New research findings on 11th-early 13th-century polychrome wood sculpture at the Royal Institute for Cultural Heritage, Brussels

11th- to early 13th-century medieval polychrome sculptures can be considered as ancestral testimony of knowledge, practices, and the exchange of carving and painting techniques in the Middle Ages. This paper aims to provide an analysis of 50 years of research in Belgium, including recent case studies. New material elements and analysis results will likely resuscitate the debate on the relative chronology that is usually suggested. The identification of materials reveals the circulation of goods and trade. The richness of pictorial effects and techniques demonstrates a knowhow long considered as typical of the late Gothic period, including the use of oil in the binding media. Most of the information collected in the Belgian corpus matches the results of analyses carried out on sculptures from other European regions, both in terms of the evolution of their appearance and of their techniques. These observations make it possible to put forward the hypothesis of a fast and oral transmission not only within local workshops but in the broader European global context

New research findings on 11th-early 13th-century polychrome wood sculpture at the Royal Institute for Cultural Heritage, Brussels

11th- to early 13th-century medieval polychrome sculptures can be considered as ancestral testimony of knowledge, practices, and the exchange of carving and painting techniques in the Middle Ages. This paper aims to provide an analysis of 50 years of research in Belgium, including recent case studies. New material elements and analysis results will likely resuscitate the debate on the relative chronology that is usually suggested. The identification of materials reveals the circulation of goods and trade. The richness of pictorial effects and techniques demonstrates a knowhow long considered as typical of the late Gothic period, including the use of oil in the binding media. Most of the information collected in the Belgian corpus matches the results of analyses carried out on sculptures from other European regions, both in terms of the evolution of their appearance and of their techniques. These observations make it possible to put forward the hypothesis of a fast and oral transmission not only within local workshops but in the broader European global context.As esculturas policromadas dos séculos XI-início de XIII podem ser consideradas um testemunho ancestral de conhecimento, de práticas bem como das trocas de técnicas de escultura e pintura na Idade Média. O presente artigo visa prover uma análise de 50 anos de pesquisa na Bélgica, incluindo também recentes estudos. Elementos materiais novos e os resultados de análises irão provavelmente relançar o debate sobre a cronologia relativa que por norma se sugere. A identificação de materiais revela a circulação de bens e comércio. A riqueza de efeitos pictóricos e técnicas demonstra um savoir-faire considerado até então como típico do período gótico recente, inclusive o uso de óleo como aglutinante. A maioria da informação reunida no corpus belga corresponde aos resultados de análises realizadas em esculturas de outras regiões europeias, tanto em termos de evolução de aspectos como de evolução técnica. Estas observações permitem avançar a hipótese de uma transmissão rápida e oral não só dentro das oficinas mas no contexto global europeu mais vast

La polychromie de la sculpture mosane en bois du XIIIe siècle

La recherche porte sur l’étude technologique de la polychromie de la sculpture mosane en bois du XIIIe siècle. Elle se base sur l’élaboration d’un catalogue comportant 82 sculptures dont 26 ont été étudiées en atelier, principalement à l’Institut royal du Patrimoine artistique de Bruxelles (IRPA), ou dans des conditions d’atelier. Les résultats de la recherche ont été analysés selon un double point de vue : technologique (les matériaux et leur mise en oeuvre) et historique (l’analyse de l’aspect des sculptures dans leur contexte)

Randomized trial evaluating serial protein C levels in severe sepsis patients treated with variable doses of drotrecogin alfa (activated)

International audienceINTRODUCTION: Serial alterations in protein C levels appear to correlate with disease severity in patients with severe sepsis, and it may be possible to tailor severe sepsis therapy with the use of this biomarker. The purpose of this study was to evaluate the dose and duration of drotrecogin alfa (activated) treatment using serial measurements of protein C compared to standard therapy in patients with severe sepsis. METHODS: This was a phase 2 multicenter, randomized, double-blind, controlled study. Adult patients with two or more sepsis-induced organ dysfunctions were enrolled. Protein C deficient patients were randomized to standard therapy (24 μg/kg/hr infusion for 96 hours) or alternative therapy (higher dose and/or variable duration; 24/30/36 μg/kg/hr for 48 to 168 hours). The primary outcome was a change in protein C level in the alternative therapy group, between study Day 1 and Day 7, compared to standard therapy. RESULTS: Of 557 patients enrolled, 433 patients received randomized therapy; 206 alternative, and 227 standard. Baseline characteristics of the groups were largely similar. The difference in absolute change in protein C from Day 1 to Day 7 between the two therapy groups was 7% (P = 0.011). Higher doses and longer infusions were associated with a more pronounced increase in protein C level, with no serious bleeding events. The same doses and longer infusions were associated with a larger increase in protein C level; higher rates of serious bleeding when groups received the same treatment; but no clear increased risk of bleeding during the longer infusion. This group also experienced a higher mortality rate; however, there was no clear link to infusion duration. CONCLUSIONS: The study met its primary objective of increased protein C levels in patients receiving alternative therapy demonstrating that variable doses and/or duration of drotrecogin alfa (activated) can improve protein C levels, and also provides valuable information for incorporation into potential future studies. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00386425

