Oskar Bordeaux
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Study of the effect of gender-affirming hormone therapy on cardiac repolarization in a cohort of transgender adults
No full textIntroduction : la population transgenre semble avoir un risque cardio-vasculaire augmenté, en particulier arythmogène, en lien avec l’hormonothérapie d’affirmation de genre (GAHT). L’action connue des hormones sexuelles sur la repolarisation cardiaque contribue au dimorphisme sexuel des troubles de la conduction cardiaque objectivé entre les femmes et les hommes adultes. Notre travail a pour but d’évaluer l’action de la GAHT sur la repolarisation cardiaque (mesure de la durée du QTc). Méthodes : il s’agit d’une étude longitudinale, observationnelle, monocentrique portant sur une cohorte de personnes transgenres suivies au CHU de Bordeaux. Chaque participant a bénéficié d’une (si GAHT déjà instaurée) ou deux (avant/après instauration de la GAHT) évaluations cliniques, biologiques et électrocardiographiques. Résultats : cent-neuf personnes transgenres ont participé à l’étude : 73 (41 hommes trans, 35 femmes trans) étaient déjà traitées par la GAHT et 33 (18 hommes trans et 15 femmes trans) ont eu deux évaluations (avant et après instauration de la GAHT). Chez ces derniers, le traitement féminisant (oestrogénothérapie et anti-androgène) allongeait le QTc (378 vs 396ms, p=0.0001) tandis que le traitement masculinisant (testostérone) raccourcissait le QTc (394 vs 385 ms, p<0.0001). Les durées de QTc chez les personnes trans traitées étaient similaires à celles des personnes cis du genre souhaité. Nous n’avons pas mis en évidence de corrélation entre la durée du QTc et les taux plasmatiques d’hormones sexuelles ni de gonadotrophines. Conclusion : notre étude a permis de montrer que la GAHT modifie significativement la repolarisation cardiaque : l’hormonothérapie féminisante allonge le QTc alors que l’hormonothérapie masculinisante le raccourcit.Introduction: the transgender population appears to have an increased cardiovascular risk, particularly arrhythmogenic, associated with gender-affirming hormone therapy (GAHT). The known effect of sex hormones on cardiac repolarization contributes to the sexual dimorphism of cardiac conduction disorders objectified between adult women and men. The aim of our work is to evaluate the effect of GAHT on cardiac repolarization (measurement of QTc duration). Methods: this is a longitudinal, observational, monocentric study of a cohort of transgender people followed at the University Hospital of Bordeaux. Each participant underwent one (if already undergoing GAHT) or two (before/after GAHT initiation) clinical, biological and electrocardiographic evaluations. Results: one hundred and nine transgender individuals participated in the study: 73 (41 transmen, 35 trans women) were already treated with GAHT, and 33 (18 transmen, 15 transwomen) had two assessments (before and after GAHT initiation). We have shown that feminizing treatment (estrogen therapy and anti-androgen) prolonged QTc (378 vs. 396 ms, p=0.0001), while masculinizing treatment (testosterone) shortened QTc (394 vs. 385 ms, p<0.0001). QTc duration in treated transgender individuals was similar to that of cis individuals of the desired gender. We found no correlation between QTc duration and plasma levels of sex hormones or gonadotropins. Conclusion: our study has highlighted that GAHT significantly modified cardiac repolarization: feminizing hormone therapy prolonged QTc, while masculinizing hormone therapy shortened it
Satisfying human needs at low material footprints: an investigation on the role of provisioning systems
No full textTo achieve social and environmental sustainability, humankind must balance satisfying human needs and preventing ecological collapse. The material footprint—the total materials required for production and consumption—plays a crucial role in this dynamic. This study uses data from 151 countries and a regression-based moderation approach to analyse how material footprints and human need satisfaction are influenced by socio-economic factors known as "provisioning factors."Countries with strong socioecological performance were characterized by factors such as democracy, rule of law, public health coverage, effective corruption control, access to electricity and clean fuels, trade and transport infrastructure, and urbanization. In contrast, weaker socio-ecological performance was often marked by extractivism and inequality. Improving provisioning systems could help countries reduce material use while enhancing need satisfaction. Yet, even under favorable conditions, the current economic system remains incompatible
