De la constitution des réseaux des notaires-secrétaires royaux sous les premiers Valois (1328-1380) : famille, viviers et institutions

Le présent propos a pour objet l’appréhension et l’étude des différents types de réseaux tissés entre et par les notaires-secrétaires de la chancellerie des trois premiers souverains Valois. Des lignées notariales y voient le jour, affichant leurs liens de parenté et veillant à sauvegarder les richesses accumulées dans le cadre de leur(s) fonction(s). D’autres consolident leur situation au moyen d’unions matrimoniales, souvent réalisées entre familles exerçant dans l’administration. La création d’une confrérie des clercs, notaires-secrétaires du roi, leur offre un autre lieu de partage et de fédération. Ainsi, il sera question d’examiner au travers d’exemples précis la construction et les différentes formes adoptées par ces réseaux tout en questionnant leur caractère plus ou moins pérenne. Ces réflexions prennent appui sur des documents issus de différents fonds des Archives nationales (en particulier le Trésor des chartes, séries J et JJ) et de la Bibliothèque nationale de France

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

From charters to registers. The royal notaries and secretaries in the 14th century. Social and documentary study.

Centrée sur le règne des trois premiers Valois (1328-1380), cette thèse a pour objectif d’étudier la construction, le fonctionnement et les pratiques du groupe social formé par les notaires et secrétaires exerçant à la chancellerie royale française. Elle se fonde pour cela sur l’examen combiné de leurs pratiques scripturales et de leurs parcours.Ce travail s’appuie sur l’étude de l’intégralité des registres de chancellerie de Philippe VI, Jean le Bon et Charles V. Sujets d’une archéologie textuelle, ces documents sont considérés comme des unités de sens composées de plusieurs strates d’actions humaines s’échelonnant de leur création au XIXe siècle. Une étude comparative avec les registres du Parlement civil contemporains est menée dans le but de déterminer s’il existe, au sein de l’administration royale, un ou plusieurs arts du registre.Les mentions extra sigillum, la signature et les sceaux personnels de plusieurs notaires et secrétaires sont également analysées. Ces marqueurs personnels nous donnent accès tant à des pratiques administratives qu’à l’expression d’une individualité.En pleine expansion sous les trois premiers Valois, l’ornementation des chartes et des registres est également l’objet d’une étude. Pratique connexes aux deux genres documentaires, elle développe une rhétorique visuelle dans le temps long.Les parcours d’une vingtaine de notaires et secrétaires royaux sont enfin appréhendés afin de mettre en évidence les caractéristiques et points de cohésion de ce groupe professionnel devenu communauté confraternelle suite à la création de leur confrérie en mars 1351.Centered on the reign of the first three Valois (1328-1380), this thesis aims to study the construction, functioning and practices of the social group formed by the notaries and secretaries of the French royal chancellery. It is based on the combined examination of their scriptural practices and their experiences.This work is based on the study of the totality of the chancery registers of Philippe VI, Jean le Bon and Charles V. At the center of textual archeology, these documents are treated as units of meaning composed of several layers of human actions ranging from their creation to the 19th century. A comparative study with registers of civil Parliament is being conducted to determine whether one or more arts of registry within the royal administration are implied.The extra sigillum entries, the signature and the personal seals of several notaries and secretaries are also analysed. These personal markers give us access to administrative practices as well as to the expression of an individuality.In full expansion under the first three Valois, the ornamentation of the charters and registers is also the subject of a study. A practice related to the two documentary genres, it develops a visual rhetoric over time.The careers of some twenty notaries and royal secretaries are finally apprehended in order to highlight the characteristics and points of cohesion of this professional group that became a brotherly community following the creation of their confraternity in March 1351

Lettre diplomatique, registres et enregistrement à la chancellerie des premiers Valois : pratiques, traces et réalité.

International audienceA plus d'un titre, le règne des trois premiers Valois (1328-1380) marque un tournant tant d'un point de vue dynastique que d'un point de vue documentaire. La chancellerie royale française y parfait sa structure et poursuit sa croissance, parfois mal maîtrisée et nécessitant quelques retouches, tout en réalisant des documents de plus en plus nombreux et variés. Ces derniers sont les héritiers de pratiques scripturales anciennes et en constante mutation où le modèle épistolaire joua un rôle important. Malgré cette parenté, lettre et charte sont souvent présentées comme deux entités bien distinctes aux frontières étanches. Dans la sphère royale, quoique différents ces deux types d'écrits cohabitent et n'en demeurent pas moins perméables, se mêlant parfois à des degrés variables. Le vocabulaire, les ornements voire même les rapports induits par l'acte en tant que vecteur de communication sont autant de points qu'il convient d'aborder afin de mettre en évidence tant les différences que les métissages documentaires. Bien que n'étant pas conservées dans les registres de chancellerie, il convient de démontrer que les lettres, en tant que pièces importante du canevas complexe donnant vie aux chartes, ne sont pas totalement absentes de ces sommes documentaires et permettent d'aborder la question de la transmission des originaux et des rapports qu'ils entretiennent avec leur copie

De la constitution des réseaux des notaires-secrétaires royaux sous les premiers Valois (1328-1380). Famille, viviers et institutions.

