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Fraunhoffer N, Hammel P, Conroy T, Nicolle R, Bachet JB, Harlé A, Rebours V, Turpin A, Ben Abdelghani M, Mitry E, Biagi J, Chanez B, Bigonnet M, Lopez A, Evesque L, Lecomte T, Assenat E, Bouché O, Renouf DJ, Lambert A, Monard L, Mauduit M, Cros J, Iovanna J, Dusetti N. Development and validation of AI-assisted transcriptomic signatures to personalize adjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma. Ann Oncol 2024; 35:780-791. [PMID: 38906254 DOI: 10.1016/j.annonc.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/14/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND After surgical resection of pancreatic ductal adenocarcinoma (PDAC), patients are predominantly treated with adjuvant chemotherapy, commonly consisting of gemcitabine (GEM)-based regimens or the modified FOLFIRINOX (mFFX) regimen. While mFFX regimen has been shown to be more effective than GEM-based regimens, it is also associated with higher toxicity. Current treatment decisions are based on patient performance status rather than on the molecular characteristics of the tumor. To address this gap, the goal of this study was to develop drug-specific transcriptomic signatures for personalized chemotherapy treatment. PATIENTS AND METHODS We used PDAC datasets from preclinical models, encompassing chemotherapy response profiles for the mFFX regimen components. From them we identified specific gene transcripts associated with chemotherapy response. Three transcriptomic artificial intelligence signatures were obtained by combining independent component analysis and the least absolute shrinkage and selection operator-random forest approach. We integrated a previously developed GEM signature with three newly developed ones. The machine learning strategy employed to enhance these signatures incorporates transcriptomic features from the tumor microenvironment, leading to the development of the 'Pancreas-View' tool ultimately clinically validated in a cohort of 343 patients from the PRODIGE-24/CCTG PA6 trial. RESULTS Patients who were predicted to be sensitive to the administered drugs (n = 164; 47.8%) had longer disease-free survival (DFS) than the other patients. The median DFS in the mFFX-sensitive group treated with mFFX was 50.0 months [stratified hazard ratio (HR) 0.31, 95% confidence interval (CI) 0.21-0.44, P < 0.001] and 33.7 months (stratified HR 0.40, 95% CI 0.17-0.59, P < 0.001) in the GEM-sensitive group when treated with GEM. Comparatively patients with signature predictions unmatched with the treatments (n = 86; 25.1%) or those resistant to all drugs (n = 93; 27.1%) had shorter DFS (10.6 and 10.8 months, respectively). CONCLUSIONS This study presents a transcriptome-based tool that was developed using preclinical models and machine learning to accurately predict sensitivity to mFFX and GEM.
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Ratovomanana T, Nicolle R, Cohen R, Diehl A, Siret A, Letourneur Q, Buhard O, Perrier A, Guillerm E, Coulet F, Cervera P, Benusiglio P, Labrèche K, Colle R, Collura A, Despras E, Le Rouzic P, Renaud F, Cros J, Alentorn A, Touat M, Ayadi M, Bourgoin P, Prunier C, Tournigand C, de la Fouchardière C, Tougeron D, Jonchère V, Bennouna J, de Reynies A, Fléjou JF, Svrcek M, André T, Duval A. Prediction of Response to Immune Checkpoint Blockade in Patients with Metastatic Colorectal Cancer with Microsatellite Instability. Ann Oncol 2023:S0923-7534(23)00695-6. [PMID: 37269904 DOI: 10.1016/j.annonc.2023.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Mismatch repair deficient (dMMR) tumors displaying microsatellite instability (MSI) represent a paradigm for the success of immune checkpoint inhibitor (ICI)-based immunotherapy, particularly in patients with metastatic colorectal cancer (mCRC). However, a proportion of patients with dMMR/MSI mCRC exhibit resistance to ICI. Identification of tools predicting MSI mCRC patient response to ICI are required for the design of future strategies further improving this therapy. PATIENTS AND METHODS We combined high-throughput DNA and RNA sequencing of tumors from 116 patients with MSI mCRC treated with anti-PD-1 +/- anti-CTLA-4 of the NIPICOL phase II trial (C1, NCT03350126, discovery set) and the IMMUNOMSI prospective cohort (C2, validation set). The DNA/RNA predictors whose status was significantly associated with ICI status of response in C1 were subsequently