with socio-ecological sustainability, highlighting the need for more radical changes to meet human needs with minimal material consumption
Ann Oncol
No full textBACKGROUND: Radiotherapy is essential for locoregional control in resectable soft-tissue sarcoma (STS) and remains a key strategy for unresectable STS. PARP inhibitors, such as olaparib, may enhance radiosensitivity by targeting DNA damage repair pathways. PATIENTS AND METHODS: This multicenter phase 1b trial evaluated the combination of olaparib and radiotherapy in STS of the limbs or trunk wall. Olaparib was administered twice daily at doses of 25, 50, 100, or 150 mg during the dose-escalation phase. Radiotherapy consisted of 50 Gy (25 fractions) for resectable tumors or 59.4 Gy (33 fractions) for unresectable tumors. Radiotherapy was exclusively preoperative for operable patients. Primary objectives were to determine the maximum tolerated dose (MTD) and recommended phase II dose (RP2D). Dose escalation was conducted using the Time-to-Event Continual Reassessment Method (TITE-CRM). Histological response was assessed in surgical cases, and RECIST 1.1 criteria were applied for non-surgical cases. RESULTS: Between October 2016 and April 2021, 41 patients were recruited across five French centers. The RP2D was identified as 100 mg olaparib twice daily. For operable patients, a favorable histological response was observed in 33% of patients, with a local relapse-free survival rate of 90.5% at one year. In contrast, among patients with inoperable tumors, the median progression-free survival was 7.7 months (95% CI: 2.6-28.4), with partial responses achieved in 20% of cases and stable disease in 60%. Grade 3 radiation dermatitis was the most frequent adverse event (34.1%), and two patients experienced grade 5 toxicity (4.8%). CONCLUSION: The combination of olaparib and radiotherapy is feasible for STS patients but requires stringent selection, avoiding patients with tumors involving critical vascular structures or those at high surgical risk, to minimize severe complications. Further randomized trials are warranted to validate efficacy and safety compared to radiotherapy alone
Déterminants de l’hésitation vaccinale contre le HPV chez les filles et les garçons de 11 à 19 ans en France : revue systématique de la littérature
No full textLa vaccination contre les HPV a montré son efficacité dans la protection contre les cancers HPV induits. En France, elle est recommandée chez les filles depuis 2007 et chez les garçons depuis 2019. La couverture vaccinale y reste inférieure aux objectifs et aux taux observés dans le reste de l’Europe. L’objectif de notre étude était d’identifier les déterminants de l’hésitation vaccinale contre le HPV chez les adolescents français et leurs parents. Nous avons réalisé une revue systématique de la littérature étudiant les décisions vaccinales des adolescents de 11 à 19 ans et de leurs parents. L’équation de recherche construite à partir des dérivés des mots-clés « hésitation vaccinale », « vaccin contre les papillomavirus » et « France » a été soumise dans 3 bases de données. Les articles publiés depuis le 1er janvier 2013 ont été inclus en juin 2023. 197 références ont été identifiées et 24 ont été incluses dans la revue de la littérature. 13 articles traitaient d’études quantitatives, 8 d’études qualitatives, 2 comportaient un volet quantitatif et un qualitatif, 1 étude utilisait la méthode des choix discrets. Les principaux freins à la vaccination étaient le manque d’informations et la crainte d’effets indésirables. Le principal levier était la recommandation par le médecin généraliste. L’école et la mère ainsi que le contexte médiatique ont des influences déterminantes. Les multiples déterminants de l’hésitation vaccinale retrouvés dans cette étude pourraient servir à construire des campagnes de communication ciblées afin d’informer la population. Le médecin généraliste doit pouvoir délivrer une information adaptée à l’adolescent et à ses parents. Des modifications de politiques de santé publique comme le retrait de l’autorisation parentale ou l’envoi d’invitations par la CNAM pourront être discutées.HPV vaccination has been shown to be effective in protecting against HPV-induced cancers. In France, it has been recommended for girls since 2007 and for boys since 2019. Vaccination coverage in France remains below the targets and rates observed in the rest of Europe. The aim of our study was to identify the determinants of vaccination hesitancy against HPV among French adolescents and their parents. We carried out a systematic review of the literature studying the vaccination decisions of adolescents aged 11 to 19 and their parents. The search equation constructed from the keywords ‘vaccine hesitancy’, ‘HPV vaccine’ and ‘France’ was submitted to 3 databases. Articles published since January 1, 2013 were included in June 2023. 