Voir le monde à travers les lunettes du métacontraste: un modèle mathématique inspiré de la psychologie sociale

La théorie de l'autocatégorisation est une théorie de psychologie sociale qui porte sur la relation entre l'individu et le groupe. Elle explique le comportement de groupe par la conception de soi et des autres en tant que membres de catégories sociales, et par l'attribution aux individus des caractéristiques prototypiques de ces catégories. Il s'agit donc d'une théorie de l'individu qui est censée expliquer des phénomènes collectifs. Les situations dans lesquelles un grand nombre d'individus interagissent de manière non triviale génèrent typiquement des comportements collectifs complexes qui sont difficiles à prévoir sur la base des comportements individuels. La simulation informatique de tels systèmes est un moyen fiable d'explorer de manière systématique la dynamique du comportement collectif en fonction des spécifications individuelles. Dans cette thèse, nous présentons un modèle formel d'une partie de la théorie de l'autocatégorisation appelée principe du métacontraste. À partir de la distribution d'un ensemble d'individus sur une ou plusieurs dimensions comparatives, le modèle génère les catégories et les prototypes associés. Nous montrons que le modèle se comporte de manière cohérente par rapport à la théorie et est capable de répliquer des données expérimentales concernant divers phénomènes de groupe, dont par exemple la polarisation. De plus, il permet de décrire systématiquement les prédictions de la théorie dont il dérive, notamment dans des situations nouvelles. Au niveau collectif, plusieurs dynamiques peuvent être observées, dont la convergence vers le consensus, vers une fragmentation ou vers l'émergence d'attitudes extrêmes. Nous étudions également l'effet du réseau social sur la dynamique et montrons qu'à l'exception de la vitesse de convergence, qui augmente lorsque les distances moyennes du réseau diminuent, les types de convergences dépendent peu du réseau choisi. Nous constatons d'autre part que les individus qui se situent à la frontière des groupes (dans le réseau social ou spatialement) ont une influence déterminante sur l'issue de la dynamique. Le modèle peut par ailleurs être utilisé comme un algorithme de classification automatique. Il identifie des prototypes autour desquels sont construits des groupes. Les prototypes sont positionnés de sorte à accentuer les caractéristiques typiques des groupes, et ne sont pas forcément centraux. Enfin, si l'on considère l'ensemble des pixels d'une image comme des individus dans un espace de couleur tridimensionnel, le modèle fournit un filtre qui permet d'atténuer du bruit, d'aider à la détection d'objets et de simuler des biais de perception comme l'induction chromatique. Abstract Self-categorization theory is a social psychology theory dealing with the relation between the individual and the group. It explains group behaviour through self- and others' conception as members of social categories, and through the attribution of the proto-typical categories' characteristics to the individuals. Hence, it is a theory of the individual that intends to explain collective phenomena. Situations involving a large number of non-trivially interacting individuals typically generate complex collective behaviours, which are difficult to anticipate on the basis of individual behaviour. Computer simulation of such systems is a reliable way of systematically exploring the dynamics of the collective behaviour depending on individual specifications. In this thesis, we present a formal model of a part of self-categorization theory named metacontrast principle. Given the distribution of a set of individuals on one or several comparison dimensions, the model generates categories and their associated prototypes. We show that the model behaves coherently with respect to the theory and is able to replicate experimental data concerning various group phenomena, for example polarization. Moreover, it allows to systematically describe the predictions of the theory from which it is derived, specially in unencountered situations. At the collective level, several dynamics can be observed, among which convergence towards consensus, towards frag-mentation or towards the emergence of extreme attitudes. We also study the effect of the social network on the dynamics and show that, except for the convergence speed which raises as the mean distances on the network decrease, the observed convergence types do not depend much on the chosen network. We further note that individuals located at the border of the groups (whether in the social network or spatially) have a decisive influence on the dynamics' issue. In addition, the model can be used as an automatic classification algorithm. It identifies prototypes around which groups are built. Prototypes are positioned such as to accentuate groups' typical characteristics and are not necessarily central. Finally, if we consider the set of pixels of an image as individuals in a three-dimensional color space, the model provides a filter that allows to lessen noise, to help detecting objects and to simulate perception biases such as chromatic induction.

Involvement of family physicians in structured programs for chronic diseases or multi-morbidity in Switzerland.

