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De Théophraste aux Pères de l’Église, en passant par les Lapidaires grecs ou Pline l’Ancien, un important discours scientifique et littéraire a servi à composer une vision polychrome de l’architecture antique qui s’est concrétisée dans les romans médiévaux et a culminé, au xve s., dans Le Songe de Poliphile. Cette vision a engendré, au Moyen Âge puis à la Renaissance, des œuvres somptueuses dans lesquelles les marbres grecs – en particulier le porphyre vert de Lacédémone « plus riant qu’aucun autre » – tiennent une place de choix, aussi esthétique que symbolique. Esthétique par leur mariage avec d’autres variétés colorées, symbolique par la puissance dont elles furent investies : la puissance mémorielle de leurs bigarrures qui faisaient ressurgir de manière particulièrement voyante et suggestive les mystères, les rêves et les charmes d’un âge d’or. Ainsi le réemploi de roches grecques, qui furent des matériaux romains, a-t-il pu exprimer la quête de l’Antiquité et, au-delà encore, un sempiternel désir d’hellénisme. From Theophrastus to the Fathers of the Church, passing through the Greek Lapidaries or Pliny the Elder, an important literary and scientific discourse has served to compose a vision of polychromatic marble in ancient antique architecture, that was given concrete expression through medieval novels, and crystallized during the 15th century with Le Songe de Poliphile (Poliphilo’s Strife of Love in a Dream). This vision, from Medieval Times up until the Renaissance, generated luxurious masterpieces in which Greek marble, and in particular, green porphyry from Lacedemonia “plus riant qu’aucun autre” (more pleasant than any other), held a place of esthetical and symbolical choice. An Esthetical choice by its marriage with other colored varieties, and a Symbolic choice by the power that was invested in it: the renowned supremacy of its mottled appearance that re-emerged in a particularly gaudy and suggestive manner unveiling the mysteries, dreams and charms of a golden age. In this manner, the re-use of Greek rock, that was a roman material, could have expressed the quest for Antiquity, and above all, a never-ceasing desire for Hellenism. Από τον Θεόφραστο έως τους Πατέρες της εκκλησίας, περνώντας από τα ελληνικά κείμενα Περί λίθων και τον Πλίνιο τον πρεσβύτερο, ένας σημαντικός επιστημονικός και φιλολογικός λόγος βοήθησε στη σύνθεση μιας πολύχρωμης αντίληψης της αρχαίας αρχιτεκτονικής, η οποία συγκεκριμενοποιήθηκε στα μεσαιωνικά διηγήματα και έφτασε στο αποκορύφωμά της το 15° αι. στην Υπνερωτομαχία του Πολύφιλου. Η άποψη αυτή συνέβαλε, πρώτα στο Μεσαίωνα και έπειτα στην Αναγέννηση, στην παραγωγή υπέροχων έργων, στα οποία τα ελληνικά μάρμαρα και ιδιαιτέρως ο πράσινος πορφυρίτης της Λακεδαίμονος, « πιο ευχάριστος από οποιονδήποτε άλλον », κατέχουν ξεχωριστή θέση, τόσο αισθητικά, όσο και ως προς το συμβολισμό τους. Αισθητικά λόγω του συνδυασμού τους με άλλα χρωματιστά μάρμαρα και συμβολικά από τη δύναμη με την οποίαν περιεβλήθησαν: την ισχύ δηλαδή της ποικιλοχρωμίας τους, μέσα από την οποία αναδύονταν με πολύ φανταχτερό και διεγερτικό τρόπο τα μυστήρια, τα όνειρα και τα θέλγητρα μιας χρυσής εποχής. Έτσι, η επαναχρησιμοποίηση των ελληνικών λίθων, που ήταν ρωμαϊκά υλικά, μπόρεσε να εκφράσει την αναζήτηση της αρχαιότητας και, ακόμα παραπέρα, μια ακατάπαυστη επιθυμία για τον ελληνισμό.

AIMS The aim of the study was to identify independent correlates of survival in patients undergoing PCI for refractory cardiogenic shock due to myocardial infarction (RCS-MI) with the need for extracorporeal life support (ECLS). METHODS AND RESULTS This observational single tertiary centre study enrolled 106 consecutive patients (52.7±10.4 years) with ECLS placed before or after the PCI. Half of the patients had triple vessel disease and PCI was attempted whenever possible (74.5%). The 30-day mortality rate was 63.2%. Left main culprit vessel disease (19% of patients) (adj. HR [95% CI]: 2.31 [1.27-4.18], p=0.006) and sepsis-related organ failure assessment ≥13 (adj. HR 2.17 [1.25-3.75], p=0.005) were independently associated with 30-day mortality. The use of intra-aortic balloon pump (IABP) combined with ECLS was an independent protective factor (adj. HR 0.48 [0.28-0.80], p=0.006). Neither complete (p=0.66) nor successful (p=0.69) myocardial revascularisation was associated with 30-day survival. CONCLUSIONS RCS in MI patients often reveals a severe multivessel coronary artery disease with no impact of early percutaneous coronary revascularisation on clinical outcome. The survival advantage of IABP when combined with ECLS further suggests that achieving an early effective haemodynamic support should be the major goal in this young patient population.

