ABSTRACT
Population genetic models only provide coarse representations of real-world ancestry. We used a pedigree compiled from 4 million parish records and genotype data from 2276 French and 20,451 French Canadian individuals to finely model and trace French Canadian ancestry through space and time. The loss of ancestral French population structure and the appearance of spatial and regional structure highlights a wide range of population expansion models. Geographic features shaped migrations, and we find enrichments for migration, genetic, and genealogical relatedness patterns within river networks across regions of Quebec. Finally, we provide a freely accessible simulated whole-genome sequence dataset with spatiotemporal metadata for 1,426,749 individuals reflecting intricate French Canadian population structure. Such realistic population-scale simulations provide opportunities to investigate population genetics at an unprecedented resolution.
Subject(s)
Datasets as Topic , Pedigree , Population , Humans , Alleles , Canada , Genetics, Population , Genotype , Quebec , France/ethnology , Population/genetics , Whole Genome Sequencing , Models, Genetic , Human Migration , Genetic VariationABSTRACT
This study had three goals: to examine the stability of deficits in the phonological and lexical routes in dyslexia (group study), to determine the prevalence of dyslexia profiles (multiple-case study), and to identify the prediction of phonemic segmentation and discrimination skills before reading acquisition on future reading level. Among a group of 373 non-readers seen at age 5, 38 students were subsequently diagnosed as either consistent dyslexic readers (18 DYS) or consistent typical readers (20 TR). Their phonological and lexical reading skills were assessed at ages 10 and 17 and their phonemic segmentation and discrimination skills at age 5. In comparison with TR of the same chronological age (CA-TR), individuals with dyslexia demonstrated an impairment of the two reading routes, especially of the phonological reading route. In the comparison with younger TR (age 10) of the same reading level (RL-TR), only a deficit of the phonological route is observed. In the multiple-case study, the comparisons with CA-TR showed a prevalence of mixed profiles and very few dissociated profiles, whereas the comparison with RL-TR resulted mostly in two profiles depending on the measure: a phonological profile when accuracy was used and a delayed profile when speed was used. In addition, the correlations between early phonemic segmentation and discrimination skills (age 5) and later reading skills (age 17) were significant, and in the group of individuals with dyslexia, early phonemic segmentation skills significantly predicted these later reading skills. Phonological reading deficits are persistent and mainly caused by early phonemic impairments.
Subject(s)
Dyslexia , Phonetics , Reading , Adolescent , Child , Child, Preschool , Humans , Dyslexia/classification , Dyslexia/diagnosis , Dyslexia/epidemiology , Dyslexia/physiopathology , Students , Case-Control Studies , Prevalence , Longitudinal Studies , France/ethnology , England/ethnology , AgingABSTRACT
Drawing on participant observation and interviews in two yoga studios in the highly socially stratified city of Marseille, France, this paper explores the understandings of yoga as a health practice that emerge at the intersections between yoga styles and their social contexts of consumption. Its insights emerge from the comparison of three modern yoga styles that were developed for Western English-speaking cultural contexts - Iyengar, Bikram and Forrest - and which differ in form but also in the chronology of their emergence on the global yoga market and that of their reception in France. These three yoga styles are also branded through contrasting mythologies of transformational healing, and the aim of this paper is to explore how a brand conceptualization of yoga as a health practice relates to or resonates with the embodied experiences of practitioners, and to the socio-cultural contexts in which practitioners and their practices are embedded. The paper contributes a new case study to the global yoga scholarship and to a poorly studied French yoga scene, but more importantly, it cross-examines the discourses through which a yoga style is branded, the way it is transmitted, and the social context and social positioning of the individuals who practice it. Combining perspectives on the body, narrative and rituals, it identifies how yoga healing is construed in relation to gender, ethnicity and class and the points of consensus and dissent that emerge from the encounters between French social bodies and exogenous yoga styles.
