Communauté urbaine de Lyon

The crucial differences between normal cells and cancer cells stem from discrete changes in specific genes controlling proliferation and tissue homeostasis. Over 100 such cancer-related genes have been discovered, several of which are implicated in the natural history of human cancer because they are consistently found to be mutated in tumors. The p53 tumor-suppressor gene is the most striking example because it is mutated in about half of almost all types of cancer arising from a wide spectrum of tissues. Other tumor-suppressor genes important in human cancers, such as adenomatous polyposis coli, Wilms' tumor type 1, and neurofibromatosis type 1, . . .

Microorganisms are vital in mediating the earth’s biogeochemical cycles; yet, despite our rapidly increasing ability to explore complex environmental microbial communities, the relationship between microbial community structure and ecosystem processes remains poorly understood. Here, we address a fundamental and unanswered question in microbial ecology: ‘When do we need to understand microbial community structure to accurately predict function?’ We present a statistical analysis investigating the value of environmental data and microbial community structure independently and in combination for explaining rates of carbon and nitrogen cycling processes within 82 global datasets. Environmental variables were the strongest predictors of process rates but left 44% of variation unexplained on average, suggesting the potential for microbial data to increase model accuracy. Although only 29% of our datasets were significantly improved by adding information on microbial community structure, we observed improvement in models of processes mediated by narrow phylogenetic guilds via functional gene data, and conversely, improvement in models of facultative microbial processes via community diversity metrics. Our results also suggest that microbial diversity can strengthen predictions of respiration rates beyond microbial biomass parameters, as 53% of models were improved by incorporating both sets of predictors compared to 35% by microbial biomass alone. Our analysis represents the first comprehensive analysis of research examining links between microbial community structure and ecosystem function. Taken together, our results indicate that a greater understanding of microbial communities informed by ecological principles may enhance our ability to predict ecosystem process rates relative to assessments based on environmental variables and microbial physiology.

In this article, a dataset from a collaborative non-target screening trial organised by the NORMAN Association is used to review the state-of-the-art and discuss future perspectives of non-target screening using high-resolution mass spectrometry in water analysis. A total of 18 institutes from 12 European countries analysed an extract of the same water sample collected from the River Danube with either one or both of liquid and gas chromatography coupled with mass spectrometry detection. This article focuses mainly on the use of high resolution screening techniques with target, suspect, and non-target workflows to identify substances in environmental samples. Specific examples are given to emphasise major challenges including isobaric and co-eluting substances, dependence on target and suspect lists, formula assignment, the use of retention information, and the confidence of identification. Approaches and methods applicable to unit resolution data are also discussed. Although most substances were identified using high resolution data with target and suspect-screening approaches, some participants proposed tentative non-target identifications. This comprehensive dataset revealed that non-target analytical techniques are already substantially harmonised between the participants, but the data processing remains time-consuming. Although the objective of a "fully-automated identification workflow" remains elusive in the short term, important steps in this direction have been taken, exemplified by the growing popularity of suspect screening approaches. Major recommendations to improve non-target screening include better integration and connection of desired features into software packages, the exchange of target and suspect lists, and the contribution of more spectra from standard substances into (openly accessible) databases. Graphical Abstract Matrix of identification approach versus identification confidence.

