Why do French women refuse to have Down's syndrome screening by maternal serum testing? A mixed methods study

Purpose: The study aims to analyse the reasons underpinning women's refusal to undertake Down's syndrome screening (DSS) by maternal serum testing (MST). Methods: A retrospective, mixed methods sequential approach was used. An online survey on women's experience of prenatal testing followed by in-depth interviews were conducted, with women over 18 years old, who had been pregnant within five years prior to the study. Altogether, 1726 responses were gathered, of which 217 related to women who had refused MST. The study compares the women who refused MST with women who accepted it on sociodemographic characteristics, the evolution and experience of the pregnancy, their knowledge about Down's syndrome (DS). It also utilises survey comments and five in-depth interviews to explore, using Thematic Analysis, the reasons for refusing MST. Results: To refuse MST is cognitively demanding. Indeed, women who refused MST were better educated, knew more about prenatal diagnosis sequences and DS than women who accepted it. This position is also emotionally challenging as women's interactions with practitioners can put them in difficult situations, where they have to defend their point of view. Reasons for refusing MST go beyond religious beliefs, negative attitudes towards abortion and/or medicalisation of pregnancy. Rather, women's position appears to be driven by a holistic conception of care-based monitoring, values of inclusivity and a desire to remain in control of their pregnancy. Conclusions: It is essential that women feel accepted and supported in their choice to refuse MST. Consequently, it is important for professionals to remain cognisant of the diversity of factors underpinning women's decision, the pressure this position generates and the challenges that come with it

L’environnement comme objet de médiation littéraire dans les récits d’exploration de Zebulon Pike et Zadok Cramer dans la vallée du Mississippi

Questioning the inclusion of exploration writings in the field of travel literature leads to examine the definition of this type of text. The genre’s complexity requires to think travel narratives in terms of continuity rather than in terms of categories based on scientific and literary features. However, understanding exploration writings as a branch of literary travel narratives seems to depend on the reconsideration of their scientific value and objectivity.In the early 19th century, Zebulon Pike and Zadok Cramer’s writings offer a verbal depiction of the abundance of the Mississippi Valley, among which landscape descriptions. The explorers’ points of views propel the reader not in a geographical space but in a literary one.Nathalie Blanc, Thomas Pughe and Denis Chartier question "the link between environmental awareness and literary esthetics" (Blanc, Chartier, Pughe 2008, 36). Studying the link between nonhuman encounter and the literarity of these narratives also questions the link between environment and imagination, as well as the link between what is described by the traveller and what is received by the reader.We will examine the environmental knowledge which appears in Cramer’s Navigator (Cramer 1811) as well as in Pike’s Exploratory Travels (Pike 1810) connected to their literary scope. We will determine why and how some elements from the Mississippian nature—in particular the beauty of the river and the abundance provided by its surroundings—raise in the explorer and the reader an awareness of what is around, if not a feeling of wonder at the sight of nature which becomes an object of literary mediation

L’environnement comme objet de médiation littéraire dans les récits d’exploration de Zebulon Pike et Zadok Cramer dans la vallée du Mississippi

Questioning the inclusion of exploration writings in the field of travel literature leads to examine the definition of this type of text. The genre’s complexity requires to think travel narratives in terms of continuity rather than in terms of categories based on scientific and literary features. However, understanding exploration writings as a branch of literary travel narratives seems to depend on the reconsideration of their scientific value and objectivity.In the early 19th century, Zebulon Pike and Zadok Cramer’s writings offer a verbal depiction of the abundance of the Mississippi Valley, among which landscape descriptions. The explorers’ points of views propel the reader not in a geographical space but in a literary one.Nathalie Blanc, Thomas Pughe and Denis Chartier question "the link between environmental awareness and literary esthetics" (Blanc, Chartier, Pughe 2008, 36). Studying the link between nonhuman encounter and the literarity of these narratives also questions the link between environment and imagination, as well as the link between what is described by the traveller and what is received by the reader.We will examine the environmental knowledge which appears in Cramer’s Navigator (Cramer 1811) as well as in Pike’s Exploratory Travels (Pike 1810) connected to their literary scope. We will determine why and how some elements from the Mississippian nature—in particular the beauty of the river and the abundance provided by its surroundings—raise in the explorer and the reader an awareness of what is around, if not a feeling of wonder at the sight of nature which becomes an object of literary mediation

