Université De Picardie Jules Verne

Traumatic dissociation is defined as a disruption or disturbance in the integration of various cognitive functions in response to a traumatic event and has been the subject of extensive research in recent decades. For mental health professionals, exposure to patients with a history of trauma can have both negative and positive effects on their well-being. However, few studies have focused on the specific experiences of professionals encountering patients with traumatic dissociation.

This study analyzed the experiences of 23 professionals (psychiatrists, psychologists, and residents in psychiatry) working with patients presenting manifestations of traumatic dissociation, using Interpretative Phenomenological Analysis (IPA) methodology.

This approach led to the identification of three key themes: (1) professionals' reactions to patient dissociation, (2) professionals' emotional and dissociative response, and (3) factors influencing reactions and impact on professionals' life.

In light of these findings, we propose several key points for training and supervision: taking into account the question of the body and physical contact; addressing the emotions experienced by professionals, particularly helplessness and loneliness, and carefully utilizing the diffusion of emotions and dissociation from the patient to the professional as a therapeutic tool to help patients self-regulate and reintegrate dissociated parts of themselves.

The Peritoneal Cancer Index (PCI) is widely used to quantify disease extent and guide therapeutic decisions for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) across multiple primary tumors. While PCI is a validated prognostic indicator, the use of a single total surgical PCI threshold as a determinant of eligibility for CRS-HIPEC presents significant conceptual and practical limitations. Surgical PCI calculation is subject to inter-surgeon variability, particularly at anatomical region boundaries, where lesion allocation may alter the total score sufficiently to influence treatment decisions. In addition, surgical PCI frequently overestimates disease extent compared with pathological PCI, while laparoscopic assessment may underestimate peritoneal involvement. Increasing evidence indicates that the anatomical distribution of peritoneal metastases, particularly involvement of critical regions such as the hepatoduodenal ligament, small bowel, and mesentery, is more predictive of resectability, morbidity, and oncologic outcome than aggregate PCI alone. Furthermore, the prognostic significance of PCI varies according to primary tumor biology, challenging the applicability of universal threshold values. These considerations suggest that total PCI should not be used in isolation to contraindicate CRS-HIPEC. Decision-making frameworks should instead emphasize regional disease distribution, technical resectability, and tumor-specific behavior to optimize patient selection.

One of the major obstacles in treating diseases that affect the central nervous system is delivering drugs across the blood-brain-barrier (BBB). Cell-penetrating peptides (CPPs) can be used as delivery vectors, but their translocation mechanism is still poorly understood, in part due to the simplistic membrane models applied to their interpretation. Here we investigate the translocation mechanism of two CPPs, R9 and MPG, using molecular dynamics and enhanced sampling techniques on a realistic membrane model of human brain microvascular endothelial cells. The results suggest that R9 induces greater membrane disruption compared to MPG, yet that both face a significant free energy barrier to translocation. In both peptides the first interactions were initiated by the N-terminus and prominently involved arginine residues even for MPG. The crucial role of the plasticity of both partners (BBB bending, partial CPP unfolding) on the translocation energetics was also explored by sampling ad hoc collective variables, revealing the important role of long polyunsaturated acyl chain lipids. Together, these findings provide mechanistic insight into CPP-mediated transport and offer guidelines for rational design.