Une communauté convulsionnaire dans l’attente du millénium : les « Fareinistes » (1783-1805)

Le groupe convulsionnaire « fareiniste », apparu dans les années 1780 dans les Dombes, et qui s’est reconstitué à Paris sous le Directoire et le Consulat, est le type même d’une « communauté utopique », structurée autour de l’attente du millénium et de la fin des temps. Nous verrons dans quelle mesure cette micro-société fonctionne selon le mode de la « clôture », hors du temps et du monde. En effet, ces croyants dissidents perçoivent les événements (externes, et internes au groupe) à travers un prisme biblique tendant à l’ésotérisme. Leur fonctionnement interne obéit également à une logique « sectaire ». Mais certains de ces fareinistes ont un ancrage politique et social réel, ce que tendraient à occulter les discours convulsionnaires sur lesquels nous avons essentiellement travaillé (et qui majorent les données proprement religieuses).The “Fareinist” convulsionary group, which appeared in the 1780s in the Dombes region and which was reconstituted in Paris during the Directory and the Consulate, was a prototype of a “utopic community,” structured around the expectation of millennium and the end of time. We will see in what ways this micro-society functioned in the style of a “walled-off” social order, timeless and separated from the world. Indeed, these dissident believers perceived of events (both external and internal to the group) through a biblical prism tending to esotericism. Their internal organization also obeyed a “sectarian” logic. However, certain of these Fareinists were grounded in the politics and social events of their time, which tended to conceal the convulsionary discourse which we have examined extensively (and which increased the weight of strictly religious elements)

Mercury and methylmercury concentrations in high altitude lakes and fish (Arctic charr) from the French Alps related to watershed characteristics

International audienceTotal mercury (THg) andmethylmercury (MeHg) concentrations were measured in the muscle of Arctic charr (Salvelinus alpinus) and in the water column of 4 lakes that are located in the French Alps. Watershed characteristics were determined (6 coverage classes) for each lake in order to evaluate the influence of watershed composition on mercury and methylmercury concentrations in fish muscle and in the water column. THg and MeHg concentrations in surface water were relatively low and similar among lakes and watershed characteristics play a major role in determining water column Hg and MeHg levels. THg muscle concentrations for fish with either a standardized length of 220 mm, a standardized age of 5 years or for individualuals did not exceed the 0.5 mg kg−1 fish consumption advisory limit established for Hg by the World Health Organization (WHO, 1990). These relatively low THg concentrations can be explained by watershed characteristics, which lead to short Hg residence time in the water column, and also by the short trophic chain that is characteristic of mountain lakes. Growth rate did not seem to influence THg concentrations in fish muscles of these lakes and we observed no relationship between fish Hg concentrations and altitude. This study shows that in the French Alps, high altitude lakes have relatively low THg and MeHg concentrations in both the water column and in Arctic charr populations. Therefore, Hg does not appear to present a danger for local populations and the fishermen of these lakes

The Neandertal bone industry at Chagyrskaya cave, Altai Region, Russia

peer reviewedFor a long time, the rich bone industries of the Upper Palaeolithic were opposed to the opportunistic Neandertal bone tools among which the bone retoucher was the most common type. The recent finding of a few shaped bone tools into Mousterian contexts has been taken as an emergence of a “modern behaviour”. However, this outlook is based on biased corpuses. On one side, the large number of unshaped bone tools recently discovered in Upper Palaeolithic assemblages leads us to reconsider what a bone industry can be. On the other side, the increasing discoveries of bone tools in more ancient contexts indicates that this type of production is not strictly linked to Homo sapiens. Chagyrskaya cave, located in the Siberian Altai, brings us the opportunity to discuss this question. Dated around 50,000 years BP, the site yielded a local facies of Mousterian lithic industry associated to several Neandertal remains. A technological and functional analysis of the faunal remains reveal more than one thousand bone tools. Most are retouchers, but a significant part belongs to other morpho-functional categories: intermediate tools, retouched tools and tools with a smoothed end. Even though these tools were mainly manufactured by direct percussion, their number and the recurrence of their morphological and traceological features lead us to consider them as a true bone industry. Far from the Homo sapiens standards, this industry has its own coherence that needs now to be understood

Not so unusual Neanderthal bone tools: new examples from Abri Lartet, France

peer reviewedNeanderthal bone tools are often seen as negligible, consisting mainly of retouchers made from diaphyseal fragments and recognizable by their impact marks. One category, however, stand out, consisting of elongated pieces with blunt ends, most often on ribs, whose shaping involved scraping and abrasion and which are regarded as anticipating Upper Paleolithic. They are termed lissoir (smoother or burnisher) by typological analogy, although the diversity of their active ends suggests a greater functional diversity than this designation implies. Their apparent standardization results from the use of anatomically suitable blanks that only required the shaping of an active end. Mostly reported in older publications as isolated finds, they are beginning to be found in greater quantities through the careful examination of faunal remains. We describe here a series partly published in the 1970s, completed by new pieces thanks to a recent reassessment of the assemblage, and we consider it in a broader perspective

Neanderthal bone tools from inside, at Jonzac, Quina level, France

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Multi-national survey on the methods, efficacy, and safety on the post-approval clinical use of pulsed field ablation (MANIFEST-PF).