This paper explores some of the potential determinants of efficiency and contestability in the banking systems of major emerging countries, using a sample of the 24 countries over the period 2004-13. Stochastic and data envelopment analyses are used to estimate national levels of efficiency, while market contestability is captured through the H-statistic. Panel data econometric methods are used to determine potential drivers of both efficiency and market contestability, which provides the basis for an evaluation of potential complementarities and trade-offs between these two dimensions. JEL classification: E44, G14, G21, G28, L11 Keywords: Banking, competition, efficiency, emerging markets

A 70-year-old man was referred to the emergency department for acute chest pain. His previous medical history included a recent inferior STEMI, which was treated six weeks before in a differ-ent institution by implantation of a 3.0×33 mm everolimus-elut-ing stent on the mid RCA. A significant lesion was diagnosed on the distal LAD during this procedure. The patient’s current treat-ment included aspirin 75 mg/d, clopidogrel 75 mg/d, atorvastatin 40 mg/d, enalapril 1.25 mg/d and bisoprolol 1.25 mg/d. Other sig-nificant medical history included systemic hypertension.An acute STEMI was diagnosed on the admission electrocardio-gram (ECG)

The aim of this article is to study the development of the social networks of eight academic or corporate spin-off companies. These spin-offs have been set up by intrapreneurs who used to work in universities or big companies. However, intrapreneurs usually maintain strong relationships with the parent company, which may constrain their autonomy when developing their businesses. Consequently, to understand the conditions required for intrapreneurs to benefit from the initial set of relationships of the parent company and still be able to leverage new ties, we require a better understanding of the development of a new social network for spin-offs. We conduct a comparative case study of eight technological spin-offs in France. The processual and qualitative method is based on interviews with intrapreneurs who became autonomous entrepreneurs by creating their own companies.

Lung-protective ventilation with the use of low tidal volumes and positive end-expiratory pressure is considered best practice in the care of many critically ill patients. However, its role in anesthetized patients undergoing major surgery is not known.In this multicenter, double-blind, parallel-group trial, we randomly assigned 400 adults at intermediate to high risk of pulmonary complications after major abdominal surgery to either nonprotective mechanical ventilation or a strategy of lung-protective ventilation. The primary outcome was a composite of major pulmonary and extrapulmonary complications occurring within the first 7 days after surgery.The two intervention groups had similar characteristics at baseline. In the intention-to-treat analysis, the primary outcome occurred in 21 of 200 patients (10.5%) assigned to lung-protective ventilation, as compared with 55 of 200 (27.5%) assigned to nonprotective ventilation (relative risk, 0.40; 95% confidence interval [CI], 0.24 to 0.68; P=0.001). Over the 7-day postoperative period, 10 patients (5.0%) assigned to lung-protective ventilation required noninvasive ventilation or intubation for acute respiratory failure, as compared with 34 (17.0%) assigned to nonprotective ventilation (relative risk, 0.29; 95% CI, 0.14 to 0.61; P=0.001). The length of the hospital stay was shorter among patients receiving lung-protective ventilation than among those receiving nonprotective ventilation (mean difference, -2.45 days; 95% CI, -4.17 to -0.72; P=0.006).As compared with a practice of nonprotective mechanical ventilation, the use of a lung-protective ventilation strategy in intermediate-risk and high-risk patients undergoing major abdominal surgery was associated with improved clinical outcomes and reduced health care utilization. (IMPROVE ClinicalTrials.gov number, NCT01282996.).

Pulmonary involvement with multiple myeloma is rare. We report the case of a 61-year-old man with past medical history of chronic respiratory failure with emphysema, and a known multiple myeloma (Durie and Salmon stage III B and t(4;14) translocation). Six months after diagnosis and first line of treatment, he presented acute dyspnea with interstitial lung disease. Computed tomography showed severe bullous emphysema and diffuse, patchy, multifocal infiltrations bilaterally with nodular character, small bilateral pleural effusions, mediastinal lymphadenopathy, and a known lytic lesion of the 12th vertebra. He was treated with piperacillin-tazobactam, amikacin, oseltamivir, and methylprednisolone. Finally, outcome was unfavourable. Postmortem analysis revealed diffuse and nodular infracentimetric infiltration of the lung parenchyma by neoplastic plasma cells. Physicians should be aware that acute respiratory distress syndrome not responding to treatment of common causes could be a manifestation of the disease, even with negative BAL or biopsy and could be promptly treated with salvage therapy.

