Opportunistic testing for urogenital infection with Chlamydia trachomatis in south-western Switzerland, 2012 : a feasibility study

The feasibility of opportunistic screening of urogenital infections with Chlamydia trachomatis was assessed in a cross-sectional study in 2012, in two cantons of south-western Switzerland: Vaud and Valais. Sexually active persons younger than 30 years, not tested for C. trachomatis in the last three months, were invited for free C. trachomatis testing by PCR in urine or self-applied vaginal swabs. Of 2,461 consenting participants, 1,899 (77%) were women and all but six (0.3%) submitted a sample. Forty-seven per cent of female and 25% of male participants were younger than 20 years. Overall, 134 (5.5%) of 2,455 tested participants had a positive result and were followed up. Seven per cent of all candidates for screening were not invited, 10% of invited candidates were not eligible, 15% of the eligible candidates declined participation, 5% of tested participants testing positive were not treated, 29% of those treated were not retested after six months and 9% of those retested were positive for C. trachomatis. Opportunistic C. trachomatis testing proved technically feasible and acceptable, at least if free of charge. Men and peripheral rural regions were more difficult to reach. Efforts to increase testing and decrease dropout at all stages of the screening procedure are necessary.

Carte topographique de la route du Simplon entre Brieg et Domo d'Ossola / dressée par Ch[ar]les Picquet, géographe ord[inai]re du roi et de S.A.R m[onsei]g[neu]r le duc d'Orléans

Échelle(s) : 1:100 000

Evolution of Y chromosomes : lessons from mammals and amphibians

RÉSUMÉ : Le sexe des individus peut être déterminé par l'environnement ou la génétique. Lorsque la détermination du sexe est génétique, il y a dans le génome, la présence de chromosomes spécifiques qui détermineront le sexe. Dans cette thèse, j'ai étudié l'évolution des chromosomes sexuels et dans quel contexte des marqueurs sur ces chromosomes peuvent être utilisés. Pour explorer la formation du chromosome Y, nous avons étudié les caractéristiques des chromosomes sexuels chez la rainette verte, Hyla arborea. Dans un premier temps, nous avons utilisé un marqueur situé sur les chromosomes sexuels X et Y chez plusieurs espèces appartenant au groupe de la rainette verte. Cela nous a permis de révéler chez toutes ces espèces une hétérogamétie mâle. Dans un deuxième temps, nous avons tiré profit de deux autres marqueurs situés sur les chromosomes sexuels pour montrer que la recombinaison est supprimée chez les mâles mais pas chez les femelles. Pour expliquer la réduction de la variabilité sur le chromosome Y, il n'est pas nécessaire d'invoquer le balayage sélectif ou la sélection d'arrière-plan : le nombre de copies plus petit du chromosome Y dans le génome et l'absence de recombinaison suffisent à l'expliquer. Nous avons également analysé plus en détail la suppression de la recombinaison chez les mâles de H. arborea. Les modèles classiques de l'évolution des chromosomes sexuels supposent que la taille de la région non-recombinante augmente progressivement pendant l'évolution du chromosome Y, due à l'accumulation de changements structuraux. Dans cette étude, nous montrons un modèle différent, à savoir que la recombinaison est supprimée ou diminuée non seulement sur les chromosomes sexuels mais aussi sur les autosomes chez les mâles, dû à l'action de modificateurs généraux. En utilisant des marqueurs localisés sur le chromosome Y, ainsi que sur l'ADN mitochondrial et le chromosome X, nous avons étudié l'histoire évolutive de la musaraigne musette, Crocidura russula. Cette étude illustre que les analyses génétiques avec plusieurs types de marqueurs génétiques peuvent faciliter l'interprétation de l'histoire évolutive des espèces, mais que l'utilisation des marqueurs sur les chromosomes X et Y pour des études phylogéographiques est limitée par le peu de polymorphisme observé sur ces deux types de marqueurs. Le même jeu de données combiné avec des simulations a été employé pour comprendre les facteurs responsables de la faible variabilité sur le chromosome Y qui peut être expliqué, dans notre étude, par la démographie et les traits d'histoire de vie de C. russula. SUMMARY The sex of an individual is determined either by its environment or its genetics. Genetic sex determination relies on the presence of specific chromosomes that will determine the sex of their bearer. In this thesis, I studied the evolution of the sex chromosomes and the context in which markers on this type of chromosomes can be used. To explore the evolution of a Y chromosome, we studied the nascent sex chromosomes in the European tree frog Hyla arborea. First; we amplified a sex specific marker in several related species of European tree frog and found a homogeneous pattern of male heterogamety. Secondly, we used two additional sex-specific markers to show that recombination is suppressed in males but not in females. There is, therefore, no need to invoke background selection or selective sweeps to explain the reduced genetic variability on the Y chromosome, because the lower number of copies of the Y chromosomes per breeding pair and the absence of recombination are sufficient. To further analyze the suppression of recombination in male European. tree frogs, we constructed a microsatellite linkage map for this species. Classical models of sex-chromosome evolution assume that the non-recombining region expands progressively during the long-term evolution of the Y chromosome, owing to the accumulation of structural changes. Here we show a strikingly different pattern: recombination is suppressed or depressed both on sex chromosomes and autosomes in the heterogametic sex, presumably due to the action of general modifiers. We investigated the evolutionary history of the greater white-toothed shrew, Crocidura russula, using markers on both sex chromosomes and mtDNA. This study illustrates that multilocus genetic analyses facilitates the interpretation of a species' evolutionary history. It also demonstrates that phylogeographic inferences from X and Y chromosomal markers are restricted by the low levels of observed polymorphism. Combining this genetic study with simulations, we determined that the demography and the life-history traits of this species can alone be responsible for the low Y diversity. In conclusion, this thesis shows that sex chromosomes, in combination with autosomes or mtDNA, are necessary to understand the evolution of sex chromosomes and to precisely infer the population history of a species.