Subject(s)
Yoga , Anthropology, Medical , Attitude to Health/ethnology , Female , France/ethnology , Humans , MaleABSTRACT
We investigated changes in alcohol consumption following the COVID-19 lockdown among French-speaking Belgian individuals at risk for severe alcohol use disorder. Participants (N = 299) at risk for alcohol use disorder (AUD, i.e., score higher than 19 at the Alcohol Use Disorder Identification Test), and 299 moderate drinkers (MOD, i.e., score lower than 8) individually matched for age, gender and education provided self-reports of alcohol consumption changes (i.e., number of alcohol units consumed during a typical week before and during lockdown). AUD were more likely (91.31%) than MOD (71.57%) to modify their consumption following lockdown (p < 0.0001). They were more likely to decrease (65.89% vs. 35.12%, p < 0.0001) and less likely to increase (25.42% vs. 36.45%, p = 0.004) their consumption than MOD. Analyses of post-pre lockdown differences in alcohol consumption showed that AUD presented a stronger decrease than MOD (-13.97 units/week vs. -0.07, p < 0.0001). Among individuals who decreased consumption, AUD decreased more (-27.92 vs. -2.74, p < 0.0001) than MOD. Among those who increased consumption, AUD increased more (17.32 vs. 2.44, p < 0.0001) than MOD. We thus observed sharp consumption increases or conversely abrupt decreases in individuals at high risk of alcohol use disorder, underscoring the need to develop prophylactic interventions for this population during such sanitary crises, to avoid brutal changes of the alcohol consumption pattern. Efforts should be made to mitigate consumption increases but also to favor progressive rather than sudden decreases in order to prevent damaging withdrawal symptoms.
Subject(s)
Alcohol Drinking/epidemiology , Alcoholism/etiology , COVID-19/prevention & control , Communicable Disease Control , Adolescent , Adult , Age Factors , Aged , Alcohol Drinking/psychology , Alcoholism/epidemiology , Alcoholism/psychology , Belgium/epidemiology , COVID-19/epidemiology , Female , France/ethnology , Humans , Male , Middle Aged , Risk Factors , Surveys and Questionnaires , Young AdultABSTRACT
INTRODUCTION: Military surgery requires skills that in general cannot be easily learnt in civilian training. Participation in a fellowship abroad adapted to the particular operating conditions of the foreign deployment is one route that might secure the necessary supplementary training. We therefore assessed the relevance of such a fellowship in the preparedness of young military surgeons in their first deployment. METHODS: This study included all active military surgeons who had completed a fellowship abroad during their initial training from 2004 to 2017 in Tchad or Senegal or Djibouti. The collection of data was performed using a questionnaire. The main judgement criterion was the rate of positive answers awarded to the relevance of this fellowship in the preparedness of respondents' first foreign deployment. RESULTS: Sixty-nine of 73 surgeons answered. Sixty-one estimated the fellowship had allowed them to feel more operational during their first mission, with 83.61% rating this feeling as important. Also, 61 recommended the use of a fellowship for war surgery training. The grade assigned to the surgical benefit was 8.48/10. CONCLUSION: A fellowship abroad permits one to become familiar with surgical practice under austere circumstances and the particularities of the surgical structures at the front. Current trainees' feedback confirms its relevance.
Subject(s)
Education, Medical, Continuing/standards , Fellowships and Scholarships/standards , Surgeons/education , Education, Medical, Continuing/methods , Fellowships and Scholarships/methods , France/ethnology , Humans , Military Personnel/education , Retrospective Studies , Surgeons/statistics & numerical data , Surveys and Questionnaires , Teaching/standardsABSTRACT
The primary mission of the French military surgical teams deployed in external operations in the Sahel is to provide support for combatants. However, many of their activities and of the limited human and material resources allocated to them are devoted to providing free medical assistance to the local population. The French military surgical teams are very often expected to take care of serious burns for the benefit of civil populations because of the absence of dedicated civilian medical structures. Surgical teams are faced with a necessary triage of patients to be taken care of because of the discrepancy between the high demand for care and the means at their disposal. But the triage can lead to ethical dilemmas when the values that come into play in the decision contradict each other or when they run up against the quota of available human and material resources, as well as the interests of the military institution. The challenge is then to become aware of these dilemmas in this particular context. A discussion of these ethical dilemmas would help carers to avoid developing fatalistic attitudes or developing chronic pathologies due to unresolved or unconscious predicaments. Solutions are proposed that place ethical reflection at the heart of the practices during external operations by the French surgical teams. The ethics of discussion must bring together all players in care management and also the military authorities, before, during and after the missions. Training programmes for ethical reflection would benefit surgical teams and help them approach and become aware of the dilemmas they will necessarily face.
