Photo-ethnographie et élaboration collective de savoirs. Le cas d’un programme interdisciplinaire et participatif au Sénégal

Il est désormais fréquent que des chercheurs en sciences sociales soient sollicités dans des programmes de recherche sur l’environnement et la biodiversité. Ce type de collaboration mobilise une attention croissante à l’hétérogénéité des formes de production et de légitimation des savoirs, d’autant plus forte lorsqu’il s’agit de programmes qui impliquent des experts non-scientifiques. Ce contexte génère des tensions, entre d’une part, la rationalisation gestionnaire des formes du travail scientifique et notamment de son évaluation standardisée, et d’autre part, l’ouverture épistémologique à la diversité des modes de légitimation des savoirs et par conséquent à une créativité dans les formes du travail qui contrecarre les tendances à la standardisation.C’est pour rendre compte de l’attention à la pluralité des savoirs et de ce qu’elle implique et qu’elle crée précisément dans le courant d’une recherche collective, que nous revenons sur une démarche photo-ethnographique menée dans le cadre d’un programme de recherche participatif et interdisciplinaire au Sénégal. Cette démarche a permis de : (i) recueillir des données sur les savoirs locaux et les savoirs scientifiques ; (ii) participer au partage des savoirs propres aux différents acteurs impliqués et (iii) restituer et diffuser des résultats de la recherche partenariale. Mais elle a surtout constitué une forme d’expérimentation collective de formes de communication, de mise en discussion et en circulation des savoirs singuliers mobilisés et produits dans le cadre du projet.Au travers de cette démarche photo-ethnographique est révélée l’importance de la construction d’une sémiotique pratique commune à l’ensemble des acteurs pour le partage effectif de savoirs multiples dans le cadre de recherche collaborative. Cette étude souligne la manière dont toute construction et toute expression d’un savoir quel qu’il soit est liée à des situations de communication. Une démarche réflexive sur les modes de co-construction de connaissance implique donc nécessairement un travail d’analyse et d’expérimentation sur les pratiques de communication dans des recherches qui associent des collectifs différents.It is now frequent that researchers in social sciences are requested in research programs on the environment and the biodiversity. This type of collaboration mobilizes an increasing attention on the heterogeneousness of knowledge production and legitimization ; especially when there are programs that involve non-scientific experts. This context generates tensions enters, on one hand, the rationalization administrator of the scientific work and in particular its standardized evaluation, and on the other hand, the epistemological opening to the diversity of legitimization modes of the knowledge and consequently a creativity in the forms of the work which thwarts the tendencies to the standardization.From a photo-ethnographical approach developed during a participative and interdisciplinary research in Senegal, we report the attention on the plurality of the knowledge and what it implies, and it creates exactly in the course of a collective research. This approach allowed : (i) to collect data on the local and the scientific knowledge ; (ii) to participate in the sharing of the knowledge of the various actors implied, and (iii) to restore and to spread results of the research. But it especially constituted a shape of collective experiment of communicational forms, putting in discussion and in circulation singular knowledge mobilized and produced during the project.Through this photo-ethnographical approach is underlined the importance of the construction of a practical semiotic common to all the actors to share multiple knowledge in a collaborative research. This study shows the way any construction and any expression of knowledge is bound to situations of communication. So, a reflexive approach on the modes of co-construction of knowledge implies inevitably a work of analysis and experiment on the practices of communication in researches that associate different collectives

Tratamiento de las enfermedades del aparato respiratorio por las aguas sulfuradas-cálcicas, frías, sulfhídrico-nitrogenadas : observaciones y estudios efectuados en el balneario de Castillo-Elejabeitia (Vizcaya)

Présentation du contexte Les systèmes écologiques des zones africaines sont soumis depuis des décennies à d’importantes perturbations climatiques (effets de la sécheresse et des fortes températures) et anthropiques (surexploitation des terres, modification des pratiques culturales). Ainsi, on assiste généralement à un accroissement de l’aridité d’origine édaphique et à une modification du couvert végétal et des paysages, qui affectent la productivité des systèmes de production et les conditio..

Topographic steering of enhanced ice flow at the bottleneck between East and West Antarctica

Hypothesized drawdown of the East Antarctic Ice Sheet (EAIS) through the ‘bottleneck’ zone between East and West Antarctica would have significant impacts for a large proportion of the Antarctic Ice Sheet. Earth observation satellite orbits and a sparseness of radio-echo sounding (RES) data have restricted investigations of basal boundary controls on ice flow in this region until now. New airborne RES surveys reveal complex topography of high relief beneath the southernmost Weddell/Ross ice divide, with three subglacial troughs connecting interior Antarctica to the Foundation and Patuxent Ice Streams and Siple Coast ice streams. These troughs route enhanced ice flow through the interior of Antarctica but limit potential drawdown of the EAIS through the bottleneck zone. In a thinning or retreating scenario, these topographically-controlled corridors of enhanced flow could however drive ice divide migration, and increase mass discharge from interior West Antarctica to the Southern Ocean

Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis.