Influence of aroma compounds on the mechanical properties of starch-based food systems

International audienceDifferent starches, and in particular a normal corn starch, were tested in a concentrated and complex food product. Increasing amounts of aroma compounds (limonene, ethyl vanillin or isoamyl acetate) were added at levels up to 5 mmol/mol glucose equivalent. The modifications that were induced in the gel network were characterized by penetrometry or uniaxial compression until fracture. The addition of these aroma compounds led to slightly weaker gel networks than when no flavor had been added. These effects appeared to be not related to the complexing ability of the aroma compound. The addition of isoamyl acetate slowed down the retrogradation phenomenon in corn starchbased products. It seems that the amylopectin fraction of the starch is engaged in the interactions with these aroma compounds

Les Rencontres de l’humain et du non-humain dans la littérature de voyage et d’exploration anglophone

L’intérêt des voyageurs pour le monde non humain permet-il de considérer le récit de voyage comme un exemple de littérature environnementale ? Les voyageurs, explorateurs et montagnards révèlent-ils dans leurs textes une conscience réelle de la nécessaire interconnexion entre le monde humain et le monde non humain, animal, végétal ou minéral ? Les articles présentés dans ce numéro de Caliban répondront à ces questions et, à travers des œuvres littéraires et des ouvrages géographiques et scientifiques divers, montreront que la conscience réside dans la perception du monde qui nous entoure. Des universitaires et des écrivains participent à ce volume, notamment Kev Reynolds, auteur britannique de plus de quarante guides et récits de voyages dans les montagnes du monde, et Scott Slovic, spécialiste américain de l’écocritique. C’est un numéro interdisciplinaire qui convoque aussi bien la littérature que l’histoire, la pédagogie et l’enseignement de l’écriture du voyage, la géographie, la botanique et les sciences de la nature. Does the interest of travellers in the nonhuman world allow the travel narrative to be regarded as an example of environmental literature? Do travellers, explorers and mountaineers reveal in their texts a real awareness of the vital interconnection between the human world and the nonhuman, animal, plant or mineral worlds? The articles presented in this volume will try to answer these questions and, through literary and various geographical and scientific works, will show that consciousness and mindfulness are at the core of the perception of the world which surrounds us. Among scholars and writers, who summon both literature and history, pedagogy and teaching of travel writing, geography and exploration, botany and physical sciences, Kev Reynolds, British author of more than forty travel guides and travelogues about the mountains of the world, and Scott Slovic, American specialist in Environmental Literature and Ecoriticism, urge us to turn our cultural attention back from the specifically human realm to the wider, other-than-human, living environment

Cancer Induces a Stress Ileopathy Depending on beta-Adrenergic Receptors and Promoting Dysbiosis that Contributes to Carcinogenesis

Gut dysbiosis has been associated with intestinal and extraintestinal malignancies, but whether and how carcinogenesis drives compositional shifts of the microbiome to its own benefit remains an open conundrum. Here, we show that malignant processes can cause ileal mucosa atrophy, with villous microvascular constriction associated with dominance of sympathetic over cholinergic signaling. The rapid onset of tumorigenesis induced a burst of REG3γ release by ileal cells, and transient epithelial barrier permeability that culminated in overt and long-lasting dysbiosis dominated by Gram-positive Clostridium species. Pharmacologic blockade of β-adrenergic receptors or genetic deficiency in Adrb2 gene, vancomycin, or cohousing of tumor bearers with tumor-free lit-termates prevented cancer-induced ileopathy, eventually slowing tumor growth kinetics. Patients with cancer harbor distinct hallmarks of this stress ileopathy dominated by Clostridium species. Hence, stress ileopathy is a corollary disease of extraintestinal malignancies requiring specific therapies. SIGNIFICANCE: Whether gut dysbiosis promotes tumorigenesis and how it controls tumor progression remain open questions. We show that 50% of transplantable extraintestinal malignancies triggered a β-adrenergic receptor–dependent ileal mucosa atrophy, associated with increased gut permeability, sustained Clostridium spp.–related dysbiosis, and cancer growth. Vancomycin or propranolol prevented cancer-associated stress ileopathy

