École Nationale Supérieure d'Art

Data are needed on the effect of oxygen delivered through a high-flow nasal cannula, as compared with standard oxygen therapy, on intubation and mortality in patients with acute hypoxemic respiratory failure. In this multicenter, open-label trial, we randomly assigned patients who had acute hypoxemic respiratory failure to receive high-flow-oxygen or standard-oxygen therapy. All the patients had a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of 200 or less, a respiratory rate of more than 25 breaths per minute, and pulmonary infiltrate on chest imaging. The primary outcome was death by day 28. A total of 1116 patients underwent randomization. Of these patients, 1110 (556 in the high-flow-oxygen group and 554 in the standard-oxygen group) were included in the analysis. Mortality at day 28 was 14.6% (in 81 of 556 patients) in the high-flow-oxygen group and 14.6% (in 81 of 554 patients) in the standard-oxygen group (difference, -0.05 percentage points; 95% confidence interval [CI], -4.21 to 4.10; P = 0.98). The incidence of intubation by day 28 was 42.4% (in 236 of 556 patients) in the high-flow-oxygen group and 48.4% (in 268 of 554 patients) in the standard-oxygen group (difference, -5.93 percentage points; 95% CI, -11.78 to -0.08). Serious adverse events (cardiac arrest or pneumothorax) occurred during spontaneous breathing in 13 patients (2.3%) in the high-flow-oxygen group and in 6 patients (1.1%) in the standard-oxygen group. Among patients with acute hypoxemic respiratory failure, the use of oxygen delivered through a high-flow nasal cannula did not significantly reduce mortality at day 28. (Funded by the French Ministry of Health and Fisher and Paykel Healthcare; SOHO ClinicalTrials.gov number, NCT04468126.).

Abstract There is growing interest in deploying insect traps in forest canopies for ecological research, invasive species surveillance, and biodiversity monitoring. However, forest canopies also harbor a diverse and abundant bat community, which may be incidentally trapped and killed by these devices. In this study, we investigated the impact of flight interception traps and multi-funnel traps deployed in oak canopies on incidental bat captures, and evaluated whether trap modifications could reduce this bycatch. We also examined how these modifications influenced the species richness, abundance, and mean body size of several beetle taxa, including Buprestidae, Cerambycidae, Cetoniinae, and Scolytinae. Both trap types captured bats. Flight interception traps accidentally caught seven species - Myotis bechsteinii , Myotis daubentonii , Myotis mystacinus , Nyctalus noctula , Nyctalus leisleri , Plecotus auritus , and Pipistrellus pipistrellus - with an average of 0.42 bats per trap. Multi-funnel traps primarily caught males of P. pipistrellus , with an average of 0.29 bats per trap. Adding a 13-mm mesh above the collection container significantly reduced bat bycatch to 0.02 and 0.05 bats per trap in flight interception traps and multi-funnel traps, respectively. This modification had no significant effect on insect species richness or mean body size, although it did reduce Cerambycidae and Scolytinae abundance in black multi-funnel and flight interception traps, respectively. This was likely due to more frequent clogging by twigs and leaves. We recommend modifying flight interception and multi-funnel traps deployed in forest canopies to prevent unintentional harm to protected bat species.

Au Pôle de phénotypage des petits ruminants (P3R) d’INRAE à Bourges, l’année 2022 a été caractérisée par une forte implication des équipes autour du sujet de l’enrichissement du milieu des caprins. De nouveaux enrichissements ont été installés, d’autres ont été fabriqués de toutes pièces avec du matériel recyclé trouvé sur site, et un enrichissement coopératif a entièrement été pensé et conçu par certains employés du P3R. Dans une quête constante d’amélioration du bien-être de nos animaux élevés en bâtiments, les dispositifs conçus doivent leur permettre d’enrichir leur répertoire comportemental et, notamment, d’exprimer des comportements naturels ; c’est pourquoi ils doivent être adaptés à l’espèce.

