Multiscale analysis reveals that diet-dependent midgut plasticity emerges from alterations in both stem cell niche coupling and enterocyte size

The gut is the primary interface between an animal and food, but how it adapts to qualitative dietary variation is poorly defined. We find that the Drosophila midgut plastically resizes following changes in dietary composition. A panel of nutrients collectively promote gut growth, which sugar opposes. Diet influences absolute and relative levels of enterocyte loss and stem cell proliferation, which together determine cell numbers. Diet also influences enterocyte size. A high sugar diet inhibits translation and uncouples ISC proliferation from expression of niche-derived signals but, surprisingly, rescuing these effects genetically was not sufficient to modify diet's impact on midgut size. However, when stem cell proliferation was deficient, diet's impact on enterocyte size was enhanced, and reducing enterocyte-autonomous TOR signaling was sufficient to attenuate diet-dependent midgut resizing. These data clarify the complex relationships between nutrition, epithelial dynamics, and cell size, and reveal a new mode of plastic, diet-dependent organ resizing

Regional Cell-Specific Transcriptome Mapping Reveals Regulatory Complexity in the Adult Drosophila Midgut

SummaryDeciphering contributions of specific cell types to organ function is experimentally challenging. The Drosophila midgut is a dynamic organ with five morphologically and functionally distinct regions (R1–R5), each composed of multipotent intestinal stem cells (ISCs), progenitor enteroblasts (EBs), enteroendocrine cells (EEs), enterocytes (ECs), and visceral muscle (VM). To characterize cellular specialization and regional function in this organ, we generated RNA-sequencing transcriptomes of all five cell types isolated by FACS from each of the five regions, R1–R5. In doing so, we identify transcriptional diversities among cell types and document regional differences within each cell type that define further specialization. We validate cell-specific and regional Gal4 drivers; demonstrate roles for transporter Smvt and transcription factors GATAe, Sna, and Ptx1 in global and regional ISC regulation, and study the transcriptional response of midgut cells upon infection. The resulting transcriptome database (http://flygutseq.buchonlab.com) will foster studies of regionalization, homeostasis, immunity, and cell-cell interactions

Quand les mots manquent, le corps signifie (apports de la recherche qualitative à la compréhension du rôle de la nourriture chez l'adolescent obèse et sa famille)

L'obésité de l'enfant et de l'adolescent est un enjeu majeur de santé publique en France et dans le monde, de par sa prévalence et son retentissement sévère. Les relations familiales y occupent une place importante, dans la genèse du trouble, son maintien, et sa prise en charge. La famille est au cœur du dispositif thérapeutique. Pourtant, le lien entre le fonctionnement relationnel familial et la nourriture n'est pas clairement établi sur le plan théorique. L'objectif de ce travail est de poser les bases d'une élaboration théorique de cette question. Pour ceci, nous avons utilisé des méthodes qualitatives de deux manières. La 1ère partie a consisté en une étude qualitative phénoménologique du rôle de l'alimentation dans les relations familiales chez ces adolescents obèses. Deux entretiens semi-structurés (adolescents, parents) se déroulaient autour d'une photographie de la fin d'un repas prise par le sujet (méthode de la photo-elicitation). L'analyse du matériel verbal utilisait l'Interpretative Phenomenological Analysis (IPA). La 2ème partie a consisté en une revue de la littérature qualitative sur l'obésité de l'adolescent, à l'aide d'une méthode d'analyse d'inspiration phénoménologique. Les articles inclus interrogeaient les adolescents obèses, leurs parents ou les spécialistes de santé travaillant auprès de jeunes souffrant d'obésité. Les principaux résultats sont d'une part, la mise en évidence d'interelations majeures entre relations et nourriture au sein de la famille ; le fonctionnement alimentaire apparait comme le reflet du fonctionnement relationnel ; d'autre part, la mise en évidence d'une impossibilité à dire obésité, qui semble le témoin d'une impossibilité à utiliser la parole signifiante dans la relation familiale. L'hypothèse retenue serait celle d'un trouble de la sphère relationnelle, où le passage par les mots est compromis. L'alimentation deviendrait alors le principal moyen de communication et d'expression au sein de la famille.CLERMONT FD-BCIU-Santé (631132104) / SudocSudocFranceF

Critères de décisions sur le choix du système de chirurgie guidée en implantologie

Les implants dentaires constituent aujourd'hui la solution de choix pour la réhabilation prothétique. Toute réhabilitation par prothèse sur implants doit être précédée d'une étude diagnostic permettant l'élaboration d'un projet prothétique. Celle-ci est réalisée à l'aide d'un guide radiologique, permettant ainsi de réaliser un guide chirurgical soit de manière traditionnelle (en faisant appel à une méthode artisanale) soit de manière informatique (par stéréolithographie). Cependant, cette technique présente des limites et des complications d'où la nécessité d'une parfaite maitrise de la prothèse et de la chirurgie conventionnelle. De plus, elle répond à des indications précises. Par ailleurs, il existe plusieurs systèmes de planification et plusieurs types de guide chirurgicaux. Il parait donc intéressant de définir un arbre décisionnel.PARIS7-Odontologie (751062104) / SudocSudocFranceF

Metasynthesis: An Original Method to Synthesize Qualitative Literature in Psychiatry