INTRODUCTION: The aim of this study was to determine the prevalence of burnout, and of associated factors, amongst family doctors (FDs) in European countries. Methodology. A cross-sectional survey of FDs was conducted using a custom-designed and validated questionnaire which incorporated the Maslach Burnout Inventory Human Services Survey (MBI-HSS) as well as questions about demographic factors, working experience, health, lifestyle and job satisfaction. MBI-HSS scores were analysed in the three dimensions of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). RESULTS: Almost 3500 questionnaires were distributed in 12 European countries, and 1393 were returned to give a response rate of 41%. In terms of burnout, 43% of respondents scored high for EE burnout, 35% for DP and 32% for PA, with 12% scoring high burnout in all three dimensions. Just over one-third of doctors did not score high for burnout in any dimension. High burnout was found to be strongly associated with several of the variables under study, especially those relative to respondents' country of residence and European region, job satisfaction, intention to change job, sick leave utilization, the (ab)use of alcohol, tobacco and psychotropic medication, younger age and male sex. CONCLUSIONS: Burnout seems to be a common problem in FDs across Europe and is associated with personal and workload indicators, and especially job satisfaction, intention to change job and the (ab)use of alcohol, tobacco and medication. The study questionnaire appears to be a valid tool to measure burnout in FDs. Recommendations for employment conditions of FDs and future research are made, and suggestions for improving the instrument are listed.

Abstract The aim of this study was to compare match performance in professional soccer players across two major European championships: Spanish La Liga and English FA Premier League (FAPL). Data were collected using a computerized match analysis system. A total of 5938 analyses were recorded during the 2006–2007 season. The players were classified into six positional roles: central defenders, full backs, central defensive midfielders, wide midfielders, central attacking midfielders, and forwards. The match performance variables analysed included: (i) physical activity – total distance covered, distances covered at high‐intensities both with and without possession of the ball; (ii) technical actions – heading and ground duels, passing, time in possession, and ball touches. Comparison of the total distance covered by FAPL and La Liga players showed no difference across individual playing positions but FAPL players generally covered greater distances in sprinting. In contrast, more of the total distance in sprinting was covered by La Liga players when their team was in possession (values from P < 0.05 to P < 0.001), while an equal total sprint distance, irrespective of possession, was observed in FAPL players. La Liga players won more heading duels (49.32% vs. 48.68%) and performed the same proportion of successful passes (76.17%). FAPL wide midfielders had ~20% more ball touches per possession than their La Liga counterparts (2.24±0.54 vs. 2.03±0.55, P < 0.001). In conclusion, our results show that FAPL and La Liga teams present differences in various physical and technical aspects of match‐play, suggesting that cultural differences may exist across professional soccer leagues and playing positions.

In Brief Study Design. A retrospective study of the sagittal alignment in developmental spondylolisthesis. Objectives. To investigate the role of pelvic anatomy and its effect on the global balance of the trunk in developmental spondylolisthesis. Summary of Background Data. Pelvic incidence (PI) is a fundamental anatomic parameter that is specific and constant for each individual, and independent of the three-dimensional orientation of the pelvis. Recent studies have suggested an association between a high PI and patients with isthmic spondylolisthesis. Methods. The lateral standing radiographs of the spine and pelvis of 214 subjects with developmental L5–S1 spondylolisthesis were analyzed with a dedicated software allowing the calculation of the following parameters: pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), and grade of spondylolisthesis. All measurements were done by the same individual and compared to those of a cohort of 160 normal subjects. Student’s tests were used to compare the parameters between the curve types and Pearson’s correlation coefficients were used to investigate the association between all parameters (α = 0.01). Results. PI, SS, PT, and LL are significantly greater (P < 0.01) in subjects with spondylolisthesis, while TK is significantly decreased. PI has a direct linear correlation (0.41–0.65) with SS, PT, and LL. Furthermore, the differences between the two populations increase in a direct linear fashion as the severity of the spondylolisthesis increases. Conclusions. Since PI is a constant anatomic pelvic variable specific to each individual and strongly determines SS, PT, and LL, which are position-dependent variables, this study suggests that pelvic anatomy has a direct influence on the development of a spondylolisthesis. Study participants with an increased pelvic incidence appear to be at higher risk of presenting a spondylolisthesis, and an increased PI may be an important factor predisposing to progression in developmental spondylolisthesis. This study investigates the relation between pelvic parameters and sagittal spine balance in a cohort of adolescents and young adults with developmental spondylolisthesis, as compared with a cohort of normal subjects. Pelvic incidence, sacral slope, pelvic tilt, and lumbar lordosis are significantly greater (P < 0.01) in subjects with spondylolisthesis, while thoracic kyphosis is significantly decreased, suggesting that pelvic anatomy has a direct influence on the development of a spondylolisthesis.

