Clouds across the new dawn for clinical, diagnostic and biological data : accelerating the development, delivery and uptake of personalized medicine

This research was funded by Reducing Disparities Across the European Union (BEACON) Project Number: 101080005.Peer reviewe

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Peintures murales romaines inédites de Gironde

In Gironde, the first studies maked about gallo-roman settings-painted date of the years 1982-83 ; they concern the documents issued of Plassac excavation, situated in Blayais, and those of the Allées de Tourny, Saint Christoly and Saint Seurin in Bordeaux. The goal of ours presents researchs is to bring up some setting-painted, still unstudied, coming from archeologic sites which excavation have been stopped for a few years. It concerns the gallo-roman sites of Rions, Loupiac, Saint Yzans-du-Médoc and Monséjour. So, seven decorativ sets of different period (Ist-IVth after J.-C.) ; among whose we count, exceptional thing, three ceiling geometric decor, have been reconstitued and analysed. In the whole, those documents reveal a prevailling influence of the third pompeien style. Some of those have brougt some precision about the use of the villa room ’s, some others have put back into the melting pot the chronology of site occupation (Loupiac, their candelabrum decor). These researchs confirm the implantation and the expansion of this art in Gironde, since the begining of the Ith and this, up the IVth after J.-C. They also underline the large mobility of the artists, the importance of exchange and influence between different regions.En Gironde, les premières études réalisées sur des enduits peints gallo-romains remontent aux années 1982-83 ; elles concernent les documents issus des fouilles de Plassac, situé dans le Bayais, celles des Allées de Toumy, de Saint Christoly et de Saint Seurin à Bordeaux. Nos présentes recherches ont pour but de publier des enduits peints, jusque là inexploités, provenant de sites archéologiques dont la fouille est suspendue depuis plusieurs années. Il s’agit des sites gallo-romains de Rions, Loupiac, Saint Yzans-du-Médoc et Monséjour. Ainsi ont pu être reconstitués et analysés sept ensembles décoratifs d’ époques différentes du Ier au IVe siècle après J.-C., parmi lesquels nous comptons, chose fort rare, trois décors géométriques de plafond. Dans l’ensemble, ces documents révèlent une influence dominante du IIIème style pompéien. Certains ont pu même apporter quelques précisions sur l’utilisation des pièces de la villa (Saint Yzans-du-Médoc), d’autres ont remis en question la chronologie de l’ocupation du site (Loupiac, décor aux candélabres grêles). Ces recherches viennent donc confirmer l’implantation et l’expansion de cet art de peindre en Gironde dès le début du 1er siècle après J.-C., et ce jusqu’au IVe. Elles soulignent également la grande mobilité des artistes, l’importance des échanges et influences entre diverses régions.Clyti-Bayle Catherine. Peintures murales romaines inédites de Gironde. In: Aquitania : une revue inter-régionale d'archéologie, tome 7, 1989. pp. 95-117

Les Histoires de morts aux cours de nos vies

International audienceLes morts de proches et les frôlements de la sienne sont des événements biographiques qui bousculent profondément les cours de vies, sociale, relationnelle, personnelle. Et pourtant les vies reprennent leur cours, survivent. Pourquoi ? Et comment ? Autant de luttes pour la vie, péri et post mortem, intrigantes, riches d'acquis expérientiels vitaux à reconnaître, connaître, pour apprendre à vivre au mieux avec la mort. Tout un chantier de formation permanente à ouvrir, dans le prolongement complémentaire de celui des histoires de vies en formation

Implication du papillomavirus humain dans l'apparition des carcinomes épidermoïdes buccaux

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Organisation des textes et cohérence des discours

Ces travaux ont été discutés lors d’une journée d’étude organisée en mai 2005 par le CRISCO (Centre de Recherches Interlangues sur la Signification en Contexte) à l’Université de Caen, dans le cadre de l’opération "Organisation des textes et cohérence des discours"

Beliefs of rehabilitation professionals towards guided self-rehabilitation contracts for post stroke hemiparesis

