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Background: Negative Pressure Therapy in closed incisions (ciNPT) after surgery has shown positive effects including reduction of Surgical Site Infection (SSI) incidence. In patients undergoing elective open incisional hernia repair, however, ciNPT is not standard care, perhaps due to high-quality evidence still not provided. This study hypothesizes that this patient group would benefit from ciNPT by reducing wound complications and improving postoperative quality of life. Method: This is a multicenter Randomized Controlled Trial (RCT) including a total of 110 patients allocated in a 1:1 ratio with one intervention arm and one active control arm receiving ciNPT (i.e., Prevena™) and standard wound dressing, respectively. The primary outcome is the incidence of SSI at 30 days postoperatively and secondary outcomes are 1) pooled incidence of Surgical Site Occurrence (SSO), 2) patient-reported pain and satisfaction with the scar, and 3) hernia-related quality of life. Conclusion: Patients undergoing elective open incisional hernia repair are fragile with a high risk of wound complication development. This multicenter RCT seeks to deliver the high-quality evidence needed to establish the role ciNPT must play for exactly this group with the aim of reducing SSI incidence and health economic costs, and finally improving quality of life. There are no theoretical or clinical experience of unwanted consequences of this treatment.

Abstract We aimed to detect physiologic changes of leg muscle signal on magnetic resonance (MR) diffusion-weighted imaging (DWI) in asymptomatic subjects after repetitive plantar flexion exercises. In this monocentric prospective study, DWI of both legs were performed at rest and after exercise periods (5 min, Ex5: and 10 min, Ex10) in 20 active healthy subjects (mean age 31 years). The exercise consisted in repetitive plantar flexion of the right foot using elastic band, the patient being sited directly on the MR table. Both visual semiquantitative evaluations and quantitative (apparent diffusion coefficient, ADC; fractional anisotropy, FA) were performed in 5 leg compartments. Visually, signal changes involved mainly the fibular and gastrocnemius muscles and were considered intense after Ex5 in 3 subjects, moderate only after Ex5 in 10, and moderate only after Ex10 in 4. No changes were visible in 3 subjects. Quantitative evaluation confirmed significant signal changes in the fibular (ADC: + 17.4%, p

Kin selection theory provides a strong theoretical framework to explain the evolution of altruism and cooperative behaviour among genetically related individuals. However, the proximate mechanisms underlying kin discrimination, a necessary process to express kin-related behaviour, remain poorly known. In particular, no study has yet unambiguously disentangled mechanisms based on learned familiarity from true phenotype matching in kin discrimination based on vocal signals. Here we show that in addition to genetic background, social accommodation also shapes individual voices in an Old World monkey (Mandrillus sphinx), even though primate vocalizations were thought to be innate and little flexible. Nonetheless, social shaping of voice parameters does not impair kin discrimination through phenotype-matching of unknown relatives, revealing unexpected discriminatory versatility despite signal complexity. Accurate signal production and perception, therefore, provide a basis for kin identification and kin-biased behaviour in an Old World primate.

BackgroundAccording to guidelines, all patients with sarcoma must be managed from initial diagnosis at expert sarcoma centers. However, in everyday practice, the time interval to an expert center visit can be long, which delays presentation to an expert multidisciplinary tumor board and increases the risk of inappropriate management, negatively affecting local tumor control and prognosis. The advent of mobile health offers an easy way to facilitate communication and cooperation between general health care providers (eg, general practitioners and radiologists) and sarcomas experts. We developed a mobile app (Sar’Connect) based on the algorithm designed by radiologists from the French Sarcoma Group. Through a small number of easy-to-answer questions, Sar’Connect provides personalized advice for the management of patients and contact information for the closest expert center. ObjectiveThis retrospective study is the first to assess this mobile app’s potential benefits in reducing the time interval for patient referral to an expert center according to the initial clinical characteristics of the soft tissue tumor. MethodsFrom May to December 2021, we extracted tumor mass data for 78 patients discussed by the multidisciplinary tumor boards at 3 centers of the French Sarcoma Group. We applied the Sar’Connect algorithm to these data and estimated the time interval between the first medical description of the soft tissue mass and the referral to expert center. We then compared this estimated time interval with the observed time interval. ResultsWe found that the use of Sar’Connect could potentially shorten the time interval to an expert center by approximately 7.5 months (P

