease course management metrics and patient satisfaction. Health outcomes to be considered include hospitalization rates and emergency room visit rates.

METHODS

This scoping review will consider both experimental and quasi-experimental study designs in addition to analytical observational studies. Qualitative studies, systematic reviews that meet the inclusion criteria, and text and opinion papers will also be included. The search will be limited to those studies published in English since 1967, the year the first free clinic opened in the United States. The proposed review will be conducted in accordance with the JBI methodology for scoping reviews. Data will be extracted from papers by two independent reviewers using an extraction tool developed by the reviewers.

SAT0309 CARDIAC MAGNETIC RESONANCE IMAGING ELEVATED NATIVE MYOCARDIAL T1 IS PREDICTIVE FOR THE DEVELOPMENT OF MYOCARDIAL DYSFUNCTION IN SYSTEMIC SCLEROSIS

Background:

All patients included in the study fulfilled the ACR/EULAR classification criteria for SSc. We prospectively included patients who underwent at least two CMR at 1.5T, including native T1 and T2 mapping (which give account for myocardial fibrosis and myocardial edema respectively), left and right ventricles morphology and functional assessment, and Late Gadolinium Enhancement (LGE) as a part of routine follow-up between 2015 and 2019.

Objectives:

To evaluate the prognostic value of initial abnormal T1 mapping.

Methods:

All patients included in the study fulfilled the ACR/EULAR classification criteria for SSc. We prospectively included patients who underwent at least two CMR at 1.5T, including native T1 and T2 mapping (which give account for myocardial fibrosis and myocardial edema respectively), left and right ventricles morphology and functional assessment, and Late Gadolinium Enhancement (LGE) as a part of routine follow-up between 2015 and 2019.

Results:

Sixty-three patients underwent at list two CMR during the study period. Forty-three patients were women. Mean age was 52.5±15.5 years old. Follow-up duration between the initial and the follow-up CMR was 14.5±11.5 months. Forty-one had diffuse SSc. The mean native T1 was 1066.8 ±44.6 ms. Twenty-one patients suffered from cardiac clinical manifestations. Nine patients died during the follow-up. Thirty patients (47.6%) had elevated T1 (ET1) with mean T1 1105.4±36.7 ms at the time of initial CMR. Initial ET1 was clearly correlated with: 1/ alteration of Left Ventricle (LV) Ejection fraction (EF) (r=0.5, p<0.0001) during the study period, 2/LV dilatation at initial screening and follow up (r=0.22, p=0.03 and r=0.3, p=0.02). Regarding Right ventricle, initial ET1 was correlated with initial Right Ventricle (RV) dilatation (r=0.3, p=0.02) but neither with RV volume nor RVEF at follow-up. Interestingly, initial ET1 correlated with pericardial effusion (r=0.3, p=0.003) which is known to be a pejorative prognostic factor. Seventeen patients (28%) had LGE but the ET1 at initial screening and follow-up was not correlated with LGE.

Six patients had elevated T2 (ET2) which correlated with initial and follow up LV dilatation (r=0,32, p=0.002 and r=0.5, p<0.0001 respectively) but not with LVEF during the period study. Among other parameters, initial increased BNP was correlated with follow up ET1 LVEF and RVEF (r=0.4, p=0.01; r=0.35, p=0.007; r=0,37, p=0.005 respectively). In the same way, initial Pulmonary Arterial Hypertension (PAH) was correlated with follow up ET1 (r=0.3, p=0.02). Initial ET1 did not correlate with age, sex, cardiovascular risk factors, cardiac manifestations or death.

Conclusion:

Assessment of diffuse myocardial fibrosis by native T1 is predictive of the occurrence of cardiac dysfunction at the follow-up as initial ET1 was associated with decreased left ventricular function and LV and RV dilatations). These data highlights the potential role of CMR with T1mapping in initial screening and at the follow-up and provides new insights in the cardiac SSc follow up strategy.

References:

[1]Poindron V, Chatelus E, Canuet M, Gottenberg JE, Arnaud L, Gangi A, Gavand PE, Guffroy A, Korganow AS, Germain P, Sibilia J, El Ghannudi S, Martin T.T1 mapping cardiac magnetic resonance imaging frequently detects subclinical diffuse myocardial fibrosis in systemic sclerosis patients.Semin Arthritis Rheum. 2019 Jun 19.

