And the first were named Honor and Faith... : The office of arms in the 16th Hapsburg monarchy, from myths to realities

Au moyen âge et au début de l’époque moderne, un groupe de personnes se présentait comme les serviteurs de toute la noblesse : les hérauts. Ces personnages en apparence inférieurs se trouvaient investis de fonctions importantes pour l’identité des nobles et du prince. À la Renaissance, malgré un déclin certain cet office continua à exister et à servir princes et nobles dans un contexte d’évolution importantes. Auprès des Habsbourg, ils participèrent notamment aux guerres de Charles Quint, à la sédentarisation et à l’hispanisation de la cour sous Philippe II et à la révolte des Pays-Bas. A travers eux, c’est l’histoire du principat des premiers grands Habsbourg et de leur noblesse que l’on peut deviner.During the middle-ages and the early modern period, a group of person was claiming to be the servants of the whole noble order. They were the heralds. Several important functions related with the identity of the prince and his nobility were associated with these apparently inferior persons. During the Renaissance, in spite of a manner of decline, this officeremained in existence and continued to serve both princes and nobles. The evolutions of these two traditionnal groups were nonetheless important. At the court of the Hapsburg, the heralds took part in particular in the wars of Charles V, in the sedentarisation an hispanisation of the court of Philip II and in the Dutch revolt. Through these persons, the history of the reign of the two first Hapsburg reveals itself

Chroniques de l'Europe

National audienceRetracer six siècles d’histoire de l’Europe en quelque 120 dates et plusieurs centaines de documents : tel est le défi que relèvent ces Chroniques.Loin d’inventorier les « grandes dates qui ont fait l’histoire », cet ouvrage préfère mettre en lumière celles que l’on connaît moins. On y découvre, entre autres, l’adoption de l’écriture romaine dans l’imprimerie dès 1470, l’entrée de la tomate dans la cuisine européenne en 1613, l’exécution de la dernière sorcière en 1782, les luttes pour la diminution du temps de travail en 1817, le vote des femmes en Finlande en 1906, la première victime du mur de Berlin le 22 août 1961, le lancement de la fusée Europa II en 1971.Les historiennes et historiens – des techniques, du politique, de l’environnement, des idées, du genre, des arts, de l’économie – ici réunis, ont bien voulu se prêter à un exercice original : choisir un événement qui fait sens à l’échelle de l’Europe, puis, documents et repères chronologiques à l’appui, en faire le récit et rendre compte de ses résonances à travers le temps et l’espace.Une formidable plongée dans l’histoire longue de l’Europe à travers des figures marquantes, la circulation de savoirs, des innovations techniques ou artistiques, des tensions, conflits ou convergences. Une nouvelle façon de questionner ce qui fait date en histoire et de raconter l’Europe

Histoires courtes, histoire longue

National audienc

Association of nitrogen balance trajectories with clinical outcomes in critically ill COVID-19 patients: A retrospective cohort study

International audienceackground & aims: The intensity and duration of the catabolic phase in COVID-19 patients can differ between survivors and non-survivors. The purpose of the study was to assess the determinants of, and association between, nitrogen balance trajectories and outcome in critically ill COVID-19 patients. Methods: This retrospective monocentric observational study involved patients admitted to the intensive care unit (ICU) of the University Hospital of Clermont Ferrand, France, from January 2020 to May 2021 for COVID-19 pneumonia. Patients were excluded if referred from another ICU, if their ICU length of stay was <72 h, or if they were treated with renal replacement therapy during the first seven days after ICU admission. Data were collected prospectively at admission and during ICU stay. Death was recorded at the end of ICU stay. Comparisons of the time course of nitrogen balance according to outcome were analyzed using two-way ANOVA. At days 3, 5, 7, 10 and 14, uni- and multivariate logistic regression analyses were performed to assess the impact of a non-negative nitrogen-balance on ICU death. To investigate the relationships between nitrogen balance, inflammatory markers and protein intake, linear and non-nonlinear models were run at days 3, 5 and 7, and the amount of protein intake necessary to reach a neutral nitrogen balance was calculated. Subgroup analyses were carried out according to BMI, age, and sex. Results: 99 patients were included. At day 3, a similar negative nitrogen balance was observed in survivors and non-survivors: -16.4 g/d [-26.5, -3.3] and -17.3 g/d [-22.2, -3.8] (p = 0.54). The trajectories of nitrogen balance over time thus differed between survivors and non-survivors (p = 0.01). In survivors, nitrogen balance increased over time, but decreased from day 2 to day 6 in non-survivors, and thereafter increased slowly up to day 14. At days 5 and 7, a non-negative nitrogen-balance was protective from death. Administering higher protein amounts was associated with higher nitrogen balance. Conclusion: We report a prolonged catabolic state in COVID patients that seemed more pronounced in non-survivors than in survivors. Our study underlines the need for monitoring urinary nitrogen excretion to guide the amount of protein intake required by COVID-19 patients. (c) 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism

Effects of Standard-Dose Prophylactic, High-Dose Prophylactic, and Therapeutic Anticoagulation in Patients With Hypoxemic COVID-19 Pneumonia The ANTICOVID Randomized Clinical Trial

International audienceIMPORTANCE Given the high risk of thrombosis and anticoagulation-related bleeding in patients with hypoxemic COVID-19 pneumonia, identifying the lowest effective dose of anticoagulation therapy for these patients is imperative. OBJECTIVES To determine whether therapeutic anticoagulation (TA) or high-dose prophylactic anticoagulation (HD-PA) decreases mortality and/or disease duration compared with standard-dose prophylactic anticoagulation (SD-PA), and whether TA outperforms HD-PA; and to compare the net clinical outcomes among the 3 strategies. DESIGN, SETTINGS, AND PARTICIPANTS The ANTICOVID randomized clinical open-label trial included patients with hypoxemic COVID-19 pneumonia requiring supplemental oxygen and having no initial thrombosis on chest computer tomography with pulmonary angiogram at 23 health centers in France from April 14 to December 13, 2021. Of 339 patients randomized, 334 were included in the primary analysis-114 patients in the SD-PA group, 110 in the HD-PA, and 110 in the TA. At randomization, 90% of the patients were in the intensive care unit. Data analyses were performed from April 13, 2022, to January 3, 2023. INTERVENTIONS Patients were randomly assigned (1:1:1) to receive either SD-PA, HD-PA, or TA with low-molecular-weight or unfractionated heparin for 14 days. MAIN OUTCOMES AND MEASURES A hierarchical criterion of all-cause mortality followed by time to clinical improvement at day 28. Main secondary outcome was net clinical outcome at day 28 (composite of thrombosis, major bleeding, and all-cause death). RESULTS Among the study population of 334 individuals (mean [SD] age, 58.3 [13.0] years; 226 [67.7%] men and 108 [32.3%] women), use of HD-PA and SD-PA had similar probabilities of favorable outcome (47.3% [95%CI, 39.9% to 54.8%] vs 52.7%[95%CI, 45.2%to 60.1%]; P = .48), as did TA compared with SD-PA (50.9% [95%CI, 43.4%to 58.3%] vs 49.1% [95%CI, 41.7%to 56.6%]; P = .82) and TA compared with HD-PA (53.5%[95%CI 45.8% to 60.9%] vs 46.5% [95%CI, 39.1% to 54.2%]; P = .37). Net clinical outcome was met in 29.8% of patients receiving SD-PA (20.2%thrombosis, 2.6%bleeding, 14.0% death), 16.4% receiving HD-PA (5.5%thrombosis, 3.6%bleeding, 11.8%death), and 20.0% receiving TA (5.5% thrombosis, 3.6% bleeding, 12.7%death). Moreover, HD-PA and TA use significantly reduced thrombosis compared with SD-PA (absolute difference, -14.7 [95%CI -6.2 to -23.2] and -14.7 [95%CI -6.2 to -23.2], respectively). Use of HD-PA significantly reduced net clinical outcome compared with SD-PA (absolute difference, -13.5; 95%CI -2.6 to -24.3). CONCLUSIONS AND RELEVANCE This randomized clinical trial found that compared with SD-PA, neither HD-PAnor TAuse improved the primary hierarchical outcome of all-cause mortality or time to clinical improvement in patients with hypoxemicCOVID-19 pneumonia; however, HD-PA resulted in significantly better net clinical outcome by decreasing the risk of de novo thrombosis

High-Dose Dexamethasone and Oxygen Support Strategies in Intensive Care Unit Patients With Severe COVID-19 Acute Hypoxemic Respiratory Failure

International audienc