BACKGROUND: Optimal doses of i.v. glucocorticoids for Graves' orbitopathy (GO) are undefined. METHODS: We carried out a multicenter, randomized, double-blind trial to determine efficacy and safety of three doses of i.v. methylprednisolone in 159 patients with moderate to severe and active GO. Patients were randomized to receive a cumulative dose of 2.25, 4.98, or 7.47 g in 12 weekly infusions. Efficacy was evaluated objectively at 12 wk by blinded ophthalmologists and subjectively by blinded patients (using a GO specific quality of life questionnaire). Adverse events were recorded at each visit. RESULTS: Overall ophthalmic improvement was more common using 7.47 g (52%) than 4.98 g (35%; P = 0.03) or 2.25 g (28%; P = 0.01). Compared with lower doses, the high-dose regimen led to the most improvement in objective measurement of ocular motility and in the Clinical Activity Score. The Clinical Activity Score decreased in all groups and to the least extent with 2.25 g. Quality of life improved most in the 7.47-g group, although not reaching statistical significance. No significant differences occurred in exophthalmos, palpebral aperture, soft tissue changes, and subjective diplopia score. Dysthyroid optic neuropathy developed in several patients in all groups. Because of this, differences among the three groups were no longer apparent at the exploratory 24-wk visit. Major adverse events were slightly more frequent using the highest dose but occurred also using the lowest dose. Among patients whose GO improved at 12 wk, 33% in the 7.47-group, 21% in the 4.98-group, and 40% in the 2.25-group had relapsing orbitopathy after glucocorticoid withdrawal at the exploratory 24-wk visit. CONCLUSIONS: The 7.47-g dose provides short-term advantages over lower doses. However, this benefit is transient and associated with slightly greater toxicity. The use of a cumulative dose of 7.47 g of methylprednisolone provides short-term advantage over lower doses. This may suggest that an intermediate-dose regimen be used in most cases and the high-dose regimen be reserved to most severe cases of GO.

PURPOSE: Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children. METHODS: The European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method. An electronic literature search in PubMed and EMBASE was performed using a combination of medical subject heading terms and text words related to mechanical ventilation and disease-specific terms. RESULTS: The Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) consisted of a panel of 15 experts who developed and voted on 152 recommendations related to the following topics: (1) general recommendations, (2) monitoring, (3) targets of oxygenation and ventilation, (4) supportive measures, (5) weaning and extubation readiness, (6) normal lungs, (7) obstructive diseases, (8) restrictive diseases, (9) mixed diseases, (10) chronically ventilated patients, (11) cardiac patients and (12) lung hypoplasia syndromes. There were 142 (93.4%) recommendations with "strong agreement". The final iteration of the recommendations had none with equipoise or disagreement. CONCLUSIONS: These recommendations should help to harmonise the approach to paediatric mechanical ventilation and can be proposed as a standard-of-care applicable in daily clinical practice and clinical research.

To ensure their survival, animals exhibit a number of reward-directed behaviors, such as foraging for food or searching for mates. This suggests that a core set of brain regions may be shared by many species to process different types of rewards. Conversely, many new brain areas have emerged over the course of evolution, suggesting potential specialization of specific brain regions in the processing of more recent rewards such as money. Here, using functional magnetic resonance imaging in humans, we identified the common and distinct brain systems processing the value of erotic stimuli and monetary gains. First, we provide evidence that a set of neural structures, including the ventral striatum, anterior insula, anterior cingulate cortex, and midbrain, encodes the subjective value of rewards regardless of their type, consistent with a general hedonic representation. More importantly, our results reveal reward-specific representations in the orbitofrontal cortex (OFC): whereas the anterior lateral OFC, a phylogenetically recent structure, processes monetary gains, the posterior lateral OFC, phylogenetically and ontogenetically older, processes more basic erotic stimuli. This dissociation between OFC representations of primary and secondary rewards parallels current views on lateral prefrontal cortex organization in cognitive control, suggesting an increasing trend in complexity along a postero-anterior axis according to more abstract representations. Together, our results support a modular view of reward value coding in the brain and propose that a unifying principle of postero-anterior organization can be applied to the OFC.