The increasing prevalence of chronic diseases and multi-morbidity represents challenges for health systems worldwide. In that perspective, the current organization of healthcare delivery, fragmentation of care, limited use of evidence-based guidelines and patients'insufficient empowerment are some reasons explaining the current limited effectiveness of the management of chronically ill patients. Based on theoretical models such as the Chronic Care Model (CCM), initiatives targeting improvements in the care of patients with chronic diseases have been implemented worldwide since more than a decade. Their development in Switzerland, a health system where more than half of practices are still single handed [6], is only recent and infrequent. Structured programs for patients with chronic diseases or multimorbidity usually propose patient-centered interventions and consider an integrative multidisciplinary approach. Currently, little is known on the existence of such programs and on the role of family physicians (FPs)within these programs, in Switzerland. The objective of this study was to identify and describe current structured programs targeting chronic diseases or multi-morbidity in Switzerland. This may help in examining innovative approaches that are only developed locally but would deserve wider interest for further implementation. We conducted a telephone-based survey between June and November 2013 and contacted systematically key institutions, informants and stakeholders nationwide and in the 26 cantons...

Multifunctional mitoxantrone-conjugated magnetic nanosystem for targeted therapy of folate receptor-overexpressing malignant cells.

BACKGROUND: Targeted delivery of anticancer chemotherapeutics such as mitoxantrone (MTX) can significantly intensify their cytotoxic effects selectively in solid tumors such as breast cancer. In the current study, folic acid (FA)-armed and MTX-conjugated magnetic nanoparticles (MNPs) were engineered for targeted eradication of folate receptor (FR)-positive cancerous cells. Polyethylene glycol (PEG), FA and MTX were covalently conjugated onto the MNPs to engineer the PEGylated FA-MTX-MNPs. The internalization studies were performed using fluorescein isothiocyanate (FITC)-labeled FA-decorated MNPs (FA-FITC-MNPs) in both FR-positive MCF-7 cells and FR-negative A549 cells by means of fluorescence microscopy and flow cytometry. The cellular and molecular impacts of FA-MTX-MNPs were examined using trypan blue cell viability and FITC-labeled annexin V apoptosis assays and 4',6-diamidino-2-phenylindole (DAPI) staining, DNA ladder and quantitative polymerase chain reaction (qPCR) assays. RESULTS: The FR-positive MCF-7 cells showed significant internalization of the FA-FITC-MNPs, but not the FR-negative A549 cells. The FR-positive cells treated with the PEGylated FA-MTX-MNPs exhibited the IC50 values of 3 μg/mL and 1.7 μg/mL, 24 h and 48 h post-treatment, respectively. DAPI staining and DNA ladder assays revealed significant condensation of nucleus and fragmentation of genomic DNA in the FR-positive MCF-7 cells treated with the PEGylated FA-MTX-MNPs as compared to the FR-negative A549 cells. The FITC-labeled annexin V assay confirmed emergence of late apoptosis (>80%) in the FR-positive MCF-7 cells treated with the PEGylated FA-MTX-MNPs, but not in the FR-negative A549 cells. The qPCR analysis confirmed profound cytotoxic impacts via alterations of apoptosis-related genes induced by MTX-FA-MNPs in MCF-7 cells, but not in the A549 cells. CONCLUSION: Our findings evince that the engineered PEGylated FA-MTX-MNPs can be specifically taken up by the FR-positive malignant cells and effectively demolish them through up-regulation of Bcl-2-associated X protein (Bax) and Caspase 9 and down-regulation of AKt. Hence, the engineered nanosystem is proposed for simultaneous targeted imaging and therapy of various cancers overexpressing FRs.

Thoracic aortic dissection associated with cocaine abuse.

Cardiovascular complications of cocaine abuse include myocardial ischemia and infarction, dysrhythmias, cardiomyopathies and aortic dissection. The case in point pertains to a 26-year-old, Caucasian male, substance abuser who suffered a thoracic aortic dissection following the use of crack cocaine. The autopsy and histological findings showed a connective tissue abnormality including a focal microcystic medial necrosis and a fragmentation of the elastic fibers in the arterial walls. Blood concentrations of cocaine and benzoylecgonine, taken individually, were considered to be within a potentially toxic range. Blood concentrations of methadone also indicated use of this drug at the same time. The small amounts of morphine found in the blood and urine were compatible with heroine or morphine use more than 24 h before death.