Multiple sclerosis is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability. Epidemiological studies have shown that genetic factors are primarily responsible for the substantially increased frequency of the disease seen in the relatives of affected individuals, and systematic attempts to identify linkage in multiplex families have confirmed that variation within the major histocompatibility complex (MHC) exerts the greatest individual effect on risk. Modestly powered genome-wide association studies (GWAS) have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects have a key role in disease susceptibility. Most of the genetic architecture underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9,772 cases of European descent collected by 23 research groups working in 15 different countries, we have replicated almost all of the previously suggested associations and identified at least a further 29 novel susceptibility loci. Within the MHC we have refined the identity of the HLA-DRB1 risk alleles and confirmed that variation in the HLA-A gene underlies the independent protective effect attributable to the class I region. Immunologically relevant genes are significantly overrepresented among those mapping close to the identified loci and particularly implicate T-helper-cell differentiation in the pathogenesis of multiple sclerosis

No Association Between Vitamin D Status and Risk of Barrett's Esophagus or Esophageal Adenocarcinoma: A Mendelian Randomization Study.

BACKGROUND & AIMS: Epidemiology studies of circulating concentrations of 25 hydroxy vitamin D (25(OH)D) and risk of esophageal adenocarcinoma (EAC) have produced conflicting results. We conducted a Mendelian randomization study to determine the associations between circulating concentrations of 25(OH)D and risks of EAC and its precursor, Barrett's esophagus (BE). METHODS: We conducted a Mendelian randomization study using a 2-sample (summary data) approach. Six single-nucleotide polymorphisms (SNPs; rs3755967, rs10741657, rs12785878, rs10745742, rs8018720, and rs17216707) associated with circulating concentrations of 25(OH)D were used as instrumental variables. We collected data from 6167 patients with BE, 4112 patients with EAC, and 17,159 individuals without BE or EAC (controls) participating in the Barrett's and Esophageal Adenocarcinoma Consortium, as well as studies from Bonn, Germany, and Cambridge and Oxford, United Kingdom. Analyses were performed separately for BE and EAC. RESULTS: Overall, we found no evidence for an association between genetically estimated 25(OH)D concentration and risk of BE or EAC. The odds ratio per 20 nmol/L increase in genetically estimated 25(OH)D concentration for BE risk estimated by combining the individual SNP association using inverse variance weighting was 1.21 (95% CI, 0.77-1.92; P = .41). The odds ratio for EAC risk, estimated by combining the individual SNP association using inverse variance weighting, was 0.68 (95% CI, 0.39-1.19; P = .18). CONCLUSIONS: In a Mendelian randomization study, we found that low genetically estimated 25(OH)D concentrations were not associated with risk of BE or EAC

World Heart Federation Cholesterol Roadmap 2022.

BACKGROUND: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipoproteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome. METHODS: Through a review of published guidelines and research papers since 2017, and consultation with a committee composed of experts in clinical management of dyslipidaemias and health systems research in low-and-middle income countries (LMICs), this Roadmap identifies (1) key principles to effective ASCVD prevention (2) gaps in implementation of these interventions (knowledge-practice gaps); (3) health system roadblocks to treatment of elevated cholesterol in LMICs; and (4) potential strategies for overcoming these. RESULTS: Reducing the future burden of ASCVD will require diverse approaches throughout the life-course. These include: a greater focus on primordial prevention; availability of affordable cholesterol testing; availability of universal cholesterol screening for inherited dyslipidaemias; risk stratification moving beyond 10-year risk to look at lifetime risk with adequate risk estimators; wider availability of affordable cholesterol-lowering therapies which should include statins as essential medications globally; use of adequate doses of potent statin regimens; and combination therapies with ezetimibe or other therapies in order to attain and maintain robust reductions in LDL-C in those at highest risk. Continuing efforts are needed on health literacy for both the public and healthcare providers, utilising multi-disciplinary teams in healthcare and applications that quantify both ASCVD risk and benefits of treatment as well as increased adherence to therapies. CONCLUSIONS: The adverse effects of LDL-cholesterol and apo B containing lipoprotein exposure are cumulative and result in ASCVD. These are preventable by implementation of different strategies, aimed at efficiently tackling atherosclerosis at different stages throughout the human life-course. Preventive strategies should therefore be updated to implement health policy, lifestyle changes and when needed pharmacotherapies earlier with investment in, and a shift in focus towards, early preventive strategies that preserve cardiovascular health rather than treat the consequences of ASCVD

Genome-wide association studies in oesophageal adenocarcinoma and Barrett's oesophagus: a large-scale meta-analysis.