Disclosure of Interests:

None declared

AB1049 CLINICAL SPECTRUM AND THERAPEUTIC MANAGEMENT OF AUTO-IMMUNE MYELOFIBROSIS: A NATION-WIDE STUDY OF 30 CASES

Background:

Little is known about autoimmune myelofibrosis (AIMF), a rare entity that can occur alone or in association with another autoimmune disease (AID) and is responsible for bone marrow (BM) failure and life-threatening complications.

Objectives:

We conducted a nationwide retrospective observational study of AIMF cases to better characterize the epidemiology, clinical presentation and evolution of this rare entity.

Methods:

The aim of the study was to analyze the characteristics of AIMF and the nature and indication of treatments currently used. Response to treatment was evaluated by the revised Tefferi et al. response criteria.

Results:

Among 30 cases of AIMF, the sex ratio (F/M) was 4:1 and the median age at diagnosis was 37 years (interquartile range 30–49). AIMF was diagnosed after the onset of an associated AID in 12 cases and concomitant to an AID in the remaining 18 cases. The most frequently associated AID was systemic lupus erythematous, followed by Sjögren syndrome. All cases consisted of reticulin fibers, and no collagen fibrosis was described. More than 50% of cases showed complete response after first-line therapy, with glucocorticoids (GC) in 28 cases. Half of the cases had treatment complications mainly related to GC therapy.

Conclusion:

Diagnosis of AIMF remains challenging in the absence of a validated set of diagnosis criteria, and must always be searched in the presence of hematological abnormalities at onset or during follow-up of AID. Clinical context, search for mutations and pathology findings can help differentiating this rare disease from a clonal pathology. GC is currently an effective first-choice therapy for AIMF, but a high rate of GC dependency and long-term complications indicate the need to find new sparing drugs.

Disclosure of Interests:

PHILIPPE MERTZ: None declared, Emilie Chalayer: None declared, Jean Sibilia: None declared, Jacques-Eric Gottenberg Grant/research support from: BMS, Pfizer, Consultant of: BMS, Sanofi-Genzyme, UCB, Speakers bureau: Abbvie, Eli Lilly and Co., Roche, Sanofi-Genzyme, UCB, Anne-Sophie Korganow: None declared, Laurent Arnaud: None declared, Thierry Martin: None declared

AB0510 INFLIXIMAB IS AN EFFECTIVE GLUCOCORTICOID-SPARING TREATMENT FOR TAKAYASU ARTERITIS: RESULTS OF A MULTICENTER OPEN-LABEL PROSPECTIVE STUDY

Background:

Approximately half of patients with Takayasu Arteritis (TA) have glucocorticoid (GC)-dependency and require the addition of a second-line immunosuppressive treatment.

Objectives:

Here, we conducted a multicenter open-label prospective cohort study to assess the efficacy and safety of infliximab originator as a GC-sparing agent in TA.

Methods:

A temporary recommendation for use for infliximab in refractory TA was approved by the French National Drug Authorities (April 2014). Infliximab was administered to patients in case of disease activity with a NIH score ≥2 despite conventional therapy. Data regarding patient’s clinical, laboratory, imaging and treatments were obtained at baseline, and at each following visit until last visit (October 2017). TA activity was evaluated according to NIH criteria and GC requirement throughout the study.

Results:

Twenty-three patients were enrolled, including 19 female. The median age at inclusion was 33 years (Interquartile range, IQR: 23-44 years). At baseline, 17 (74%) patients were treated with GCs, at a median dose of 10 mg/day (IQR: 0-21) of prednisone-equivalent. After a median follow-up of 36.9 months (IQR: 10-58.7), improvement of ≥1 NIH criterion of TA activity was achieved for 14/22 (64%) patients. The median GC dose was 8 mg/day (IQR: 7-10) at 6 months; 5 mg/day (IQR: 0-8) at 12 months and 0 mg/day (IQR: 0-5) at 36 months of follow-up. Overall, infliximab originator had a significant GC-sparing effect between baseline and last follow-up (p=0.009).

Conclusion:

This multicenter open-label cohort study suggests that infliximab originator is an effective GC-sparing treatment for TA refractory to conventional therapy.