validated in C2. Primary endpoint was iPFS (progression-free survival by iRECIST). RESULTS Analyses showed no impact of previously suggested DNA/RNA indicators of resistance to ICI, e.g., MSISensor score, tumor mutational burden, or specific cellular and molecular tumoral contingents. By contrast, iPFS under ICI was shown in C1 and C2 to depend both on a multiplex MSI signature involving the mutations of 19 microsatellites (HRC2 = 3.63; 95% CI [1.65-7.99] ; p = 1.4x10-3) and the expression of a set of 182 RNA markers with a non-epithelial TGFB-related desmoplastic orientation (HRC2 = 1.75 ; 95% CI [1.03-2.98] ; p = 0.035). Both DNA and RNA signatures were independently predictive of iPFS. CONCLUSIONS iPFS in patients with MSI mCRC can be predicted by simply analyzing the mutational status of DNA microsatellite-containing genes in epithelial tumor cells together with nonepithelial TGFB-related desmoplastic RNA markers.
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De Dreuille B, Nicolle R, Cazals-Hatem D, Cros J, Bado A, Le Beyec-Le Bihan J, Le Gall M, Joly F. Glp-2 Modulated Genes In Adult Patients With Short Bowel Syndrome Treated With Teduglutide. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Tarancón A, Novella O, Pujadas M, Batlle M, Cros J, García J. Development of an equipment for real-time continuous monitoring of alpha and beta radioactivity in river water. Appl Radiat Isot 2022; 187:110322. [DOI: 10.1016/j.apradiso.2022.110322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 05/17/2022] [Accepted: 06/07/2022] [Indexed: 11/02/2022]
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Nicolle R, Gayet O, Bigonnet M, Roques J, Chanez B, Puleo F, Augustin J, Emile JF, Svrcek M, Arsenijevic T, Hammel P, Rebours V, Giovannini M, Grandval P, Dahan L, Moutardier V, Mitry E, Van Laethem JL, Bachet JB, Cros J, Iovanna J, Dusetti NJ. Relevance of biopsy-derived pancreatic organoids in the development of efficient transcriptomic signatures to predict adjuvant chemosensitivity in pancreatic cancer. Transl Oncol 2021; 16:101315. [PMID: 34906890 PMCID: PMC8681024 DOI: 10.1016/j.tranon.2021.101315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 02/07/2023] Open
Abstract
Most patient with pancreatic cancer are treated by chemotherapy. Treatments selection are not personalized on the tumor characteristics. Signatures predicting chemotherapy efficiency are essential for personalizing treatments. An RNA signature of gemcitabine-sensitivity is developed leveraged on the dissimilarities between 2D and 3D in vitro models. Combining different in vitro models can help in defining clinically efficient transcriptomic signatures. Pancreatic ductal adenocarcinoma (PDAC) patients are frequently treated by chemotherapy. Even if personalized therapy based on molecular analysis can be performed for some tumors, PDAC regimens selection is still mainly based on patients' performance status and expected efficacy. Therefore, the establishment of molecular predictors of chemotherapeutic efficacy could potentially improve prognosis by tailoring treatments. We have recently developed an RNA-based signature that predicts the efficacy of adjuvant gemcitabine using 38 PDAC primary cell cultures. While demonstrated its efficiency, a significant association with the classical/basal-like PDAC spectrum was observed. We hypothesized that this flaw was due to the basal-like biased phenotype of cellular models used in our strategy. To overcome this limitation, we generated a prospective cohort of 27 consecutive biopsied derived pancreatic organoids (BDPO) and include them in the signature identification strategy. As BDPO's do not have the same biased phenotype as primary cell cultures we expect they can compensate one with each other and cover a broader range of molecular phenotypes. We then obtained an improved signature predicting gemcitabine sensibility that was validated in a cohort of 300 resected PDAC patients that have or have not received adjuvant gemcitabine. We demonstrated a significant association between the improved signature and the overall and disease-free survival in patients predicted as sensitive and treated with adjuvant gemcitabine. We propose then that including BDPO along primary cell cultures represent a powerful strategy that helps to overcome primary cell cultures limitations producing unbiased RNA-based signatures predictive of adjuvant treatments in PDAC.