AIMS Pulsed field ablation (PFA) is a novel atrial fibrillation (AF) ablation modality that has demonstrated preferential tissue ablation, including no oesophageal damage, in first-in-human clinical trials. In the MANIFEST-PF survey, we investigated the 'real world' performance of the only approved PFA catheter, including acute effectiveness and safety-in particular, rare oesophageal effects and other unforeseen PFA-related complications. METHODS AND RESULTS This retrospective survey included all 24 clinical centres using the pentaspline PFA catheter after regulatory approval. Institution-level data were obtained on patient characteristics, procedure parameters, acute efficacy, and adverse events. With an average of 73 patients treated per centre (range 7-291), full cohort included 1758 patients: mean age 61.6 years (range 19-92), female 34%, first-time ablation 94%, paroxysmal/persistent AF 58/35%. Most procedures employed deep sedation without intubation (82.1%), and 15.1% were discharged same day. Pulmonary vein isolation (PVI) was successful in 99.9% (range 98.9-100%). Procedure time was 65 min (38-215). There were no oesophageal complications or phrenic nerve injuries persisting past hospital discharge. Major complications (1.6%) were pericardial tamponade (0.97%) and stroke (0.4%); one stroke resulted in death (0.06%). Minor complications (3.9%) were primarily vascular (3.3%), but also included transient phrenic nerve paresis (0.46%), and TIA (0.11%). Rare complications included coronary artery spasm, haemoptysis, and dry cough persistent for 6 weeks (0.06% each). CONCLUSION In a large cohort of unselected patients, PFA was efficacious for PVI, and expressed a safety profile consistent with preferential tissue ablation. However, the frequency of 'generic' catheter complications (tamponade, stroke) underscores the need for improvement

A worldwide survey on incidence, management and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: The POTTER-AF study.

AIMS Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management and outcome are sparse. METHODS AND RESULTS This international multicenter registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation. A total of 553,729 catheter ablation procedures (radiofrequency: 62.9%, cryoballoon: 36.2%, other modalities: 0.9%) were performed at 214 centers in 35 countries. In 78 centers 138 patients (0.025%, radiofrequency: 0.038%, cryoballoon: 0.0015% (p<0.0001)) were diagnosed with an oesophageal fistula. Periprocedural data were available for 118 patients (85.5%). Following catheter ablation, the median time to symptoms and the median time to diagnosis were 18 (7.75, 25; range: 0-60) days and 21 (15, 29.5; range: 2-63) days, respectively. The median time from symptom onset to oesophageal fistula diagnosis was 3 (1, 9; range: 0-42) days. The most common initial symptom was fever (59.3%). The diagnosis was established by chest computed tomography in 80.2% of patients. Oesophageal surgery was performed in 47.4% and direct endoscopic treatment in 19.8%, and conservative treatment in 32.8% of patients. The overall mortality was 65.8%. Mortality following surgical (51.9%) or endoscopic treatment (56.5%) was significantly lower as compared to conservative management (89.5%) (odds ratio 7.463 (2.414, 23.072) p<0.001). CONCLUSIONS Oesophageal fistula after catheter ablation of atrial fibrillation is rare and occurs mostly with the use of radiofrequency energy rather than cryoenergy. Mortality without surgical or endoscopic intervention is exceedingly high

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population.

In clinical practice and for scientific purposes, cardiologists and primary care physicians perform risk assessment in patients with cardiac diseases or conditions with high risk of developing such. The European Heart Rhythm Association (EHRA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS) set down this expert consensus statement task force to summarize the consensus regarding risk assessment in cardiac arrhythmias. Objectives were to raise awareness of using the right risk assessment tool for a given outcome in a given population, and to provide physicians with practical proposals that may lead to rational and evidence-based risk assessment and improvement of patient care in this regard. A large variety of methods are used for risk assessment and choosing the best methods and tools hereof in a given situation is not simple. Even though parameters and test results found associated with increased risk of one outcome (e.g. death) may also be associated with higher risk of other adverse outcomes, specific risk assessment strategies should be used only for the purposes for which they are validated. The work of this task force is summarized in a row of consensus statement tables

Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study

Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.Peer reviewe