Subject(s)
Burns/therapy , Military Medicine/ethics , Military Personnel/education , Operating Rooms/trends , Africa, Central , France/ethnology , Humans , Military Medicine/methods , Military Medicine/trends , Military Personnel/statistics & numerical data , Operating Rooms/ethics , Operating Rooms/organization & administration , Warfare/ethics , Warfare/statistics & numerical dataABSTRACT
We aimed to compare COVID-19-specific and all-cause mortality rates among natives and migrants in Italy and to investigate the clinical characteristics of individuals dying with COVID-19 by native/migrant status. The mortality rates and detailed clinical characteristics of natives and migrants dying with COVID-19 were explored by considering the medical charts of a representative sample of patients deceased in Italian hospitals (n = 2,687) between February 21st and April 29th, 2020. The migrant or native status was assigned based on the individual's country of birth. The expected all-cause mortality among natives and migrants living in Italy was derived by the last available (2018) dataset provided by the Italian National Institute of Statistics. Overall, 68 individuals with a migration background were identified. The proportions of natives and migrants among the COVID-19-related deaths (97.5% and 2.5%, respectively) were similar to the relative all-cause mortality rates estimated in Italy in 2018 (97.4% and 2.6%, respectively). The clinical phenotype of migrants dying with COVID-19 was similar to that of natives except for the younger age at death. International migrants living in Italy do not have a mortality advantage for COVID-19 and are exposed to the risk of poor outcomes as their native counterparts.
Subject(s)
Betacoronavirus , Coronavirus Infections/mortality , Pandemics , Pneumonia, Viral/mortality , Transients and Migrants/statistics & numerical data , Adult , Age Distribution , Aged , Aged, 80 and over , Albania/ethnology , COVID-19 , Cardiovascular Diseases/epidemiology , Cause of Death , Comorbidity , Diabetes Mellitus, Type 2/epidemiology , Female , France/ethnology , Healthy Worker Effect , Hospital Records , Humans , Italy/epidemiology , Male , Middle Aged , Mortality/ethnology , Neoplasms/epidemiology , Obesity/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Renal Insufficiency, Chronic/epidemiology , SARS-CoV-2ABSTRACT
OBJECTIVE: Systemic lupus is a chronic autoimmune disease characterised by its phenotypic heterogeneity. Neutropaenia is a frequent event in SLE occurring in 20%-40% of patients depending on the threshold value of neutrophil count. On a daily basis, the management of neutropaenia in SLE is difficult with several possible causes. Moreover, the infectious consequences of neutropaenia in SLE remain not well defined. METHODS: 998 patients from the Lupus BioBank of the upper Rhein (LBBR), a large German and French cohort of patients with SLE, mostly of Caucasian origin (83%), were included in this study. Neutropaenia was considered when neutrophil count was below 1800×106/L. An additional analysis of detailed medical records was done for 65 LBBR patients with neutropaenia. RESULTS: 208 patients with neutropaenia (21%) were compared with 779 SLE patients without neutropaenia. Neutropaenia in SLE was significantly associated with thrombocytopaenia (OR 4.11 (2.57-10.3)), lymphopaenia (OR 4.41 (2.51-11.5)) and low C3 (OR 1.91 (1.03-4.37)) in multivariate analysis. 65 representative patients with neutropaenia were analysed. Neutropaenia was moderate to severe in 38%, chronic in 31%, and both severe and chronic in 23% of cases. Moderate to severe and chronic neutropaenia were both associated with lymphopaenia and thrombopaenia. Chronic neutropaenia was also associated anti-Ro/SSA antibodies and moderate to severe neutropaenia with oral ulcers. CONCLUSION: This study is to date the largest cohort to describe neutropaenia in SLE. Neutropaenia displays a strong association with other cytopaenias, suggesting a common mechanism. Chronic neutropaenia is associated with anti-Ro/SSA antibodies with or without identified Sjögren's disease.
