Thérapie focale du cancer de la prostate: rationnel, résultats et perspectives [Focal therapy in prostate cancer: rationale, results and perspectives].

Focal therapy is a novel treatment strategy in prostate cancer aiming to treat only the area of the gland harbouring clinically significant disease. The overall objective is to maintain the oncological benefit of active treatment while minimising treatment-related morbidity. Leading centres are currently evaluating various minimally invasive technologies in a rigorous manner. Oncological and functional results in mid-term are encouraging with low rate of urinary incontinence and erectile dysfunction. However, the oncological outcome needs to be evaluated in the long-term in the light of the prolonged natural history of the disease.

Uncovering the genetic basis of adaptive change: on the intersection of landscape genomics and theoretical population genetics

A workshop recently held at the Ecole Polytechnique Federale de Lausanne (EPFL, Switzerland) was dedicated to understanding the genetic basis of adaptive change, taking stock of the different approaches developed in theoretical population genetics and landscape genomics and bringing together knowledge accumulated in both research fields. Indeed, an important challenge in theoretical population genetics is to incorporate effects of demographic history and population structure. But important design problems (e.g. focus on populations as units, focus on hard selective sweeps, no hypothesis-based framework in the design of the statistical tests) reduce their capability of detecting adaptive genetic variation. In parallel, landscape genomics offers a solution to several of these problems and provides a number of advantages (e.g. fast computation, landscape heterogeneity integration). But the approach makes several implicit assumptions that should be carefully considered (e.g. selection has had enough time to create a functional relationship between the allele distribution and the environmental variable, or this functional relationship is assumed to be constant). To address the respective strengths and weaknesses mentioned above, the workshop brought together a panel of experts from both disciplines to present their work and discuss the relevance of combining these approaches, possibly resulting in a joint software solution in the future.

El dialecte saxó:Presència escrita i prestigi social

El treball següent ofereix una visió global d'un dels dialectes de la llengua alemanya que menys ha estat objecte de recerca i investigació, el saxó, centrant-se en la presència escrita de què gaudeix aquesta varietat actualment i el seu prestigi social a Alemanya a través dels anys