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Nicolle R, Gayet O, Duconseil P, Vanbrugghe C, Roques J, Bigonnet M, Blum Y, Elarouci N, Armenoult L, Ayadi M, de Reyniès A, Puleo F, Augustin J, Emile J, Svrcek M, Arsenijevic T, Hammel P, Giovannini M, Grandval P, Dahan L, Moutardier V, Gilabert M, Van Laethem J, Bachet J, Cros J, Iovanna J, Dusetti N. A transcriptomic signature to predict adjuvant gemcitabine sensitivity in pancreatic adenocarcinoma. Ann Oncol 2021; 32:250-260. [DOI: 10.1016/j.annonc.2020.10.601] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 01/07/2023] Open
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Azoulay A, Cros J, Vullierme MP, de Mestier L, Couvelard A, Hentic O, Ruszniewski P, Sauvanet A, Vilgrain V, Ronot M. Morphological imaging and CT histogram analysis to differentiate pancreatic neuroendocrine tumor grade 3 from neuroendocrine carcinoma. Diagn Interv Imaging 2020; 101:821-830. [PMID: 32709455 DOI: 10.1016/j.diii.2020.06.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE To compare morphological imaging features and CT texture histogram parameters between grade 3 pancreatic neuroendocrine tumors (G3-NET) and neuroendocrine carcinomas (NEC). MATERIALS AND METHODS Patients with pathologically proven G3-NET and NEC, according to the 2017 World Health Organization classification who had CT and MRI examinations between 2006-2017 were retrospectively included. CT and MRI examinations were reviewed by two radiologists in consensus and analyzed with respect to tumor size, enhancement patterns, hemorrhagic content, liver metastases and lymphadenopathies. Texture histogram analysis of tumors was performed on arterial and portal phase CT images. images. Morphological imaging features and CT texture histogram parameters of G3-NETs and NECs were compared. RESULTS Thirty-seven patients (21 men, 16 women; mean age, 56±13 [SD] years [range: 28-82 years]) with 37 tumors (mean diameter, 60±46 [SD] mm) were included (CT available for all, MRI for 16/37, 43%). Twenty-three patients (23/37; 62%) had NEC and 14 patients (14/37; 38%) had G3-NET. NECs were larger than G3-NETs (mean, 70±51 [SD] mm [range: 18 - 196mm] vs. 42±24 [SD] mm [range: 8 - 94mm], respectively; P=0.039), with more tumor necrosis (75% vs. 33%, respectively; P=0.030) and lower attenuation on precontrast (30±4 [SD] HU [range: 25-39 HU] vs. 37±6 [SD] [range: 25-45 HU], respectively; P=0.002) and on portal venous phase CT images (75±18 [SD] HU [range: 43 - 108 HU] vs. 92±19 [SD] HU [range: 46 - 117 HU], respectively; P=0.014). Hemorrhagic content on MRI was only observed in NEC (P=0.007). The mean ADC value was lower in NEC ([1.1±0.1 (SD)]×10-3 mm2/s [range: (0.91 - 1.3)×10-3 mm2/s] vs. [1.4±0.2 (SD)]×10-3 mm2/s [range: (1.1 - 1.6)×10-3 mm2/s]; P=0.005). CT histogram analysis showed that NEC were more heterogeneous on portal venous phase images (Entropy-0: 4.7±0.2 [SD] [range: 4.2-5.1] vs. 4.5±0.4 [SD] [range: 3.7-4.9]; P=0.023). CONCLUSION Pancreatic NECs are larger, more frequently hypoattenuating and more heterogeneous with hemorrhagic content than G3-NET on CT and MRI.