197 references were identified and 24 were included in the literature review. 13 articles dealt with quantitative studies, 8 with qualitative studies, 2 had a quantitative and a qualitative component, 1 study used the discrete choice method. 10 articles studied only the parents‘ point of view, 6 the parents and the girls, 4 the girls, and the other 4 the boys’ point of view, the girls and the boys, the parents and the boys, and the parents and the adolescents. The main obstacles to vaccination were lack of information and fear of adverse effects. The main motivation was the GP's recommendation. The school and the mother, as well as the media context, had decisive influences. The multiple determinants of vaccine hesitancy identified in this study could be used to develop targeted communication campaigns to inform the public. General practitioners must be able to provide appropriate information to adolescents and their parents. Changes to public health policy, such as withdrawing parental authorisation or sending out invitations by the national health insurance, could be discussed
Kidney Int Rep
Get PDFIntroduction: Denys-Drash syndrome (DDS) is a rare disease typically associated with a triad of early onset nephrotic syndromes (NS), susceptibility to Wilms tumor (WT), and genitourinary structural defects. DDS is caused by Wilms’ tumor suppression gene (WT1) variants, with the most frequent variants in exons 8 and 9. This study aimed to evaluate the long-term clinical outcomes and genotype-to-phenotype correlations in a large, multicenter cohort of children with typical DDS. Methods: We conducted a national retrospective study of all children diagnosed with a pathogenic variant in WT1 exons 8 or 9 in France between 2000 and 2022. Results: Fifty-eight children with DDS and variants in exons 8 (n = 23) and 9 (n = 35) of the WT1 gene were identified. Half of the children presented with NS (57% congenital, median age at presentation 0.3 years [interquartile range, IQR: 0.0–0.6]). Twenty-nine percent of children developed WT at a median age of 1.2 (0.5–2.2) years. Children with a variant in exon 8 developed NS much earlier than those with a variant in exon 9 (P = 0.0048), regardless of the type of genetic variation, leading to earlyier kidney failure (KF) (0.3 vs.1.4 years respectively; P = 0.0001) and higher mortality (35% vs 9%, P = 0.02). More than 90% of the truncating variants were located in exon 9 and were significantly associated with the occurrence of WT compared with the DNA-binding-site variants (P < 0.0015). Conclusion: In our cohort, children's DDS clinical trajectory was associated with exon localization. In the era of genomic newborn screening, depicting genetic risk is of utmost importance for personalized patient care. © 2025 International Society of Nephrolog
Population sequencing of cherry accessions unravels the evolution of Cerasus species and the selection of genetic characteristics in edible cherries
No full textCerasus is a subgenus of Prunus in the family Rosaceae that is popular owing to its ornamental, edible, and medicinal properties. Understanding the evolution of the Cerasus subgenus and identifying selective trait loci in edible cherries are crucial for the improvement of cherry cultivars to meet producer and consumer demands. In this study, we performed a de novo assembly of a chromosome-scale genome for the sweet cherry (Prunus avium L.) cultivar 'Burlat' , covering 297.55 Mb and consisting of eight chromosomes with 33,756 protein-coding genes. The resequencing and population structural analysis of 384 Cerasus representative accessions revealed that they could be divided into four groups (Group 1, Group 2, Group 3, and Group 4). We inferred that Group 1 was the oldest population and Groups 2, 3, and 4 were clades derived from it. In addition, we found selective sweeps for fruit flavor and improved stress resistance in different varieties of edible cherries (P. avium, P. cerasus, and P. pseudocerasus). Transcriptome analysis revealed significant differential expression of genes associated with key pathways, such as sucrose starch and sucrose metabolism, fructose and mannose metabolism, and the pentose phosphate pathway, between the leaves and fruits of P. avium. This study enhances the understanding of the evolutionary processes of the Cerasus subgenus and provides resources for functional genomics research and the improvement of edible cherries.</div
Wet Season Environments Drive Local Adaptation in the Timber Tree <i>Dicorynia guianensis</i> in French Guiana
