Incidences et valeur prépositionnelle de com(e) suivi d’un adjectif qualificatif en français médiéval

Dans la perspective d’appréhender l’entier du microsystème comme, le présent article s’efforce d’étudier les emplois spécifiques de com(e) suivi d’un adjectif qualificatif en français médiéval. L’analyse proposée des caractéristiques de ce syntagme complexe s’appuie sur l’idée de l’existence d’une double incidence de com(e) et sur le lien étroit qui existe entre l’incidence interne et externe et le concept de caractérisation autarcique et accidentelle. Elle aboutit ainsi à mieux définir une des valeurs subduites de ce morphème.This paper attempts to explore the specific uses of com(e) followed by an adjective in medieval French with the aim of understanding the entire microsystem of “comme”. The proposed analysis of the com(e) ADJ complex syntagm relies on the hypothesis of a dual incidence of com(e). We assume these internal and external incidences are tightly related and we put forward the concept of autarkical and accidental characterization in order to explain the dematerialized values of this morpheme

Similar at-sea behaviour but different habitat use between failed and successful breeding albatrosses

Breeding failure is expected to induce behavioural changes in central place foragers. Indeed, after a failed reproductive attempt, breeding individuals are relieved from having to return to their breeding site for reproductive duties and thus are less constrained than successful breeders in their movements during the remainder of the breeding season. Accordingly, they are expected to adjust their behaviour, travelling longer in distance and/or time to reach foraging grounds. They are also expected to use different foraging areas to decrease local intra-specific competition with successful breeders. We compared the at-sea behaviour and habitat use of successful and failed Indian yellow-nosed albatrosses nesting in Amsterdam Island, Southern Indian Ocean, during 2 chick-rearing seasons. Failed breeders exhibited the same at-sea foraging behaviour, travelling as far and as long as successful breeders. They also spent the same amount of time on their nest between at-sea trips. Nevertheless, habitat models revealed partial spatial segregation of failed breeders, which used specific foraging areas characterized by deeper and colder waters in addition to the areas they shared with successful breeders. Our study shows the importance of combining a range of analytical methods (spatial analysis, behavioural inferences with advanced movement models and habitat models) to infer the at-sea behaviour and habitat use of seabirds. It also stresses the importance of considering individual breeding status when aiming to understand the spatial distribution of individuals, especially when this information may have conservation implications

Muscular compartment syndrome and in vivo optical spectroscopy monitoring: a new model

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Performance measures for endoscopic retrograde cholangiopancreatography and endoscopic ultrasound: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a short list of key performance measures for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). We recommend that endoscopy services across Europe adopt the following seven key and one minor performance measures for EUS and ERCP, for measurement and evaluation in daily practice at centre and endoscopist level: 1 Adequate antibiotic prophylaxis before ERCP (key performance measure, at least 90%); 2 antibiotic prophylaxis before EUS-guided puncture of cystic lesions (key performance measure, at least 95%); 3 bile duct cannulation rate (key performance measure, at least 90%); 4 tissue sampling during EUS (key performance measure, at least 85%); 5 appropriate stent placement in patients with biliary obstruction below the hilum (key performance measure, at least 95%); 6 bile duct stone extraction (key performance measure, at least 90%); 7 post-ERCP pancreatitis (key performance measure, less than 10%); and 8 adequate documentation of EUS landmarks (minor performance measure, at least 90%). This present list of quality performance measures for ERCP and EUS recommended by the ESGE should not be considered to be exhaustive; it might be extended in future to address further clinical and scientific issues

Implementation of endoscopic submucosal dissection in Europe: survey after ten ESD expert training workshops 2009 – 2018

Background and aims Transfer of ESD technique for early gastrointestinal cancer from Japan requires expert-supervised experimental training before unsupervised implementation of clinical ESD. Aims To evaluate unsupervised implementation of ESD-intention-to-treat (-ITT). Methods ESD Workshops (in-vivo porcine model) lasted 3.3 days including one day theory for 177 participants from 135 Western referral centers. A questionnaire was sent to the senior participant of all 135 centers. Design Cross-sectional questionnaire survey. Main outcome measurements Performance, organ distribution, severe adverse events of ESD-ITT. Results Feedback was received from 113 centers (84%), i.e. 73 (54%) ESD centers and 40 centers (30%) with zero ESD; 10 (7%) had published ESD; no feedback from 12 (9%) centers with unknown status. Altogether, 83 centers (61.5%) perform ESD: 21 (16%) had >150 ESD (professional category), 33 (24%) had 31-150 ESD (competent category), and 29 (21.5%) had ≤ 30 ESD (initial learning category). Most implemented ESD centers (91%, 72 of 79) were analyzed: Centers on initial learning (420 ESD) compared to centers with >30 ESD (5676 ESD) performed en-bloc ESD in 64% vs. 84%, hybrid-ESD in 26% vs.11% and piecemeal-EMR in 10% vs. 5.2%. Majority of ESD (66-68%) were in colorectum, overall with low risk (30-day mortality 0.03%, surgical repair 3.5% vs. 1.7%) and satisfactory outcome (oncosurgery 7.4% vs. 5.2%, local recurrence 1.5% vs. 0.3%). Conclusions Beyond guideline recommendations, unsupervised implementation of ESD was successful in colorectum with step-up approach. Now, Western ESD centers have to aim for professional (i.e. >80%) curative ESD

Treatment of post-cholecystectomy biliary strictures with fully-covered self-expanding metal stents - results after 5 years of follow-up

BACKGROUND: Endoscopic treatment of post-cholecystectomy biliary strictures (PCBS) with multiple plastic biliary stents placed sequentially is a minimally invasive alternative to surgery but requires multiple interventions. Temporary placement of a single fully-covered self-expanding metal stent (FCSEMS) may offer safe and effective treatment with fewer re-interventions. Long-term effectiveness of treatment with FCSEMS to obtain PCBS resolution has not yet been studied. METHODS: In this prospective multi-national study in patients with symptomatic benign biliary strictures (N = 187) due to various etiologies received a FCSEMS with scheduled removal at 6-12 months and were followed for 5 years. We report here long-term outcomes of the subgroup of patients with PCBS (N = 18). Kaplan Meier analyses assessed long-term freedom from re-stenting. Adverse events were documented. RESULTS: Endoscopic removal of the FCSEMS was achieved in 83.3% (15/18) of patients after median indwell of 10.9 (range 0.9-13.8) months. In the remaining 3 patients (16.7%), the FCSEMS spontaneously migrated and passed without complications. At the end of FCSEMS indwell, 72% (13/18) of patients had stricture resolution. At 5 years after FCSEMS removal, 84.6% (95% CI 65.0-100.0%) of patients who had stricture resolution at FCSEMS removal remained stent-free. In addition, at 75 months after FCSEMS placement, the probability of remaining stent-free was 61.1% (95% CI 38.6-83.6%) for all patients. Stent or removal related serious adverse events occurred in 38.9% (7/18) all resolved without sequalae. CONCLUSIONS: In patients with symptomatic PCBS, temporary placement of a single FCSEMS intended for 10-12 months indwell is associated with long-term stricture resolution up to 5 years. Temporary placement of a single FCSEMS may be considered for patients with PCBS not involving the main hepatic confluence. TRIAL REGISTRATION NUMBERS: NCT01014390; CTRI/2012/12/003166; Registered 17 November 2009

Endoscopic mucosal resection with anchoring of the snare tip: multicenter retrospective evaluation of effectiveness and safety

International audienc