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Deguelte S, de Mestier L, Hentic O, Cros J, Lebtahi R, Hammel P, Kianmanesh R. Sporadic pancreatic neuroendocrine tumor: Surgery of the primary tumor. J Visc Surg 2018; 155:483-492. [PMID: 30448206 DOI: 10.1016/j.jviscsurg.2018.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The management of patients with sporadic pancreatic neuroendocrine tumors (PNET) is multi-disciplinary and often, multimodal. Surgery has a large part in treatment because it is the only potentially curative therapeutic modality if resection can be complete. The update reviews the operative indications and the different surgical techniques available (including parenchymal-sparing surgery) to treat the primary lesion according to patient status, preoperative work-up and whether the tumor is functioning or not. The place of observation for "small" non-functional sporadic PNET is also discussed.
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Deguelte S, de Mestier L, Hentic O, Cros J, Lebtahi R, Hammel P, Kianmanesh R. Preoperative imaging and pathologic classification for pancreatic neuroendocrine tumors. J Visc Surg 2018; 155:117-125. [PMID: 29397338 DOI: 10.1016/j.jviscsurg.2017.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The management of patients with pancreatic neuroendocrine tumor (PNET), whether hormonally secretory or not, is multidisciplinary and often multimodal. Surgical treatment plays a central role because complete resection is the only potentially curative treatment. The choice of the therapeutic plan for a PNET requires precise localization of the primary tumor (which may sometimes be multiple in case of genetic predisposition), confirmation of the diagnosis of PNET, a search for metastases (mainly hepatic), and identification of the main histoprognostic factors. This update focuses on the WHO 2017 histological classification and recent innovations in the preoperative assessment of PNET using conventional and isotopic imaging. The aim is to not only allow the mapping of primary and metastatic lesions but also to predict tumor aggressiveness.
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Ahmed O, Pommier R, Cros J, Sauvanet A. A false postoperative recurrence of intraductal and papillary mucinous neoplasm of the pancreas. J Visc Surg 2018; 155:165-166. [PMID: 29291923 DOI: 10.1016/j.jviscsurg.2017.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Stenosis of pancreatico-digestive anastomoses following pancreaticoduodenectomy is frequently observed. In a patient operated on for intraductal papillary and mucinous neoplasm, it can induce a massive dilatation of the main pancreatic duct leading to the misdiagnosis of tumor recurrence with main duct involvement.
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Hammel P, Bachet JB, Portales F, Mineur L, Metges JP, de la Fouchardiere C, Louvet C, El Hajbi F, Faroux R, Guimbaud R, Tougeron D, Volet J, Lecomte T, Tournigand C, Rebischung C, Berlier W, Gupta A, Cros J, André T, El-Hariry I. A Phase 2b of eryaspase in combination with gemcitabine or FOLFOX as second-line therapy in patients with metastatic pancreatic adenocarcinoma (NCT02195180). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Jegatheesan P, Surowska A, Campos V, Cros J, Stefanoni N, Rey V, Schneiter P, De Bandt JP, Tappy L. MON-P291: Dietary Protein Content Modulates the Amino-Acid and IGF1 Responses to Sucrose Overfeeding in Humans. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30798-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cros J, Hentic O, Rebours V, Zappa M, Gille N, Theou-Anton N, Vernerey D, Maire F, Lévy P, Bedossa P, Paradis V, Hammel P, Ruszniewski P, Couvelard A. MGMT expression predicts response to temozolomide in pancreatic neuroendocrine tumors. Endocr Relat Cancer 2016; 23:625-33. [PMID: 27353036 DOI: 10.1530/erc-16-0117] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 06/28/2016] [Indexed: 01/31/2023]
Abstract
Temozolomide (TEM) showed encouraging results in well-differentiated pancreatic neuroendocrine tumors (WDPNETs). Low O(6)-methylguanine-DNA methyltransferase (MGMT) expression and MGMT promoter methylation within tumors correlate with a better outcome under TEM-based chemotherapy in glioblastoma. We aimed to assess whether MGMT expression and MGMT promoter methylation could help predict the efficacy of TEM-based chemotherapy in patients with WDPNET. Consecutive patients with progressive WDPNET and/or liver involvement over 50% who received TEM between 2006 and 2012 were retrospectively studied. Tumor response was assessed according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 guidelines. Nuclear expression of MGMT was assessed by immunochemistry (H-score, 0-300) and MGMT promoter methylation by pyrosequencing. Forty-three patients (21 men, 58years (27-84)) with grade 1 WDPNET (n=6) or 2 (n=36) were analyzed. Objective response, stable disease, and progression rates were seen in 17 patients (39.5%), 18 patients (41.9%), and 8 patients (18.6%), respectively. Low MGMT expression (≤50) was associated with radiological objective response (P=0.04) and better progression-free survival (PFS) (HR=0.35 (0.15-0.81), P=0.01). Disease control rate at 18months of treatment remained satisfying with an MGMT score up to 100 (74%) but dropped with a higher expression. High MGMT promoter methylation was associated with a low MGMT expression and longer PFS (HR=0.37 (0.29-1.08), P=0.05). Low MGMT score (≤50) appears to predict an objective tumor response, whereas an intermediate MGMT score (50-100) seems to be associated with prolonged stable disease.
