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A bstract Background Due to the close proximity of the prostate and rectum, rectal toxicity remains a major problem in patient treated by radiotherapy for prostate adenocarcinoma. One method of increasing the distance between the prostate and the rectum is to use a spacer implanted into the rectoprostatic space. This report describes the long-term outcomes obtained with a new ballon spacer. Methods Patients treated with curative radiotherapy for low- or intermediate-risk prostate adenocarcinoma, who underwent insertion of the ProSpace® (BioProtect Ltd, Tzur Yigal, Israel) rectal-prostate balloon spacer, were included. The main objective was to evaluate the dosimetric benefit of the spacer for OARs. The secondary objectives were to evaluate the feasibility and tolerability of ProSpace® balloon placement and to evaluate its long-term therapeutic efficacy and tolerance. Results Between October 2013 and March 2015, 16 patients were enrolled in the Pasteur Clinic, Toulouse, France. The median follow-up was 85.5 months. From top to bottom, the space created was a mean of 16.3 mm (range: 11–20.5 mm) at the base of the prostate, 12.1 mm (range: 4–16 mm) at the middle and 8.9 mm at the apex (range: 5–15 mm). On average, rectal volumes receiving a dose of 70 Gy, 60 Gy and 50 Gy were significantly lower after balloon implantation: -4.81 cc (1.5 vs. 6.3; p  < 0.0005), -8.08 cc (6.4 vs. 14.5; p  = 0.002) and -9.06 cc (16.7 vs. 25.7; p  = 0.003), respectively. There were significant differences in coverage after balloon implantation: Median V95% ( p  < 0.0005), median Dmin ( p  = 0.01) and median V98% ( p  < 0.001) were higher after balloon implantation. At 5 years, cumulative gastrointestinal toxicity was grade 1 in 6% (1/16 patients). No toxicity of grade 2 or higher was found. At 5 years, no urinary toxicity grade 3 or 4 toxicity was found. The QoL was not deteriorated. Conclusions The use of the ProSpace® balloon seems to be well accepted by patients, allowing a double dosimetric gain: a decrease in doses received by the rectum and an improvement in the coverage of the high-risk PTV. The long-term gastrointestinal toxicity remains low and QoL is preserved in all treated patients.

Although the Common Agricultural Policy of the European Union has broadened its objectives to integrate social issues, several hard-to-reach groups of farmers and workers continue to be ignored by advisory services and associated policies. Connecting with these groups has a strong potential to increase the economic and social cohesion of European agricultures. We interviewed over 1,000 farmers across Europe and identified features of these groups that are often overlooked by advisory services. We critically reflected on the social cohorts omitted from advisory services and how they could be better reached; they include farm labourers, new entrants or ‘career changers', and later adopters. We clarify the different types of advisors in the advisory landscape, distinguishing between those who are linked to or independent from sales of inputs or technologies. We make concrete recommendations about how to engage advisors with hard-to-reach groups, with approaches suited to different national contexts of Agricultural Knowledge and Innovation Systems (AKIS); thus contributing to the ‘AKIS dimension of National Strategic Plans of the next Common Agricultural Policy, 2023–2027. We argue for the more effective use of advances in the social sciences through a better understanding of advice as social interaction which can bolster the inclusiveness of public policies.

Le \"paysage\" occupe, dans l'œuvre poétique et critique de Baudelaire, un statut à la fois majeur et ambivalent: si la poétique des \"correspondances\" préside aux diverses modalités du locus amoenus (la femme-paysage; le paysage élégiaque ou féerique; le paysage \"surnaturaliste\"), celle-ci est contestée et dépassée dans l'expérience d'une violence liée au \"paysage des grandes villes\". A côté d'une saisie symbolique du paysage, on peut donc parler d'une saisie beaucoup plus fragmentaire de la réalité qu'assume le déchiffrement allégorique. C'est ainsi qu'est proposée la notion de \"paysage moral\", catégorie paradoxale qui permettrait de rendre compte de l'atmosphère allégorique de maints décors baudelairiens, construits comme des paysages.

Résumé Le « paysage » occupé, dans l'oeuvre poétique et critique de Baudelaire, un statut à la fois majeur et ambivalent : si la poétique des «correspondances » préside aux diverses modalités du locus amoenus (la femme-paysage; le paysage élégiaque ou féerique ; le paysage «surnaturaliste »), celle-ci est contestée et dépassée dans l'expérience d'une violence liée au « paysage des grandes villes ». A côté d'une saisie symbolique du paysage, on peut donc parler d'une saisie beaucoup plus fragmentaire de la réalité qu'assume le déchiffrement allégorique. C'est ainsi qu'est proposée la notion de «paysage moral », catégorie paradoxale qui permettrait de rendre compte de l'atmosphère allégorique de maints décors baudelairiens, construits comme des paysages.

Hostility and chronic stress are known risk factors for heart disease, but they are costly to assess on a large scale. We used language expressed on Twitter to characterize community-level psychological correlates of age-adjusted mortality from atherosclerotic heart disease (AHD). Language patterns reflecting negative social relationships, disengagement, and negative emotions—especially anger—emerged as risk factors; positive emotions and psychological engagement emerged as protective factors. Most correlations remained significant after controlling for income and education. A cross-sectional regression model based only on Twitter language predicted AHD mortality significantly better than did a model that combined 10 common demographic, socioeconomic, and health risk factors, including smoking, diabetes, hypertension, and obesity. Capturing community psychological characteristics through social media is feasible, and these characteristics are strong markers of cardiovascular mortality at the community level.

In a cluster-randomized trial, villages were assigned in a 1:1 ratio to use a salt substitute (75% sodium chloride and 25% potassium chloride by mass) or regular salt. Among persons who had a history of stroke or were 60 years of age or older and had hypertension, rates of stroke, major cardiovascular events, and death were lower with the salt substitute, which had no apparent serious adverse effects.