BackgroundMetasynthesis—the systematic review and integration of findings from qualitative studies—is an emerging technique in medical research that can use many different methods. Nevertheless, the method must be appropriate to the specific scientific field in which it is used. The objective is to describe the steps of a metasynthesis method adapted from Thematic Synthesis and phenomenology to fit the particularities of psychiatric research.MethodWe detail each step of the method used in a metasynthesis published in 2015 on adolescent and young adults suicidal behaviors. We provide clarifications in several methodological points using the latest literature on metasyntheses. The method is described in six steps: define the research question and the inclusion criteria, select the studies, assess their quality, extract and present the formal data, analyze the data, and express the synthesis.ConclusionMetasyntheses offer an appropriate balance between an objective framework, a rigorously scientific approach to data analysis and the necessary contribution of the researcher’s subjectivity in the construction of the final work. They propose a third level of comprehension and interpretation that brings original insights, improve the global understanding in psychiatry, and propose immediate therapeutic implications. They should be included in the psychiatric common research toolkit to become better recognized by clinicians and mental health professionals

Issues around food in mixed families of adolescent girls with bulimia nervosa: A qualitative study with photo-elicitation

International audienceOBJECTIVES: Bulimia nervosa (BN) is a common psychiatric disorder among adolescent girls with potentially significant complications. Family relationships play a major role in the development and progression of this disorder. Studies in migrant populations suffering from eating disorders show contrasting results depending on the generation of migrants: first generation migrants have fewer eating disorders than the native population, while the prevalence of this disorder is more important than the latter among second and third generation migrants. In our clinical experience, we have frequently encountered so-called "mixed" families, which are families composed of one migrant parent and one non-migrant parent. Research focusing on this kind of family is scarce which is why we chose to explore their dynamic. METHODS: This study explored the issues around food and family relationships of adolescent girls suffering from BN, a topic that, to date, has not yet been studied. Ten interviews were conducted with five adolescent girls with BN between the ages of 16 and 20 and their parents, using photo-elicitation to enrich the collected data. RESULTS: The results were organized around two axes: (1) identity issues around food, that is the assimilation process described by both parents and adolescents concerning family meals and food habits, and how the adolescents struggle to manage this interbreeding; and (2) transmission issues with the consequences the migrant parent has to deal with to transmit his/her cultural identity with food while being far away from the homeland, and the difficulties between this parent and his/her child to share this heritage. Both issues, identity and transmission, appear to be central among these families. CONCLUSIONS: Our results suggest a difficulty in mentalizing identity issues in adolescent girls; the function of appeasement around non-mentalized tensions was highlighted. In our opinion, in this particular context, BN acts as a means of expressing the difficulty of their mixed culture. This enables it to draw some clinical implications, especially using mentalization-based therapy which has already shown efficacy in adolescents with borderline personality disorder and ED. Copyrigh

The role of food in family relationships amongst adolescents with bulimia nervosa: A qualitative study using photo-elicitation

International audienc

A qualitative exploration of what works for migrant adolescents in transcultural psychotherapy: perceptions of adolescents, their parents, and their therapists

International audienceBackground: Migrant adolescents are at a higher risk than their native-born counterparts of psychiatric disorders, and their care is a public health issue. In France, transcultural psychotherapy is a treatment provided by a group of therapists designed to meet the specific needs of these patients when usual care appears ineffective. The objective of this study was to explore the therapeutic elements at work in transcultural psychotherapy. Methods: We conducted a qualitative study crossing the perspectives of adolescents receiving transcultural psychotherapy, their parents, their first-line therapist (FLT), and the transcultural therapists. The families were chosen by purposive sampling. Data were collected during semi-structured individual (for FLTs) and group (families and transcultural therapists) interviews that explored the therapeutic elements involved and effective in transcultural psychotherapy. We used interpretative phenomenological analysis (IPA) to examine the data. In all, 44 participants were questioned: three adolescents (2 girls and 1 boy, all aged 18 to 21 years) and their parents (3 mothers and 1 father), three FLTs (2 child psychiatrists and 1 psychologist), and the 34 therapists participating in the three transcultural psychotherapy groups. Results: The analysis uncovered three themes: (1) the perceived effectiveness of the group’s functioning; (2) the recounting of the individual, family, and cultural history to allow for complexity and nuance; and (3) the personal investment by therapists, made possible by the group. Conclusions: Our results show some therapeutic elements at work in transcultural psychotherapy that enable it to meet the particular needs of some migrant adolescents that are unmet in standard therapy. Continuing to study transcultural psychotherapy and assess its effectiveness is essential for promoting and optimizing psychiatric care for migrant adolescents

Metasynthesis of Youth Suicidal Behaviours: Perspectives of Youth, Parents, and Health Care Professionals

<div><p>Background</p><p>Youth suicide is a major public health issue throughout the world. Numerous theoretical models have been proposed to improve our understanding of suicidal behaviours, but medical science has struggled to integrate all the complex aspects of this question. The aim of this review is to synthesise the views of suicidal adolescents and young adults, their parents, and their healthcare professionals on the topics of suicidal behaviour and management of those who have attempted suicide, in order to propose new pathways of care, closer to the issues and expectations of each group.</p><p>Methods and Findings</p><p>This systematic review of qualitative studies — Medline, PsycInfo, Embase, CINAHL, and SSCI from 1990 to 2014 — concerning suicide attempts by young people used thematic synthesis to develop categories inductively from the themes identified in the studies. The synthesis included 44 studies from 16 countries: 31 interviewed the youth, 7 their parents, and 6 the healthcare professionals. The results are organised around three superordinate themes: the individual experience, that is, the individual burden and suffering related to suicide attempts in all three groups; the relational experience, which describes the importance of relationships with others at all stages of the process of suicidal behaviour; and the social and cultural experience, or how the group and society accept or reject young people in distress and their families and how that affects the suicidal process and its management.</p><p>Conclusion</p><p>The violence of the message of a suicidal act and the fears associated with death lead to incomprehension and interfere with the capacity for empathy of both family members and professionals. The issue in treatment is to be able to witness this violence so that the patient feels understood and heard, and thus to limit recurrences.</p></div