Disclosure of Interests:

None declared

FRI0249 IN MYOSITIS PATIENTS, SJÖGREN’S SYNDROME IS ASSOCIATED WITH INCLUSION BODY MYOSITIS AND WITH ANTI-CN1A ANTIBODIES INDEPENDENTLY OF THE MYOSITIS SUBTYPE

Background:

Myositis are characterized by weakness and muscle inflammation. They encompass heterogeneous conditions, which include dermatomyositis (DM), inclusion body myositis (IBM) and polymyositis (PM) according to the EULAR/ACR 2017 criteria. We recently recorded a high prevalence of IBM in a cohort of primary Sjögren’s syndrome (SS) (1). The signification of SS in the setting of myositis is unanswered.

Objectives:

To refine the signification of SS in the setting of myositis.

Methods:

Among a monocentric myositis cohort (according to the EULAR/ACR 2017 criteria), SS patients (according to the ACR/EULAR 2016 criteria) were identified (myositis/SS+ group) and compared to myositis patients without SS (myositis/SS- group).

Results:

Among 414 myositis patients, SS criteria were available for 96 patients. Thirty two (33%) presented SS. Patients with SS tended to be more frequently women (F/M ratio 9.7 vs 3.0, p = 0.07). Age at diagnosis of myositis was similar in both groups (53 years [range 21-74] vs 53 years [range 16-77], p = 0.51).

Myositis subtypes repartition (as defined by EULAR/ACR 2017 criteria) was different in myositis/SS+ and myositis/SS- groups (p = 0.021), IBM being four-fold more prevalent in myositis/SS+ group (25% vs 6%, p = 0.018). Accordingly, the delay between the first muscle symptoms and myositis diagnosis was longer in myositis/SS+ group (7 months [0-336] vs 4 months [0-122], p = 0.041). Moreover, aside anti-cN1A antibodies, myositis-specific antibodies were less frequently found in myositis/SS+ patients than in myositis/SS- ones (16/32 [50%] vs 46/64 [72%], p = 0.035).

Anti-cN1A antibodies were more prevalent in myositis/SS+ patients (33% vs 5.8%, p = 0.0032). However, in myositis/SS+ group, anti-cN1A were frequent in each of the EULAR/ACR 2017 myositis subtypes and the association between SS and anti-cN1A positivity was maintained in a multivariate analysis adjusted with the diagnosis of IBM (p = 0.023).

Seven of the myositis/SS+ patients (22%) had systemic involvement typical of SS (vs 6 [9%] of the myositis/SS- patients, p = 0.12) including polyneuropathy (6 [20%] vs 6 [10%]) and type 2 cryoglobulinaemic vasculitis (1 [3%] vs 1 [1.6%]). In addition, 2 (6%) myositis/SS+ patients developed a lymphoma (one B diffuse large cell lymphoma of the parotid and one non-Hodgkin lymphoma), vs none of the myositis/SS- patients (p = 0.11). Only one (3%) of the myositis/SS+ patients developed myositis-associated cancer (diagnosed within 3 years of myositis diagnosis) versus 6 (9%) of the myositis/SS- patients (p = 0.66).

Aside hydroxychloroquine, more frequently used in myositis/SS+ group (38% vs 16%, p = 0.018), no significant difference was found in the management of the patients (taking into account the myositis subtype).

Conclusion:

Myositis patients with SS have more frequently IBM than myositis patients without SS. They also have more frequently anti-cN1A antibodies, independently of the myositis subtype. They might develop systemic complications of SS.

References:

[1]Felten R, Seror R, Vittecoq O, Hachulla E, Perdriger A, Dieude P, et al. SAT0470 Myositis, often suspected, is actually rare in primary Sjögren’s syndrome: data from the French cohort ASSESS. In BMJ Publishing Group Ltd and European League Against Rheumatism; 2018. p. 1093.1–1093. Available from:http://ard.bmj.com/lookup/doi/10.1136/annrheumdis-2018-eular.2945

Disclosure of Interests:

Dan LEVY: None declared, Benoit Nespola: None declared, Margherita Giannini: None declared, Renaud FELTEN: None declared, Coralie Varoquier: None declared, Marina Rinagel: None declared, Anne-Sophie Korganow: None declared, Vincent Poindron: None declared, Thierry Martin: None declared, Francois Maurier: None declared, Hassam Chereih: None declared, Bastien Bouldoires: None declared, Baptiste Hervier: None declared, Cédric Lenormand: None declared, Laurent Arnaud: None declared, Bernard Geny: None declared, Jean Sibilia: None declared, Jacques-Eric Gottenberg Grant/research support from: BMS, Pfizer, Consultant of: BMS, Sanofi-Genzyme, UCB, Speakers bureau: Abbvie, Eli Lilly and Co., Roche, Sanofi-Genzyme, UCB, alain meyer: None declared

Properties of Neon, Magnesium, and Silicon Primary Cosmic Rays Results from the Alpha Magnetic Spectrometer

We report the observation of new properties of primary cosmic rays, neon (Ne), magnesium (Mg), and silicon (Si), measured in the rigidity range 2.15 GV to 3.0 TV with 1.8×10^{6}  Ne, 2.2×10^{6}  Mg, and 1.6×10^{6}  Si nuclei collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. The Ne and Mg spectra have identical rigidity dependence above 3.65 GV. The three spectra have identical rigidity dependence above 86.5 GV, deviate from a single power law above 200 GV, and harden in an identical way. Unexpectedly, above 86.5 GV the rigidity dependence of primary cosmic rays Ne, Mg, and Si spectra is different from the rigidity dependence of primary cosmic rays He, C, and O. This shows that the Ne, Mg, and Si and He, C, and O are two different classes of primary cosmic rays.

Nevirapine Use Is Associated with Higher Bone Mineral Density in HIV-1 Positive Subjects on Long-Term Antiretroviral Therapy

We assessed bone mineral density (BMD) in a cohort of human immunodeficiency virus (HIV)-positive patients after a median of 11 years of combination antiretroviral therapy (cART) and evaluated the respective role of HIV infection and antiretroviral drugs (ARVs). A cross-sectional study of 162 participants (131 male) from the ANRS-C08 cohort was performed with bone dual-energy X-ray absorptiometry (DXA) scans and renal assessment. The window of exposure to ARVs was defined as an exposure of more than six cumulative months during the last 3 years before the DXA evaluation to account for a cumulative exposure that could affect bone remodeling. The association with low BMD (Z-score < -2) was assessed by a multiple logistic regression model. The study population was 50 years (median), hepatitis C virus (HCV) (18%), and hepatitis B virus (HBV) (8%) coinfection with HIV-RNA <50 c/mL in 89%, median CD4 of 619/mm³. Prevalence of low BMD was 18% in males and 6% in females. The factors associated with a Z-score < -2 in males were uric acid renal loss [adjusted odds ratio (aOR): 6.1; 95% confidence interval (CI): 1.2-31.5; p = .03], HCV coinfection (aOR: 4.0; 95% CI: 1.3-12.2; p = .02), and less frequent window of exposure to nevirapine (NVP) (aOR: 0.1; 95% CI: 0.02-0.6; p = .01). For the full study sample, there was a strong positive association between duration of exposure to NVP and lumbar spine Z-score (p = .004). HIV-positive patients exposed to long-term cART have a high incidence of low BMD. Tenofovir disoproxil fumarate and ritonavir-boosted protease inhibitors did not seem to be associated with increased risk of low BMD, whereas NVP exposure appeared to have an independent positive association.

Confidential image transfer: an ethico-legal dilemma

Clinical photographs aid decision-making and represent important medicolegal records. Storage and transfer of images of the facial area must adhere to Caldicott Principles. Outside working hours, clinical photography services are often limited. Our Trust has introduced a Secure Clinical Image Transfer (SCIT) app allowing clinicians to take photographs on personal devices to be securely uploaded to the patient's electronic health record. To evaluate whether clinicians were taking clinical images in an insecure manner, clinicians completed an anonymous questionnaire before and after introduction of the SCIT app. The standard was 100% knowledge of, and adherence to, trust information governance guidelines. Response rate was 100% in both cycles. Introduction of the SCIT app reduced inappropriate clinical photography on personal devices. Our completed audit cycle shows that the SCIT app allows convenient, secure information capture on personal devices and automatic secure synchronisation to trust electronic health records.

Geographic disparities in bladder cancer incidence among women in the department of Bouches-du-Rhône

Key messages

We identify for the first time a cluster of bladder cancers in women in France. Practitioners need to think about bladder cancers in women with urinary signs because this cancer will become a public health issue in the future.