Early exposure to sunlight and allergic morbidity: The PARIS birth cohort.

The relationship between sunlight and allergies in children has received limited attention from researchers. We sought to explore how early exposure to solar radiation is associated with allergic morbidity within the PARIS birth cohort study. Our research dealt with children who attended at least one of two health checkups: at 18 months (n = 2012) and at 8-9 years (n = 1080). Early exposure to solar radiation was assessed using meteorological data (e.g., solar radiation, temperature, and relative humidity). Children with similar meteorological exposure trajectories were grouped by a longitudinal and multidimensional cluster analysis. The association between solar radiation exposure and allergic morbidity (i.e., allergic sensitization at 18 months and 8-9 years; current asthma, rhinitis, and eczema at 8-9 years) was quantified by multivariable logistic regression models adjusted for potential confounders. The effect modification of maternal vitamin D supplementation during pregnancy was tested. Four meteorological exposure trajectories were found. The trajectory with the highest exposure to early solar radiation had a reduced risk of sensitization at 8-9 years compared to the trajectory with the lowest exposure (p = 0.06). The association was statistically significant in the vitamin D supplementation group. Solar radiation during prenatal and postnatal periods was significantly associated with a lower risk of sensitization at 8-9 years (for one interquartile range (IQR) increase, adjusted odds ratio (aOR): 0.47; 95 % confidence interval (CI): 0.25-0.87 and 0.84; 0.7-1.00, respectively). Increased prenatal exposure to solar radiation was significantly associated with a lower risk of asthma at 8-9 years (for one IQR increase, aOR: 0.32; 95 % CI: 0.1-0.96). Early sunlight exposure may reduce the risk of sensitization and asthma in school-aged children, especially in those prenatally exposed to vitamin D. These findings highlight the importance of vitamin D in preventing allergic diseases in children, either through supplementation or sunlight exposure.

[Messages from the estates general on French internal medicine]. / Que retenir des états généraux de la médecine interne française ?

Internal medicine is a medical specialty that is often poorly understood by the general public and sometimes misidentified. In an era of increasing subspecialization and high technicality, it is characterized by a comprehensive approach centered on clinical evaluation. Unlike what is observed in most developed countries, where systemic autoimmune diseases are managed by organ specialists based on their mode of presentation, French internists are at the forefront for diagnosing and managing these diseases. Their multidisciplinary training gives them legitimacy to justify this role. Internists also play a crucial role in the management of patients requiring unplanned hospitalizations downstream from emergency departments and in connection with primary care. Internists primarily practice in a hospital setting, with a specific position in the French healthcare system aligned with the training frameworks of all medical specialties. To better define internal medicine, its role in care activities, as well as in education and research, internists organized a General Assembly of internal medicine that took place on September 28, 2023, in Paris. Structured around think tanks focusing on care, education, and research activities, the general assembly aimed to improve visibility on internal medicine and internists. This article recounts the discussions that animated this meeting and highlights the main ideas that emerged. These general assemblies constitute a foundational step and will be followed by a Consultation Conference in order to better identify and promote internal medicine and internists, regardless of their types and places of practice.

First complete mitogenome of Massarineae and its contribution to phylogenetic implications in Pleosporales.

Endophytic fungi play an important role in the growth and development of traditional Chinese medicine plants. We isolated a strain of Acrocalymma vagum from the endophytic fungi of the traditional Chinese plants Paris. To accurately identify this endophytic fungal species of interest, we sequenced the mitochondrial genome of A. vagum, which is the first discovered mitochondrial genome in Massarineae. The A. vagum mitochondrial genome consists of a 35,079-bp closed circular DNA molecule containing 36 genes. Then, we compared the general sequence characteristics of A. vagum with those of Pleosporales, and the second structure of the 22 tRNAs was predicted. The phylogenetic relationship of A. vagum was constructed using two different data sets (protein-coding genes and amino acids). The phylogenetic tree shows that A. vagum is located at the root of Pleosporales. The analysis of introns shows that the number of introns increases with the increase in branch length. The results showed that monophyly was confirmed for all families in Pleosporales except for Pleosporaceae. A. vagum is an ancient species in the Pleosporales, and Pleosporaceae may require further revision. In Pleosporales, the number of introns is positively correlated with branch length, providing data for further study on the origin of introns.

[Transition, a complex and holistic process]. / La transition, un processus complexe et holistique.

Transition is a complex process that enables a young person living with a chronic illness to become an adult. It begins early in adolescence and ends once the transfer to the adult service is complete. The high risk of disruption during this transition calls for coordinated care focused on the patient and his or her life course. Many programs are dedicated to this delicate stage, including Jump, developed within the neurology department of a Paris hospital.