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Tarancón A, Novella O, Batlle M, Pujadas M, Cros J, García JF. Robustness of plastic scintillation microspheres in the continuous measurement of different river waters. Appl Radiat Isot 2016; 114:145-53. [PMID: 27235888 DOI: 10.1016/j.apradiso.2016.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 04/22/2016] [Accepted: 05/13/2016] [Indexed: 11/18/2022]
Abstract
Plastic scintillation microspheres (PSm) represent one of the most promising options for monitoring alpha and beta radioactivity in river water. For that reason, a study of the stability of PSm packed into a cell against the continuous flow of river water with different degrees of turbidity was performed over a period of 100h. The results showed that the volume of the cell became stable after 15h of pumping and continued to be stable throughout the 100h of the experiment. During this period of time, the detection efficiency of the PSm, in terms of efficiency*volume, presented mean values of 0.75(3)% for (3)H and 272(11)% for (90)Sr/(90)Y. No dependence on flow time or river water type was observed. The background was also constant for 100h and for the different water types, although (222)Rn should be removed from the water beforehand to prevent its accumulation in the PSm. Since PSm did not present any degradation throughout the whole experiment, PSm can undoubtedly be used for monitoring radioactivity with low reagent consumption, low waste generation and low maintenance costs.
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Ballouhey Q, Fourcade L, Lescure V, Chuffart E, Romain J, Cros J, Garnier F, Guigonis V. P-076 – Variation de la contamination des urines au cours du jet. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ramirez L, Cros J, Marin B, Boulogne P, Bergeron A, de Lafont G, Renon-Carron F, de Vinzelles MA, Guigonis V, Nathan N, Beaulieu P. Analgesic interaction between ondansetron and acetaminophen after tonsillectomy in children: The Paratron randomized, controlled trial. Eur J Pain 2014; 19:661-8. [DOI: 10.1002/ejp.587] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2014] [Indexed: 12/21/2022]
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Platikanov S, Rodriguez-Mozaz S, Huerta B, Barceló D, Cros J, Batle M, Poch G, Tauler R. Chemometrics quality assessment of wastewater treatment plant effluents using physicochemical parameters and UV absorption measurements. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2014; 140:33-44. [PMID: 24726963 DOI: 10.1016/j.jenvman.2014.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 03/15/2014] [Accepted: 03/17/2014] [Indexed: 06/03/2023]
Abstract
Chemometric techniques like Principal Component Analysis (PCA) and Partial Least Squares Regression (PLS) are used to explore, analyze and model relationships among different water quality parameters in wastewater treatment plants (WWTP). Different data sets generated by laboratory analysis and by an automatic multi-parametric monitoring system with a new designed optical device have been investigated for temporal variations on water quality parameters measured in the water influent and effluent of a WWTP over different time scales. The obtained results allowed the discovery of the more important relationships among the monitored parameters and of their cyclic dependence on time (daily, monthly and annual cycles) and on different plant management procedures. This study intended also the modeling and prediction of concentrations of several water components and parameters, especially relevant for water quality assessment, such as Dissolved Organic Matter (DOM), Total Organic Carbon (TOC) nitrate, detergent, and phenol concentrations. PLS models were built to correlate target concentrations of these constituents with UV spectra measured in samples collected at (1) laboratory conditions (in synthetic water mixtures); and at (2) WWTP conditions (in real water samples from the plant). Using synthetic water mixtures, specific wavelengths were selected with the aim to establish simple and reliable prediction models, which gave good relative predictions with errors of around 3-4% for nitrates, detergent and phenols concentrations and of around 15% for the DOM in external validation. In the case of nitrate and TOC concentrations modeling in real water samples from the effluent of the WWTP using the reduced spectral data set, results were also promising with low prediction errors (less than 20%).
