Abūnā Sam‘ān un prêtre bâtisseur en Égypte

Alors qu’on présente souvent les coptes cantonnés dans leur rôle de victimes de la violence islamiste, le monastère copte de Saint-Sam‘ān montre au contraire les capacités d’action et d’adaptation de la minorité chrétienne. Le prêtre Sam‘ān a construit au début des années 1990 un complexe de sept églises, au cœur du quartier de chiffonniers du Muqaṭṭam qui attire de nombreux visiteurs égyptiens et étrangers. L’initiative s’inscrit dans différentes scènes et logiques d’action : le développement urbain, la politique locale, et, surtout, la scène communautaire copte. Sam‘ān a exercé son office religieux dans un style que l’on peut qualifier de charismatique, caractérisé notamment par des exorcismes publics. Il s’est également appuyé sur la tradition pour mettre en valeur une vision régulièrement dénoncée par ses adversaires comme une dérive protestante.This article argues that the Copts are not simply victims of the violence perpetrated by Islamists in Egypt, but that they are also agents capable of acting and adapting to their environment. This argument will be based on the case of Father Sam‘ān, a prominent priest, known, among other things, for having built an impressive complex of seven churches at the heart of the garbage collector area of Muqaṭṭam in Cairo. As the paper highlights, the priest had to adapt to the different strategies and modes of action structuring local communities that were made available to him, such as urban development, local politics, and, above all, the characteristics of the communal Coptic milieu. He fulfilled his religious role in a style that could be called charismatic, and which included the practice of public exorcisms. This article explains how he took advantage of the Coptic tradition to serve a vision regularly criticized by his opponents, representatives of a protestant trend.El objetivo de este artículo es demostrar que los coptos, contrariamente a lo que se piensa de ellos como víctimas de la violencia islamista, constituyen una comunidad cristiana cuya capacidad de adaptación y acción se contrapone a la pasividad que por lo general se les atribuye. El análisis está basado en el caso del sacerdote copto Sam‘ān, quien goza hoy de una gran popularidad. Efectivamente, a principios de la década de los noventa, el sacerdote construyó un complejo de siete iglesias en el corazón del barrio de recicladores de Muqaṭṭam, lo que atrae a numerosos visitantes tanto egipcios como extranjeros. Para llevar a cabo el análisis, se darán a conocer las maneras en que el sacerdote se adaptó a las diferentes lógicas de acción de los contextos en los que se dio a conocer: el desarrollo urbano, la política local y, especialmente, el campo de acción de la comunidad copta. El sacerdote Sam‘ān ofició su labor religiosa en un estilo que puede ser calificado como carismático, principalmente caracterizado por el recurso a exorcismos públicos. Se darán a conocer las maneras en que el sacerdote Sam‘ān se apoyó en la tradición para atribuirle valor a una visión que era, por lo general, calificada como una desviación protestante por sus adversarios

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/)