International audiencePurpose: To investigate the beliefs of physiotherapy students (ST), professionals (PT) and physicians (MD) about engaging patients with post-stroke hemiparesis into Guided Self-Rehabilitation Contracts (GSC), to increase their exercise intensity and responsibility level. Method: A survey examining beliefs about post-stroke rehabilitation was completed by first (n = 95), second (n = 105), and third (n = 48) year STs; PTs (n = 129) and MDs (n = 65) in France. Results: The belief about whether a patient may exercise alone varied between the professional groups with more STs and MDs finding it acceptable: 62% of PTs vs. 74% of STs (p = 0.005) and 79% of MDs (p = 0.02). For 93% of therapists (STs and PTs together), the caregiver may take part in physical therapy sessions. The appropriate weekly duration of exercises in chronic hemiparesis should be over 5 h for 19% of PTs, 37% of STs, and 51% of MDs (MDs vs. PTs, p < 0.005). After stroke, functional progress through rehabilitation is possible all lifelong for 11% of STs, 19% of PTs (p < 0.05, STs vs. PTs), and 29% of MDs (MD vs. PT, NS). Conclusions: The strategy of asking patients to perform exercises alone, in the practice or at home, is still not accepted by a large proportion of physical therapy professionals as compared with students or with physicians. Most therapists still see a <5-h weekly duration of exercise as sufficient after stroke. Few therapists are ready to utilize the persistence of behavior-induced brain plasticity regardless of age or delay after the lesion

Les vestiges humains gravettiens de la grotte de Gargas (Aventignan, France) : datations 14C AMS directes et contexte chrono-culturel)

