Measurement invariance of the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) between Australia, the USA, and the UK

The Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) is widely used to assess Internet Gaming Disorder behaviors. Investigating cultural limitations and implications in its applicability is imperative. One way to evaluate the cross-cultural feasibility of the measure is through measurement invariance analysis. The present study used Multigroup Confirmatory Factor Analysis (MGCFA) to examine the IGDS9-SF measurement invariance across gamers from Australia, the United States of America (USA), and the United Kingdom (UK). To accomplish this, 171 Australian, 463 USA, and 281 UK gamers completed the IGDS9-SF. Although results supported the one-factor structure of the IGD construct, they indicated cross-country variations in the strength of the relationships between the indicators and their respective factor (i.e., non-invariant loadings of items 1, 2, 5), and that the same scores may not always indicate the same level of IGD severity across the three groups (i.e., non-invariant intercepts for items 1, 5, 7, 9)

Suivi à 1 an d'une cohorte de patients participant à un dépistage ciblé du mélanome (évaluation des délais de consultation et des facteurs associés à une mauvaise observance)

Contexte. La promotion d'un dépistage ciblé du mélanome est limitée par l'absence de données scientifiques sur sa faisabilité et son impact sur la morbi-mortalité. Objectif. Décrire le parcours de soin de patients à haut risque de mélanome au cours des 12 mois suivant leur inclusion dans une procédure de dépistage ciblé. L'objectif secondaire était d'identifier des facteurs socio-démographiques associés à une mauvaise observance de la procédure de dépistage proposée. Méthodologie. Design : étude de cohorte prospective. Critères d'inclusion : patients à risque identifiés par le Self Assessment Melanoma risk Score. Déroulement: Les médecins généralistes investigateurs examinaient les patients inclus. En cas d'identification d'une lésion suspecte, le patient était adressé au dermatologue. Le dermatologue pouvait conclure que la lésion était bénigne, proposer une surveillance, ou orienter le patient vers une exérèse. Critères de jugement : Réduction des effectifs entre les différentes étapes du dépistage, délais de consultation, et taux de non observance. Résultats. Sur 3953 patients à risque, 909 ont consulté un dermatologue, 100 ont eu une exérèse, 8 avaient un mélanome. Tous les mélanomes dépistés avaient un Breslow inférieur à 1mm. Le délai médian de consultation chez le dermatologue a été de 84 jours. Le délai médian avant exérèse d'un mélanome a été de 79 jours. 34.8% des patients adressés chez le dermatologue ne s'y sont pas rendus. Orienter vers un dermatologue en particulier augmenterait l'observance (OR=2.13, p<0.001). Habiter en Vendée et non en Loire-Atlantique serait associé à une observance 2.27 fois moindre (OR=2.27, p<0.001). Conclusion. Le bénéfice d'un dépistage ciblé pourrait être important. De futures études devraient s'intéresser aux raisons pour lesquelles certains patients ne respectent pas la procédure de dépistage proposée.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF

Two-step self-assembly of a spider silk molecular clamp

Molecular details that underlie mechanical properties of spider silk are of great interest to material scientists. Here, the authors report a previously unknown three-state mechanism of folding and an expanded structure of a spider silk protein that may contribute to elasticity of spider silk

Timing and distribution of exhumation in the Ebro basin reveal a plate-scale 10 Ma geodynamic event

