L’architecture de l’ancien bâtiment thermal d’Aix-les-Bains : un témoignage de l’histoire des thérapeutiques physiques et manuelles

L’ancien bâtiment thermal d’Aix-les-Bains (Savoie) est composé d’une série de constructions qui se sont peu à peu greffées à l’édifice initial, bâti en 1786 près de sources connues depuis l’époque romaine. Les derniers agrandissements significatifs datent des années 1970. La station accueillait alors près de 50 000 curistes par an. Le dépouillement des publications médicales locales sur un siècle et demi et l’analyse des plans successifs de l’établissement mettent en lumière une profonde imbrication de l’architecture avec la médecine. Alors que le premier bâtiment avait été édifié dans le contexte d’une médecine encore hippocratique, où la sudation était considérée comme un principe de soin fondamental, les constructions de la seconde moitié du XIXe siècle accordent plus de place aux thérapeutiques physiques et manuelles (massages, douches) qui accompagnent le développement de la médecine physique. Au XXe siècle, ce sont les techniques de mobilisation et de rééducation en piscine qui déterminent les nouveaux aménagements, répondant aux besoins naissants de la rhumatologie et de la chirurgie orthopédique. Le développement architectural du bâtiment reflète ainsi l’histoire de ces spécialités médicales et témoigne de leur fondement hippocratique. L’éclectisme stylistique qui le caractérise est précisément ce qui le rend remarquable sous l’angle de ce patrimoine immatériel que constitue la pratique thermale aixoise.The old spa building at Aix-les-Bains (Savoie) is composed of a series of constructions progressively added to the original monument, built in 1786 close to springs that were known to the Romans. The most recent significant additions date from the 1970s. At this period, over 50,000 people per year came to Aix-les-Bains to take the waters. The analysis of local medical publications dating from the last century and a half, along with the examination of successive plans of the establishment, has drawn attention to the close imbrication between architecture and medicine. The first building date from a period still inspired by Hippocratic medicine for which sweating is one of the basic principles of health. The buildings of the second half of the nineteenth century give more emphasis to physical and manual therapies (massages, showers) which accompany the development of physical medicine. During the twentieth century, mobility and re-education techniques in a bathing pool determine new architectural designs which come to meet the needs of rheumatology and orthopedic surgery. The architectural evolution of the establishment reflects the history of medical specialities and their Hippocratic basis. The architectural eclecticism which characterises the spa buildings also makes them precious from the perspective of intangible heritage: the rites and rituals of taking the waters at Aix-les-Bain

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/)

Pour tout l'art de Dieu (contribution à une sociologie picturale des églises parisiennes pendant l'ère paroissiale)

PARIS5-BU Saints-Pères (751062109) / SudocSudocFranceF

Lockdown impact on COVID-19 epidemics in regions across metropolitan France

International audienc

Glycerolipids in photosynthesis: Composition, synthesis and trafficking.

International audience: Glycerolipids constituting the matrix of photosynthetic membranes, from cyanobacteria to chloroplasts of eukaryotic cells, comprise monogalactosyldiacylglycerol, digalactosyldiacylglycerol, sulfoquinovosyldiacylglycerol and phosphatidylglycerol. This review covers our current knowledge on the structural and functional features of these lipids in various cellular models, from prokaryotes to eukaryotes. Their relative proportions in thylakoid membranes result from highly regulated and compartmentalized metabolic pathways, with a cooperation, in the case of eukaryotes, of non-plastidic compartments. This review also focuses on the role of each of these thylakoid glycerolipids in stabilizing protein complexes of the photosynthetic machinery, which might be one of the reasons for their fascinating conservation in the course of evolution. This article is part of a Special Issue entitled: Dynamic and ultrastructure of bioenergetic membranes and their components

Plant growth control by water deficit: which process(es) to lead the game?

National audienceThe nature of plant growth limitation by environmental stresses such as water deficit is a central question for physiologists and breeders because this knowledge could help to target key processes for breeding programs and help designing plants able to maintain growth under stressful conditions. In order to grow, plant cells must loosen their walls, absorb water, reduce and process enough C and minerals to match the plant demand. Therefore, plant cell growth can be limited by cell wall rheological properties, cell or tissue hydraulics or by metabolism. In addition, cell division can be an important process to consider as cell number, together with cell size, contributes to the whole organ size. Over the past few years, our group has questioned the importance of these limitations using combinations of ecophysiological tools, spatio-temporal growth analysis and modelling in ranges of genotypes (including natural variants and mutants). Among the outcomes of these studies, I will show that (i) hydraulic limitation plays a great role on organ growth on the short term, (ii) distinct members of the cell wall loosening expansins family are downstream, unspecific targets of a range of converging developmental, genetic, and environmental cues (iii) metabolism and growth are tightly connected, possibly through a remote control of leaf expansion by starch metabolism and (iv) leaf cell size is more a consequence of growth control at higher levels of organization than vice-vers