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Ponsonnard S, Duvoid T, Gagnoud R, Dalmay F, Cros J, Nathan N. [Survey national professional practice on the use of the laryngeal mask]. ACTA ACUST UNITED AC 2014; 33:405-10. [PMID: 24961706 DOI: 10.1016/j.annfar.2014.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 05/26/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND This survey aimed to describe the current use of laryngeal mask (LM) and to define the difference of use according to a group defined like experts. METHODS A self-questionnaire available on Internet was sent by e-mail to French anesthesiologists. Results were compared by a Chi(2) test between anesthesiologists according to their expertise defined by a >750 LM use. RESULTS Nine hundred and fifty-three anesthesiologists answered to the survey. Only 19 reported never using LM and 37% of responders were defined as expert. More than half of the MAR used the ideal weight to set the size of the MLA to use. Pressure leak was sought by less than one-third of the MAR. In case of leakage, a mobilization of the ML or the patient's head was performed first. In second intention, nearly a quarter of MAR changed technique for the benefit of oral intubation. Only 50% of responders used LM as a rescue technique in case of difficult intubation and ventilation. Experts had less insertion failure and laryngospasm. Complications and medico-legal suites are few. CONCLUSIONS Variability of practice may be explained by low-grade recommendations in the literature. LM insertion in case of difficult intubation/ventilation to provide adequate oxygenation and should be formally reminded to clinicians.
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Ballouhey Q, Chuffart E, Cros J, Berenguer D, Romain J, Vaquerie V, Longis B, Fourcade L. Bronchogenic cyst excision using a robotic laparoscopic transdiaphragmatic approach. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2014. [DOI: 10.1016/j.epsc.2014.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Gagnoud R, Woillard JB, Ponsonnard S, Cros J, Youssef B, Nathan N. [Epidural analgesia apart from obstetrics: a survey of practice]. ACTA ACUST UNITED AC 2014; 33:318-25. [PMID: 24845409 DOI: 10.1016/j.annfar.2014.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 03/19/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To describe the current use of epidural anesthesia (EA) apart from obstetrics, and to explain the reasons of its low utilization. STUDY DESIGN Observational study. METHODS A survey of practice with a self-questionnaire was sent by e-mail and available on Internet. Answers were compared between groups doing or not an epidural analgesia with exact Fisher tests (P<0.05 statistically significant). RESULTS Among the 176 anesthesiologists who answered to the questionnaire, only 21.4% never used epidural analgesia. The main reasons were alternatives therapeutics such as PCA with opioids or TAP block (24/38 vs. 46/140). TAP block was the most common alternative used by more than 50% of anesthesiologists. Loss of competence (4/30 vs. 0/39) was rarely the reason to its low utilization. The low accessibility to specialized postoperative units was recognized in both groups as a limiting factor to do an epidural but not the fear of neurological complications. Those who never perform epidural analgesia were statistically more often physicians between 40 and 50 years (12/38 vs. 19/140). Heparin, aspirin and clopidogrel are no longer contraindications according to anesthesiologists less than 40 years old (50/68 vs. 31/68; 44/68 vs. 31/68; 37/68 vs. 23/68 respectively) but not for older. CONCLUSIONS Epidural analgesia is performed more often by younger anesthesiologists. This survey suggests the need of specific postoperative area to allow anesthesiologist to perform and supervise safely this technique. Recommendations of the French society of Anesthesiologists are also poorly applied.