Subject(s)
Lupus Erythematosus, Systemic/blood , Lupus Erythematosus, Systemic/complications , Neutropenia/etiology , Sjogren's Syndrome/blood , Adult , Antibodies, Antinuclear/blood , Autoimmune Diseases/complications , Case-Control Studies , Complement C3/immunology , Cross-Sectional Studies , Female , France/ethnology , Germany/ethnology , Humans , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/pathology , Lymphopenia/epidemiology , Male , Neutropenia/diagnosis , Sjogren's Syndrome/complications , Thrombocytopenia/epidemiologyABSTRACT
BACKGROUND: Through various research lead in the past, it has been made evident that Quebec is home to higher rates of acute myocardial infarction (AMI) and higher prevalence of cardiovascular risk factors than other Canadian provinces. This proposed study will perform a retrospective analysis on Caucasian populations in order to analyze the cardiovascular risk factors in partially francophone populations in comparison to French and Non-French Canadians. Furthermore, we will closely analyze both genders of aforementioned populations. METHODS: This population-based retrospective cohort study was achieved using the University of Ottawa Heart Institute CCTA registry. Included are Caucasian patients of all ages who came to UOHI for a CCTA between 2006 and 2018 and provided written informed consent. SPSS was used to compare the different populations (French Canadian, partially French Canadian and non-French Canadian) and sex. RESULTS: The PFC population more closely resembles FC, having higher incidence of cardiovascular risk factors such as smoking, dyslipidemia and type 2 diabetes. INTERPRETATION: Our results suggest that PFC, like FC, may benefit from more intensive education and lifestyle modification techniques.
Subject(s)
Heart Disease Risk Factors , Canada/epidemiology , Computed Tomography Angiography , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/ethnology , Disease Susceptibility , Dyslipidemias/epidemiology , Dyslipidemias/ethnology , Female , France/ethnology , Humans , Male , Middle Aged , Myocardial Infarction/epidemiology , Myocardial Infarction/ethnology , Prevalence , Quebec/epidemiology , Registries , Retrospective Studies , Risk Factors , Sex Factors , Smoking/epidemiology , Smoking/ethnology , White PeopleABSTRACT
BACKGROUND: High HIV-1 DNA levels in peripheral blood mononuclear cells (PBMC) were associated with a higher risk of severe morbidity and a faster decline in CD4 count in ART-naive patients. We report the association between HIV-1 DNA and mortality in HIV-infected adults in a trial of early ART in West Africa. METHODS: In the Temprano trial, HIV-infected adults were randomly assigned to start ART immediately or defer ART. After trial termination, HIV-1 DNA was measured in whole blood samples frozen at baseline. We analyzed the association between baseline PBMC HIV-1 DNA and long-term mortality. FINDINGS: 2019 patients were followed for 9253 patient-years (median 4.9 years). At baseline, the median CD4 count was 462/mm3 [IQR 368-571], the median plasma HIV-1 RNA 4.7 log10 copies/ml [IQR 4.0-5.2], and the median HIV-1 DNA 2.9 log10 copies/million PBMC [IQR 2.5-3.3]. During follow-up, 86 participants died. In univariate analysis, the hazard ratio [HR] of death was 2.67 (95% CI, 1.68-4.22) for patients with HIV-1 DNA ≥3 log10 copies/million PBMC vs. others, and 2.10 (95% CI, 1.38-3.21) for patients with HIV-1 RNA ≥5 log10 copies/ml vs. others. In multivariate Cox regression analysis, HIV-1 DNA levels ≥3 log10 copies/million PBMC were strongly associated mortality (adjusted HR = 2.09, 95% CI 1.24-3.52, p= 0.005) while the association between baseline plasma HIV-1 RNA and mortality was not significant. INTERPRETATION: In these African adults who started ART with high CD4 counts, HIV-1 DNA was a strong independent predictor of death. The HIV reservoir still plays a prognostic role in the early ART era. FUNDING: This trial was supported by the French National Agency for AIDS and viral hepatitis research (ANRS, Paris, France; Grants ANRS 12136, 12224 and 12253).
