INTENSITY OF SYMPTOMS FROM ALCOHOL WITHDRAWAL IN ALCOHOL-DEPENDENT PATIENTS: COMPARISON BETWEEN SMOKERS AND NON-SMOKERS

Background: in patients with a dual dependence on alcohol and tobacco, the spontaneous discourse among doctors is not to encourage them to consider preparing to give up both substances. The argument put forward is that withdrawal would be more difficult. We wanted to compare the intensity of withdrawal symptoms in patients hospitalised for alcohol detoxification between smokers and non-smokers. Subject and methods: We compared patients hospitalised for alcohol detoxification who smoke versus non-smokers who received replacement therapy through benzodiazepines and not nicotine replacement. The blood pressure and the cardiac frequency measure on the first day of hospitalisation, the doses of Diazepam dispensed on the first day, and the Clinical Institute Withdrawal Assessment of Alcohol Scale Revised (CIWA-Ar) score on the second day were compared. Results: a trend emerged whereby smoking patients undergoing alcohol detoxification showed higher blood pressure, higher cardiac frequency and required higher doses of benzodiazepines on the first day of hospitalisation. Patients who smoke also had higher CIWA-Ar scores on the second day of hospitalisation. Discussion: from a physiological point of view, the intensity of the symptoms of alcoholic withdrawal seems to be greater in hospitalised patients who smoke vs. non-smokers in the first two days. Does giving up both substances at the same time result in fewer withdrawal symptoms? And in this case, should a double replacement be recommended: benzodiazepines and nicotine replacement therapy? Conclusion: to be able to refine the recommendations on alcohol-tobacco dual withdrawal programmes, other studies are needed to compare giving up both substances with or without nicotine replacement

MOOD DISORDERS IN ADOLESCENTS: CONCEPTS AND INTERROGATIONS AMONG FRANCOPHONE PSYCHIATRISTS

Background: With the publication of DSM III, the nosology of children and adolescents’ disorders has evolved differently in Francophone and Anglo-Saxon countries. We want to 1 / familiarize readers with the nosographic concepts of mood disorders and bipolar disorders in the Francophone world of Adolescent Psychiatry; 2/ highlight the major current issues of concern to both Francophone and Anglo-Saxon adolescents’ psychiatrists. Method: A review of the literature in PubMed, PsycINFO and PsycARTICLES, but also of Francophone journals or textbooks not included in these databases nor distributed outside Francophone countries. Results: Although Francophone adolescents’ psychiatrists still rely on the DSM II, particularly in reference to the transitory dimension of problems during adolescence, the DSM III led to a tightening of criteria for bipolar disorder in the Anglo-Saxon countries. These disorders have become rare in the 2000s while still common in Francophone countries. Nowadays the evolution of current criteria in Anglo-Saxon countries tends to bring the diagnostic criteria closer to the Francophone’s one even though important differences still persist. Conclusion: Despite differences between these two approaches in Psychiatry, there is agreement regarding the poor prognosis of type I bipolar disorder, particularly when psychotic traits are observed. Early diagnosis and treatment are therefore a challenge for both, but their limitations are inherent to their respective approaches. In Anglo-Saxon countries, if the criteria are met for bipolar disorder, treatment is decided at the risk of over-diagnosis and stigmatization of false positives. In Francophone countries, even if the criteria for bipolar disorder are met, it is still necessary that the psychopathological analysis of the disorder in the developmental framework of adolescence confirms that the disorder is stable, at the risk of later treatment and of increase of insufficiently treated false negatives. A reconciliation of these fields may limit the above side effects

a research protocol for a mixed methods study

Funding Information: This work was supported by the European Union under the Horizon Europe Research and Innovation Programme under the grant agreement no 101057825. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2024 Valli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction Adverse events in health care affect 8% to 12% of patients admitted to hospitals in the European Union (EU), with surgical adverse events being the most common types reported. Aim SAFEST project aims to enhance perioperative care quality and patient safety by establishing and implementing widely supported evidence-based perioperative patient safety practices to reduce surgical adverse events. Methods We will conduct a mixed-methods hybrid type III implementation study supporting the development and adoption of evidence-based practices through a Quality Improvement Learning Collaborative (QILC) in co-creation with stakeholders. The project will be conducted in 10 hospitals and related healthcare facilities of 5 European countries. We will assess the level of adherence to the standardised practices, as well as surgical complications incidence, patient-reported outcomes, contextual factors influencing the implementation of the patient safety practices, and sustainability. The project will consist of six components: 1) Development of patient safety standardised practices in perioperative care; 2) Guided self-evaluation of the standardised practices; 3) Identification of priorities and actions plans; 4) Implementation of a QILC strategy; 5) Evaluation of the strategy effectiveness; 6) Patient empowerment for patient safety. Sustainability of the project will be ensured by systematic assessment of sustainability factors and business plans. Towards the end of the project, a call for participation will be launched to allow other hospitals to conduct the self-evaluation of the standardized practices. Discussion The SAFEST project will promote patient safety standardized practices in the continuum of care for adult patients undergoing surgery. This project will result in a broad implementation of evidence-based practices for perioperative care, spanning from the care provided before hospital admission to post-operative recovery at home or outpatient facilities. Different implementation challenges will be faced in the application of the evidence-based practices, which will be mitigated by developing context-specific implementation strategies. Results will be disseminated in peer-reviewed publications and will be available in an online platform.publishersversionpublishe