National audienceLa présente communication aura pour objet l'appréhension et l'étude des différents types de réseaux tissés entre et par les notaires-secrétaires de la chancellerie des trois premiers souverains Valois. Des lignées notariales y voient le jour, affichant leurs liens de parenté et veillant à sauvegarder les richesses accumulées dans le cadre de leur(s) fonction(s). D'autres consolident leur situation au moyen d'unions matrimoniales, souvent réalisées entre familles exerçant dans l'administration. La création d'une confrérie des clercs, notaires-secrétaires du roi leur offre un autre lieu de partage et de fédération. Ainsi, il sera question d'examiner au travers d'exemples précis, la construction et les différentes formes adoptées par ces réseaux tout en questionnant leur caractère plus ou moins pérenne. Le propos s'appuiera sur des documents issus de différents fonds des Archives nationales (en particulier le Trésor des chartes, séries J et JJ) et de la Bibliothèque nationale de France

La lettre diplomatique à la chancellerie des premiers Valois (1328-1380)

Pour chaque chose, il faut un cadre. Pareil pour la pensée. On ne doit pas craindre le cadre exagérément, mais il ne faut pas non plus craindre de le casser. C’est ça le plus important pour trouver la liberté. Respecter et détester le cadre. Les choses qui comptent le plus dans la vie d’un homme sont toujours ambivalentes. Voilà à peu près tout ce que je peux dire. Haruki Murakami, L’incolore Tsukuru Tazaki et ses années de pèlerinage Extraite de la littérature japonaise contemporaine, la cit..

Evaluation of new apolipoprotein C-II and apolipoprotein C-III automatized immunoturbidimetric kits

International audienc

Une combinaison de polymorphismes mononucléotidiques est associée à la variabilité interindividuelle de labiodisponibilité du cholécalciférol chez des hommes sains

Une combinaison de polymorphismes mononucléotidiques est associée à la variabilité interindividuelle de labiodisponibilité du cholécalciférol chez des hommes sains. Journées francophones de nutrition (JFN 2016

A Combination of Single-Nucleotide Polymorphisms Is Associated with the Interindividual Variability in VitaminD Bioavailability in Healthy Men.

Background – A significant part of vitamin D present in the human body is synthesized in the skin following UV light exposition. However, to obtain or maintain an adequate vitamin D status, most individuals have to consume vitamin D, either as part of their diet or as supplements. The blood response to vitamin D supplementation has been shown to exhibit a large interindividual variability. Moreover, vitamin D intestinal transport depends, at least partly, on proteins and we have shown that the bioavailability of other lipid micronutrients (tocopherol, lutein, lycopene and beta-carotene), which share common absorption mechanism with cholecalciferol (D3),was partly modulated by single nucleotide polymorphisms (SNPs) in genes involved in the intestinal transport of these micronutrients and in the metabolism of chylomicrons. The main objective of this study was thus to identify SNPs associated with the interindividual variability in the bioavailability of D3. Methods – Thirty nine healthy adult men were genotyped using whole-genome microarrays. They consumed a meal that contained 5g D3 as a supplement. D3 and calcifediol (25(OH)D) concentration in plasma chylomicrons was measured at regular time intervals up to 8h after meal intake. The association between SNPs in genes involved in vitamin D and lipid metabolism (61 candidate genes representing 3791 SNPs) and the D3 response (calculated as the area-under-the-curve of the postprandial chylomicron D3 concentration) was analysed by partial least squares regression (PLS regression).Results – The postprandial chylomicron D3 concentration peaked 5.4 h after meal intake. There was no significant variation in the postprandial chylomicron 25(OH)D concentration. The D3 response displayed a large interindividual variability (CV=47%). It correlated positively with the postprandial chylomicron triglyceride response (r=0.60, P<0.001) but not with the fasting 25(OH) D plasma concentration (a marker of vitamin D status) (r=0.04, P=0.83). A significant (P=1.32x10-4) PLS regression model, which included 17 SNPs in 13 genes (LPL, ISX, SLC10A2, GC, SCARB1, PNLIP, DHCR7, ABCA1, ABCB1, APOB, MAPRE2, BET1, NAT2), was associated with the variance in the D3 response. Five of these genes (ABCA1, APOB, BET1, LPL and NAT2) have been associated in another study with the postprandial chylomicron triglyceride response in the same subjects.Conclusions – In a group of healthy men, we observed a high interindividual variability in D3 bioavailability which was associated with a combination of SNPs located in/near genes involved in both vitamin D and lipid metabolism.Desmarchelier et al., A Combination of Single-Nucleotide Polymorphisms Is Associated with Interindividual Variability inCholecalciferol Bioavailability in Healthy Men, Journal of Nutrition, In Press