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Summary and conclusion: One of the main challenges facing the Swiss health care system remains continued fragmentation as a consequence of the federal structure and the division of responsibilities. This constitutes a major barrier for the implementation of a nationwide public health strategy and a more rational organization of health care. Much of the health reform agenda during the past decade was driven by cost-containment efforts. Despite the absence of a national regulatory framework targeting prevention and care of chronic diseases, national strategies and programmes have been developed within a growing recognition of the need to address chronic disease in the health care system. In addition, several small-scale pilot and preliminary structured care programmes have been implemented in selected localities. The latter are however still too few and limited in scope to cover the needs of the majority of patients with chronic diseases residing in Switzerland. Given the continued high satisfaction with the system among health care users, of around 80%, pressure to actually initiate larger scale changes might not yet be sufficiently strong.

Effect of biogeographic history on population vulnerability in European amphibians.

The genetic diversity of populations, which contributes greatly to their adaptive potential, is negatively affected by anthropogenic habitat fragmentation and destruction. However, continental-scale losses of genetic diversity also resulted from the population expansions that followed the end of the last glaciation, an element that is rarely considered in a conservation context. We addressed this issue in a meta-analysis in which we compared the spatial patterns of vulnerability of 18 widespread European amphibians in light of phylogeographic histories (glacial refugia and postglacial routes) and anthropogenic disturbances. Conservation statuses significantly worsened with distances from refugia, particularly in the context of industrial agriculture; human population density also had a negative effect. These findings suggest that features associated with the loss of genetic diversity in post-glacial amphibian populations (such as enhanced fixation load or depressed adaptive potential) may increase their susceptibility to current threats (e.g., habitat fragmentation and pesticide use). We propose that the phylogeographic status of populations (i.e., refugial vs. post-glacial) should be considered in conservation assessments for regional and national red lists.

Dying neurons in thalamus of asphyxiated term newborns and rats are autophagic

Enjeu: Déterminer si la macroautophagie est activée de façon excessive dans les neurones en souffrance dans l'encéphalopathie anoxique-ischémique du nouveau-né à terme. Contexte de la recherche: L'encéphalopathie anoxique-ischémique suite à une asphyxie néonatale est associée à une morbidité neurologique à long terme. Une diminution de son incidence reste difficile, son primum movens étant soudain, imprévisible voire non identifiable. Le développement d'un traitement pharmacologique neuroprotecteur post-anoxie reste un défi car les mécanismes impliqués dans la dégénérescence neuronale sont multiples, interconnectés et encore insuffisamment compris. En effet, il ressort des études animales que la notion dichotomique de mort cellulaire apoptotique (type 1)/nécrotique (type 3) est insuffisante. Une même cellule peut présenter des caractéristiques morphologiques mixtes non seulement d'apoptose et de nécrose mais aussi parfois de mort autophagique (type 2) plus récemment décrite. L'autophagie est un processus physiologique normal et essentiel de dégradation de matériel intracellulaire par les enzymes lysosomales. La macroautophagie, nommée simplement autophagie par la suite, consiste en la séquestration de parties de cytosol à éliminer (protéines et organelles) dans des compartiments intermédiaires, les autophagosomes, puis en leur fusion avec des lysosomes pour former des autolysosomes. Dans certaines conditions de stress telles que l'hypoxie et l'excitoxicité, une activité autophagique anormalement élevée peut être impliquée dans la mort cellulaire soit comme un mécanisme de mort indépendant (autodigestion excessive correspondante à la mort cellulaire de type 2) soit en activant d'autres voies de mort comme celles de l'apoptose. Description de l'article: Ce travail examine la présence de l'autophagie et son lien avec la mort cellulaire dans les neurones d'une région cérébrale fréquemment atteinte chez le nouveau- né humain décédé après une asphyxie néonatale sévère, le thalamus ventro-latéral. Ces résultats ont été comparés à ceux obtenus dans un modèle d'hypoxie-ischémie cérébrale chez le raton de 7 jours (dont le cerveau serait comparable à celui d'un nouveau-né humain de 34-37 semaines de gestation). Au total 11 nouveau-nés à terme décédés peu après la naissance ont été rétrospectivement sélectionnés, dont 5 présentant une encéphalopathie hypoxique- ischémique sévère et 6 décédés d'une cause autre que l'asphyxie choisis comme cas contrôle. L'autophagie et l'apoptose neuronale ont été évaluées sur la base d'une étude immunohistochimique et d'imagerie confocale de coupes histologiques en utilisant des marqueurs tels que LC3 (protéine dont la forme LC3-II est liée à la membrane des autophagosomes), p62/SQSTM1 (protéine spécifiquement dégradée par autophagie), LAMP1 (protéine membranaire des lysosomes et des autolysosomes), Cathepsin D ou B (enzymes lysosomales), TUNEL (détection de la fragmentation de l'ADN se produisant lors de l'apoptose), CASPASE-3 activée (protéase effectrice de l'apoptose) et PGP9.5 (protéine spécifique aux neurones). Chez le raton l'étude a pu être étendue en utilisant d'autres méthodes complémentaires telles que la microscopie électronique et le Western-blot. Une quantification des différents marqueurs montre une augmentation statistiquement significative de l'autophagie neuronale dans les cas d'asphyxie par rapport aux cas contrôles chez l'humain comme chez le raton. En cas d'asphyxie, les mêmes neurones expriment une densité accrue d'autophagosomes et d'autolysosomes par rapport aux cas contrôles. De plus, les neurones hautement autophagiques présentent des caractéristiques de l'apoptose. Conclusion: Cette étude montre, pour la première fois, que les neurones thalamiques lésés en cas d'encéphalopathie hypoxique-ischémique sévère présentent un niveau anormalement élevé d'activité autophagique comme démontré chez le raton hypoxique-ischémique. Ce travail permet ainsi de mettre en avant l'importance de considérer l'autophagie comme acteur dans la mort neuronale survenant après asphyxie néonatale. Perspectives: Récemment un certain nombre d'études in vitro ou sur des modèles d'ischémie cérébrale chez les rongeurs suggèrent un rôle important de la macroautophagie dans la mort neuronale. Ainsi, l'inhibition spécifique de la macroautophagie devrait donc être envisagée dans le futur développement des stratégies neuroprotectrices visant à protéger le cerveau des nouveau-nés à terme suite à une asphyxie.