Body Composition and Nutritional Status of the Spanish National Breaking Team Aspiring to the Paris 2024 Olympic Games.

Breaking is a sports dance modality that will debut for the first time at the Paris 2024 Olympic Games. This dance form combines street dance steps with acrobatics and athletic elements. It complies with gender equality, maintains aesthetic appeal, and is practised indoors. The objective of this study is to assess the characteristics of body composition and nutritional status of the athletes that make up the Breaking national team. This national team was recruited, and they underwent an analysis of body composition using bioimpedance measurement and a nutritional interview status with the completion of a survey on the frequency of the consumption of sports supplements and ergogenic aids. In addition, they completed a consumption questionnaire for a series of food groups with specified protein, lipid, and carbohydrate content. After that, parameters were analyzed in relation to their nutritional status during a complete medical examination at the Endocrinology and Nutrition Service of the Sports Medicine Center of CSD. A descriptive analysis of the results obtained was carried out to find the mean values of the variables analyzed. The analytical parameters described an adequate nutritional status, except for the mean capillary determination of 25-OH-vitamin D3, which was 24.2 ng/dL (SD: 10.3). Bone mineral density values were higher than those of the general population. This is the first time that a study of these characteristics has been carried out on Breakers, so it is highly relevant to increase knowledge in this area in order to conduct nutritional interventions aimed at improving the sports performance of these athletes.

Analyzing implementation of public health interventions: A need for rigor, and the challenges of stakeholder involvement.

OBJECTIVES: This article shows how conceptual models can help to develop and evaluate public health interventions. It also reports on the challenges of getting stakeholders involved. METHOD: The analysis is based on the reflexive approach applied by the authors during their participation in two public health intervention research (PHIR) projects, in France and in Burkina Faso. RESULTS: In Paris, PHIR aimed to enable sub-Saharan immigrants to appropriate the existing means of prevention and sexual health care and to strengthen their empowerment in view of preserving their health. Evaluation was carried out using mixed methods. The intervention process theory is based on Ninacs' conceptual model of individual empowerment. The Consolidated Framework For Implementation Research (CFIR) was mobilized a posteriori to analyze the process. PHIR stemmed from collaboration between a research team and two associations. The different stakeholders were involved in the evaluation process, as were, at certain times, persons in highly precarious situations. In Ouagadougou, a community-based dengue vector control intervention was deployed to address an essential but neglected need. As regards evaluation, we opted for a holistic, mixed method approach (effectiveness and process). The contents of the intervention were determined based on tacit knowledge, a community preference survey and solid evidence. The theoretical framework of the intervention consisted in an eco-biological model of vector control. The implementation analysis combined an internal assessment of implementation fidelity with an external CFIR process analysis. All stakeholders were involved in the evaluation process. DISCUSSION: Analysis confirmed not only the value of process evaluations in PHIR, but also the primordial importance of a rigorous approach. Stakeholder involvement is a major challenge to be addressed early in the planning of RISPs; with this in mind, effective and ethically sound assessment mechanisms need to be drawn up. Interdisciplinary evaluative approaches should be preferred, and the use of justified, relevant, and flexible frameworks is highly recommended. CONCLUSION: Lessons learned for those wishing to engage in the process evaluation of a public health intervention are hereby presented.

Proof of concept of a sexual health outreach program led by community health workers in homeless hostels in the greater Paris region.

Context: Homeless individuals face exacerbated risks of infectious diseases, including sexually transmitted infections (STIs). Programs led by Community Health Workers (CHWs) have demonstrated potential to enhance healthcare access for marginalized groups such as homeless families. This study aims to evaluate the feasibility and effectiveness of a novel CHW-based outreach program addressing sexual health issues among individuals residing in homeless hostels. Methods: Twelve social homeless hostels in the greater Paris region were selected as program implementation sites. An outreach program was developed consisting of two interventions: sexual health workshops and STI screening sessions (HIV and hepatitis B and C) accompanied by individual interviews, both conducted by CHWs within each hostel over an 8-week period and scheduled weekly. Feasibility, participation and engagement were evaluated using complementary methods including qualitative field observations, semi-structured interviews and focus groups with CHWs, satisfaction questionnaires for participants, and quantitative outcome data collection of each intervention. Results: A total of 80 program activities (workshops and screening sessions) were conducted. Among the participants, 542 women and 30 men engaged in workshops. During the 30 Rapid Diagnostic Testing sessions, 150 individuals underwent testing for HIV, hepatitis B, and/or hepatitis C. Positivity rates were 6.7% for hepatitis B and 0.9% for hepatitis C. No HIV infections were detected. Participant satisfaction rates were consistently high (>76%) across workshops. Qualitative analysis unveiled two critical axes influencing program feasibility and effectiveness: program organization and CHW involvement. Discussion: This assessment of the program highlights its feasibility among a population that is difficult to reach through conventional healthcare efforts. The intervention's potential effectiveness is suggested by self- and CHW-reported improvements in sexual health literacy and high rates of referral to the healthcare system, as well as holistic well-being considerations. CHW involvement is a vital determinant of program success, as are robust coordination among stakeholders, deep understanding of the target population, and strong partner engagement. Conclusion: This outreach program amplifies the voices of often-overlooked populations while empowering them to navigate health and social challenges. Although these workshops serve as lifelines for those frequently excluded from mainstream services, long-term improvements to the health and wellbeing of homeless populations will necessitate systemic governmental intervention.