BACKGROUND: Oesophageal adenocarcinoma represents one of the fastest rising cancers in high-income countries. Barrett's oesophagus is the premalignant precursor of oesophageal adenocarcinoma. However, only a few patients with Barrett's oesophagus develop adenocarcinoma, which complicates clinical management in the absence of valid predictors. Within an international consortium investigating the genetics of Barrett's oesophagus and oesophageal adenocarcinoma, we aimed to identify novel genetic risk variants for the development of Barrett's oesophagus and oesophageal adenocarcinoma. METHODS: We did a meta-analysis of all genome-wide association studies of Barrett's oesophagus and oesophageal adenocarcinoma available in PubMed up to Feb 29, 2016; all patients were of European ancestry and disease was confirmed histopathologically. All participants were from four separate studies within Europe, North America, and Australia and were genotyped on high-density single nucleotide polymorphism (SNP) arrays. Meta-analysis was done with a fixed-effects inverse variance-weighting approach and with a standard genome-wide significance threshold (p<5 × 10-8). We also did an association analysis after reweighting of loci with an approach that investigates annotation enrichment among genome-wide significant loci. Furthermore, the entire dataset was analysed with bioinformatics approaches-including functional annotation databases and gene-based and pathway-based methods-to identify pathophysiologically relevant cellular mechanisms. FINDINGS: Our sample comprised 6167 patients with Barrett's oesophagus and 4112 individuals with oesophageal adenocarcinoma, in addition to 17 159 representative controls from four genome-wide association studies in Europe, North America, and Australia. We identified eight new risk loci associated with either Barrett's oesophagus or oesophageal adenocarcinoma, within or near the genes CFTR (rs17451754; p=4·8 × 10-10), MSRA (rs17749155; p=5·2 × 10-10), LINC00208 and BLK (rs10108511; p=2·1 × 10-9), KHDRBS2 (rs62423175; p=3·0 × 10-9), TPPP and CEP72 (rs9918259; p=3·2 × 10-9), TMOD1 (rs7852462; p=1·5 × 10-8), SATB2 (rs139606545; p=2·0 × 10-8), and HTR3C and ABCC5 (rs9823696; p=1·6 × 10-8). The locus identified near HTR3C and ABCC5 (rs9823696) was associated specifically with oesophageal adenocarcinoma (p=1·6 × 10-8) and was independent of Barrett's oesophagus development (p=0·45). A ninth novel risk locus was identified within the gene LPA (rs12207195; posterior probability 0·925) after reweighting with significantly enriched annotations. The strongest disease pathways identified (p<10-6) belonged to muscle cell differentiation and to mesenchyme development and differentiation. INTERPRETATION: Our meta-analysis of genome-wide association studies doubled the number of known risk loci for Barrett's oesophagus and oesophageal adenocarcinoma and revealed new insights into causes of these diseases. Furthermore, the specific association between oesophageal adenocarcinoma and the locus near HTR3C and ABCC5 might constitute a novel genetic marker for prediction of the transition from Barrett's oesophagus to oesophageal adenocarcinoma. Fine-mapping and functional studies of new risk loci could lead to identification of key molecules in the development of Barrett's oesophagus and oesophageal adenocarcinoma, which might encourage development of advanced prevention and intervention strategies. FUNDING: US National Cancer Institute, US National Institutes of Health, National Health and Medical Research Council of Australia, Swedish Cancer Society, Medical Research Council UK, Cambridge NIHR Biomedical Research Centre, Cambridge Experimental Cancer Medicine Centre, Else Kröner Fresenius Stiftung, Wellcome Trust, Cancer Research UK, AstraZeneca UK, University Hospitals of Leicester, University of Oxford, Australian Research Council

Comparing the delay with different anticoagulants before elective electrical cardioversion for atrial fibrillation/flutter.

AimsTo assess the impact of the introduction of direct oral anticoagulants upon the outcomes from elective electrical cardioversion for atrial fibrillation.MethodsThis is a retrospective comparison of delay to elective cardioversion with different anticoagulants. The data was gathered from a large regional hospital from January 2013 to September 2017. There were 3 measured outcomes: 1) the time in weeks from referral to the date of attempted electrical cardioversion; 2) the proportion of patients who were successfully cardioverted; and 3) the proportion of patients who remained in sinus rhythm by the 12 week follow-up. Time-to-cardioversion was non-parametrically distributed so was analysed with Kruskal-Wallis testing and Mann-Whitney-U testing. Maintenance of sinus rhythm was analysed using z-testing.Results1,374 patients were submitted to cardioversion. The referrals for cardioversion were either from primary care or from cardiologists. At the time of cardioversion, 789 cases were anticoagulated on warfarin (W), 215 on apixaban (A) and 370 on rivaroxaban (R). All 3 cohorts were initially compared independently using Kruskal-Wallis testing. This demonstrated a significant difference in the delay (measured in weeks) between the A and W group (A = 7, W = 9, PConclusionDOACs appear to significantly shorten the latency between the decision to cardiovert and the cardioversion procedure by at least 2 weeks compared to warfarin in a real-world setting. In this study, patients who had not previously been cardioverted who were anticoagulated with warfarin had a significantly lower probability of conversion to sinus rhythm and a significantly lower probability to remain in sinus rhythm at the 12 week follow-up compared to the combined apixaban and rivaroxaban group