L-tyrosine and nitric oxide synergize to prevent cytotoxic effects of superoxide.

We found previously that the nitric oxide donor DEA/NO enhanced lipid peroxidation, DNA fragmentation, and cytotoxicity in human bronchial epithelial cells (BEAS-2B) when they were cultured in LHC-8 medium containing the superoxide-generating system hypoxanthine/xanthine oxidase (HX/XO). We have now discovered that DEA/NO's prooxidant action can be reversed by raising the L-tyrosine concentration from 30 to 400 microM. DEA/NO also protected the cells when they were cultured in Dulbecco's Modified Eagle's Medium (DMEM), whose standard concentration of L-tyrosine is 400 microM. Similar trends were seen with the colon adenoma cell line CaCo-2. Since HPLC analysis of cell-free DMEM or LHC-8 containing 400 microM L-tyrosine, DEA/NO, and HX/XO revealed no evidence of L-tyrosine nitration, our data suggest the existence of an as-yet uncharacterized mechanism by which L-tyrosine can influence the biochemical and toxicological effects of reactive nitrogen species.

Transition mutation in codon 248 of the p53 tumor suppressor gene induced by reactive oxygen species and a nitric oxide-releasing compound.

Exposing the human bronchial epithelial cell line BEAS-2B to the nitric oxide (NO) donor sodium 1-(N,N-diethylamino)diazen-1-ium-1, 2-diolate (DEA/NO) at an initial concentration of 0.6 mM while generating superoxide ion at the rate of 1 microM/min with the hypoxanthine/xanthine oxidase (HX/XO) system induced C:G-->T:A transition mutations in codon 248 of the p53 gene. This pattern of mutagenicity was not seen by 'fish-restriction fragment length polymorphism/polymerase chain reaction' (fish-RFLP/PCR) on exposure to DEA/NO alone, however, exposure to HX/XO led to various mutations, suggesting that co-generation of NO and superoxide was responsible for inducing the observed point mutation. DEA/NO potentiated the ability of HX/XO to induce lipid peroxidation as well as DNA single- and double-strand breaks under these conditions, while 0.6 mM DEA/NO in the absence of HX/XO had no significant effect on these parameters. The results show that a point mutation seen at high frequency in certain common human tumors can be induced by simultaneous exposure to reactive oxygen species and a NO source.