Anniversary Oncology Days in Paris.

On June 14-16 2023, the 45th meeting of the General Assembly of Organization of European Cancer Institutes (OECI) dedicated to the 120th anniversary of the award of the first Nobel Prize in Physics for the discovery of radioactivity to Marie Sklodowska-Curie was held in Paris hosted by the Institut Curie. More than 130 leading specialized institutions and organizations that focus their efforts on finding ways and optimizing coordination to improve the quality of cancer care in Europe attended the OECI Oncology Days and the General Assembly. The first plenary session, chaired by S. Oberst and J.-B. Burrion, was devoted to the issues of quality in oncology and the role of research and education in optimizing healthcare services. It was noted that today, in the field of providing medical services to cancer patients in European countries, there are significant differences in access to digital, research and innovation technologies. The efforts of the team in the field of accreditation and certification of cancer centers within the framework of the European Cancer Plan help to improve and build the capacity of the EU member states to improve the quality of healthcare services. The OECI is working to support, improve and integrate cancer patient care, research and education in cancer care as well as survivorship to minimize inequalities in access to quality health care. A separate session chaired by E. Jolly was devoted to the role of patient organizations in improving the quality of cancer care, research and education. The reports presented the best experiences of cooperation between cancer centers and patient organizations in Central and Eastern Europe, as well as models of increasing interaction between clinical research centers and patient organizations in the European Union and Japan. The OECI is making considerable efforts to create an optimal model of the pathway that a patient should follow from the moment of diagnosis to palliative care and long-term survival. Optimization of European standards for the provision of high-quality specialized medical care and the development of quality indicators and patient-reported outcomes will improve the ability of researchers and healthcare providers to combine their efforts. On the one hand, the patient pathway is a tool for improving the quality of medical services and patient care, and on the other hand, it guarantees cost control and takes into account the patient's experience to make the best decision by a multidisciplinary team. At the session chaired by M. Nilsert, the best practices of oncology care provided by OECI-certified centres in Toulouse, Helsinki, Stockholm (Karolinska) and Dublin were presented. It is convincingly proven that the certification procedure helps to optimize the quality of medical services, communication with patients, research and improve the quality of education. Considerable attention at the special session chaired by G. Apolone and G. Brunelli was devoted to the issues of quality of life as the basis of cancer care. The EUonQoL project coordinated the optimization of research, the role of stakeholders in this process and the need to create an appropriate network of cancer infrastructure to reduce cancer in Europe. Today, as part of the development of the European Model Cancer Control Plan and with the support of the EU Mission and Horizon Europe, the goal of bringing together opportunities for the provision of high-quality healthcare services, joint research and innovation is under realization. The priority goal is to create comprehensive cancer infrastructures that will provide opportunities for the efficient use of national resources of European countries and associated EU members for improving the quality of healthcare services. At the plenary session chaired by G. Ciliberto and P. Mahon, dedicated to the role of digitalization as a factor of modern European opportunities, cancer centers presented pilot programs and trainings that contribute to the development and implementation of new opportunities to address complex cancer problems. A significant role in optimizing the coordination of European cancer centers should be played by the development and implementation of modern technologies in the creation and implementation of modern information databases that will improve the quality of research and health care services. Attention is focused on the role of the state policy of the OECI countries in supporting the development of digitalization of cancer centers. A significant event of the 45th OECI General Assembly was the plenary session on the preparation of the Ukrainian oncology service on the way to the European Union, chaired by T. Philippe and V. Chekhun. In his address on behalf of the Vice Prime Minister of Ukraine for European Integration Olha Stefanishyna, the First Deputy Minister of Health of Ukraine Serhii Dubrov welcomed the participants of the OECI Oncology Days and General Assembly. Francois Braun, Minister of Health of France, addressed the participants with a greeting and confirmed the comprehensive support for Ukraine on its way to the EU. The presentation of V. Chekhun and O. Rossylna focused on the current structure of the Ukrainian Cancer Service and the legislative framework for its transformation in the frames of reforms in the Ukrainian healthcare sector. The report of the OECI President highlighted the active position of OECI on the implementation of European standards to increase accessibility and improve the quality of cancer care for patients. T. Philippe drew special attention to the need to transform and optimize the oncology infrastructure network on the way of Ukraine's European integration efforts. The Ukrainian delegation's presentation was received with much enthusiasm from the audience. The participants from Moldova insisted on continuous support to Ukrainian medicine and patients. It was stressed that Ukraine fights not only for their territory but also for freedom in all Europe. As part of the OECI Oncology Days, the scientific session "The Cell as a Therapy" chaired by T. Philippe and G. Apolone was held to present new perspectives on cancer treatment. Below is a brief program of this conference: - Overview of the status of cancer cell therapy: theoretical and practical issues. - CAR-T Cells in the field of hematology: comparison between Western Europe and Eastern Europe. - The future of CAR-T in the field of solid tumors. - CAR-T allogenic, NK cells, TIL: other possible chapters for cell therapy. On the final day of the OECI General Assembly, T. Philip summarized the results of his program as a President, presented a financial report on the activities of OECI, and transferred the powers to the newly elected President G. Apolone for the period 2023-2026.