High aboveground carbon stock of African tropical montane forests

Tropical forests store 40-50 per cent of terrestrial vegetation carbon(1). However, spatial variations in aboveground live tree biomass carbon (AGC) stocks remain poorly understood, in particular in tropical montane forests(2). Owing to climatic and soil changes with increasing elevation(3), AGC stocks are lower in tropical montane forests compared with lowland forests(2). Here we assemble and analyse a dataset of structurally intact old-growth forests (AfriMont) spanning 44 montane sites in 12 African countries. We find that montane sites in the AfriMont plot network have a mean AGC stock of 149.4 megagrams of carbon per hectare (95% confidence interval 137.1-164.2), which is comparable to lowland forests in the African Tropical Rainforest Observation Network(4) and about 70 per cent and 32 per cent higher than averages from plot networks in montane(2,5,6) and lowland(7) forests in the Neotropics, respectively. Notably, our results are two-thirds higher than the Intergovernmental Panel on Climate Change default values for these forests in Africa(8). We find that the low stem density and high abundance of large trees of African lowland forests(4) is mirrored in the montane forests sampled. This carbon store is endangered: we estimate that 0.8 million hectares of old-growth African montane forest have been lost since 2000. We provide country-specific montane forest AGC stock estimates modelled from our plot network to help to guide forest conservation and reforestation interventions. Our findings highlight the need for conserving these biodiverse(9,10) and carbon-rich ecosystems. The aboveground carbon stock of a montane African forest network is comparable to that of a lowland African forest network and two-thirds higher than default values for these montane forests.Peer reviewe

The European Reference Genome Atlas: piloting a decentralised approach to equitable biodiversity genomics.

ABSTRACT: A global genome database of all of Earth’s species diversity could be a treasure trove of scientific discoveries. However, regardless of the major advances in genome sequencing technologies, only a tiny fraction of species have genomic information available. To contribute to a more complete planetary genomic database, scientists and institutions across the world have united under the Earth BioGenome Project (EBP), which plans to sequence and assemble high-quality reference genomes for all ∼1.5 million recognized eukaryotic species through a stepwise phased approach. As the initiative transitions into Phase II, where 150,000 species are to be sequenced in just four years, worldwide participation in the project will be fundamental to success. As the European node of the EBP, the European Reference Genome Atlas (ERGA) seeks to implement a new decentralised, accessible, equitable and inclusive model for producing high-quality reference genomes, which will inform EBP as it scales. To embark on this mission, ERGA launched a Pilot Project to establish a network across Europe to develop and test the first infrastructure of its kind for the coordinated and distributed reference genome production on 98 European eukaryotic species from sample providers across 33 European countries. Here we outline the process and challenges faced during the development of a pilot infrastructure for the production of reference genome resources, and explore the effectiveness of this approach in terms of high-quality reference genome production, considering also equity and inclusion. The outcomes and lessons learned during this pilot provide a solid foundation for ERGA while offering key learnings to other transnational and national genomic resource projects.info:eu-repo/semantics/publishedVersio

X-chromosome and kidney function:evidence from a multi-trait genetic analysis of 908,697 individuals reveals sex-specific and sex-differential findings in genes regulated by androgen response elements

X-chromosomal genetic variants are understudied but can yield valuable insights into sexually dimorphic human traits and diseases. We performed a sex-stratified cross-ancestry X-chromosome-wide association meta-analysis of seven kidney-related traits (n = 908,697), identifying 23 loci genome-wide significantly associated with two of the traits: 7 for uric acid and 16 for estimated glomerular filtration rate (eGFR), including four novel eGFR loci containing the functionally plausible prioritized genes ACSL4, CLDN2, TSPAN6 and the female-specific DRP2. Further, we identified five novel sex-interactions, comprising male-specific effects at FAM9B and AR/EDA2R, and three sex-differential findings with larger genetic effect sizes in males at DCAF12L1 and MST4 and larger effect sizes in females at HPRT1. All prioritized genes in loci showing significant sex-interactions were located next to androgen response elements (ARE). Five ARE genes showed sex-differential expressions. This study contributes new insights into sex-dimorphisms of kidney traits along with new prioritized gene targets for further molecular research.</p

The European Reference Genome Atlas: piloting a decentralised approach to equitable biodiversity genomics

A genomic database of all Earth’s eukaryotic species could contribute to many scientific discoveries; however, only a tiny fraction of species have genomic information available. In 2018, scientists across the world united under the Earth BioGenome Project (EBP), aiming to produce a database of high-quality reference genomes containing all ~1.5 million recognized eukaryotic species. As the European node of the EBP, the European Reference Genome Atlas (ERGA) sought to implement a new decentralised, equitable and inclusive model for producing reference genomes. For this, ERGA launched a Pilot Project establishing the first distributed reference genome production infrastructure and testing it on 98 eukaryotic species from 33 European countries. Here we outline the infrastructure and explore its effectiveness for scaling high-quality reference genome production, whilst considering equity and inclusion. The outcomes and lessons learned provide a solid foundation for ERGA while offering key learnings to other transnational, national genomic resource projects and the EBP.info:eu-repo/semantics/publishedVersio