Analyse systémique et prospective des usages de l'eau dans la région de Crans-Montana-Sierre (Suisse)

Crans-Montana-Sierre is a tourist area locateci in Rhone valley in central Valais, cha-racterized by dry climate and scarce summer precipitations. More than other regions in Switzerland, this area has suffered the effects of the drought (heat wave) that affec¬ted all Western Europe during summer 2003. In the future, climate change together with societal and economic development will signicantly modify the water need of the region and, consequently, may increase the potential conflicts of interest. Within a long term planning strategy, decision-makers require precise information about the current amount of water needed in the region, with particular attention to temporal and spatial concentration, and the forecasted amount for 2050. This work therefore aims at estimating the variation of the water demand by taking into account the influence of climate change (CH2011) and socio-economic scenarios, developed in cooperation with the competent authorities. This thesis, whose aim is to study the water management and water uses is a core part of the MontanAqua project "Water management in times of scarcity and global change" mainly because of its interdisciplinary topic at the interface between water resources, land development and the socio-political structure. Results show that socio-economic development by 2050 could have a greater impact than expected climate changes (CH2011, A1B scenarios) for the same time horizon for water demand. Demography, spatial planning, tourism and economic development are just some of the factors that could significantly affect the water consumption of the Crans-Montana-Sierre region. Compared with the future water resources available, the maximal water demand forecasted by the socio-economic scenarios developed within the project MontanAqua, could not always be satisfied. This issue, like extreme climate phenomena (as it was the summer drought occurred in 2003 or in April / May 2011), could be mitigated adopting regional management policies relating to a more rational water use and preventive storage of water resource. - Crans-Montana-Sierre est une région touristique située dans la vallée du Rhône; dans le Valais central, qui se caractérise par un climat relativement pauvre en précipitations et qui plus que d'autres a subi les effets de la sécheresse qui a touché l'Europe occidentale durant l'été 2003. À l'avenir, les changements climatiques ainsi que le développement socio-économique modifieront de manière significative les besoins en eau de la région, ce qui risque de faire augmenter les rivalités d'usage concernant cette ressource. Afin de jouer à l'avance, les décideurs ont besoin d'informations précises sur la quantité d'eau nécessaire à la région, avec une attention particulière à sa concentration temporelle et spatiale, à l'heure actuelle et à l'horizon 2050. Ce travail vise donc à estimer la variation de la demande en eau en tenant compte de l'influence des changements climatiques (CH2011) et des scénarios socio-économiques, élaborés en collaboration avec les autorités compétentes. Cette thèse, qui met l'accent sur les usages de l'eau fait partie du projet Montan Aqua « Gestion de l'eau en temps de pénurie et de changement global », est à l'intersection entre les ressources hydriques, l'aménagement du territoire et son organisation socio-politique, fait qui la met, non pas par son importance, mais par son emplacement et ses interconnexions, au coeur de cette recherche. Les résultats obtenus montrent comment les développements socio-économiques d'ici à 2050 ont un impact potentiellement plus important que les changements climatiques prévus par les scénarios AlB de CH2011 pour le même horizon temporel sur la demande en eau. Démographie, aménagement du territoire et contexte économico-touristique, ne sont que quelques-uns des facteurs qui ont la capacité d'agir significativement sur les usages de l'eau en ce qui concerne les aspects qualitatif et quantitatif de la région de Crans-Montana-Sierre. Par rapport aux ressources en eau disponibles à l'avenir, la demande maximale d'eau prévue par les scénarios socio-économiques développés au sein du projet MontanAqua risque de ne pas être toujours satisfaite. Ce danger et la manifestation de phénomènes climatiques extrêmes, comme la sécheresse estivale survenue en 2003 ou celle d'avril/mai 2011, ne pourront être atténués que par l'adoption de politiques de gestion à l'échelle régionale favorisant une utilisation plus rationnelle et un stockage préventif de la ressource en eau.