Cancer Induces a Stress Ileopathy Depending on β-Adrenergic Receptors and Promoting Dysbiosis that Contributes to Carcinogenesis

International audienceAbstract Gut dysbiosis has been associated with intestinal and extraintestinal malignancies, but whether and how carcinogenesis drives compositional shifts of the microbiome to its own benefit remains an open conundrum. Here, we show that malignant processes can cause ileal mucosa atrophy, with villous microvascular constriction associated with dominance of sympathetic over cholinergic signaling. The rapid onset of tumorigenesis induced a burst of REG3γ release by ileal cells, and transient epithelial barrier permeability that culminated in overt and long-lasting dysbiosis dominated by Gram-positive Clostridium species. Pharmacologic blockade of β-adrenergic receptors or genetic deficiency in Adrb2 gene, vancomycin, or cohousing of tumor bearers with tumor-free littermates prevented cancer-induced ileopathy, eventually slowing tumor growth kinetics. Patients with cancer harbor distinct hallmarks of this stress ileopathy dominated by Clostridium species. Hence, stress ileopathy is a corollary disease of extraintestinal malignancies requiring specific therapies. Significance: Whether gut dysbiosis promotes tumorigenesis and how it controls tumor progression remain open questions. We show that 50% of transplantable extraintestinal malignancies triggered a β-adrenergic receptor–dependent ileal mucosa atrophy, associated with increased gut permeability, sustained Clostridium spp.–related dysbiosis, and cancer growth. Vancomycin or propranolol prevented cancer-associated stress ileopathy. This article is highlighted in the In This Issue feature, p. 87

Matching for the non-conventional MHC-I MICA gene significantly reduces the incidence of acute and chronic GVHD

Graft-versus-host disease (GVHD) is among the most challenging complications in unrelated donor hematopoietic cell transplantation (HCT). The highly polymorphic "MHC class I chain-related gene A", MICA, encodes a stress-induced glycoprotein expressed primarily on epithelia. MICA interacts with the invariant activating receptor NKG2D; expressed by cytotoxic lymphocytes. The MICA gene is located in the MHC, next to HLA-B; hence MICA has the requisite attributes of a bona fide transplantation antigen. Using high-resolution sequence-based genotyping of MICA, we retrospectively analyzed the clinical impact of MICA mismatches in a multicenter cohort of 922 unrelated donor HLA-A, -B, -C, -DRB1, and -DQB1 10/10 allele-matched HCT. Among the 922 pairs, 113 (12.3%) were mismatched in MICA MICA mismatches were significantly associated with an increased incidence of grade III-IV acute GVHD (HR, 1.83; 95% CI, 1.50 to 2.23; P<0.001), chronic GVHD (HR, 1.50; 95% CI, 1.45 to 1.55; P<0.001) and non-relapse mortality (HR, 1.35; 95% CI, 1.24 to 1.46; P<0.001). The increased risk of GVHD was mirrored by a lower risk of relapse (HR, 0.50; 95% CI, 0.43 to 0.59; P<0.001), indicating a possible graft-versus-leukemia effect. In conclusion, when possible, selecting a MICA-matched donor significantly influences key clinical outcomes of HCT in which a marked reduction of GVHD is paramount. The tight linkage disequilibrium between MICA and HLA-B renders identifying a MICA-matched donor readily feasible in clinical practice