Behavioral discrimination of kin is a key process structuring social relationships in animals. In this study, we provide evidence for discrimination towards non-kin by third-parties through a mechanism of phenotype matching. In mandrills, we recently demonstrated increased facial resemblance among paternally related juvenile and adult females indicating adaptive opportunities for paternal kin recognition. Here, we hypothesize that mandrill mothers use offspring’s facial resemblance with other infants to guide offspring’s social opportunities towards similar-looking ones. Using deep learning for face recognition in 80 wild mandrill infants, we first show that infants sired by the same father resemble each other the most, independently of their age, sex or maternal origin, extending previous results to the youngest age class. Using long-term behavioral observations on association patterns, and controlling for matrilineal origin, maternal relatedness and infant age and sex, we then show, as predicted, that mothers are spatially closer to infants that resemble their own offspring more, and that this maternal behavior leads to similar-looking infants being spatially associated. We then discuss the different scenarios explaining this result, arguing that an adaptive maternal behavior is a likely explanation. In support of this mechanism and using theoretical modeling, we finally describe a plausible evolutionary process whereby mothers gain fitness benefits by promoting nepotism among paternally related infants. This mechanism, that we call ‘second-order kin selection’, may extend beyond mother-infant interactions and has the potential to explain cooperative behaviors among non-kin in other social species, including humans.

Recent studies have highlighted the large diversity of malaria parasites infecting African great apes (subgenus Laverania) and their strong host specificity. Although the existence of genetic incompatibilities preventing the cross-species transfer may explain host specificity, the existence of vectors with a high preference for a determined host represents another possibility. To test this hypothesis, we undertook a 15-mo-long longitudinal entomological survey in two forest regions of Gabon, where wild apes live, at different heights under the canopy. More than 2,400 anopheline mosquitoes belonging to 18 species were collected. Among them, only three species of Anopheles were found infected with ape Plasmodium: Anopheles vinckei, Anopheles moucheti, and Anopheles marshallii Their role in transmission was confirmed by the detection of the parasites in their salivary glands. Among these species, An. vinckei showed significantly the highest prevalence of infection and was shown to be able to transmit parasites of both chimpanzees and gorillas. Transmission was also shown to be conditioned by seasonal factors and by the heights of capture under the canopy. Moreover, human landing catches of sylvan Anopheles demonstrated the propensity of these three vector species to feed on humans when available. Our results suggest therefore that the strong host specificity observed in the Laveranias is not linked to a specific association between the vertebrate host and the vector species and highlight the potential role of these vectors as bridge between apes and humans.

Unravelling the determinants of host variation in susceptibility and exposure to parasite infections, infection dynamics and the consequences of parasitism on host health is of paramount interest to understand the evolution of complex host-parasite interactions. In this study, we evaluated the determinants, temporal changes and physiological correlates of Plasmodium infections in a large natural population of mandrills (Mandrillus sphinx). Over six consecutive years, we obtained detailed parasitological and physiological data from 100 male and female mandrills of all ages. The probability of infection by Plasmodium gonderi and P. mandrilli was elevated (ca. 40%) but most infections were chronical and dynamic, with several cases of parasite switching and clearance. Positive co-infections also occurred between both parasites. Individual age and sex influenced the probability of infections with some differences between parasites: while P. mandrilli appeared to infect its hosts rather randomly, P. gonderi particularly infected middle-aged mandrills. Males were also more susceptible to P. gonderi than females and were more likely to be infected by this parasite at the beginning of an infection by the simian immunodeficiency virus. P. gonderi, and to a lesser extent P. mandrilli, influenced mandrills’ physiology: skin temperatures and neutrophil/lymphocyte ratio were both impacted, generally depending on individual age and sex. These results highlight the ecological complexity of Plasmodium infections in nonhuman primates and the efforts that need to be done to decipher the epidemiology of such parasites. Keywords: Host susceptibility, Infection dynamics, Nonhuman primates, Plasmodium infections