Abstract Owing to a long history of anthropogenic pressures, freshwater ecosystems are among the most vulnerable to biodiversity loss 1 . Mitigation measures, including wastewater treatment and hydromorphological restoration, have aimed to improve environmental quality and foster the recovery of freshwater biodiversity 2 . Here, using 1,816 time series of freshwater invertebrate communities collected across 22 European countries between 1968 and 2020, we quantified temporal trends in taxonomic and functional diversity and their responses to environmental pressures and gradients. We observed overall increases in taxon richness (0.73% per year), functional richness (2.4% per year) and abundance (1.17% per year). However, these increases primarily occurred before the 2010s, and have since plateaued. Freshwater communities downstream of dams, urban areas and cropland were less likely to experience recovery. Communities at sites with faster rates of warming had fewer gains in taxon richness, functional richness and abundance. Although biodiversity gains in the 1990s and 2000s probably reflect the effectiveness of water-quality improvements and restoration projects, the decelerating trajectory in the 2010s suggests that the current measures offer diminishing returns. Given new and persistent pressures on freshwater ecosystems, including emerging pollutants, climate change and the spread of invasive species, we call for additional mitigation to revive the recovery of freshwater biodiversity.

STUDY DESIGN: A multicentric retrospective study on primary adult scoliosis patients operated on between 2002 and 2007. A 3-step statistical analysis was performed to describe the incidence of complications, the risk factors, and the reoperation risk with survival curves for the entire cohort. OBJECTIVE: To describe complication rate and risk factors as well as survival curves associated with adult primary scoliosis surgery in patients aged 50 years or older. SUMMARY OF BACKGROUND DATA: Adult deformity surgery is classically associated with a high rate of complications. The identification of risk factors for developing such complications is consequently of major interest as well as survival curves that can provide useful information on reoperation risks. Although many reports exist in the literature, the cohorts analyzed are often heterogeneous and the actual prevalence of complications varies widely. This study represents to our knowledge the largest series on adult patients aged 50 years or older operated for the first time for lumbar or thoracolumbar scoliosis and excluding every other possible diagnosis. METHODS: A retrospective review of prospectively collected data from 6 centers in France. A total of 306 primary lumbar adult or degenerative scoliosis patients older than 50 years undergoing surgery between 2002 and 2007 were included. Demographics, comorbidities, x-ray parameters, surgical data, and complications were analyzed. Statistical analysis was performed to obtain correlations and risk factors for developing complications. Reoperation risk was calculated with Kaplan-Meier survival curves. RESULTS: A total of 306 patients aged 63 years (range, 50-83), with 83% women. Mean follow-up was 54 months. Mean Cumulative Illness Rating Scale score was 5 (range, 0-26). Main curve was 50° (range, 4-96) with apex between T12 and L2. Ten percent of patients had anterior surgery only, 18% had double anteroposterior approach, and 72% had posterior surgery only. Seventy-four percent (226 patients) had long fusions of 3 or more levels and 44% (134 patients) were fused to the sacrum. Forty percent (122 patients) had a decompression performed and 18% had an osteotomy. There were 175 complications for 119 patients (39%). No cases of death or blindness were reported. General complication rate was 13.7%, early infection occurred in 4% (12 patients), and late infection occurred in 1.2%. Neurological complications were present in 7% with 2 cases (0.6%) of late cord-level deficits and 12 reoperations (4%). Prevalence of mechanical complications was 24% (73 patients), with 58 patients (19%) needing a reoperation. Risk factors for mechanical or neurological complications were number of instrumented vertebra (P ≤ 0.01) fusion to the sacrum (P ≤ 0.001), pedicle subtraction osteotomy (PSO) (P = 0.01), and a high preoperative pelvic tilt of 26° or more (P ≤ 0.05). Kaplan-Meier survival curves showed reoperation risk of 44% at 70 months. Long fusion risk was 40% at 50 months and fusions to the sacrum reoperation risk was 48% at 49 months. CONCLUSION: Overall complication rate was 39%, and 26% of the patients were reoperated for mechanical or neurological complications. Risk factors include number of instrumented vertebra, fusion to the sacrum, PSO, and preoperative pelvic tilt of 26° or more. There is a 44% risk of a new operation in the 6-year-period after the primary procedure.