International audienceThe interplays between deep geodynamic processes and Earth-surface erosion processes control the elevation and distribution of land masses, which in turn control environmental changes. These interactions can be best evaluated in post-orogenic landscapes defined by decaying crustal deformation. This is the case of the Iberia peninsula where a growing body of geological evidence suggests the existence of a post-orogenic erosion around 10 Ma, well documented across the Pyrenees. Different mechanisms have been proposed, including lithospheric and sublithospheric processes, and Earth-surface processes triggered by base-level change and/or climate forcing on erosion. Here, we focus on the Ebro basin, which was a closed basin that opened towards the Mediterranean in the late Miocene. The distribution and exact timing of erosion in the Ebro basin are, however, only partially known, and do not yet allow resolving the post-orogenic mechanisms involved. We present new (U-Th-Sm)/He dates on apatite obtained in sandstones distributed from the edges of the Ebro basin to its center. The results of the thermal modelling confirm that the exhumation of the Ebro Basin took place between 12 and 6 Ma, or around 10 Ma when accounting for model uncertainties. Reconstruction of the sediment infill reveals that the late Miocene post-orogenic deposits were the thickest, between 1 and 1.6 km, near the topographic front of adjacent mountain ranges and were the thinnest, approximately 300 m, in the center. The exhumation in the Ebro basin occurred after shortening has stopped, and before the Messinian Salinity Crisis. It is consistent with the widespread 10 Ma-exhumation event documented throughout Iberia, from the Aquitaine basin to the Betic Cordillera, and provides evidence of large-scale lithospheric and sublithospheric processes that coincide with the cessation of slab retreat in the West Mediterranean. We propose that a plate-scale uplift driven by deep-seated processes is the main cause of the Ebro basin incision. The response of the landscape to this geodynamically controlled erosion event led to a complex tectonic reorganization, e.g. along the strike of the Pyrenees, environmental changes in the Mediterranean, leading to the Messinian Salinity Crisis, and faunal turnover over Iberia

Conservation of folding and association within a family of spidroin N-terminal domains

Web spiders synthesize silk fibres, nature’s toughest biomaterial, through the controlled assembly of fibroin proteins, so-called spidroins. The highly conserved spidroin N-terminal domain (NTD) is a pH-driven self-assembly device that connects spidroins to super-molecules in fibres. The degree to which forces of self-assembly is conserved across spider glands and species is currently unknown because quantitative measures are missing. Here, we report the comparative investigation of spidroin NTDs originating from the major ampullate glands of the spider species Euprosthenops australis, Nephila clavipes, Latrodectus hesperus, and Latrodectus geometricus. We characterized equilibrium thermodynamics and kinetics of folding and self-association using dynamic light scattering, stopped-flow fluorescence and circular dichroism spectroscopy in combination with thermal and chemical denaturation experiments. We found cooperative two-state folding on a sub-millisecond time scale through a late transition state of all four domains. Stability was compromised by repulsive electrostatic forces originating from clustering of point charges on the NTD surface required for function. pH-driven dimerization proceeded with characteristic fast kinetics yielding high affinities. Results showed that energetics and kinetics of NTD self-assembly are highly conserved across spider species despite the different silk mechanical properties and web geometries they produce

Cervical cancer screening uptake: A randomized controlled trial assessing the effect of sending invitation letters to non-adherent women combined with sending their general practitioners a list of their non-adherent patients (study protocol)

International audienceIntroduction Cervical cancer (CC) is the fourth most common cancer among women. It can be cured if diagnosed at an early stage and treated promptly. The World Health Organization suggests that 70% of women should be screened with a high-performance test by the age of 35. This paper reports a protocol to assess the effect of two modalities of organized CC screening programmes on CC screening uptake. Methods and analysis Design and setting: The design involves a 3-arm randomized controlled study performed in a French geographic area on the west coast. A total of 1,395 general practitioners will be randomized, depending on their general practice surgeries. Participants: The design is based on a total of 94,393 women aged 40 to 65 years who are eligible for CC screening. Intervention: In the “optimized cancer screening” group, the intervention will combine sending invitation letters to non-adherent women with sending general practitioners (GPs) a list of their non-adherent patients. In the “standard cancer screening” group, the intervention will be limited to sending invitation letters to non-adherent women. In the “usual care” group, no letter will be sent either to women or to their GPs. Primary endpoint: CC screening test uptake will be assessed after a 6-month follow-up period. Statistical analysis: The percentage of women who are up-to-date with their screening at 6 months after the intervention will be compared across arms using a generalized mixed linear model. Discussion A large-scale randomized trial of this nature is unprecedented. The study will enable us to assess a strategy relying on GPs, identified as the coordinators in this screening strategy. The study results should help policy makers to implement organized CC screening programs in the future. Ethics and dissemination The study was approved was approved by the Ethics Committee of the National College of Teaching General practitioners (IRB00010804). It was recorded in ClinicalTrials.gov on the number NCT04689178 (28 December 2020). The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings

Early diagnosis of melanoma: a randomized trial assessing the impact of the transmission of photographs taken with a smartphone from the general practitioner to the dermatologist on the time to dermatological consultation

International audienceAbstract Background Difficulty obtaining a dermatological consultation is an obstacle to the early diagnosis of melanoma. On the one hand, patients survival depends on the lesion thickness at the time of diagnosis. On the other hand, dermatologists treat many patients with benign lesions. Optimizing patient care pathways is a major concern. The aim of the present study was to assess whether the e-mail transmission of photographs of suspected melanoma lesions between general practitioners (GPs) and dermatologists reduces the time to dermatological consultation for patients whose suspicious skin lesions ultimately require resection. Methods We conducted a cluster-randomized controlled study in primary care involving 51 French GPs between April 2017 and August 2019. A total of 250 patients referred to a dermatologist for a suspected melanoma lesion were included GPs were randomized to either the smartphone arm or the usual care arm. In the smartphone arm, the GPs referred patients to the dermatologist by sending 2 photographs of the suspicious lesion using their smartphone. The dermatologist then had to set up an appointment at an appropriate time. In the usual care arm, GPs referred patients to a dermatologist according to their usual practice. The primary outcome was the time to dermatological consultation for patients whose lesion ultimately required resection. Results 57 GPs volunteered were randomized (27 to the smartphone arm, and 30 to the usual care arm). A total of 125 patients were included in each arm (mean age: 49.8 years; 53% women) and followed 8 months. Twenty-three dermatologists participated in the study. The time to dermatological consultation for patients whose suspicious skin lesion required resection was 56.5 days in the smartphone arm and 63.7 days in the usual care arm (mean adjusted time reduction: -18.5 days, 95% CI [-74.1;23.5], p = .53). Conclusions The e-mail transmission of photographs from GPs to dermatologists did not improve the dermatological management of patients whose suspicious skin lesions ultimately required resection. Further research is needed to validate quality criteria that might be useful for tele-expertise in dermatology. Trial Registration Registered on ClinicalTrials.gov under reference number NCT03137511 (May 2, 2017)

Proposal for an annual skin examination by a general practitioner for patients at high risk for melanoma: a French cohort study

International audienceOBJECTIVE: To evaluate the efficacy of a targeted screening for melanoma in high-risk patients following the receipt of a mailed invitation to an annual skin examination by a general practitioner (GP).METHODS: A prospective cohort study was conducted in a primary care setting in western France. A total of 3897 patients at elevated risk of melanoma (identified using the Self-Assessment of Melanoma Risk Score) consented to participate in a targeted melanoma screening project in 2011. One year later, the participants were invited by mail to consult their GP for an annual skin examination. Efficacy of the procedure was evaluated according to patient participation and the number of melanomas detected. The consultation dates and results were collected during the 12 months postreminder and were analysed using SAS. Analyses of whether participation decreased compared with that during the year of inclusion and whether populations at risk for thick melanoma showed reduced participation in the screening were performed.RESULTS: Of the 3745 patients who received the mailed invitation, 61% underwent a skin examination. The participation of patients at risk for thick melanoma (any patient over 60 years of age and men over 50 years of age) was significantly greater than that of the patients in the other subgroups (72.4% vs 49.6%, p<0.001; and 66% vs 52.4%, p<0.001, respectively). The patients referred to the dermatologist after 1 year were more compliant compared with those referred during the first year (68.8% vs 59.1%, p=0.003). Six melanomas were detected within 1 year postreminder; therefore, the incidence of melanoma in the study population was 160/100 000.CONCLUSIONS: This study confirms the benefits of developing a targeted screening strategy in primary care. In particular, after the annual reminder, patient participation and the diagnosis of melanoma remained high in the patients at elevated risk of thick melanomas

P2X7 Cell Death Receptor Activation and Mitochondrial Impairment in Oxaliplatin-Induced Apoptosis and Neuronal Injury: Cellular Mechanisms and In Vivo Approach.

