Seeing revolution non-linearly: www.filmingrevolution.org

Filming Revolution, launched in 2015, is an online interactive data base documentary tracing the strands and strains of independent (mostly) documentary filmmaking in Egypt since the revolution. Consisting of edited interviews with 30 filmmakers, archivists, activists, and artists based in Egypt, the website is organised by the themes that emerged from the material, allowing the viewer to engage in an unlimited set of “curated dialogues” about issues related to filmmaking in Egypt since 2011. With its constellatory interactive design, Filming Revolution creates as much as documents a community of makers, as it attempts to grapple with approaches to filmmaking in the wake of such momentous historical events. The non-hierarchical polysemous structure of the project is meant to echo the rhizomatic, open-ended aspect of the revolution and its aftermath, in yet another affirmation and instantiation of contemporary civil revolution as a non-linear, ever-unfolding, on-going, event

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Identification of molecular and pathophysiological mechanisms involved in facioscapulohumeral muscular dystrophy

La dystrophie musculaire facioscapulohumérale (FSHD) est une maladie autosomique dominante, caractérisée par une faiblesse et une atrophie progressive de certains muscles squelettiques. La FSHD est liée à une répression inefficace de la région des macrosatellites D4Z4 sur le chromosome 4, entraînant l'expression inappropriée dans le muscle squelettique, d’un gène à double homeobox 4 (DUX4), et la dérégulation des gènes avoisinants. La surexpression de DUX4 est responsable du phénotype atrophié des myotubes FSHD et induit la dérégulation de gènes impliqués dans la réponse au stress oxydant. Malgré les avancés majeures dans la compréhension du locus morbide, les mécanismes exacts impliqués dans la FSHD ne sont pas totalement compris et aucun traitement curatif n’est disponible. Cependant, de nombreuses données montrent le rôle prépondérant du stress oxydant dans la FSHD. Récemment, nous avons caractérisé la présence d’un stress oxydant dans les biopsies musculaires et les prélèvements sanguins des patients atteints de FSHD. Nous avons démontré que ce stress est corrélé à une altération de la fonction musculaire chez ces patients et qu’une supplémentation en antioxydants adaptée améliore la fonction musculaire et réduit les dommages oxydatifs. Par ailleurs, nous avons démontré que les myoblastes dérivés des biopsies FSHD sont plus sensibles à des agents pro-oxydants et présentent des défauts de différenciation. L’objectif de nos travaux est de caractériser les mécanismes moléculaires impliqués dans la FSHD afin de faciliter la mise en place d’approches thérapeutiques. Ce projet de thèse original réunit à la fois une approche fondamentale et clinique. Grâce à la mise en place d’un nouveau modèle in vitro de culture primaire de myoblastes de patients atteints de FSHD, nous avons montré la présence d’un stress oxydant dans ces myoblastes corroborant les observations précédemment obtenues aux niveaux systémiques et musculaires chez ces patients. Par ailleurs, les traitements par des agents pro-oxydants (paraquat et peroxyde d'hydrogène) ont un effet différentiel sur l’expression des enzymes antioxydantes par rapport aux contrôles suggérant un défaut dans les mécanismes d'adaptation au stress oxydant chez les patients atteints de FSHD.D’autre part, afin d'améliorer les procédures de réadaptation pour les patients atteints de FSHD, nous avons proposé d'étudier la faisabilité, la sécurité et l'efficacité de l’entraînement de force par électrostimulation neuromusculaire (ESNM) pour contrer la faiblesse musculaire des quadriceps chez ces patients. Cette étude, en cours, semble être une stratégie de réhabilitation prometteuse pour les patients atteints de FSHD et n’a montré aucun effets indésirables jusqu’à présent.Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant disease, characterized by progressive weakness and atrophy of specific skeletal muscles. FSHD is linked to an inefficient repeat-mediated epigenetic repression of the D4Z4 macrosatellite repeat array on chromosome 4, resulting in the unappropriated expression in skeletal muscle of the double homeobox 4 (DUX4) retrogene. DUX4 overexpression leads to atrophic myotubes phenotype and dysregulation of antioxidant genes. Despite major progress in the understanding of the genetic locus, exact mechanisms that lead to FSHD defects are not completely understood and no curative treatment is available. However, several lines of evidence have proposed oxidative stress and myogenesis defect as the major biological processes affected in FSHD. Recently, we characterized oxidative stress in skeletal muscle biopsies and blood samples from patients with FSHD. We demonstrated that oxidative stress is associated with reduced physical performance in patients with FSHD and that antioxidants adapted strategy was effective to reduce oxidative stress and maintain muscle functions. Furthermore, satellite cell-derived myoblasts from these patients were more susceptible to pro-oxidant agents than control myoblasts and showed a defect in differentiation. The originality of this project relies on creating a synergy between basic and clinical research. The major goal of this work is to identify molecular mechanisms involved in FSHD oxidative stress in order to identify therapeutic approaches.Using in vitro cell model of FSHD, recently developed and optimized in our team, we demonstrate the presence of oxidative stress in FSHD primary myoblast cultures that corroborates previous observations at systemic and muscular levels. Furthermore, treatments with different pro-oxidant agents (paraquat and hydrogen peroxide) have a differential effect on the expression of antioxidant enzymes compared to controls, suggesting a defect in the oxidative stress adaptive response in FSHD myoblasts.Furthermore, in order to improve rehabilitation procedures for patients affected with FSHD, we proposed to investigate the feasibility, safety, and effectiveness of neuromuscular electrostimulation (NMES) strength training to counteract quadriceps muscle weakness in these patients. This ongoing study appears to be a promising rehabilitation strategy and shows no adverse effect for patients with FSHD