PURPOSE: Our goal was to compare results of partial medial arthroscopic meniscectomy with results of partial lateral arthroscopic meniscectomy and to determine prognostic factors. TYPE OF STUDY: Retrospective comparative study with statistical analysis. METHODS: In this study, 362 medial and 109 lateral isolated arthroscopic meniscectomies are presented with a minimum follow-up time of 10 years. All knees were stable with no previous surgery or traumatic lesion. RESULTS: In this study, 95% of the patients were very satisfied or satisfied with the results of the medial meniscectomy, and 95.5% with results of the lateral meniscectomy (P =.32). According to grades 1 and 2 of the International Knee Documentation Committee (IKDC) form, 85.8% of the medial meniscectomy group were free of any symptoms, as were 79.7% of the lateral meniscectomy group (P =.11). Radiologic changes after medial and lateral meniscectomy were found in 21.5% and 37.5%, respectively (P =.11). The rates of radiologic changes in patients in whom the contralateral knee was radiologically normal were 22.3% and 39%, respectively (P =.016). The rate of repeat surgeries for osteoarthritis was less than 0.2%. CONCLUSIONS: Subjective and clinical results after medial or lateral meniscectomy are quite similar, but radiologic results are significantly worse after lateral meniscectomy. The most accurate way to determine the degeneration caused by the meniscectomy is to evaluate joint space narrowing in patients in whom the contralateral knee was radiologically normal. Otherwise, partial medial or lateral meniscectomy are well tolerated. A better prognosis can be predicted for a patient with an isolated medial meniscal tear with one or more of the following factors: age less than 35 years, a vertical tear, no cartilage damage, and an intact meniscal rim at the end of the meniscectomy. With an isolated lateral meniscal tear, a better prognosis can be predicted if the patient is young and has an intact meniscal rim at the end of the meniscectomy.

Core Ideas OZCAR is a network of sites studying the critical zone. OZCAR covers various disciplines. OZCAR will help disciplines to work together for a better representation and modeling of the critical zone. The French critical zone initiative, called OZCAR (Observatoires de la Zone Critique–Application et Recherche or Critical Zone Observatories–Application and Research) is a National Research Infrastructure (RI). OZCAR‐RI is a network of instrumented sites, bringing together 21 pre‐existing research observatories monitoring different compartments of the zone situated between “the rock and the sky,” the Earth's skin or critical zone (CZ), over the long term. These observatories are regionally based and have specific initial scientific questions, monitoring strategies, databases, and modeling activities. The diversity of OZCAR‐RI observatories and sites is well representative of the heterogeneity of the CZ and of the scientific communities studying it. Despite this diversity, all OZCAR‐RI sites share a main overarching mandate, which is to monitor, understand, and predict (“earthcast”) the fluxes of water and matter of the Earth's near surface and how they will change in response to the “new climatic regime.” The vision for OZCAR strategic development aims at designing an open infrastructure, building a national CZ community able to share a systemic representation of the CZ, and educating a new generation of scientists more apt to tackle the wicked problem of the Anthropocene. OZCAR articulates around: (i) a set of common scientific questions and cross‐cutting scientific activities using the wealth of OZCAR‐RI observatories, (ii) an ambitious instrumental development program, and (iii) a better interaction between data and models to integrate the different time and spatial scales. Internationally, OZCAR‐RI aims at strengthening the CZ community by providing a model of organization for pre‐existing observatories and by offering CZ instrumented sites. OZCAR is one of two French mirrors of the European Strategy Forum on Research Infrastructure (eLTER‐ESFRI) project.