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Ballouhey Q, Lescure V, Grimaudo Benaissa A, Berenguer D, Cros J, Verbecke S, Fourcade L. SFCP CO-41 - Scintigraphie rénale au MAG3 - quelles conditions d’interprétation ? Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71679-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cros J, Sbidian E, Hans S, Roussel H, Scotte F, Tartour E, Brasnu D, Laurent-Puig P, Bruneval P, Blons H, Badoual C. Expression and mutational status of treatment-relevant targets and key oncogenes in 123 malignant salivary gland tumours. Ann Oncol 2013; 24:2624-2629. [PMID: 23933559 DOI: 10.1093/annonc/mdt338] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Malignant tumours of the salivary glands (MSGT) are rare and pleomorphic entities. Patients with advanced disease may benefit from targeted therapy; however, specific targets for optimising and personalising treatments are yet to be identified. DESIGN Immunohistochemistry for C-KIT, EGFR, HER2, MUC1, phospho-mTOR, androgen/estrogens/progesterone receptors and Ki67 was carried out and evaluated in terms of progression-free and overall survival. High throughput molecular screening of key oncogenes was done in 107 patients using routine diagnostic methods and Sequenom technology. RESULTS Several therapy leads were identified, including high levels of HER2 and androgen receptors in salivary duct carcinomas, C-KIT in myoepithelial carcinomas and EGFR in mucoepidermoid carcinomas. Recurrent mutations involving downstream elements of the EGFR pathway were found in HRAS, notably in tumours with a myoepithelial component, and in other key oncogenes (KRAS/NRAS/PI3KCA/BRAF/MAP2K). On the other hand, <1% of samples had EGFR or HER2 mutations. CONCLUSION Several tumour subtypes overexpressed targets of directed therapies suggesting potential therapy leads. Genotyping results suggest activation downstream of EGFR in 18 of the 107 samples that could be associated with low efficacy of EGFR inhibitors. Other molecules, such as PI3K/MEK or mTOR inhibitors, may have anti-tumour activity in this subgroup. The high mutation rate in HRAS highlights a novel key oncogenic event in MSGT.
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Fourcade L, Pommepuy I, Mons F, Pham Dang A, Compagnon R, Longis B, Grimaudo A, Cros J, Berenguer D, Languepin J. Diagnostic et prise en charge de la maladie de Hirschsprung à la naissance. Arch Pediatr 2012. [DOI: 10.1016/s0929-693x(12)71120-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Martín de la Vega PT, Martínez de Salazar E, Jaramillo MA, Cros J. New contributions to the ORP & DO time profile characterization to improve biological nutrient removal. BIORESOURCE TECHNOLOGY 2012; 114:160-167. [PMID: 22483572 DOI: 10.1016/j.biortech.2012.03.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 03/12/2012] [Accepted: 03/13/2012] [Indexed: 05/31/2023]
Abstract
Changes in the oxidation-reduction potential (ORP), pH and dissolved oxygen (DO), along with organic load and nutrient removal in a municipal wastewater treatment plant (WWTP) have been monitored throughout one year. The "nitrate knee" and the "nitrate break point" in ORP profiles, the "nitrate apex" and the "ammonia valley" in pH profiles and the "DO elbow" in DO profiles have been identified. Furthermore, these bending points have been correlated with the oxygen uptake rate (OUR), the temperature in the vessel and the aeration and non-aeration time profiles by using Principal Component Analysis (PCA). The data have been previously split up into wet and dry weather cycles by means of a K-means clustering algorithm. Finally, two new parameters have been defined: the "ORP Arrow", which is closely related to the inhibition of the denitrification process, and the "Oxygen Rise Average Slope" (ORAS), which shows the oxygen transfer rate.
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Cros J, Letierce A, Posseme K, Benoit G, Guettier C, Ferlicot S. Identification de nouveaux marqueurs moléculaires à valeur pronostique des adénocarcinomes à cellules claires du rein. Ann Pathol 2011. [DOI: 10.1016/j.annpat.2011.09.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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