Shrews in suburbia: an application of Goodman's extinction model

An equation is applied for calculating the expected persistence time of an unstructured population of the white-toothed shrew Crocidura russula from Preverenges, a suburban area in western Switzerland. Population abundance data from March and November between 1977 and 1988 were fit to the logistic density dependence model to estimate mean population growth rate as a function of population density. The variance in mean growth rate was approximated with two different models. The largest estimated persistence time was less than a few decades, the smallest less than 10 years. The results are sensitive to the magnitude of variance in population growth rate. Deviations from the logistic density dependence model in November are quite well explained by weather variables but those in March are uncorrelated with weather variables. Variability in population growth rates measured in winter months may be better explained by behavioural mechanisms. Environmental variability, dispersal of juveniles and refugia within the range of the population may contribute to its long-term survival.

Breast cancer incidence in younger swiss women

Background Breast cancer in younger women has received increased attention in recent years. Although breast cancer is uncommon in young women, it is the most frequent cancer and the leading cause of cancer death for younger women in developed countries. For Switzerland, the United States and several European countries, declines in breast cancer incidence have been reported since around the year 2000, after decades of increase, among women aged 50 and older. On the other hand an increase in the incidence of breast cancer in younger women has been reported in recent years. Therefore, this study aims to evaluate time trends in breast cancer incidence in younger women in Switzerland. Methods Data on invasive breast cancer cases were obtained from the Swiss Cancer Registries of Basel, Fribourg, Geneva, Graubunden/Glarus, Jura, Neuchatel, St. Gallen-Appenzell, Ticino, Valais, Vaud and Zurich, covering the time period 1996 to 2009. Mid-year population estimates for the respective time period were supplied by the Swiss Federal Statistical Office. For females aged 20-49 years, annual age-standardized incidence rates (ASIRs) (European standard) per 100,000 person-years and corresponding 95%-confidence intervals (95% CI) were calculated. For females aged 20-39 and 40-49 years, ASIRs and incidence rate ratios (IRRs) were calculated by grouped time periods, consisting of 3-5 incidence years. IRRs and corresponding 95% CI were calculated using Poisson regression adjusting for age (reference period 1996-2000). Results ASIRs in females aged 20-49 increased gradually since 1996, being 57.36 per 100,000 person-years in 1996 (95% CI 52.54-62.51) and rising to 68.34 (95% CI 63.40-73.57) per 100,000 person-years in 2009. Comparing the time-period 2007-2009 and the reference period 1996-2000, IRRs show values of 1.17 (95% CI 1.04-1.31) for the age-group 20-39 years and 1.04 (95% CI 0.97-1.10) for the age-group 40-49 years. Conclusions Our findings confirm a slight increase in the incidence of invasive breast cancer in younger women in Switzerland during the period 1996-2009. An increase in breast cancer incidence in younger patients is an important public health problem. It warrants further investigations to identify specific risk factors of this population and to better understand the biology of this particular breast cancer.

Réponses de la musaraigne musette Crocidura russula, aux marquages odorants d'individus de son espèce (Insectivota, Soricidae)

In order to evaluate the reaction to conspecifics scent tracks of Crocidura russula, a shrew with poorly developped territorial behaviour, simple choice tests in a Y-shaped systems were used. C. russula prefers a marked path to an unmarked one, the tracks of an unknown individual to its own, the tracks of an individual of the opposite sex to those of an individual of the same sex, and the tracks of its sexual partner to those of another individual of the same sex. The choices between two tracks gave a less obvious result than the choices between a marked path and an unmarked one. Ecological and social implications of these results are discussed.