Subject(s)
Anti-HIV Agents/therapeutic use , DNA, Viral/genetics , HIV Infections/mortality , HIV-1/genetics , Adult , Anti-HIV Agents/pharmacology , Antiretroviral Therapy, Highly Active , Black People/statistics & numerical data , CD4 Lymphocyte Count , Female , France/ethnology , HIV Infections/drug therapy , HIV Infections/virology , HIV-1/drug effects , Humans , Leukocytes, Mononuclear/virology , Male , Risk Factors , Survival Analysis , Treatment Outcome , Viral LoadABSTRACT
BACKGROUND: Nucleotide triphosphate diphosphatase (NUDT15) genetic testing in addition to thiopurine methyl transferase (TPMT) is recommended to reduce the incidence of adverse severe myelotoxicity episodes induced by thiopurines. OBJECTIVE: We assessed the cost-effectiveness ratio of combined screening for TMPT and NUDT15 defective alleles by genotyping or next-generation sequencing (NGS) using TPMT genotyping as the reference. Because of the genetic differences in thiopurine toxicity, we tested the screening strategies on individuals of Caucasian and Asian descent. METHODS: A decision tree compared conventional TPMT genotyping with combined TPMT/NUDT15 genotyping or NGS using a Monte-Carlo microsimulation model of patients with inflammatory bowel disease. The main outcome was the incremental cost-effectiveness ratios (ICER) with effectiveness being one averted severe myelotoxicity requiring hospitalization. RESULTS: The mean estimated cost of the TPMT genotyping for one year is twice in Asian compared with Caucasian patients (980 euro/patient versus 488 euro/patient), and the effectiveness of TPMT genotyping in Caucasian avoided 43 severe myelosuppressions per 10 000 patients over a year compared with 3.6 per 10 000 patients in Asian. Combined TPMT/NUDT15 genotyping compared with TPMT genotyping had an ICER of 7 491 281 euro per severe myelotoxicity averted in Caucasian, compared to 619 euro in Asian. The ICER of the NGS-based screening strategy is disproportionally high compared with genotyping, irrespective of ethnic descent. CONCLUSION: With a low cost-effectiveness threshold, combined screening for NUDT15 and TPMT defective alleles is cost-effective compared to TMPT screening alone in patients of Asian descent, but is unrealistic from a cost-effectiveness point of view in Caucasians.
Subject(s)
Azathioprine/adverse effects , Bone Marrow Diseases/diagnosis , Drug Hypersensitivity/diagnosis , Genotyping Techniques/economics , Inflammatory Bowel Diseases/drug therapy , Methyltransferases/genetics , Pyrophosphatases/deficiency , Asian People/genetics , Azathioprine/pharmacokinetics , Bone Marrow Diseases/chemically induced , Bone Marrow Diseases/genetics , Cost-Benefit Analysis , Decision Trees , Drug Hypersensitivity/genetics , France/ethnology , Genotyping Techniques/methods , High-Throughput Nucleotide Sequencing/economics , Humans , Inflammatory Bowel Diseases/genetics , Monte Carlo Method , Sequence Analysis, DNA/economics , White People/geneticsABSTRACT
BACKGROUND: Cervical cancer associated with high risk-human papillomavirus (HR-HPV) infection is becoming the one of the most common female cancer in many sub-Saharan African countries. First-generation immigrant African women living in Europe are at-risk for cervical cancer, in a context of social vulnerability, with frequent lack of cervical cancer screening and HPV vaccination. OBJECTIVE: Our objective was to address immunologically the issue of catch-up prophylactic HPV vaccination in first-generation African immigrant women living in France. METHODS: IgG immune responses and cross-reactivities to α7 (HPV-18, -45 and -68) and α9 (HPV-16, -31, -33, -35, -52 and -58) HPV types, including 7 HR-HPV targeted by the Gardasil-9® prophylactic vaccine, were evaluated in paired serum and cervicovaginal secretions (CVS) by HPV L1-virus-like particles-based