STUDY DESIGN: A review article. OBJECTIVES: The purpose of this article is to review pertinent radiologic measurements for the evaluation of spino-pelvic balance in developmental spondylolisthesis, based on the experience of the Spinal Deformity Study Group. SUMMARY OF BACKGROUND DATA: Over the past decade, pelvic morphology has been shown to significantly influence spino-pelvic balance of the human trunk in normal and pathologic conditions. This finding has important implications for the evaluation and treatment of developmental spondylolisthesis and has fostered a renewed interest in the radiologic evaluation of spino-pelvic balance in this condition. METHODS: The lateral standing radiographs of the spine and pelvis of subjects with developmental L5-S1 spondylolisthesis were analyzed with a dedicated software allowing the calculation of the following parameters: pelvic incidence, sacral slope, pelvic tilt, L5 incidence angle, lumbosacral angle, lumbar lordosis, thoracic kyphosis, and grade of spondylolisthesis. All measurements were done by the same individual and compared to those of an adult and child reference population. RESULTS: The pelvic shape, best quantified by the pelvic incidence angle, determines the position of the sacral endplate. The spine reacts to this position by adapting through lumbar lordosis, the amount of lordosis increasing as the sacral slope increases in order to balance the trunk in the upright position. Pelvic incidence, sacral slope, pelvic tilt, and lumbar lordosis are found to be significantly greater in subjects with developmental spondylolisthesis, while thoracic kyphosis is significantly lower when compared to a reference population. Furthermore, the differences between the two populations increase in a direct linear fashion as the severity of the spondylolisthesis increases, suggesting that pelvic anatomy has a direct influence on the development of a spondylolisthesis. Studies also indicate that pelvic incidence is unaffected by surgical reduction and instrumentation. Pelvic tilt, sacral slope, and thoracic kyphosis are slightly affected, while grade, L5 incidence angle, lumbosacral angle, and shape of the lumbar spine are significantly improved after surgery. A postoperative improvement in L5 incidence angle and lumbosacral angle appears correlated with a better outcome while subjects with a poor outcome have a higher preoperative grade. CONCLUSIONS: Spino-pelvic balance in the sagittal plane can be considered as an open linear chain linking the head to the pelvis where the shape and orientation of each successive anatomic segment are closely related and influence the adjacent segment. Pelvic morphology and spino-pelvic balance are abnormal in developmental spondylolisthesis. These abnormalities should be quantified on lateral standing radiographs of the spine and pelvis and have important implications for the evaluation and treatment of this pathologic condition.

BACKGROUND: ). Therefore, we investigated ΔPrs in two trials in which strict lung-protective mechanical ventilation was applied in ARDS. Our working hypothesis was that ΔPrs is a risk factor for mortality just like compliance (Crs) or plateau pressure (Pplat,rs) of the respiratory system. METHODS: , positive end-expiratory pressure (PEEP), Pplat,rs, Crs, ΔPrs, and respiratory rate recorded 24 hours after randomization, and compared them between survivors and nonsurvivors at day 90. Patients were followed for 90 days after inclusion. Cox proportional hazard modeling was used for mortality at day 90. If colinearity between ΔPrs, Crs, and Pplat,rs was verified, specific Cox models were used for each of them. RESULTS: were not associated with death in any model. CONCLUSIONS: , ΔPrs is a risk factor for death in ARDS patients, as is Pplat,rs or Crs. As our data originated from trials from which most ARDS patients were excluded due to strict inclusion and exclusion criteria, these findings must be validated in independent observational studies in patients ventilated with a lung protective strategy. TRIAL REGISTRATION: Clinicaltrials.gov NCT00299650 . Registered 6 March 2006 for the Acurasys trial. Clinicaltrials.gov NCT00527813 . Registered 10 September 2007 for the Proseva trial.