Ibn Zuhr (Avenzoar) on Head Wounds in Kitab al-Taysir (Liber Teisir).

OBJECTIVE: To present and evaluate the section concerning head wounds in Kitab al-Taysir (Liber Teisir) by Ibn Zuhr (Avenzoar). METHODS: In this study, 4 different versions of Avenzoar's work were analyzed. The first 2 versions are in Arabic and titled Kitab al-Taysir fi al-Mudawat wa al-Tadbir; one was edited by Michel Khouri and printed in Damascus in 1983, and the other was edited by Muhammad b. 'Abd Allah al-Rudani and printed in Rabat in 1991. The third and fourth versions are in Latin; one was translated by Paravicius, edited by Hieronymus Surianus, and printed in Venice in 1530, and the other was a manuscript in Bibliothèque interuniversitaire de santé, MS 5119 in Paris and was translated by John of Capua. RESULTS: The titles of the sections are "Wounds due to iron objects" and "Wounds due to stones" in Arabic and "On head injuries from external factors such as blow" and "On head wounds from iron or stone or wood" in Latin. The chapter written by Avenzoar on head wounds is divided into 2 parts. First, he explained the treatment, and subsequently he described his views and related experiences. CONCLUSIONS: The information provided by Avenzoar on head injuries technically reflects the medical and surgical comprehension of his era. In the section that is the focus of this study, he first provided technical information related to head injuries and then offered his opinions on the controversial and problematic issues in treatment such as phlebotomy. This study revealed that Avenzoar approached the subject differently than his predecessors.

Carbon emissions reductions from Indonesia's moratorium on forest concessions are cost-effective yet contribute little to Paris pledges.

International initiatives for reducing carbon emissions from deforestation and forest degradation (REDD+) could make critical, cost-effective contributions to tropical countries' nationally determined contributions (NDCs). Norway, a key donor of such initiatives, had a REDD+ partnership with Indonesia, offering results-based payments in exchange for emissions reductions calculated against a historical baseline. Central to this partnership was an area-based moratorium on new oil palm, timber, and logging concessions in primary and peatland forests. We evaluate the effectiveness of the moratorium between 2011 and 2018 by applying a matched triple difference strategy to a unique panel dataset. Treated dryland forest inside moratorium areas retained, at most, an average of 0.65% higher forest cover compared to untreated dryland forest outside the moratorium. By contrast, carbon-rich peatland forest was unaffected by the moratorium. Cumulative avoided dryland deforestation from 2011 until 2018 translates into 67.8 million to 86.9 million tons of emissions reductions, implying an effective carbon price below Norway's US$5 per ton price. Based on Norway's price, our estimated cumulative emissions reductions are equivalent to a payment of US$339 million to US$434.5 million. Annually, our estimates suggest a 3 to 4% contribution to Indonesia's NDC commitment of a 29% emissions reduction by 2030. Despite the Indonesia-Norway partnership ending in 2021, reducing emissions from deforestation remains critical for meeting this commitment. Future area-based REDD+ initiatives could build on the moratorium's outcomes by reforming its incentives and institutional arrangements, particularly in peatland forest areas.