No full textThe vast tropical rainforests of the Guiana Shield in Northern South America play a vital role in maintaining the region's ecological balance and economy. Increasing pressure from selective logging, gold mining and climate variability threatens these ecosystems. Sustainable rainforest management requires understanding the genetic diversity and local adaptation of key tree species to inform conservation. This study focuses on Dicorynia guianensis (Fabaceae), a widespread and economically important tree species in French Guiana. We performed genome resequencing on 87 individuals sampled in 11 sites across French Guiana to investigate the genetic structure, diversity and genetic basis of local adaptation. Genetic structure analysis identified three distinct groups: western, central and eastern, with similar levels of genetic diversity distributed in areas with different environmental conditions. Six methods applied to detect genomic signatures of selection revealed region-specific selective sweeps and a weak overlap between single nucleotide polymorphisms (SNPs) identified through outlier analysis or genome-environment association analyses. The strongest associations between environmental variables and genomic constitution were observed for potential evapotranspiration of the wettest quarter and for precipitation of the coldest quarter, suggesting that environmental variables related to high rainfall during the wet season are stronger drivers of local adaptation of D. guianensis populations than drought. Sites located in central and western French Guiana had higher risks of climatic maladaptation. These findings advance our understanding of local adaptation and climatic vulnerability in tropical trees and emphasise the need for targeted, area-specific management strategies for conservation and sustainable timber extraction under climate change. | IntroductionTropical rainforests in South America, in particular the extensive biodiverse forests of the Guiana Shield, play a crucial role in regulating regional and global climates by maintaining carbon stocks and influencing hydrological cycles (Bovolo et al. 2018). French Guiana, located in the Guiana Shield between Suriname and Brazil, is a region with a remarkably continuous cover of tropical rainforests that extends across 96% of the territory (De Geyer et al. 2020). However, like the rest of the globe, French Guiana is facing the multifaceted effects of climate change, alongside anthropogenic pressuresThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.CEnter of the study of Biodiversity in Amazoni
De pratique juvénile à emblème identitaire : Comment le rap américain est devenu une musique "noire"
No full textJ Psychiatr Res
No full textBACKGROUND: The college years are a developmentally sensitive period for mental disorder onset. Reliable epidemiological data are critical for informing public health responses. This study aimed to estimate prevalence and socio-demographic distributions of common DSM-5 mental disorders among first-year university students from 77 universities across 18 countries. METHODS: Data were collected 2017-2023 in the World Mental Health International College Student Initiative with n = 72,288 university students. Online surveys assessed alcohol use, attention-deficit/hyperactivity, bipolar, drug use, generalized anxiety, major depression, panic, and post-traumatic stress disorders with validated screening scales. Socio-demographics included student age, sex at birth, gender modality, sexual orientation, and parent education. RESULTS: The weighted mean response rate was 20.8%. Data were calibrated for differential response rates by sex at birth and age. 65.2% of respondents screened positive for lifetime mental disorders and 57.4% for 12-month mental disorders. Females had higher prevalence of internalizing disorders and males of substance and attention-deficit/hyperactivity disorders. Older age was associated with lower prevalence of most 12-month but not lifetime mental disorders. Non-heterosexual sexual orientation and identifying as transgender were associated with highest prevalence of most mental disorders. Parent education was for the most part uncorrelated with prevalence. CONCLUSIONS: Although prevalence might have been overestimated due to the low response rate and possible screening scale miscalibration, results nonetheless suggest that mental disorders are highly prevalent among first-year university students worldwide and are widely distributed with respect to socio-demographic characteristics. These findings highlight the need to implement effective interventions to better support first-year university student mental health