Expanding the clinical spectrum of hereditary fibrosing poikiloderma with tendon contractures, myopathy and pulmonary fibrosis due to <i>FAM111B </i>mutations

BACKGROUND: Hereditary Fibrosing Poikiloderma (HFP) with tendon contractures, myopathy and pulmonary fibrosis (POIKTMP [MIM 615704]) is a very recently described entity of syndromic inherited poikiloderma. Previously by using whole exome sequencing in five families, we identified the causative gene, FAM111B (NM_198947.3), the function of which is still unknown. Our objective in this study was to better define the specific features of POIKTMP through a larger series of patients. METHODS: Clinical and molecular data of two families and eight independent sporadic cases, including six new cases, were collected. RESULTS: Key features consist of: (i) early-onset poikiloderma, hypotrichosis and hypohidrosis; (ii) multiple contractures, in particular triceps surae muscle contractures; (iii) diffuse progressive muscular weakness; (iv) pulmonary fibrosis in adulthood and (v) other features including exocrine pancreatic insufficiency, liver impairment and growth retardation. Muscle magnetic resonance imaging was informative and showed muscle atrophy and fatty infiltration. Histological examination of skeletal muscle revealed extensive fibroadipose tissue infiltration. Microscopy of the skin showed a scleroderma-like aspect with fibrosis and alterations of the elastic network. FAM111B gene analysis identified five different missense variants (two recurrent mutations were found respectively in three and four independent families). All the mutations were predicted to localize in the trypsin-like cysteine/serine peptidase domain of the protein. We suggest gain-of-function or dominant-negative mutations resulting in FAM111B enzymatic activity changes. CONCLUSIONS: HFP with tendon contractures, myopathy and pulmonary fibrosis, is a multisystemic disorder due to autosomal dominant FAM111B mutations. Future functional studies will help in understanding the specific pathological process of this fibrosing disorder

Impact of early enteral versus parenteral nutrition on mortality in patients requiring mechanical ventilation and catecholamines: study protocol for a randomized controlled trial (NUTRIREA-2)

BACKGROUND: Nutritional support is crucial to the management of patients receiving invasive mechanical ventilation (IMV) and the most commonly prescribed treatment in intensive care units (ICUs). International guidelines consistently indicate that enteral nutrition (EN) should be preferred over parenteral nutrition (PN) whenever possible and started as early as possible. However, no adequately designed study has evaluated whether a specific nutritional modality is associated with decreased mortality. The primary goal of this trial is to assess the hypothesis that early first-line EN, as compared to early first-line PN, decreases day 28 all-cause mortality in patients receiving IMV and vasoactive drugs for shock. METHODS/DESIGN: The NUTRIREA-2 study is a multicenter, open-label, parallel-group, randomized controlled trial comparing early PN versus early EN in critically ill patients requiring IMV for an expected duration of at least 48 hours, combined with vasoactive drugs, for shock. Patients will be allocated at random to first-line PN for at least 72 hours or to first-line EN. In both groups, nutritional support will be started within 24 hours after IMV initiation. Calorie targets will be 20 to 25 kcal/kg/day during the first week, then 25 to 30 kcal/kg/day thereafter. Patients receiving PN may be switched to EN after at least 72 hours in the event of shock resolution (no vasoactive drugs for 24 consecutive hours and arterial lactic acid level below 2 mmol/L). On day 7, all patients receiving PN and having no contraindications to EN will be switched to EN. In both groups, supplemental PN may be added to EN after day 7 in patients with persistent intolerance to EN and inadequate calorie intake. We plan to recruit 2,854 patients at 44 participating ICUs. DISCUSSION: The NUTRIREA-2 study is the first large randomized controlled trial designed to assess the hypothesis that early EN improves survival compared to early PN in ICU patients. Enrollment started on 22 March 2013 and is expected to end in November 2015. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01802099 (registered 27 February 2013)

The Life Cycle of Toxoplasma gondii in the Natural Environment

Chapitre 1International audienc