Developpement et application du moniteur de tabagisme passif MoNIC

A passive sampling device, called Monitor of NICotine (MoNIC), was constructed and evaluated by the laboratory of the Institute for Work and Health to determine nicotine in Environmental Tobacco Smoke (ETS). To support a large campaign on the subject of passive smoking, the CIPRET Valais gracefully distributed more than 1500 MoNIC badges to the Swiss population in order to measure ETS. Non-stimulated saliva was also collected to determine nicotine/cotinine levels of participating volunteers. The inhaled Cigarette Equivalents (CE) by non-smokers was calculated for non-smokers, based on a reference of 0.2 mg of nicotine per cigarette. Using the detected CE on the badge for non-smokers, and comparing it to the nicotine/cotinine levels in saliva, we could confirm the use of the CE concept for estimating exposure to ETS

Attitudes towards morphine use among Swiss nurses and physicians

Background: There is little information regarding risk perception and attitudes on morphine use in Switzerland. Objectives: We aimed at assessing such attitudes in a sample of health professionals in the French-speaking part of Switzerland. Study design: Cross-sectional study. Setting: five non-university hospitals of the French-speaking canton of Valais, Switzerland. Methods: 431 nurses and 40 physicians (age range: 20-63). Risk perception and attitudes towards morphine use were assessed using a validated questionnaire. Results: Over half of participants showed a negative attitude regarding most adverse events related to morphine, while less than one third showed a similar attitude regarding other statements. On bivariate analyses, participants working in geriatrics showed a more negative attitude towards use of morphine than participants working in medicine and surgery. Non-Swiss participants also showed a more negative attitude than Swiss regarding use of morphine. Conversely, no differences were found between genders, profession (nurses or physicians), years of experience (<=14 and >14) and religion (catholic vs. others/no religion). These findings were further confirmed by multivariate adjustment. Limitations: possible selection bias due to responders only. Results limited to French speaking participants. Conclusion: Attitudes regarding morphine uses are mainly driven by its potential adverse effects and vary according to specialty and nationality. Educational measures directed at health professionals working in geriatrics or coming from abroad might reduce the high morphinophobia levels observed in these groups.

Variation in performance across Swiss mammography screening programmes: the influence of reading strategy and experience.

[Abstract] Reading volume and mammography screening performance appear positively correlated. Performance was compared across organised Swiss screening programmes, which target relatively small populations. Except for accreditation of 2nd readers radiologists (restrictive vs non-restrictive strategy), Swiss programmes have similar screening regimen/procedures and duration, which maximises comparability. Variation in performance was explored in order to improve mammography practice and optimise screening performance. Indicators of quality and effectiveness were evaluated for about 200,000 screens performed over 4 screening rounds in the 3 longest-standing Swiss cantonal programmes (of Vaud, Geneva and Valais). Interval cancers were identified by linkage with cancer registries records. Most European standards of performance were met with a favourable cancer stage shift. Several performance indicators showed substantial variation across programmes. In subsequent rounds, compared with programmes (Vaud and Geneva) which accredited few 2nd readers to increase their individual reading volume, proportions of in situ lesions and of small cancers (? 1cm) were one third lower and halved, respectively, and the proportion of advanced lesions (stage II+) nearly 50% higher in the programme without a restrictive selection strategy. Discrepancy in second-year proportional incidence of interval cancers appears to be multicausal. Differences in performance could partly be explained by a selective strategy for 2nd readers and a prior experience in service screening, but not by the levels of opportunistic screening and programme attendance. This study provides clues for enhancing mammography screening performance in low-volume Swiss programmes.

The activity of Crocidura russula (Insectivora, Soricidae) in the field and in captivity

Studied was the activity of the shrew Crocidura russula in the field (by radioactive tracking) and in laboratory (by continuous recording of nest temperature and by video). Under natural conditions, the total daily activity remained nearly constant throughout the year accounting for about 33 % of the total time. Activity was polyphasic and showed a daily rhythm; on an average, one activity phases occured every two hours and lasted 36 min. The activity periods of captive shrews were generally shorter, but always more frequent, and the total daily activity of captive shrews was much lower in winter. Two experiments carried out in the filed on shrews artificially fed, demonstrated that under natural conditions, foraging takes a major part of the winter activity. The activity patterns of Crocidura russula are compared with those of another European shrew, Sorex araneus.