Summary Rivers and streams that do not flow permanently (herein intermittent rivers; IR s) make up a large proportion of the world's inland waters and are gaining widespread attention. We review the research on IR s from its early focus on natural history through to current application in management and policy. The few early studies of the ecology of IR s were largely descriptive. Nevertheless, in the 1970s, synthesis of this sparse research complemented work on temporary standing waters to found a powerful framework for much of the subsequent research on IR s. Research on the ecology and biogeochemistry of IR s continues to fuel our understanding of resistance and resilience to drying and flooding as disturbances. Syntheses of the growing literature, including cross‐continental and cross‐climate comparisons, are revealing the generality and individuality of ecological and ecosystem responses to flow cessation and surface water loss. Meanwhile, increasing numbers of experiments test the causality of these responses. Much of the increased consideration of IR s in research, management and policy is driven by the observed and projected shifts in flow regimes from perennial to intermittent associated with changes in land and water use and climate, superimposed on the high incidence of natural intermittency. The need to protect and better manage IR s is prompting researchers to develop new or modified methods to monitor flow status and assess the ecological condition of these systems. Intermittent river research and management will benefit from greater exploration of aquatic–terrestrial linkages, wet–dry cycling and temporal dynamics, more‐detailed mapping and predictive modelling of flow intermittency and the application of metapopulation and metacommunity concepts alongside multiple‐stressors and novel‐ecosystems research. By building on existing knowledge, continuing to develop quantitative models and distribution maps and using experiments to test hypotheses and concepts, we can further ecological understanding and wise management of these ubiquitous ecosystems.

The efficacy of immune response to control human cancer remains controversial. It is particularly debated whether and to what extent the capacity of tumor-infiltrating dendritic cells (DC) to drive immunization can be turned off by transformed cells, leading to tumor-specific tolerance rather than immunization. To address this issue, we have characterized the DC isolated from human non-small cell lung cancer (NSCLC). These biopsy specimens contained CD11c(high) myeloid DC (mDC), but also CD11c(-) plasmacytoid DC (pDC) and a third DC subset expressing intermediate level of CD11c. Compared with peripheral blood, CD11c(high) tumor-infiltrating DC (TIDC) displayed a "semi-mature" phenotype, and TLR4 or TLR8 stimulation drove them to mature partially and to secrete limited amounts of cytokines. In contrast, most tumor-infiltrating pDC were immature but underwent partial maturation after TLR7 activation, whereas TLR9 ligation triggered low secretion of IFN-alpha. CD11c(int) mDC represented approximately 25% of total DC in tumoral and peritumoral tissues and expressed low levels of costimulatory molecules contrasting with high levels of the immunoinhibitory molecule B7-H1. Finally, the poor APC function of total TIDC even after TLR stimulation and the migratory response of both tumor-infiltrating mDC and pDC toward CCL21 and SDF-1 in vitro suggested their ability to compromise the tumor-specific immune response in draining lymph nodes in vivo. Further studies will be required to establish the specific role of the three TIDC subsets in tumor immunity and to draw conclusions for the design of therapeutic strategies.