ELISA. Genital HPV were detected by multiplex real time PCR (Seegene, Seoul, South Korea). RESULTS: Fifty-one immigrant women (mean age, 41.7 years; 72.5% HIV-infected) were prospectively included. More than two-third (68.6%) of them carried genital HPV (group I) while 31.4% were negative (group II). The majority (90.2%) exhibited serum IgG to at least one α7/α9 HR-HPV. Serum HPV-specific IgG were more frequently detected in group I than group II (100% versus 68.7%; P = 0.002). The distribution of serum and genital HPV-specific IgG was similar, but mean number of IgG reactivities to α7/α9 HR-HPV was higher in serum than CVS (5.6 IgG per woman in serum versus 3.2 in CVS; P<0.001). Rates of IgG cross-reactivities against HPV different from detected cervicovaginal HPV were higher in serum and CVS in group I than group II. Finally, the majority of groups I and II women (68.6% and 68.7%, respectively) exhibited serum or cervicovaginal IgG to Gardasil-9® HR-HPV, with higher mean rates in group I than group II (6.1 Gardasil-9® HR-HPV per woman versus 1.4; P<0.01). One-third (31.2%) of group II women did not show any serum and genital HPV-specific IgG. CONCLUSIONS: Around two-third of first-generation African immigrant women living in France showed frequent ongoing genital HPV infection and high rates of circulating and genital IgG to α7/α9 HPV, generally cross-reacting, avoiding the possibility of catch-up vaccination. Nevertheless, about one-third of women had no evidence of previous HPV infection, or showed only low levels of genital and circulating HR-HPV-specific IgG and could therefore be eligible for catch-up vaccination.
Subject(s)
Antibodies, Viral/metabolism , Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/immunology , Papillomavirus Infections/diagnosis , Uterine Cervical Neoplasms/virology , Adult , Africa South of the Sahara/ethnology , Antibodies, Viral/blood , Cervix Uteri/immunology , Early Detection of Cancer , Emigrants and Immigrants/statistics & numerical data , Female , France/ethnology , Human papillomavirus 16/immunology , Human papillomavirus 18/immunology , Humans , Middle Aged , Papillomavirus Infections/immunology , Uterine Cervical Neoplasms/immunology , Vagina/immunologySubject(s)
Follicular Cyst/diagnosis , Military Personnel , Neoplasms, Basal Cell/diagnosis , Skin Neoplasms/diagnosis , Warfare , Follicular Cyst/diagnostic imaging , France/ethnology , Humans , Male , Mali , Neoplasms, Basal Cell/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Young AdultABSTRACT
The anthropological part of the present research project addresses the issue of risk and uncertainties relating to perinatality and disability, and draws from the discourses of professionals in a perinatal network in the French Lorraine region. From an anthropological point of view, it is necessary to determine how and to what extent the views of professionals determine the network's management policies. The place conferred to 'the user' in these representations is one of several important issues to be analysed in order to gain better understanding of the management of relationships that result from it. What is the position of professionals who 'negotiate' and 'organise' the cost of the risk of disability when grasped in connection with their images of the 'users' (children and parents)? This qualitative study consisted of 40 semi-structured interviews conducted with 20 medical, social, and community professionals, all involved directly or indirectly with the network. The results demonstrate the importance of a network assessment as a 'culture' from the social and cultural relations of network professionals. These relations form the cement of a structure made of interpersonal ties and rooted in particular histories around a 'user' that are conveyed through individual narratives.