Performances radiologiques du programme valaisan de dépistage du cancer du sein : évolution et déterminants, 2002-12

[Résumé (extrait)] Lancé en octobre 1999, le Programme valaisan de dépistage du cancer du sein a pour mission de promouvoir, d'organiser et de mener une action de dépistage auprès de la population féminine valaisanne âgée de 50 à 70 ans. Ce programme est régulièrement évalué, de manière indépendante, afin de s'assurer que sa qualité et son efficacité répondent à des normes internationalement admises tout en minimisant ses effets adverses. Ces évaluations ont mis en évidence un niveau de performances globalement satisfaisant et suggéré un potentiel d'amélioration, notamment de la qualité des lectures radiologiques. Dans un souci d'optimiser les performances, la direction du Programme a mené ces dernières années plusieurs actions auprès de ses radiologues et pris quelques mesures. Ce rapport thématique traite de l'évolution des performances du programme, principalement au cours de la dernière décennie (2002-11), c'est-à-dire après sa phase de démarrage (1999-2001). Les tendances des principaux indicateurs de performance et leurs associations avec les actions et mesures réalisées, qui ont été répertoriées et classées selon leur types et objectifs, sont analysées. Les facteurs les plus influents sur la qualité des lectures radiologiques sont quantifiés de manière à faciliter toute décision interventionnelle. Les cancers d'intervalle (1999-2010) du Programme sont étudiés afin d'en apprécier la fréquence, d'en établir le profil pronostique et de déterminer les caractéristiques clinicoépidémiologiques qui les distinguent des cancers dépistés dans le cadre du Programme.

Confirmation biochimique du statut spécifique du mulot alpestre Apodemus alpicola Heinrich, 1952 (Mammalia, Rodentia)

Pour vérifier le statut spécifique d'Apodemus alpicola, 48 mulots de 11 localités ont été analysés par électrophorèse de protéines homologues, codés par 27 loci. Les résultats biochimiques confirment la présence de trois espèces de mulots dans la région du Vorarlberg (Autriche), soit A. sylvaticus, A.flavicollis et A. alpicola et certifient ainsi le statut spécifique de la dernière espèce. Les mêmes allozymes discriminants se retrouvent dans une population de mulots du Val d'Aoste, où A. alpicola est également en sympatrie avec les deux espèces. La présence d'A. alpicola en Suisse a été confirmée par l'analyse de spécimens de Bourg St-Bernard (Valais). Les critères de détermination morphologique, établis pour l'Autriche, ne sont que partiellement valables pour les populations occidentales.

Crocidura cossyrensis Contoli, 1989 (Mammalia, Soridiae): karyotype, biochemical genetics and hybridization experiments

Crocidura cossyrensis Contoli, 1989 (Mammalia, Soricidae): karyotype, biochemical genetics and hybridization experiments. - The shrew Crocidura cossyrensis Contoli, 1989 from Pantelleria (I), a Mediterranean island 100 km south of Sicily and 70 km west from Tunisia, was investigated in order to understand its origin and its relationship with C. russula from Tunisia, Morocco and Switzerland. With the exception of a single heterozygote centric fusion, C. cossyrensis had a karyotype identical with that of C russula from Tunisia (2N = 42, NF = 70 to 72), but it differed from C russula from Morocco and Switzerland (2N = 42, NF = 60). The former have 5-6 pairs of chromosomes with small arms that are acrocentric in the latter. Genetic comparisons with allozyme data revealed small genetic distance (0.04) between C cossyrensis and C russula from Tunisia. In contrast, this eastern clade (Tunisia and Pantelleria) is separated from the western clade (Switzerland and Morocco) by a genetic distance of 0.14. A hybridization experiment between shrews from Pantelleria and Switzerland lead rapidly to an F1 generation. From 12 F1 hybrids that were backcrossed, females reproduced normally, but none of the males did so. Concluding from the results, C. cossyrensis from Pantelleria and C. russula cf. agilis from Tunisia belong to the same taxon that may have reached the differentiation of a biological species within the C. russula group. More geographic samples are needed to determine the definitive taxonomic positions of these shrews.