This review is the synthesis of a working group on mild asthma. Mild asthma includes intermittent and persistent mild asthma according to the Global Initiative for Asthma (GINA) classification, and affects between 50% and 75% of asthmatic patients. Mild asthma is more frequent, more symptomatic, and less well controlled in children than in adults. Cohort studies from childhood to adulthood show that asthma severity usually remains stable over time. Nevertheless, mild asthma can lead to severe exacerbations, with a frequency ranging from 0.12 to 0.77 per patient-year. Severe exacerbations in mild asthma represent 30-40% of asthma exacerbations requiring emergency consultation. In mild asthma, inflammation and structural remodelling are constant, of varying intensity, but nonspecific. Therapy with inhaled corticosteroids (ICS) decreases bronchial inflammation, but has only a slight effect on structural remodelling, and, when stopped, inflammation immediately recurs. Permanent low-dose ICS therapy is the reference treatment for persistent mild asthma. Effectiveness is to be reassessed at 3 months, and if it is insufficient the patient is no longer considered mildly asthmatic, and treatment has to be stepped up. As mild asthma is the most frequent form of the disease, diagnosis and management require physicians' particular attention.

Symbiotic bacteria are known to play important roles in the biology of insects, but the current knowledge of bacterial communities associated with mosquitoes is very limited and consequently their contribution to host behaviors is mostly unknown. In this study, we explored the composition and diversity of mosquito-associated bacteria in relation with mosquitoes' habitats. Wild Aedes albopictus and Aedes aegypti were collected in three different geographic regions of Madagascar. Culturing methods and denaturing gradient gel electrophoresis (DGGE) and sequencing of the rrs amplicons revealed that Proteobacteria and Firmicutes were the major phyla. Isolated bacterial genera were dominated by Bacillus, followed by Acinetobacter, Agrobacterium and Enterobacter. Common DGGE bands belonged to Acinetobacter, Asaia, Delftia, Pseudomonas, Enterobacteriaceae and an uncultured Gammaproteobacterium. Double infection by maternally inherited Wolbachia pipientis prevailed in 98% of males (n=272) and 99% of females (n=413); few individuals were found to be monoinfected with Wolbachia wAlbB strain. Bacterial diversity (Shannon-Weaver and Simpson indices) differed significantly per habitat whereas evenness (Pielou index) was similar. Overall, the bacterial composition and diversity were influenced both by the sex of individuals and by the environment inhabited by the mosquitoes; the latter might be related to both the vegetation and the animal host populations that Aedes used as food sources.

BACKGROUND: Lipofilling is now performed to improve the breast contour, after both breast-conserving surgery and breast reconstruction. However, injection of fat into a previous tumor site may create a new environment for cancer and adjacent cells. There is also no international agreement regarding lipofilling after breast cancer treatment. METHODS: The authors included three institutions specializing in both breast cancer treatment and breast reconstruction (European Institute of Oncology, Milan, Italy; Paris Breast Center, Paris, France; and Leon Berard Centre, Lyon, France) for a multicenter study. A collective chart review of all lipofilling procedures after breast cancer treatment was performed. RESULTS: From 2000 to 2010, the authors reviewed 646 lipofilling procedures from 513 patients. There were 370 mastectomy patients and 143 breast-conserving surgery patients. There were 405 patients (78.9 percent) with invasive carcinoma and 108 (21.1 percent) with carcinoma in situ. The average interval between oncologic surgical interventions and lipofilling was 39.7 months. Average follow-up after lipofilling was 19.2 months. The authors observed a complication rate of 2.8 percent (liponecrosis, 2.0 percent). Twelve radiologic images appeared after lipofilling in 119 breast-conserving surgery cases (10.1 percent). The overall oncologic event rate was 5.6 percent (3.6 percent per year). The locoregional event rate was 2.4 percent (1.5 percent per year). CONCLUSIONS: Lipofilling after breast cancer treatment leads to a low complication rate and does not affect radiologic follow-up after breast-conserving surgery. A prospective clinical registry including high-volume multicenter data with a long follow-up is warranted to demonstrate the oncologic safety. Until then, lipofilling should be performed in experienced hands, and a cautious oncologic follow-up protocol is advised. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV [corrected].