Inserm

The nodal spreading of oral cavity and oropharynx squamous cell carcinoma (OCSCC/OSCC) remains a critical challenge. The pathological nature of lymph nodes adjacent to the tumor is sometimes difficult to interpret on PET/CT during the initial assessment. The primary objective of this study was to evaluate the impact of contralateral node PET/CT hyperfixation on disease-free survival (DFS) in lateralized OCSCC or OSCC. From our database, all patients who had a PET/CT during their management for a lateralized SCC were selected between 2018 and 2021. Clinical, histological and radiological data between patients with and without contralateral nodes on the initial PET/CT were compared, as well as the survival of these patients. The Inselspital, Bern University Hospital (ISB) publicly available dataset was then used, to estimate the positive predictive value (PPV) of a contralateral fixation. Of 48 patients who had a PET/CT for lateralized OCSCC or OSCC, 16 (33%) had contralateral lymph node hyperfixation on PET/CT (PET/CT CLN+). In this group, 4 had a bilateral lymph node dissection (27%), and only one had lymph node metastasis. Using the ISB dataset, we found a PPV of only 35% for these contralateral hyperfixation. There was no significant difference in a multivariate Cox model in terms of DFS between the two subgroups in the case of lateralized tumors. There was no difference in survival between patients with or without contralateral lymph nodes on the initial PET/CT.

Healthcare workers (HCWs) could be subject to stigma, particularly in contexts of fear of contagion related to various communicable diseases. While existing literature has established links between workplace stigma and adverse mental health outcomes, this research has largely focused on stigma derived from personal characteristics (e.g., race, gender). However, studies specifically investigating occupational stigma - the stigma resulting directly from the nature of the healthcare profession itself - remain scarce. We investigated the association between perceived occupational stigma and post-traumatic stress disorder (PTSD) symptoms one year following the onset of the COVID-19 pandemic. This study analyzed data from a cross-sectional online survey conducted in France. PTSD symptoms were measured with the Posttraumatic Stress Disorder Checklist (PCL-5), and perceived stigma was assessed with a single-item question. Associations were analyzed using inverse probability weighting based on propensity scores, which accounted for a broad range of potential confounders, including socioeconomic factors, work characteristics, and comorbidities. Among 655 respondents, who were mainly physicians, 44.8% reported experiencing occupational stigma and 8.7% met the threshold for PTSD symptoms. After adjustment, perceived occupational stigma was significantly associated with PTSD symptoms (ORa=2.16; 95% CI [1.09-4.25]). Occupational stigma is independently associated with PTSD symptoms among HCWs. These findings underscore the critical need for integrating targeted anti-stigma interventions into mental health strategies for HCWs involving in managing infectious disease or in pandemic context.

To develop and evaluate Crohn-BOOST, an open-source tool enabling semi-automatic segmentation of intestinal lesions and creeping fat on magnetic resonance enterography (MR Enterography), and to assess whether quantitative metrics derived from these segmentations relate to radiological disease activity scored with simplified MaRIA (sMaRIA) and Nancy indices. A fully annotated MR Enterography dataset was also curated to support future artificial intelligence research. This retrospective single-center study included 102 patients with Crohn's disease (134 analyzable small-bowel lesions). Crohn-BOOST was used to delineate bowel lesions and creeping fat. Extracted metrics included lesion volume, wall thickness, lesion length, ADC, arterial enhancement, and creeping fat volume. Radiologic activity was assessed with sMaRIA and Nancy scores. Spearman correlations (95% CI by bootstrap), multivariable linear regression, and fivefold cross-validation were performed (p < 0.05). Segmentation time was < 3 min per patient. Inter-reader reproducibility in a two-reader subset (n = 30) was high (Dice 0.85 for lesions; 0.87 for creeping fat). Lesion volume (sMaRIA r = 0.65; Nancy r = 0.61; p < 0.001) and ADC (sMaRIA r = -0.70) showed the strongest correlations with radiological activity. In multivariable models, these two metrics remained independent predictors, whereas creeping fat volume and enhancement metrics were not. Crohn-BOOST enables fast, reproducible 3D quantification on routine MR Enterography and supports objective estimation of radiological disease activity. Lesion volume and ADC show strong associations with sMaRIA and Nancy scores, while creeping fat volume appears more related to chronic remodeling than acute inflammation.

Erythropoietin (EPO) is a glycoprotein hormone primarily known for its central role in red blood cell production, but it is now also recognized for its immunomodulatory effects on a range of immune effectors. Several studies indicate that EPO helps regulate intestinal barrier integrity, although its effect on intraepithelial lymphocytes (IELs) is still unknown. Using multiparameter flow cytometry and both conventional and unsupervised analyses, we conducted an in-depth phenotypic assessment of IELs from the murine duodenum, jejunum, ileum and colon. Our results revealed that in EPO-treated C57BL/6 mice, the absolute IEL count in the colonic epithelium was more than twice that observed in control mice without changes in the frequencies of the various subpopulations, indicating a global increase. This was accompanied by integrin α4β7 overexpression. Furthermore, EPO treatment alters the intestinal microbiota, increasing bacterial load while reducing diversity, with a notable decrease in Muribaculaceae, a taxon involved in microbial cross-feeding. This alteration may contribute to epithelial imbalance and indirectly to the observed increase in IEL density. Importantly, EPO treatment did not trigger colonic mucosal inflammation, although the affected IELs show a microbiota-dependent decrease in CD8αα expression (known to downregulate IEL activity). The present study is the first to provide a phenotypic mapping of IEL populations in the digestive tract of C57BL/6 mice and highlighted a novel regulatory role of EPO on colonic IELs. These results raise important questions about the impact of exogenous EPO supplementation and endogenous EPO fluctuations on intestinal immune responses - particularly in the context of inflammatory diseases.

The present nationwide survey combined with a scoping review aimed to provide an overview of current paediatric robotic-assisted surgery (RAS) training practices in France, focusing on simulation tools and evaluation methods. A cross-sectional national survey was conducted among all French paediatric surgery centres with existing or upcoming RAS programmes. Answers were collected using Likert scales. A scoping review was conducted following PRISMA-ScR guidelines, screening publications from 2000 to 2025 on paediatric robotic surgery and simulation. Eighteen surgeons from 13 centres responded. Two centres had exclusive access to robotic equipment, whereas others shared platforms with adult teams. Centres reported a mean 4.2 training days per month and 37.5 RAS procedures per year. Twelve respondents reported that a dedicated paediatric RAS curriculum would be more appropriate. Fifteen (82 %) engaged in additional simulation outside their initial training. Three independent paediatric RAS simulation programmes were identified, differing in format and target audience. Only three participants used objective performance-assessment tools. The scoping review included 8 articles from 361 records. All focused on procedural robotic simulation in paediatric settings; only one addressed non-procedural interprofessional simulation. The included studies demonstrated benefits of simulation in accelerating the learning curve, improving trocar placement, and strengthening team performance. These findings support the need for structured, paediatric-specific RAS simulation programmes integrated into training pathways, supported by structured evaluation frameworks and institutional investment.