Identification of a Sesquiterpene Lactone from Arctium lappa Leaves with Antioxidant Activity in Primary Human Muscle Cells

International audienceMany pathologies affecting muscles (muscular dystrophies, sarcopenia, cachexia, renal insufficiency, obesity, diabetes type 2, etc.) are now clearly linked to mechanisms involving oxidative stress. In this context, there is a growing interest in exploring plants to find new natural antioxidants toprevent the appearance and the development of these muscle disorders. In this study, we investigated the antioxidant properties of Arctium lappa leaves in a model of primary human muscle cells exposed to H2O2 oxidative stress. We identified using bioassay-guided purification, onopordopicrin, a sesquiterpene lactone as the main molecule responsible for the antioxidant activity of A. lappa leaf extract. According to our findings, onopordopicrin inhibited the H2O2-mediated loss of muscle cell viability, by limiting the production of free radicals and abolishing DNA cellular damages. Moreover,we showed that onopordopicrin promoted the expression of the nuclear factor-erythroid-2-related factor 2 (Nrf2) downstream target protein heme oxygenase-1 (HO-1) in muscle cells. By using siRNA, we demonstrated that the inhibition of the expression of Nrf2 reduced the protective effect ofonopordopicrin, indicating that the activation of the Nrf2/HO-1 signaling pathway mediates the antioxidant effect of onopordopicrin in primary human muscle cells. Therefore, our results suggest that onopordopicrin may be a potential therapeutic molecule to fight against oxidative stress inpathological specific muscle disorder

Assessment of mycotoxins in cornflakes marketed in Lebanon

Abstract Cornflakes are a popular and convenient breakfast cereal made from corn and widely consumed worldwide, including in Lebanon. However, they are susceptible to mycotoxin contamination, which can have harmful effects on human health. Our study evaluated the occurrence of five mycotoxins (AFB1, OTA, FUM, ZEA, DON) levels in packed cornflakes marketed in Lebanon. A market screening identified 35 different cornflake stock-keeping units (SKU) in the Lebanese market, originating from 10 different brands and having different tastes and shapes. SKUs were collected and tested for five mycotoxins in triplicates using enzyme-linked immunosorbent assay technique. The results showed the presence of the five mycotoxins in the samples. The average levels of AFB1, OTA, ZEA and FUM among positive samples (above limit of detection) were 1.58, 1.2, 15.1 and 774.1 μg/kg, respectively, and were below the EU limits. On the other hand, the average level of DON was 1206.7 μg/kg, exceeding the EU limit. Furthermore, out of the positive samples, 60%, 17%, 9%, 14%, and 6% exceeded the EU limits for DON, OTA, AFB1, FUM, and ZEA, respectively. Notably, SKUs made in Lebanon had significantly (p  0.05) effect on the levels of the five mycotoxins detected in the samples. AFB1, FUM and ZEA levels differed significantly among SKUs (p > 0.05). Considering these findings, further studies should be conducted to assess the exposure to mycotoxins from the consumption of cornflakes in Lebanon, especially among children