Plasmodium vivax is considered to be absent from Central and West Africa because of the protective effect of Duffy negativity. However, there are reports of persons returning from these areas infected with this parasite and observations suggesting the existence of transmission. Among the possible explanations for this apparent paradox, the existence of a zoonotic reservoir has been proposed. May great apes be this reservoir? We analyze the mitochondrial and nuclear genetic diversity of P. vivax parasites isolated from great apes in Africa and compare it to parasites isolated from travelers returning from these regions of Africa, as well as to human isolates distributed all over the world. We show that the P. vivax sequences from parasites of great apes form a clade genetically distinct from the parasites circulating in humans. We show that this clade's parasites can be infectious to humans by describing the case of a traveler returning from the Central African Republic infected with one of them. The relationship between this P. vivax clade in great apes and the human isolates is discussed.

Agricultural practices are heterogeneous among farmers in the face of climate hazards. Structural and material resources as well as risk preferences explain some of this heterogeneity, but little is known about how psychological factors associated with the decision-making process may explain differences in practices among farmers. The aim of this study was to understand whether decision-making process factors help explain the heterogeneity of a specific practice—the date of first irrigation—among maize farmers, along with material and structural factors. We conducted semi-directed interviews with 35 farmers who irrigated maize in southwestern France. We analyzed discriminating factors of the decision-making process, such as reactivity (i.e., capacity to change plans), deliberation (i.e., level of internal information used to make decisions) and assistance (i.e., level of external information used to make decisions). We used two complementary statistical methods (linear regression and regression trees) to analyze the database. Our study confirms the influence of material and structural factors, and also reveals the strong influence of decision-making process factors. A high level of reactivity is associated with adaptive behavior. Moreover, using decision-support tools and technologies helps farmers to manage the use of water resources. These elements could be used by advisors and public policy-makers in the agriculture sector to improve adaptation.

No study has rigorously compared the performances of iodine quantification on recent CT systems employing different emission-based technologies, depending on the manufacturers and models. A specific bespoke phantom was used for this study, with 12 known concentrations of iodinated contrast agent: 0.4, 0.5, 1.0, 2.0, 3.0, 4.0, 5.0, 10.0, 15.0, 20.0, 30.0 and 50.0 mg/mL. Three different dual-energy scanners were tested: one system using dual-source acquisition (CT#1) and two systems using Fast kilovolt-peak switching technology ± artificial intelligence (AI) reconstruction methods (CT#2 and #3) from two different manufacturers. For each system, helical scans were performed following recommended clinical protocols. Four acquisitions were performed per iodine concentration (mg/mL), and measurements were made on iodine-maps using ROIs. Mean measured values were compared to the known concentrations, and the absolute quantification error (AQE) and the relative percentage error (RPE) were used to compare the performances of each CT. The accuracy of the obtained measurements varied depending on the studied model but not on the acquisition mode (dual-source vs kVp switch ± AI). The quantification was more precise at high concentrations. RPE values were below 10 % with CT#2 (kVp switch) and below 25 % with CT#1 (dual-source), but were significantly higher with CT#3 (kVp switch + AI), exceeding 50 % at low concentrations (<3 mg/mL). With the help of a phantom, we identified variability in the results accuracy depending on the CT model, with sometimes significant deviation. Considering the performances of the different DECT technologies in iodine mapping, dual-source (CT#1) and kVp switch (CT#2) technologies appear more accurate than kVp switch technology combined with deep-learning-based reconstruction (CT#3) especially at low concentrations (<3 mg/mL). As the primary and daily user of medical imaging devices, the radiographer role is to be attentive to the performance of imaging systems, particularly when performing quantitative acquisitions like iodine-quantification. In CT quantitative imaging (iodine map), it's essential for radiographers to consider their CT systems as measuring tools, and to be aware of their accuracies and limits. [ABSTRACT FROM AUTHOR]