Subject(s)
Disabled Persons , Health Personnel , Perinatal Care , Risk Assessment/ethnology , Anthropology, Medical , Child , Community Networks , Female , France/ethnology , Humans , Interviews as Topic , Pregnancy , Qualitative ResearchABSTRACT
Evolutionary medicine proposes studying alcohol use and abuse through the lens of modern evolutionary theory. This study ( https://osf.io/p48 uw/) follows this approach and uses an evolutionary framework to predict how young adults (18-35 years old) form impression of a binge drinker. We predicted that displaying sexual dysfunctions (short-term risk) in a binge drinking video would negatively influence attitudes and expectations of a target when compared to cognitive (short-term risk) or long-term deficits. In the following studies, we use a Zahavian framework to understand and influence impression formation of a male binge drinker among women (intersexual selection) and men (intrasexual competition) participants in a subsequent task. Via a randomized experimental online study in France (N = 177, M = 23.39 [4.91], 43.50% men) and a preregistered conceptual replication study in Peru (N = 176, M = 25.61 [4.76], 53.41% men), women exposed to a binge drinking video-describing sexual impotence after a binge drinking episode-tended to downgrade attractiveness evaluation of the binge drinker. However, male participants were not impacted by the different types of signals displayed in the videos. These results show that evolutionary theory could help us understand impression formation in binge drinking context and call for gender-specific health messages.
Subject(s)
Binge Drinking/ethnology , Cross-Cultural Comparison , Health Knowledge, Attitudes, Practice/ethnology , Sexual Behavior/ethnology , Social Perception , Adolescent , Adult , Binge Drinking/complications , Biological Evolution , Erectile Dysfunction/chemically induced , Female , France/ethnology , Humans , Male , Peru/ethnology , Sex Factors , Young AdultABSTRACT
About 10-20% of patients with Kawasaki disease (KD) are unresponsive to intravenous immunoglobulin (IVIg) and are at increased risk of coronary artery abnormalities (CAAs). Early identification is critical to initiate aggressive therapies, but available scoring systems lack sensitivity in non-Japanese populations. We investigated the accuracy of 3 Japanese scoring systems and studied factors associated with IVIg unresponsiveness in a large multiethnic French population of children with KD to build a new scoring system. Children admitted for KD between 2011-2014 in 65 centers were enrolled. Factors associated with second line-treatment; i.e. unresponsiveness to initial IVIg treatment, were analyzed by multivariate regression analysis. The performance of our score and the Kobayashi, Egami and Sano scores were compared in our population and in ethnic subgroups. Overall, 465 children were reported by 84 physicians; 425 were classified with KD (55% European Caucasian, 12% North African/Middle Eastern, 10% African/Afro-Caribbean, 3% Asian and 11% mixed). Eighty patients (23%) needed second-line treatment. Japanese scores had poor performance in our whole population (sensitivity 14-61%). On multivariate regression analysis, predictors of secondary treatment after initial IVIG were hepatomegaly, ALT level ≥30 IU/L, lymphocyte count <2400/mm3 and time to treatment <5 days. The best sensitivity (77%) and specificity (60%) of this model was with 1 point per variable and cut-off ≥2 points. The sensitivity remained good in our 3 main ethnic subgroups (74-88%). We identified predictors of IVIg resistance and built a new score with good sensitivity and acceptable specificity in a non-Asian population.
Subject(s)
Immunoglobulins, Intravenous/therapeutic use , Mucocutaneous Lymph Node Syndrome/immunology , Mucocutaneous Lymph Node Syndrome/therapy , Pediatrics/standards , Child , Child, Preschool , Drug Resistance , Ethnicity , Female , France/ethnology , Humans , Infant , Male , Mucocutaneous Lymph Node Syndrome/ethnology , Multivariate Analysis , Prospective Studies , Reproducibility of Results , Retrospective Studies , Risk Assessment , Risk Factors , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
OBJECTIVE: Haptoglobin is an acute-phase reactant with pleiotropic functions. We aimed to study whether urine haptoglobin may predict risk of mortality in people with type 2 diabetes. RESEARCH DESIGN AND METHODS: We employed a transethnic approach with a cohort of Asian origin (Singapore) (N = 2,061) and a cohort of European origin (France) (N = 1,438) included in the study. We used survival analyses to study the association of urine haptoglobin with risk of all-cause and cause-specific mortality. RESULTS: A total of 365 and 525 deaths were registered in the Singapore cohort (median follow-up 7.5 years [interquartile range 3.5-12.8]) and French SURDIAGENE cohort (median follow-up 6.8 years [interquartile range 4.3-10.5], respectively. Singapore participants with urine haptoglobin in quartiles 2 to 4 had higher risk for all-cause mortality compared with quartile 1 (unadjusted hazard ratio [HR] 1.47 [95% CI 1.02-2.11], 2.28 [1.62-3.21], and 4.64 [3.39-6.35], respectively). The association remained significant in quartile 4 after multiple adjustments (1.68 [1.15-2.45]). Similarly, participants in the French cohort with haptoglobin in quartile 4 had significantly higher hazards for all-cause mortality compared with quartile 1 (unadjusted HR 2.67 [2.09-3.42] and adjusted HR 1.49 [1.14-1.96]). In both cohorts, participants in quartile 4 had a higher risk of mortality attributable to cardiovascular disease and infection but not malignant tumor. CONCLUSIONS: Urine haptoglobin predicts risk of mortality independent of traditional risk factors, suggesting that it may potentially be a novel biomarker for risk of mortality in patients with type 2 diabetes.