The Gargas cave has been the subject of a research programme since 2004. This article focuses on the chronological and anthropobiological framework of the human remains found in the Gravettian habitat levels of the Lower Gallery. These remains are : – a well-preserved fragment of a child mandible (GPA-11-Wb-646) found in the GPA sector, in Room I, close to the Great Wall of Hands. The coronoid process is missing, the lateral face of the condylar process is eroded, the gonial angle is broken, and the superficial external cortical bone of the lower margin of the symphyeal region is desquamated on ca. 20 mm. The age-at-death is estimated between 1 and 3 years, based on the degree of mineralization and eruption of the teeth. The mandible was found in the upper third of a Gravettian level. Its archaeological context consisted mainly of an accumulation of faunal remains (centimetric to decimetric fragments and small burnt elements, some of them with anthropogenic traces), and some elements of lithic industry (tools and debitage products in flint and quartzite), used pebbles and coloring materials ; – a fragment of a child left clavicle (GPA-11-Wb-610). The bone is preserved on 47 mm, from the lateral third of the insertion for the deltoid muscle to the middle of the M. pectoralis major attachment site. The breaks are smooth and the bone surface displays many impacts, probably due to carnivorous activity. The age-at-death it estimated to 1 to 7 years ; – an immature clavicle fragment (uncertain determination) (GPA-11-Wb) ; in any case, this small fragment does not correspond to the previous left clavicle ; – a small (36.0 mm length and 20.0 mm width) neurocranial fragment (GPO 05-K9a) found in the GPO area (corresponding to the former entrance). This fragment belongs to an adult or a subadult ; – a first upper right deciduous incisor (GPO-07-K13b-1550). The crown is very worn and preserved only on 2 to 3 mm. Three quarters of the root appear resorbed, indicating an age between 6 to 7 years old ; – a 42 mm long body fragment of a rib (GDI-2011 deblais) with grey sediment covering one extremity, and with some red linear traces on the surfaces. This bone was found in the GDI sector, within the dumps of previous excavations. The very ovoid and fairly thick section (7 by 11 mm) makes uncertain the attribution to the human species ; – a fragment of an adult left femoral diaphysis, preserved over 242 millimeters, found in the Cartailhac-Breuil collection of the “ Institut de Paléontologie Humaine”. The bone is broken proximally below the lesser trochanter and distally at the junction between the second and last third of the diaphysis. This human remain, discovered during the excavations of É. Cartailhac and H. Breuil between 1911 and 1913, was reported by Hugo Obermaier in his book L’Homme fossile and attributed to the “ Aurignacien supérieur” (Gravettian), without further information. At least three subjects are represented in this skeletal assemblage : a young child (the mandible), an adult individual (the femur), and an older child (the deciduous tooth with resorbed root) : only the first two individuals were concerned by mortuary practices that have to be discussed in following studies. The first five human remains were discovered in situ within the Gravetian sedimentary unit, which corresponds to a palimpsest of occupations. From a chrono-cultural point of view, and on the basis of a typo-technological analysis of the lithic industry (Noailles burins, Gravette and Vachons points) and bone industry (Isturitz-type assegai points and herbivore ribs decorated with notches), Gargas settlement is attributed to the Noaillian. The mandible and the femur were directly dated (AMS C14 radiocarbon date). The results are respectively 24,930 ± 220 BP (29500-28532 cal. BP) and 24,880 ± 140 BP (29310-28593 cal. BP). These dates are compared with the chronological sequence obtained from C14 dates on the faunal remains. Considering the distribution and significant concentration of dates, two main periods of occupations can be identified : the first one is between 31,500 and 30,000 cal. years BP, the second between 29,500 and 28,500 cal. years BP. The direct dates of the human remains place them in the final phase of the occupation of the cave. The presence of human remains in the Gravettian occupation levels of Gargas, at the foot of the decorated walls, brings new perspectives for studies on the relationship between mortuary practices, settlement and art. We were able to highlight in Room I, where two thirds of the handprints are concentrated, the interpenetration of a “ domestic” and a “ symbolic” space. The taphonomical context of the human remains, isolated and without anatomical connection, sometimes covered with a thin calcite layer, suggests surface deposits that have undergone post-depositional mechanical disturbances altering the original disposition and thus making difficult to interpret their funeral context.La grotte de Gargas fait l’objet d’un programme de recherche depuis 2004. Cet article précise le cadre chronologique et stratigraphique des vestiges humains trouvés dans la couche d’habitat gravettien de la Galerie inférieure. Ils correspondent à une mandibule d’enfant (entre 1 et 3 ans), une clavicule gauche d’enfant (entre 1 et 7 ans), un fragment de neurocrâne, une dent monoradiculé déciduale, un fragment de clavicule (sujet immature), un fragment de côte, et à une diaphyse de fémur (sujet adulte). Les cinq premiers ont été découverts in situ, le sixième dans les remblais des fouilles anciennes ; le fragment de fémur avait été trouvé lors des fouilles d’É. Cartailhac et d’H. Breuil, en 1911 et 1913. Au moins trois sujets semblent être représentés dans cet assemblage : un jeune enfant (mandibule), un sujet adulte (fémur), et un enfant plus âgé (dent déciduale à la racine résorbée) : seuls les deux premiers pourraient s’intégrer dans un contexte funéraire lato sensu qu’il s’agira de préciser dans les années à venir. La mandibule et le fémur ont fait l’objet d’analyses 14C AMS directes. Les résultats sont respectivement 24 930 ± 220 BP (29500‑28532 cal. BP) et 24 880 ± 140 BP (29 310-28 593 cal. BP). Puis, ces datations sont mises en perspective par rapport à celles obtenues sur les vestiges de faune consommée dans l’habitat. Si l’on considère la distribution et la concentration significative des dates, on peut définir deux séquences principales d’occupation : la première se situe entre 31 500 et 30 000 cal. BP, la seconde entre 29 500 et 28 500 cal. BP. Les dates des restes humains se placent dans la phase finale des occupations de la grotte.Foucher Pascal, San Juan-Foucher Cristina, Villotte Sébastien, Bayle Priscilla, Vercoutère Carole, Ferrier Catherine. Les vestiges humains gravettiens de la grotte de Gargas (Aventignan, France) : datations 14C AMS directes et contexte chrono-culturel). In: Bulletin de la Société préhistorique française, tome 116, n°1, 2019. pp. 29-39

Degradation of a sulfonated aryl ether ketone model compound in oxidative media (sPAEK)

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Interventions interdisciplinaires sur des restes de mammouth en contexte d’archéologie préventive : le cas du site du Paléolithique moyen de Montereau-sur-le-Jard (Seine-et-Marne).

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