The use of vagus nerve stimulation (VNS) to reduce or stop electroconvulsive therapy (ECT) in treatment-resistant depression seems promising. The aim of this study was to investigate the efficacy of VNS on the reduction of ECT sessions and mood stabilization. We conducted a monocentric retrospective case series of patients who suffered from treatment-resistant depression, treated with ECT and referred to our center for VNS. We investigated the number and the frequency of ECT sessions before and after VNS implantation. Secondary criteria consisted in the Montgomery Åsberg Depression Rating Scale (MADRS) score, number of medical treatments, dosage of the main treatment and length of hospital stays before and after VNS. Additionally, we sent an anonymous survey to psychiatrists and other physicians in our institution to investigate their knowledge and perception of VNS therapy to treat treatment-resistant depression. Seven patients benefited from VNS: six (86%) were female (mean age of 51.7 +/- 16.0 years at surgery), and five (71%) suffered from bipolar depression (three type I and two type II). All patients were followed up at least 2 years post-implantation (range: 27-68 months). Prior to VNS, six patients were treated by maintenance ECT. After VNS, three (43%) patients did not require maintenance ECT anymore, and three (43%) patients required less frequent ECT session with a mean 14.7 +/- 9.8 weeks between sessions after VNS vs. 2.9 +/- 0.8 weeks before VNS. At last follow-up, 4 (57%) patients had stopped ECT. Five (71%) patients implanted with VNS were good responders (50% decrease relative to baseline MADRS). According to the survey, psychiatrists had a significantly better perception and knowledge of ECT, but a worse perception and knowledge of VNS compared to other physicians. VNS is a good option for treatment-resistant depression requiring maintenance ECT dependence. Larger on-going studies will help broaden the implanted patients while strengthening psychiatrists' knowledge on this therapy.

Abstract IntroductionAcute ST elevation myocardial infarction (STEMI) is one frequent and serious presentation of acute coronary syndrome. The STOP SCA+ study aimed to identify factors associated with negative outcomes one year after STEMI, particularly the impact of rehabilitation care and compliance.MethodsPatients>18 years old hospitalized for STEMI management in five interventional cardiac centers in one French region (2.5 million inhabitants), between 2014 and 2018, were included. After a probabilistic matching with the National Health Insurance database (SNDS, 96% matching), compliance for cardiac tri-therapy was studied: aspirin, P2Y12 inhibitor statin. Factors associated with poor outcomes (ischemic complications, death) were analyzed using Cox modelling and those for the compliance by logistic regression.Results3,768 patients were included, with 84% of primary percutaneous coronary intervention. At one year, 3,362 were prescribed a tri-therapy (89.2%) among whom 53% were compliant; 2,478 patients went to cardiac rehabilitation (65.8%). Death occurred in 130 patients and/or ischemic complication in 194 (total poor outcome 8.0%). Compliance was not associated with complications over the year (HR 1.16 [0.86-1.57]), while the absence of cardiac rehabilitation was (2.31 [1.73-3.08]). Additionally, cardiac rehabilitation was associated with compliance (OR 1.55 [1.34-1.79]).DiscussionSTEMI clinical evolution at one year is mainly favorable. Pejorative outcomes were scarce, and appeared to be related to patients’ characteristics, initial STEMI presentation, and no access to rehabilitation. Compliance part in patient health outcome will need further modelling to accurately study its impact. Matching clinical and medico-administrative databases proved to be relevant for assessing outcomes at a large scale.Key learning pointsWhat is already knownAlthough the compliance with a cardiac treatment and cardiac rehabilitation immediately after a myocardial infarction are key factors for improving the prognosis, less is known about compliance maintenance at one year.What this study addsAt one year, few poor outcomes occurred and were not associated with compliance to the cardiac tri-therapy, while they were associated with the absence of cardiac rehabilitation.Matching two complementary clinical and medico-administrative databases proved to be reliable for assessing outcomes on a large scale (4,000 individuals over 5 years).

Autor de una obra literaria singular, Raymond Roussel nunca dejó de fascinar a los surrealistas por su excentricidad, su imaginación caprichosa, antes de representar un hito de la modernidad al revelar, póstumamente, sus métodos de escritura. A pesar de este entusiasmo, Roussel no aparece en la obra de Buñuel. Muy poco citado en sus entrevistas, no es un gran referente para el cineasta. Si aflora en su biografía, es en secreto, de forma indirecta. Cabría entonces preguntarse sobre la naturaleza de la posible relación entre el escritor excéntrico y el cineasta español empapado de literatura naturalista finisecular, dramas picarescos y surrealismo. No hay, aparentemente, en Buñuel una estricta constricción escrita, sino el culto a lo irracional, a la emergencia poética, al dictado automático. Pero sus películas, centradas en la Ley y su transgresión, dan testimonio de una construcción rigurosa, jugando con oposiciones y repeticiones regladas, casi geométricas o musicales. El fantasma de la libertad (1974), su penúltima película, es uno de los ejemplos llamativos.