Genes, environment and sex : perspectives from ectothermic vertebrates

RESUMELes modèles classiques sur l'évolution des chromosomes sexuels supposent que des gènes sexe- antagonistes s'accumulent sur les chromosomes sexuels, entraînant ainsi l'apparition d'une région non- recombinante, qui se répand progressivement en favorisant l'accumulation de mutations délétères. En accord avec cette théorie, les chromosomes sexuels que l'on observe aujourd'hui chez les mammifères et les oiseaux sont considérablement différenciés. En revanche, chez la plupart des vertébrés ectothermes, les chromosomes sexuels sont indifférenciés et il existe une impressionnante diversité de mécanismes de détermination du sexe. Au cours de cette thèse, j'ai étudié l'évolution des chromosomes sexuels chez les vertébrés ectothermes, en outre pour mieux comprendre ce contraste avec les vertébrés endothermes. L'hypothèse « high-turnover » postule que les chromosomes sexuels sont remplacés régulièrement à partir d'autosomes afin d'éviter leur dégénérescence. L'hypothèse « fountain-of-youth » propose que la recombinaison entre le chromosome X et le chromosome Y au sein de femelles XY empêche la dégénérescence. Les résultats de ma thèse, basés sur des études théoriques et empiriques, suggèrent que les deux processus peuvent être entraînés par l'environnement et ainsi jouent un rôle important dans l'évolution des chromosomes sexuels chez les vertébrés ectothermes.SUMMARYClassical models of sex-chromosome evolution assume that sexually antagonistic genes accumulate on sex chromosomes leading to a non-recombining region, which progressively expands and favors the accumulation of deleterious mutations. Concordant with this theory, sex chromosomes in extant mammals and birds are considerably differentiated. In most ectothermic vertebrates, such as frogs, however, sex chromosomes are undifferentiated and a striking diversity of sex determination systems is observed. This thesis was aimed to investigate this apparent contrast of sex chromosome evolution between endothermic and ectothermic vertebrates. The "high-turnover" hypothesis holds that sex chromosomes arose regularly from autosomes preventing decay. The "fountain-of-youth" hypothesis posits that sex chromosomes undergo episodic X-Y recombination in sex-reversed XY females, thereby purging ("rejuvenating") the Y chromosome. We suggest that both processes likely played an important role in sex chromosome evolution of ectothermic vertebrates. The literature largely views sex determination as a dichotomous process: individual sex is assumed to be determined either by genetic (genotypic sex determination, GSD) or by environmental factors (environmental sex determination, ESD), most often temperature (temperature sex determination, TSD). We endorsed an alternative view, which sees GSD and TSD as the ends of a continuum. The conservatism of molecular processes among different systems of sex determination strongly supports the continuum view. We proposed to define sex as a threshold trait underlain by a liability factor, and reaction norms allowing modeling interactions between genotypic and temperature effects. We showed that temperature changes (due to e.g., climatic changes or range expansions) are expected to provoke turnovers in sex-determination mechanisms maintaining homomorphic sex chromosomes. The balanced lethal system of crested newts might be the result of such a sex determination turnover, originating from two variants of ancient Y-chromosomes. Observations from a group of tree frogs, on the other hand, supported the 'fountain of youth' hypothesis. We then showed that low rates of sex- reversals in species with GSD might actually be adaptive considering joint effects of deleterious mutation purging and sexually antagonistic selection. Ongoing climatic changes are expected to threaten species with TSD by biasing population sex ratios. In contrast, species with GSD are implicitly assumed immune against such changes, because genetic systems are thought to necessarily produce even sex ratios. We showed that this assumption may be wrong and that sex-ratio biases by climatic changes may represent a previously unrecognized extinction threat for some GSD species.

Dépistage du cancer de la prostate: utilité, buts et perspectives en 2010 [Prostate cancer screening: utility, goals and perspectives in 2010].

According to recent results of a sub-group of 20,000 patients from the ERSPC study, prostate cancer screening significantly increases disease specific survival for men with a life expectancy of 15 years. However presently, only 20% of prostate biopsies lead to the diagnosis of cancer. This low yield may be increased by using new tools on their way to validation, such as the blood and urinary markers p2-PSA and PCA3, so as MRI and tridimensional computerized echography. Finally, the tumours detected must be managed with subtlety, since a third of them are not overtly aggressive clinically. Hence, a significant proportion of such tumours may not need immediate curative intent treatment, and can be followed up in an active surveillance protocol.

Perspectives tecnològiques: educació superior a Iberoamèrica 2012-2017

La sèrie d'informes Horizon és el resultat més tangible del Projecte Horizon del New Media Consortium, un esforç de recerca qualitativa iniciat el 2002, que identifica i descriu les tecnologies emergents amb més potencial d'impacte en l'ensenyament, l'aprenentatge, la recerca i la expressió creativa en l'àmbit educatiu global. Aquest volum, Perspectives tecnològiques: educació superior a Iberoamèrica 2012-2017, és la segona edició del Projecte Horizon Iberoamèrica i se centra en la investigació en els països de la regió Iberoamericana (incloent-hi tota Llatinoamèrica, Espanya i Portugal) i en l'àmbit de l'educació superior. Ha estat produït pel NMC i l'eLearn Center de la Universitat Oberta de Catalunya.