Multiple Myeloma (MM) is an incurable disease characterized by a clonal evolution across the course of the diseases and multiple lines of treatment. Among genomic drivers of the disease, alterations of the tumor suppressor TP53 are associated with poor outcomes. In physiological situation, once activated by oncogenic stress or DNA damage, p53 induces either cell-cycle arrest or apoptosis depending on the cellular context. Its inactivation participates to drug resistance in MM. The frequency of TP53 alterations increases along with the progression of the disease, from 5 at diagnosis to 75% at late relapses. Multiple mechanisms of regulation lead to decreased expression of p53, such as deletion 17p, TP53 mutations, specific microRNAs overexpression, TP53 promoter methylations, and MDM2 overexpression. Several therapeutic approaches aim to target the p53 pathway, either by blocking its interaction with MDM2 or by restoring the function of the altered protein. In this review, we describe the mechanism of deregulation of TP53 in MM, its role in MM progression, and the therapeutic options to interact with the TP53 pathway.

Dual-energy CT seems to be acquiring significant attention in the field of medical imaging. Iodine mapping, specifically, has emerged as a valuable application, enabling the quantification of contrast agent concentration throughout the images. CT users lack robust criteria to assess the accuracy of iodine maps generated by various CT systems. This study seeks to compare the performances of iodine quantification on 3 recent CT systems employing different emission-based technologies, positioned in our hospital. A specific home-made phantom was used for this study, with 12 known concentrations of iodinated contrast agent: from 0.4 to 50.0 mgI/mL. Three different dual-energy scanners were tested: one employing dual-source technology and two systems equipped with Fast kilovolt-peak switching solution from two different manufacturers. Helical scans were performed for each system following specific spectral acquisition protocols. Eight acquisitions were performed for each concentration (mgI/mL) on each CT system, resulting in 24 measurements for each concentration and CT. Mean measured values were compared to the known concentrations, and the absolute quantification error (AQE) and the relative percentage error (RPE) were used to compare the performances of each CT. The obtained measurements' accuracy varied depending on the studied model but not on the acquisition mode. The quantification was more precise at high concentrations (≥5.0 mgI/mL). The accuracy of measured values at low concentrations (<4.0 mgI/mL) varied considerably from one device to another. We identified variability in the results accuracy depending on the CT model, with sometimes significant deviation. Therefore, a comprehensive evaluation of the performances of all CT systems may be necessary before routinely conducting iodine mapping. The radiographer role is to be attentive to the performances of imaging systems, especially when dealing with quantitative data such as iodine-quantification. [ABSTRACT FROM AUTHOR]

Farmers’ production decisions and agricultural practices directly and indirectly influence the quantity and quality of natural resources, some being depleted common resources such as groundwater. Representing farming systems while accounting for their flexibility is needed to evaluate targeted, regional water management policies. Farmers’ decisions regarding investing in irrigation and adopting cropping systems are inherently dynamic and must adapt to changes in climate and agronomic, economic and social, and institutional, conditions. To represent this diversity, we developed a typology of Indian farmers from a survey of 684 farms in Berambadi, an agricultural watershed in southern India (state of Karnataka). The survey provided information on farm structure, the cropping system and farm practices, water management for irrigation, and economic performances of the farm. Descriptive statistics and multivariate analysis (Multiple Correspondence Analysis and Agglomerative Hierarchical Clustering) were used to analyze relationships between observed factors and establish the farm typology. We identified three main types of farms: (1) large diversified and productivist farms; (2) small and marginal rainfed farms, and (3) small irrigated marketing farms. This typology represents the heterogeneity of farms in the Berambadi watershed.