Subject(s)
Diabetes Mellitus, Type 2/ethnology , Diabetes Mellitus, Type 2/mortality , Diabetes Mellitus, Type 2/urine , Haptoglobins/urine , Adult , Aged , Biomarkers/urine , Cardiovascular Diseases/complications , Cardiovascular Diseases/ethnology , Cardiovascular Diseases/mortality , Cardiovascular Diseases/urine , Cause of Death , Cohort Studies , Cross-Cultural Comparison , Diabetes Mellitus, Type 2/complications , Diabetic Angiopathies/diagnosis , Diabetic Angiopathies/ethnology , Diabetic Angiopathies/mortality , Diabetic Angiopathies/urine , Female , Follow-Up Studies , France/ethnology , Humans , Male , Middle Aged , Prognosis , Singapore/ethnology , Survival AnalysisABSTRACT
BACKGROUND: Uterine leiomyoma has been reported to be a worse problematic disease for African American than Caucasian women in the US. Data are almost non-existent for other populations of African ancestry. Our aim was to investigate the hypothesis of an equivalent influence of ethnicity on uterine leiomyomas for women of a French African-Caribbean population. BASIC PROCEDURES: Retrospective analysis of hysterectomies performed from 2010 to 2015 at the teaching hospital of Guadeloupe (French West Indies), where most inhabitants are of West African origin, was carried out. Data of the 899 hysterectomies, including those for malignancy, were collected, in particular, uterine weight. MAIN FINDINGS: The indications were leiomyoma in 66.5 % of cases and leiomyomas were found in 91 % of all cases. The mean age and uterine weight were 51.7 years and 464 g for the entire population, 50.2 years and 488 g for the population without malignancies, and 47.0 years and 567 g for the population with leiomyomas. PRINCIPAL CONCLUSIONS: The data were compared to those reported in the literature for several populations, notably African Americans and Caucasians in the US and mainland France. This comparison supports the hypothesis that Guadeloupean women, an African-Caribbean population, have characteristics in terms of uterine leiomyoma that are close to those of African Americans. Although confirmation is required, these results highlight the need for specific research, therapeutic approaches, and improved early management of these populations.
Subject(s)
Black or African American/ethnology , Hysterectomy , Leiomyoma/ethnology , Leiomyoma/surgery , Uterine Neoplasms/ethnology , Uterine Neoplasms/surgery , Adult , Africa/ethnology , Caribbean Region/ethnology , Female , France/ethnology , Guadeloupe/ethnology , Humans , Retrospective Studies , United States/ethnology , White People/ethnologyABSTRACT
Despite being the fourth largest island in the Mediterranean basin, the genetic variation of Corsica has not been explored as exhaustively as Sardinia, which is situated only 11 km South. However, it is likely that the populations of the two islands shared, at least in part, similar demographic histories. Moreover, the relative small size of the Corsica may have caused genetic isolation, which, in turn, might be relevant under medical and translational perspectives. Here we analysed genome wide data of 16 Corsicans, and integrated with newly (33 individuals) and previously generated samples from West Eurasia and North Africa. Allele frequency, haplotype-based, and ancient genome analyses suggest that although Sardinia and Corsica may have witnessed similar isolation and migration events, the latter is genetically closer to populations from continental Europe, such as Northern and Central Italians.