[I-CARE: a pioneering e-learning training program on LGBTIQ+ health]. / I-CARE : une formation pionnière par apprentissage en ligne sur la santé des personnes LGBTIQ.

While several recent studies suggest that approximately 1 in 6 young people in Switzerland are part of the rainbow diversity, a high proportion of health professionals have never had a course on LGBTIQ+ (lesbian, gay, bisexual, transgender, intersex, queer, questioning or other) health. This situation leads to significant gaps in the medical care of LGBTIQ+ persons as well as difficulties in accessing equitable, culturally appropriate and quality care. This article presents the ambitious and novel e-learning project I-CARE (Improving Care and Access for Rainbow Equity) which should contribute, from the end of this year, to filling the current gaps in the undergraduate and continuing education of health professionals.

Alors que plusieurs études récentes suggèrent qu'environ 1 jeune sur 6 fait partie de la diversité arc-en-ciel en Suisse, une proportion élevée des professionnel-les de santé n'a jamais eu de cours sur la santé des personnes LGBTIQ+ (lesbiennes, gays, bisexuelles, transgenres, intersexuées, queers, en questionnement ou autres). Cette situation entraîne d'importantes lacunes dans la prise en charge médicale des personnes LGBTIQ+, ainsi qu'une difficulté d'accès à des soins équitables, culturellement appropriés et de qualité. Cet article présente l'ambitieux et inédit projet de formation par apprentissage en ligne I-CARE (Improving Care and Access for Rainbow Equity) qui devra contribuer, à partir de la fin de cette année, à combler les lacunes actuelles dans la formation prégraduée et continue des professionnel-les de santé.

In Vivo Imaging-Based 3-Dimensional Pelvic Prototype Models to Improve Education Regarding Sexual Anatomy and Physiology.

BACKGROUND: Myths, misconceptions, and taboos about sexual anatomy and physiology are common and can affect sexual health and maintain harmful practices and beliefs. AIM: To construct a female and a preliminary male 3-dimensional (3D) pelvic model on the basis of in vivo imaging, which could be studied in sex education and clinical practice. METHODS: We retrospectively studied the images of 200 female pelvic magnetic resonance examinations and reviewed the literature to choose the optimum magnetic resonance imaging (MRI) protocol for the study of the clitoris and surrounding organs. We also conducted a cross-sectional study of 30 women who were undergoing a pelvic MRI. 15 women had undergone female genital mutilation/cutting involving the clitoris and 15 had not. The best-quality MRI images of 3 uncut and 1 cut clitoris, together with the principal surrounding pelvic organs, were selected to generate 3D reconstructions using dedicated software. The same software was used to reconstruct the anatomy of the penis and the principal surrounding pelvic organs, based on contrast-enhanced computer tomography images. Images of both models were exported in .stl format and cleaned to obtain single manifold objects in free, open source software. Each organ model was sliced and 3D printed. A preliminary feedback was collected from 13 potential users working in urology, gynaecology, sexual medicine, physiotherapy, and education. OUTCOMES: The main outcomes of this study are a kit of 3D pelvic models, 2-dimensional figures of female and male sexual anatomy, and files for 3D printing. RESULTS: We present a kit containing 3D models and 2-dimensional figures of female and male sexual anatomy, based on in vivo imaging and, feedbacks and suggestions received from potential users. CLINICAL TRANSLATION: Our kit can be used in anatomy and sex education among and by health professionals, teachers, sex educators, students, and the general population. STRENGTHS & LIMITATIONS: The strengths are that the models were based on in vivo imaging, can be dismantled/reassembled, and show analogous anatomic structures of the clitoris and the penis. The female models represent diversity, including women with female genital mutilation/cutting. The limitations are that the male model is preliminary and can be improved if based on an MRI; that imaging-based anatomic representations can differ from anatomic dissections; and that the models represent the sexual organs at rest or during an unknown state of arousal only. CONCLUSION: Our kit can be studied in anatomy, biology, and sex education, as well as in clinical practice. Abdulcadir J, Dewaele R, Firmenich N, et al. In Vivo Imaging-Based 3-Dimensional Pelvic Prototype Models to Improve Education Regarding Sexual Anatomy and Physiology. J Sex Med 2020;17:1590-1602.

[Transgender and non-binary teenagers : management in primary care]. / Adolescents transgenres et non ­binaires : approche et prise en charge par les médecins de premier recours.