Tooth wear in primates is caused by aging and ecological factors. However, comparative data that would allow us to delineate the contribution of each of these factors are lacking. Here, we contrast age-dependent molar tooth wear by scoring percent of dentine exposure (PDE) in two wild African primate populations from Gabonese forest and Kenyan savanna habitats. We found that forest-dwelling mandrills exhibited significantly higher PDE with age than savanna yellow baboons. Mandrills mainly feed on large tough food items, such as hard-shell fruits, and inhabit an ecosystem with a high presence of mineral quartz. By contrast, baboons consume large amounts of exogenous grit that adheres to underground storage organs but the proportion of quartz in the soils where baboons live is low. Our results support the hypothesis that not only age but also physical food properties and soil composition, particularly quartz richness, are factors that significantly impact tooth wear. We further propose that the accelerated dental wear in mandrills resulting in flatter molars with old age may represent an adaptation to process hard food items present in their environment.

During the last four years, knowledge about the diversity of Plasmodium species in African great apes has considerably increased. Several new species were described in chimpanzees and gorillas, and some species that were previously considered as strictly of human interest were found to be infecting African apes. The description in gorillas of P. praefalciparum, the closest relative of P. falciparum which is the main malignant agent of human malaria, definitively changed the way we understand the evolution and origin of P. falciparum. This parasite is now considered to have appeared recently, following a cross-species transfer from gorillas to humans. However, the Plasmodium vector mosquito species that have served as bridge between these two host species remain unknown. In order to identify the vectors that ensure ape Plasmodium transmission and evaluate the risk of transfer of these parasites to humans, we carried out a field study in Gabon to capture Anopheles in areas where wild and semi-wild ape populations live. We collected 1070 Anopheles females belonging to 15 species, among which An. carnevalei, An. moucheti and An. marshallii were the most common species. Using mtDNA-based PCR tools, we discovered that An. moucheti, a major human malaria vector in Central Africa, could also ensure the natural transmission of P. praefalciparum among great apes. We also showed that, together with An. vinckei, An. moucheti was infected with P. vivax-like parasites. An. moucheti constitutes, therefore, a major candidate for the transfer of Plasmodium parasites from apes to humans.

Unravelling the determinants of host variation in susceptibility and exposure to parasite infections, infection dynamics and the consequences of parasitism on host health is of paramount interest to understand the evolution of complex host-parasite interactions. In this study, we evaluated the determinants, temporal changes and physiological correlates of Plasmodium infections in a large natural population of mandrills (Mandrillus sphinx). Over six consecutive years, we obtained detailed parasitological and physiological data from 100 male and female mandrills of all ages. The probability of infection by Plasmodium gonderi and P. mandrilli was elevated (ca. 40%) but most infections were chronical and dynamic, with several cases of parasite switching and clearance. Positive co-infections also occurred between both parasites. Individual age and sex influenced the probability of infections with some differences between parasites: while P. mandrilli appeared to infect its hosts rather randomly, P. gonderi particularly infected middle-aged mandrills. Males were also more susceptible to P. gonderi than females and were more likely to be infected by this parasite at the beginning of an infection by the simian immunodeficiency virus. P. gonderi , and to a lesser extent P. mandrilli , influenced mandrills' physiology: skin temperatures and neutrophil/lymphocyte ratio were both impacted, generally depending on individual age and sex. These results highlight the ecological complexity of Plasmodium infections in nonhuman primates and the efforts that need to be done to decipher the epidemiology of such parasites. Copyright: B. Quintard Image 1 • Longitudinal epidemiological and physiological data on Plasmodium infection obtained from a wild primate population. • Elevated chronical infections by two species of Plasmodium. • Contrasted dynamics of infection and physiological effects of P. gonderi and P. mandrilli. • Elevated parasitaemia (P. gonderi) in male mandrills in primo-infection by the simian immunodeficiency virus. [ABSTRACT FROM AUTHOR]