Limited information is available regarding the cellular mechanisms of oxaliplatin-induced painful neuropathy during exposure of patients to this drug. We therefore determined oxidative stress in cultured cells and evaluated its occurrence in C57BL/6 mice. Using both cultured neuroblastoma (SH-SY5Y) and macrophage (RAW 264.7) cell lines and also brain tissues of oxaliplatin-treated mice, we investigated whether oxaliplatin (OXA) induces oxidative stress and apoptosis. Cultured cells were treated with 2-200 µM OXA for 24 h. The effects of pharmacological inhibitors of oxidative stress or inflammation (N-acetyl cysteine, ibuprofen, acetaminophen) were also tested. Inhibitors were added 30 min before OXA treatment and then in combination with OXA for 24 h. In SH-SY5Y cells, OXA caused a significant dose-dependent decrease in viability, a large increase in ROS and NO production, lipid peroxidation and mitochondrial impairment as assessed by a drop in mitochondrial membrane potential, which are deleterious for the cell. An increase in levels of negatively charged phospholipids such as cardiolipin but also phosphatidylserine and phosphatidylinositol, was also observed. Additionally, OXA caused concentration-dependent P2X7 receptor activation, increased chromatin condensation and caspase-3 activation associated with TNF-α and IL-6 release. The majority of these toxic effects were equally observed in Raw 264.7 which also presented high levels of PGE2. Pretreatment of SH-SY5Y cells with pharmacological inhibitors significantly reduced or blocked all the neurotoxic OXA effects. In OXA-treated mice (28 mg/kg cumulated dose) significant cold hyperalgesia and oxidative stress in the tested brain areas were shown. Our study suggests that targeting P2X7 receptor activation and mitochondrial impairment might be a potential therapeutic strategy against OXA-induced neuropathic pain

General practitioner management related to skin cancer prevention and screening during standard medical encounters: a French cross-sectional study based on the International Classification of Primary Care

International audienceOBJECTIVE:The aim of this study was to assess general practitioner (GP) management practices related to skin cancer prevention and screening during standard medical encounters.SETTING:Data on medical encounters addressing skin cancer issues were obtained from a French database containing information from 17 019 standard primary care consultations.PARTICIPANTS:Data were collected between December 2011 and April 2012 by 54 trainees who reported the regular practice of 128 GPs using the International Classification of Primary Care.OUTCOME MEASURES:Reasons for encounters and the following care processes were recorded: counselling, clinical examinations and referral to a specialist. Medical encounters addressing skin cancer issues were compared with medical encounters that addressed other health problems using a multivariate analysis.RESULTS:Only 0.7% of medical encounters addressed skin cancer issues. When patients did require management of a skin cancer-related issue, this was more likely initiated by the doctor than the patient (70.7% vs 29.3%; p<0.001). Compared with medical encounters addressing other health problems, encounters that addressed skin cancer problems required more tasks (3.7 vs 2.5; p<0.001) and lasted 1 min and 20 s longer (p=0.003). GPs were less involved in clinical examinations (67.5% vs 97.1%; p<0.001), both complete (7.3% vs 22.3%, p<0.001) and partial examinations (60.2% vs 74.9%), and were less involved in counselling (5.7% vs 16.9%; p<0.001). Patients presenting skin cancer issues were referred to a specialist more often than patients consulting for other health problems (39.0% vs 12.1%; p<0.001). GPs performed a biopsy in 6.7% of all skin cancer-related encounters.CONCLUSIONS:This study demonstrates discrepancies between the high prevalence of skin cancer and the low rate of medical encounters addressing these issues in general practice. Our findings should be followed by qualitative interviews to better understand the observed practices in this field