Transgender, non-binary and questioning teenagers are increasingly visible. However, they face barriers in accessing appropriate care that meet their needs, both specific and regarding their general health. Primary care physicians increasingly see them in consultations but often lack elements of communication and recent knowledge that is needed to accompany them and their close ones in their -individual trajectories. This article aims to answer this need and provides a synthesis about recent evidence and suggested communication approaches for primary care physicians, who play a central role for the health of all patients.

Les adolescents transgenres, non binaires ou en questionnement sont de plus en plus visibles et font face à de nombreux obstacles pour accéder à des soins appropriés, tant pour leurs besoins de santé spécifiques que généraux. Les médecins de premier recours les rencontrent au cabinet et peuvent manquer d'éléments de communication et de connaissances spécifiques récentes pour mener la consultation et accompagner ces personnes et leurs proches dans leurs trajectoires individuelles. Cet article propose une synthèse des éléments et des ressources utiles pour le médecin de premier recours, dont le rôle est ­central pour la santé de tous les patients.

Reducing the use of screen electronic devices in the evening is associated with improved sleep and daytime vigilance in adolescents.

The use of screen electronic devices in the evening negatively affects sleep. Yet, sleep is known to be essential for brain maturation and a key factor for good academic performance, and thus is particularly critical during childhood and adolescence. Although previous studies reported associations between screen time and sleep impairment, their causal relationship in adolescents remains unclear. Using actigraphy and daily questionnaires in a large sample of students (12 to 19 years old), we assessed screen time in the evening and sleep habits over 1 month. This included a 2 week baseline phase, followed by a 40 min sleep education workshop and a 2 week interventional phase, in which participants were asked to stop using screen devices after 9 pm during school nights. During the interventional phase, we found that the reduction of screen time after 9 pm correlated with earlier sleep onset time and increased total sleep duration. The latter led to improved daytime vigilance. These findings provide evidence that restricting screen use in the evening represents a valid and promising approach for improving sleep duration in adolescents, with potential implications for daytime functioning and health.

[Adolescence and sexuality: a risky business How best to inform parents ?] / Sexualité et adolescence :liaisons dangereuses ?: Guide des meilleures pratiques pour informer les parents.

Parents are often reluctant to discuss sexuality and romantic relationships with their teenagers. However, these discussions can have a strong impact on their children's health. Care providers can act as a reliable source of information to support parents in this task. Through repeated short interactions with their child over their adolescence, parents can cover most topics related to sexuality, based on teenagers' questions and the situations that they face (e.g. LGBT bullying at school). This article summarizes current best practice on how to facilitate parental dialogue with adolescents about sexuality and offer care providers guidance in transmitting this information to parents.

Les parents sont souvent réticents à parler de sexualité et de relations amoureuses avec leurs adolescents. Cependant, ces discussions ont un rôle majeur pour la santé de leurs enfants. Les professionnels de santé sont une source d'informations fiable et de soutien pour les parents dans cette démarche. De nombreuses interactions courtes durant les années de l'adolescence, entre parents et adolescents, basées sur des questions et des situations rencontrées permettent de couvrir les nombreuses thématiques liées à la sexualité. Cet article propose une aide pour les professionnels de santé afin d'informer les parents et les encourager à ouvrir le dialogue avec leurs enfants. Il résume les meilleures pratiques pour favoriser la communication avec des adolescents concernant la sexualité.

Beta- and gamma-cytoplasmic actins are required for meiosis in mouse oocytes.

In mammals, female meiosis consists of two asymmetric cell divisions, which generate a large haploid oocyte and two small polar bodies. Asymmetric partitioning of the cytoplasm results from migration of the meiotic spindle toward the cortex and requires actin filaments. However, the subcellular localization and the role of the existing two cytoplasmic actin (CYA) isoforms, beta and gamma, have not been characterized. We show that beta- and gamma-CYA are differentially distributed in the maturing oocyte from late metaphase I as well as in preimplantation embryos. Gamma-CYA is preferentially enriched in oocyte cortices and is absent from all cell-cell contact areas from metaphase II until the blastocyst stage. Beta-CYA is enriched in contractile structures, at cytokinesis, at cell-cell contacts, and around the forming blastocoel. Alteration of beta- or gamma-CYA function by isoform-specific antibody microinjection suggests that gamma-CYA holds a major and specific role in the establishment and/or maintenance of asymmetry in meiosis I and in the maintenance of overall cortical integrity. In contrast, beta- and gamma-CYA, together, appear to participate in the formation and the cortical anchorage of the second meiotic spindle in waiting for fertilization. Finally, differences in gamma-CYA expression are amongst the earliest markers of cell fate determination in development.