On the use of an appropriate TdT-mediated dUTP-biotin nick end labeling assay to identify apoptotic cells.

Apoptosis is an essential cellular mechanism involved in many processes such as embryogenesis, metamorphosis, and tissue homeostasis. DNA fragmentation is one of the key markers of this form of cell death. DNA fragmentation is executed by endogenous endonucleases such as caspase-activated DNase (CAD) in caspase-dependent apoptosis. The TUNEL (TdT-mediated dUTP-biotin nick end labeling) technique is the most widely used method to identify apoptotic cells in a tissue or culture and to assess drug toxicity. It is based on the detection of 3'-OH termini that are labeled with dUTP by the terminal deoxynucleotidyl transferase. Although the test is very reliable and sensitive in caspase-dependent apoptosis, it is completely useless when cell death is mediated by pathways involving DNA degradation that generates 3'-P ends as in the LEI/L-DNase II pathway. Here, we propose a modification in the TUNEL protocol consisting of a dephosphorylation step prior to the TUNEL labeling. This allows the detection of both types of DNA breaks induced during apoptosis caspase-dependent and independent pathways, avoiding underestimating the cell death induced by the treatment of interest.

Sleep in vitro : Erk pathway regulates sleep duration and sleep related genes

To date, for most biological and physiological phenomena, the scientific community has reach a consensus on their related function, except for sleep, which has an undetermined, albeit mystery, function. To further our understanding of sleep function(s), we first focused on the level of complexity at which sleep-like phenomenon can be observed. This lead to the development of an in vitro model. The second approach was to understand the molecular and cellular pathways regulating sleep and wakefulness, using both our in vitro and in vivo models. The third approach (ongoing) is to look across evolution when sleep or wakefulness appears. (1) To address the question as to whether sleep is a cellular property and how this is linked to the entire brain functioning, we developed a model of sleep in vitro by using dissociated primary cortical cultures. We aimed at simulating the major characteristics of sleep and wakefulness in vitro. We have shown that mature cortical cultures display a spontaneous electrical activity similar to sleep. When these cultures are stimulated by waking neurotransmitters, they show a tonic firing activity, similar to wakefulness, but return spontaneously to the "sleep-like" state 24h after stimulation. We have also shown that transcriptional, electrophysiological, and metabolic correlates of sleep and wakefulness can be reliably detected in dissociated cortical cultures. (2) To further understand at which molecular and cellular levels changes between sleep and wakefulness occur, we have used a pharmacological and systematic gene transcription approach in vitro and discovered a major role played by the Erk pathway. Indeed, pharmacological inhibition of this pathway in living animals decreased sleep by 2 hours per day and consolidated both sleep and wakefulness by reducing their fragmentation. (3) Finally, we tried to evaluate the presence of sleep in one of the most primitive species with a neural network. We set up Hydra as a model organism. We hypothesized that sleep as a cellular (neuronal) property may occur with the appearance of the most primitive nervous system. We were able to show that Hydra have periodic rest phases amounting to up to 5 hours per day. In conclusion, our work established an in vitro model to study sleep, discovered one of the major signaling pathways regulating vigilance states, and strongly suggests that sleep is a cellular property highly conserved at the molecular level during evolution. -- Jusqu'à ce jour, la communauté scientifique s'est mise d'accord sur la fonction d'une majorité des processus physiologiques, excepté pour le sommeil. En effet, la fonction du sommeil reste un mystère, et aucun consensus n'est atteint le concernant. Pour mieux comprendre la ou les fonctions du sommeil, (1) nous nous sommes d'abord concentré sur le niveau de complexité auquel un état ressemblant au sommeil peut être observé. Nous avons ainsi développé un modèle du sommeil in vitro, (2) nous avons disséqué les mécanismes moléculaires et cellulaires qui pourraient réguler le sommeil, (3) nous avons cherché à savoir si un état de sommeil peut être trouvé dans l'hydre, l'animal le plus primitif avec un système nerveux. (1) Pour répondre à la question de savoir à quel niveau de complexité apparaît un état de sommeil ou d'éveil, nous avons développé un modèle du sommeil, en utilisant des cellules dissociées de cortex. Nous avons essayé de reproduire les corrélats du sommeil et de l'éveil in vitro. Pour ce faire, nous avons développé des cultures qui montrent les signes électrophysiologiques du sommeil, puis quand stimulées chimiquement passent à un état proche de l'éveil et retournent dans un état de sommeil 24 heures après la stimulation. Notre modèle n'est pas parfait, mais nous avons montré que nous pouvions obtenir les corrélats électrophysiologiques, transcriptionnels et métaboliques du sommeil dans des cellules corticales dissociées. (2) Pour mieux comprendre ce qui se passe au niveau moléculaire et cellulaire durant les différents états de vigilance, nous avons utilisé ce modèle in vitro pour disséquer les différentes voies de signalisation moléculaire. Nous avons donc bloqué pharmacologiquement les voies majeures. Nous avons mis en évidence la voie Erkl/2 qui joue un rôle majeur dans la régulation du sommeil et dans la transcription des gènes qui corrèlent avec le cycle veille-sommeil. En effet, l'inhibition pharmacologique de cette voie chez la souris diminue de 2 heures la quantité du sommeil journalier et consolide l'éveil et le sommeil en diminuant leur fragmentation. (3) Finalement, nous avons cherché la présence du sommeil chez l'Hydre. Pour cela, nous avons étudié le comportement de l'Hydre pendant 24-48h et montrons que des périodes d'inactivité, semblable au sommeil, sont présentes dans cette espèce primitive. L'ensemble de ces travaux indique que le sommeil est une propriété cellulaire, présent chez tout animal avec un système nerveux et régulé par une voie de signalisation phylogénétiquement conservée.

