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/)

Les sulfates triples MIMIIMIII (SO4)3. I. Les sulfates rhomboédriques Na MIIMIII (SO4)3 (MII = Mg, Mn, Co, Ni, Zn ; MIII = Al, Ga, In, Cr, Fe)

The prepared triple sulfates NaM''M''' (SO₄)₃ are rhombohedral and characterized by an angle α close to 56° ; they possess the same crystalline structure as the lacunar rhombohedral sulfates of the Fe₂(SO₄)₃ type.Les sulfates triples NaM''M''' (SO₄)₃ préparés, rhomboédriques, se caractérisent par un angle α voisin de 56° ; ils possèdent la même structure cristalline que les sulfates rhomboédriques, lacunaires du type Fe₂ (SO₄)₃.Perret René, Thrierr Aline, Peter Jean-Pierre, Masse René. Les sulfates triples MIMIIMIII (SO4)3. I. Les sulfates rhomboédriques Na MIIMIII (SO4)3 (MII = Mg, Mn, Co, Ni, Zn ; MIII = Al, Ga, In, Cr, Fe). In: Bulletin de la Société française de Minéralogie et de Cristallographie, volume 98, 1, 1975. pp. 103-106

When one partner can no longer see ::exploring the lived experiences of romantic partners in the context of vision loss

This qualitative descriptive study aims to explore the lived experience of the adjustment process of couples who face vision loss, investigating the impact of such loss on daily life and the adjustments and adaptations that ensue. To undertake such an exploration, the application of an occupational perspective is relevant where the meaning and purpose partners ascribe to their everyday activities can be investigated. A total of 16 couples living in Western Switzerland were interviewed between January and June 2020. Data collection was carried out with semi-structured face-to-face interview. Three themes emerge from the thematic analysis of transcripts. The first theme emphasizes that either separate or joint everyday activities of partners can be shared within couples, which all give sense to the partnership; the second one shows that vision loss disrupts the engagement of partners in such shared everyday activities. The third theme highlights partners’ efforts to reshape their engagement in their shared everyday activities in order to maintain a sense of couple’s we-ness. While navigating vision loss requires both partners to jointly engage in this process of reshaping, couples described tension that arises because of the partners with vision loss’ growing dependence on the other partner. One’s sense of control when navigating vision loss is critical to adjust to a changing and changed daily life. Further research is needed that focuses on how romantic partners ascribe a shared meaning and purpose to their engagement in everyday activities, separate or joint, and how such meaning and purpose are impacted by the onset or aggravation of one partner’s vision loss

BET inhibitor OTX015 targets BRD2 and BRD4 and decreases c-MYC in acute leukemia cells

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The bromodomain (BRD) and extraterminal (BET) proteins including BRD2, BRD3 and BRD4 have been identified as key targets for leukemia maintenance. A novel oral inhibitor of BRD2/3/4, the thienotriazolodiazepine compound OTX015, suitable for human use, is available. Here we report its biological effects in AML and ALL cell lines and leukemic samples. Exposure to OTX015 lead to cell growth inhibition, cell cycle arrest and apoptosis at submicromolar concentrations in acute leukemia cell lines and patient-derived leukemic cells, as described with the canonical JQ1 BET inhibitor. Treatment with JQ1 and OTX15 induces similar gene expression profile

Perineal retraining improves conservative treatment for faecal incontinence: A multicentre randomized study

International audienc

Accessibilité et participation sociale

La Convention relative aux droits des personnes handicapées (CDPH) adoptée en 2006 par l’ONU réaffirme le principe selon lequel les personnes vivant une situation de handicap jouissent des mêmes droits de participer à la vie politique et communautaire que tout autre citoyen ou citoyenne. A travers lois, règlements ou conventions, les Etats ayant signé et ratifié cette convention établissent des politiques qui dessinent les orientations à suivre en faveur du développement de pratiques inclusives. Cependant, pour les personnes en situation de handicap, l’écart entre les lois et les pratiques peut s’avérer important tant les attitudes négatives, les préjugés, les lacunes dans l’organisation des services et les problèmes d’accessibilité sont lents à disparaître. Passer du principe à la réalité peut souvent sembler utopique. Pourtant, des initiatives citoyennes et scientifiques menées avec succès démontrent que l’émancipation des personnes avec une déficience intellectuelle est en marche et que l’autodétermination tend à devenir une réalité pour une partie croissante d’entre elles. Pour les enfants, on s'oriente vers une scolarisation plus inclusive, pour les adultes des dispositifs en vue d’une plus grande autonomie dans les choix de vie fondamentaux sont sporadiquement mis en place. Les contributions présentées dans cet ouvrage sont issues d’expériences de personnes concernées, de professionnel·le·s, de chercheur·e·s et d’étudiant·e·s de différents pays francophones (Suisse, France, Belgique, Canada) et offrent des pistes de réflexion et d’action en vue d’une concrétisation de l’égalité des droits