Clinical practice guidelines for BRCA1 and BRCA2 genetic testing

BRCA1 and BRCA2 gene pathogenic variants account for most hereditary breast cancer and are increasingly used to determine eligibility for PARP inhibitor (PARPi) therapy of BRCA-related cancer. Because issues of BRCA testing in clinical practice now overlap with both preventive and therapeutic management, updated and comprehensive practice guidelines for BRCA genotyping are needed. The integrative recommendations for BRCA testing presented here aim to (1) identify individuals who may benefit from genetic counselling and risk-reducing strategies; (2) update germline and tumour-testing indications for PARPi-approved therapies; (3) provide testing recommendations for personalised management of early and metastatic breast cancer; and (4) address the issues of rapid process and tumour analysis. An international group of experts, including geneticists, medical and surgical oncologists, pathologists, ethicists and patient representatives, was commissioned by the French Society of Predictive and Personalised Medicine (SFMPP). The group followed a methodology based on specific formal guidelines development, including (1) evaluating the likelihood of BRCAm from a combined systematic review of the literature, risk assessment models and expert quotations, and (2) therapeutic values of BRCAm status for PARPi therapy in BRCA-related cancer and for management of early and advanced breast cancer. These international guidelines may help clinicians comprehensively update and standardise BRCA testing practices

The Influence of Manga on the Graphic Novel

This material has been published in The Cambridge History of the Graphic Novel edited by Jan Baetens, Hugo Frey, Stephen E. Tabachnick. This version is free to view and download for personal use only. Not for re-distribution, re-sale or use in derivative works. © Cambridge University PressProviding a range of cogent examples, this chapter describes the influences of the Manga genre of comics strip on the Graphic Novel genre, over the last 35 years, considering the functions of domestication, foreignisation and transmedia on readers, markets and forms

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

L'aide humanitaire pharmaceutique (stratégie pharmaceutique en République Démocratique du Congo, mission humanitaire avec Pharmaciens Sans Frontières Comité International)

BORDEAUX2-BU Santé (330632101) / SudocSudocFranceF

Etude des troubles psychiatriques associés à la schizophrénie paranoïde

TOURS-BU Médecine (372612103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

A Study of College Admission: The Case of Taiwan and France

隨著高等教育的大眾化發展，臺灣與法國的大學招生制度經過幾次變革，以期滿足招生需求。大學學位不僅是學歷的一紙證明，更是臺灣與法國高等教育標準化歷程的體現。從高中過渡到大學，是每個學生學術生涯中關鍵且費神的階段，並與未來的成功息息相關。因此，無論在臺灣或法國，學生高中階段的學術能力測驗至關重要，可謂從青春期過渡到成年期的重要指標。學術能力測驗成績影響著絕大多數畢業生的大學申請和錄取機會。雖然臺灣和法國有不少關於兩國大學教育的研究，但對於高中學生進入大學前的學術能力測驗甚少探討。本研究旨在探討臺、法國大學申請的入學先決條件和要求，以期進一步瞭解大學入學機制。本研究透過對臺灣和法國大學系統中錄取要求，如臺灣的先修課程測驗和法國的一般入學要求等規定進行對比分析，找出各自的優缺點。研究方法包括文獻綜述，以及對兩國高中生進行問卷調查和深度訪談。研究發現，目前兩國的大學入學系統的主要難題之一是缺乏相應的學術指導機制。臺灣方面在於過分強調大學入學考試測驗，法國則與之相反，學生因為過高的升學率而缺乏學習動機。本研究建議，今後臺法兩國如何面對高教入學機會中重新出現的不公與文憑貶值等新挑戰，是雙方大學入學體系需要解決的共同問題。With the massification of their higher education systems, Taiwan and France have experienced several changes in their college admission processes in order to meet the increasing demand of enrollment into higher education. A university degree has become more than just a certificate of academic achievement but a normalized process in Taiwan and France. The transition from high school to university has become a pivotal yet nerve-racking period in a student’s academic career and is considered as one of the most crucial factor of the student’s future success. In Taiwan and France, the academic abilities of students tested during the senior high school are the most important and significant indicators of students’ transition from adolescence to adulthood. It leads a vast majority of graduates to apply to university and to undertake college admission process. Although several studies have been done in Taiwan and France, only few have previously analyzed a student’s journey through the college admission process in the two countries. The current study intends to investigate the prerequisites and requirements that college applicants in Taiwan and France are required to meet in order to access the college and university systems. By comparing and analyzing the massification of the two systems, as well as Taiwan and France college admission’s requirements such as the Scholastic Ability Test and the Advanced Subjects Test in Taiwan, and the French General Baccalaureate; the study seeks to identify the crucial pro and cons that arise in each system in order to give recommendations on improvements that can be made. Data has been collected through literature reviews, in-depth interviews as well as surveys among former senior high school students in both countries. The results of the present study show that one of the main dilemmas of today’s education systems is the lack of academic guidance. While one of the main problems of Taiwanese education is its emphasis on testing, France education, on the contrary, is facing issues due to its excessive accessibility of universities which leads students to enroll in degrees without real motivations behind their choice. The shift of inequalities in educational opportunities is also one of the new concerns that Taiwanese and French education systems are facing as well as the depreciation of diplomas