Noves perspectives en el diagnòstic del deteriorament cognitiu lleu i la malaltia de l'Alzheimer

Els criteris per al diagnòstic clínic de la malaltia d’Alzheimer es van establir el 1984 pel National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) i la Alzheimer’s Disease and Related Disorders Association (ADRDA). D’aplicació continuada fins a l’actualitat, aquests criteris estan quedant obsolets i per tant des de diversos àmbits s’ha abogat per una revisió profunda dels mateixos. Tres grups d’experts formats per reconeguts especialistes del National Institute on Aging (NIA) i la Alzheimer’s Association proposen un conjunt de recomanacions per modificar aquests criteris en l’àmbit de la investigació clínica. Dues diferències remarcables s’inclouen en aquests nous criteris: la incorporació de biomarcadors i la formalització de diferents estadis de la malaltia d’Alzheimer. D’aquesta manera, el deteriorament cognitiu lleu s’incorpora al procés diagnòstic com un estadi més de la patologia. Tanmateix, aquests criteris es troben en revisió i, de moment sols son aplicables en l’àmbit de recerca per tal d’arribar a un consens definitiu que permeti la modificació definitiva dels criteris clínics universals a aplicar. En aquest article es presenten els principals avenços en la investigació referents a la malaltia d’Alzheimer i al Deteriorament Cognitiu lleu per tal d’emmarcar els nous criteris de recerca.

Pulmonary involvement in Fabry disease: Overview and perspectives.

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by deficiency of alpha-galactosidase A, which leads to storage of sphingolipids in virtually all human cells and consequently to organ dysfunction. Pulmonary involvement is still debated. But, obstructive lung disease is up to ten times more prevalent in patients with FD compared to general public. Also, an accelerated decline in forced expiratory volume in one second (FEV1) over time was observed in these patients. Lysosomal storage of glycosphingolipids is considered leading to small airway disease via hyperplasia of the bronchiolar smooth muscle cells. Larger airways may become involved with ongoing disease process. There is no evidence for involvement of the lung interstitium in FD. The effect of enzyme replacement therapy on respiratory involvement remains to be determined in large, prospective controlled trials.

Validation des SCORES cliniques: notions théoriques et pratiques de base. [Validation of clinical scores: theoretical and practical basic notions].

Chaque jour, le médecin utilise dans sa pratique des scores cliniques. Ces scores sont souvent des aides à la décision médicale. Les étapes de validation des scores cliniques sont par contre souvent méconnues du médecin. Cette revue rappelle les bases théoriques de la validation d'un score clinique et propose des exercices pratiques. [Abstract] Physicians are using clinical scores on a regular basis. These scores are generally helpful in making medical decisions. However, the process of validation of clinical scores is often unknown to the physicians. This paper reviews the theory of validation of clinical scores and proposes practical exercises.

Monitieteinen ja tieteidenvälinen muisti : Memory from transdisciplinary perspectives

Ajankohtaista

Cancer chronotherapeutics: experimental, theoretical, and clinical aspects.

The circadian timing system controls cell cycle, apoptosis, drug bioactivation, and transport and detoxification mechanisms in healthy tissues. As a consequence, the tolerability of cancer chemotherapy varies up to several folds as a function of circadian timing of drug administration in experimental models. Best antitumor efficacy of single-agent or combination chemotherapy usually corresponds to the delivery of anticancer drugs near their respective times of best tolerability. Mathematical models reveal that such coincidence between chronotolerance and chronoefficacy is best explained by differences in the circadian and cell cycle dynamics of host and cancer cells, especially with regard circadian entrainment and cell cycle variability. In the clinic, a large improvement in tolerability was shown in international randomized trials where cancer patients received the same sinusoidal chronotherapy schedule over 24h as compared to constant-rate infusion or wrongly timed chronotherapy. However, sex, genetic background, and lifestyle were found to influence optimal chronotherapy scheduling. These findings support systems biology approaches to cancer chronotherapeutics. They involve the systematic experimental mapping and modeling of chronopharmacology pathways in synchronized cell cultures and their adjustment to mouse models of both sexes and distinct genetic background, as recently shown for irinotecan. Model-based personalized circadian drug delivery aims at jointly improving tolerability and efficacy of anticancer drugs based on the circadian timing system of individual patients, using dedicated circadian biomarker and drug delivery technologies.