Is the sword moss (Bryoxiphium) a preglacial Tertiary relict?

The disjunction of floras between East Asia, Southeast North America, West North America, and Southwest Eurasia has been interpreted in terms of the fragmentation of a once continuous mixed mesophytic forest that occurred throughout the Northern Hemisphere due to the climatic and geological changes during the late Tertiary. The sword moss, Bryoxiphium, exhibits a distribution that strikingly resembles that of the mesophytic forest elements such as Liriodendron and is considered as the only living member of an early Tertiary flora in Iceland. These hypotheses are tested here using molecular dating analyses and ancestral area estimations. The results suggest that the extant range of Bryoxiphium results from the fragmentation of a formerly wider range encompassing North America and Southeast Asia about 10 million years ago. The split of continental ancestral populations is too recent to match with a continental drift scenario but is spatially and temporally remarkably congruent with that observed in Tertiary angiosperm relict species. The timing of the colonization of Iceland from Macaronesian ancestors, about two million years ago, is, however, incompatible with the hypothesis that Bryoxiphium is the only living member of an early Tertiary flora of the island. Alaska was recurrently colonized from East Asia. The ability of Bryoxiphium to overcome large oceanic barriers is further evidenced by its occurrence on remote oceanic archipelagos. In particular, Madeira was colonized twice independently from American and East Asian ancestors, respectively. The striking range disjunction of Bryoxiphium is interpreted in terms of its mating system, as the taxon exhibits a very singular pattern of spatial segregation of the sexes.

Poorly differentiated clusters (PDC) in colorectal cancer: what is and ought to be known.

BACKGROUND: The counting of poorly differentiated clusters of 5 or more cancer cells lacking a gland-like structure in a tumor mass has recently been identified among the histological features predictive of poor prognosis in colorectal cancer. MAIN BODY: Poorly differentiated clusters can easily be recognized in the histological sections of colorectal cancer routinely stained with haematoxylin and eosin. Despite some limitations related to specimen fragmentation, counting can also be assessed in endoscopic biopsies. Based on the number of poorly differentiated clusters that appear under a microscopic field of a ×20 objective lens (i.e., a microscopic field with a major axis of 1 mm), colorectal cancer can be graded into malignancies as follows: tumors with <5 clusters as grade 1, tumors with 5 to 9 clusters as grade 2, and tumors with ≥10 clusters as grade 3. High poorly differentiated cluster counts are significantly associated with peri-neural and lympho-vascular invasion, the presence of nodal metastases or micrometastases, as well as shorter overall and progression free survival to colorectal cancer. CONCLUSION: The morphological aspects and clinical relevance of poorly differentiated clusters counting in colorectal cancer are discussed in this review.