International audience; Background: The minimalist immediate mechanical intervention (MIMI) strategy aims to restore normal anterograde flow in the culprit artery (by using manual thrombectomy or small-sized balloon predilation) and to defer potential stent implantation. This study evaluated the applicability and midterm clinical results of the MIMI strategy for ST-elevation myocardial infarction (STEMI) management. Methods: This observational study included consecutive patients admitted for ongoing STEMI (

Despite progress in the past decade, financial markets in Colombia remain relatively small and shallow. In particular the banking system suffers high intermediation costs, which limit constrains access to finance by households and firms. This paper explores some of the causes behind these intermediation costs. An accounting decomposition of the lending-deposit spread suggests that the levels of contestability and efficiency are low. A more in-depth analysis using stochastic frontier and data envelopment analyses confirm that the efficiency of the Colombian commercial banking system is low compared to other emerging markets and OECD economies with similar levels of development. Furthermore, econometric estimates of market contestability support the hypothesis that contestability in Colombia is subpar. Finally, the paper also explores some of the potential determinants of efficiency and contestability for a sample of the 24 countries over the period 2004 – 2013. This Working Paper relates to the 2014 OECD Economic Survey of Colombia. (www.oecd.org/eco/surveys/economic-survey-colombia.htm)

Low molecular weight heparins (LMWH) are commonly used in the ICU setting for thromboprophylaxis as well as curative decoagulation as required during renal replacement therapy (RRT). A rare adverse event revealing immunoallergic LMWH induced thrombopenia (HIT) is skin necrosis at injection sites. We report the case of a patient presenting with skin necrosis witnessing an HIT after RRT, without thrombocytopenia. The mechanism remains unclear. Anti-PF4/heparin antibodies, functional tests (HIPA and/or SRA), and skin biopsy are of great help to evaluate differential diagnosis with a low pretest probability 4T’s score.

Introduction Selon l’approche de Stewart, l’equilibre acido-basique plasmatique repose sur 3 variables independantes : la difference des ions forts (SID), la PaCO 2 , et la quantite totale d’acides faibles (Atot), essentiellement l’albumine. L’objectif principal de notre etude etait de decrire selon le modele de Stewart l’equilibre acido-basique des patients de reanimation en situation d’hypoalbuminemie profonde, et d’etudier l’effet acido-basique d’une supplementation en albumine chez ces patients. Materiel et methodes Etude prospective, observationnelle, menee dans le service de reanimation adulte du CHU de Clermont-Ferrand, apres avis favorable du comite d’ethique. Lorsque une supplementation en albumine etait jugee necessaire, pour un patient ayant une albuminemie Resultats Entre octobre 2013 et mars 2014, 101 perfusions d’albumine ont ete administrees chez 62 patients. Avant l’apport d’albumine, 55 % des patients avaient un pH > 7,42, 26 % avaient un pH normal et 18 % avaient un pH 2 2 > 45 mmHg. Une diminution nette du SID efficace (SIDe) etait retrouvee chez 90 % des patients, le SID apparent (SIDa) etant normal, traduisant la presence d’anions forts indoses (SIGc) en exces. Apres la perfusion, l’albuminemie augmentait de 28 % a T1–T2 ( p 2 . Le SIDe augmentait de 2 mEq/L entre T0 et T1–T2 ( p p Tableau 1 , Fig. 1 ). Discussion Notre etude a mis en evidence une quantite inattendue d’anions forts indoses chez tous les patients de reanimation ayant une hypoalbuminemie profonde. L’apport d’albumine ne modifie pas leur pH plasmatique, car l’effet acidifiant de l’augmentation de Atot est compense par une diminution du SIGc. Il pourrait s’agir d’un phenomene de liaison directe des anions forts indoses a l’albumine.

Depuis 1993, un groupe interdisciplinaire reunit a l'Universite de Provence d'Aix des chercheurs travaillant tous sur le XVIeme siecle et dans des domaines differents : histoire, litterature francaise, histoire des arts, litterature italienne, litterature espagnole. Ils livrent ici leurs regards croises sur le theme "Prendre une ville au XVIeme siecle". Il ne s'agit pas d'un traite d'art militaire ou de poliorcetique, mais d'une reflexion sur un champ vaste qui va du factuel a l'imaginaire : une facon de rompre le carcan du cloisonnement en disciplines et de restituer, si possible, la richesse d'une realite toujours difficile a saisir et toujours grosse de promesses : ne reste-t-il pas encore bien des citadelles a prendre ?

Lieu de pouvoir, l’édifice religieux est avant tout le lieu du pouvoir, celui de Dieu, autour duquel se regroupent ministres et fidèles, un lieu privilégié où l’approche du sacré doit révéler aux hommes leur dimension véritable. Si l’on y recherche une vérité spirituelle, s’y exprime également une réalité sociale et politique, parfois même de manière flagrante, comme le rappelait ce bénitier du XIIIe siècle conservé au musée d’Angers, par une inscription latine qui fut ainsi traduite : « pour...