Climat et biodiversité : « Les petits pas de la politique agricole commune ne suffisent plus » [Tribune au journal Le Monde]

Tribune cosignée par 714 collègues scientifiques spécialistes de questions agricoles issus de diverses disciplinesAlors que la nouvelle PAC est discutée à Bruxelles, un collectif de plus de 700 scientifiques de la recherche publique alerte, dans une tribune au « Monde », sur les « conséquences catastrophiques » d’un manque d’ambition en matière d’agroécologie

Le site d’Isles-sur-Suippe (Marne) à la fin de l’âge du Fer, du puits à l'habitat

International audienc

DNA Methylation Profiles Distinguish Different Subtypes of Gastroenteropancreatic Neuroendocrine Tumors

International audienceAim: Most studies have considered gastroenteropancreatic neuroendocrine tumors (GEP-NETs) as a homogenous group of samples or distinguish only gastrointestinal from pancreatic endocrine tumors. This article investigates if DNA methylation patterns could distinguish subtypes of GEP-NETs. Materials & methods: The DNA methylation level of 807 cancer-related genes was investigated in insulinomas, gastrinomas, non-functioning pancreatic endocrine tumors and small intestine endocrine tumors. Results: DNA methylation patterns were found to be tumor type specific for each of the pancreatic tumor subtypes and identified two distinct methylation-based groups in small intestine endocrine tumors. Differences of DNA methylation levels were validated by pyrosequencing for 20 candidate genes and correlated with differences at the transcriptional level for four candidate genes. Conclusion: The heterogeneity of DNA methylation patterns in the different subtypes of gastroenteropancreatic neuroendocrine tumors suggests different underlying pathways and, therefore, these tumors should be considered as distinct entities in molecular and clinical studies

Condition of Composted Microplastics After They Have Been Buried for 30 Years: Vertical Distribution in the Soil and Degree of Degradation

International audienceMicroplastics in soils are a growing concern. Composting household wastes can introduce microplastics to agroecosystems, because when unsorted compost is used as a fertilizer, the plastic debris it contains degrades to microplastics. This paper examines the distribution and degradation of microplastics in agricultural soil samples to investigate their potential mobility. The source of microplastics was a household waste compost added to the soil more than 30 years before the study. The microplastics were sorted from a plot-composite soil and characterised by Attenuated Total Reflectance combined with Fourier transform infrared spectroscopy (ATR-FTIR). The microplastics are present in the cultivated depth but have not been transferred deeper (2.9 g kg-1 in the 0–5 cm soil depth against 0.9 g kg-1 in the 30–35 cm soil depth). Polyethylene (PE), polypropylene (PP), polystyrene (PS) and Polyvinylchloride (PVC) were identified in the forms of heterogeneous fragments, films, and fibres and accounted for 90% of the total microplastics. Advanced degradation observed was mainly assumed to be due to composting, though the plastic may have degraded further in the soil matrix. Highly degraded plastics are a greater danger for further leaching of contaminants into soil and our food supply