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The recent empirical use of hydroxychloroquine (HCQ) in coronavirus disease 2019 (COVID‐19) revived the interest in its cardiac toxicity, increasingly sidelined over time. We aimed to assess and compare the profile of cardiac adverse drug reactions (CADRs) associated with HCQ before and during COVID‐19. We performed a retrospective comparative observational study using the French Pharmacovigilance network database between 1985 and May 2020 to assess all postmarketing CADRs associated with HCQ notified before COVID‐19 in its approved indications for lupus and rheumatoid arthritis (preCOV), and those concerning its empirical use in COVID‐19 (COV). Eighty‐five CADR in preCOV were compared with 141 CADRs in COV. The most common CADR of preCOV were cardiomyopathies (42.4%) and conduction disorders (28.2%), both statistically more frequent than in COV (P

Abstract Background Studies have shown disparate results on the consequences of morphine use in ST-segment elevation myocardial infarction (STEMI). No study has evaluated alternative treatments that could be at least non-inferior to morphine without its potentially damaging consequences for myocardial function and platelet reactivity. The aim of this study was to evaluate whether nitrous oxide/oxygen plus intravenous acetaminophen (NOO-A) is non-inferior to morphine to control chest pain in STEMI patients. Methods This multicenter, open-label, cluster-randomized, controlled, non-inferiority study compared NOO-A with morphine in 684 prehospital patients with ongoing suspected STEMI of

Background: The immunogenicity of a two-dose mRNA COVID-19 vaccine regimen is low in kidney transplant (KT) recipients. Here, we provide a thorough assessment of the immunogenicity of a three-dose COVID-19 vaccine regimen in this population. Methods: We performed a prospective longitudinal study in sixty-one KT recipients given three doses of the BNT162b2 COVID-19 vaccine. We performed semi-structured pharmacovigilance interviews and monitored donor-specific antibodies and kidney function. We compared levels of anti-spike IgG, pseudo-neutralization activity against vaccine homologous and heterologous variants, frequency of spike-specific interferon (IFN)-γ-secreting cells, and antigen-induced cytokine production 28 days after the second and third doses. Findings: Reactions to vaccine were mild. One patient developed donor-specific anti-HLA antibodies after the second dose which could be explained by non-adherence to immunosuppressive therapy. Spike-specific IgG seroconversion raised from 44·3% (n=27) after the second dose to 62·3% (n=38) after the third dose (p

Background Despite significant progress with antiprogrammed cell death protein 1 (PD-1) therapy, a substantial fraction of metastatic melanoma patients show upfront therapy resistance. Biomarkers for outcome are missing and the association of baseline immune function and clinical outcome remains to be determined. We assessed the in vitro nonspecific stimulation of immune response at baseline and during anti-PD-1 therapy for metastatic melanoma.Methods Previously untreated metastatic melanoma patients received nivolumab and radiotherapy as part of the multicentric phase II trial NIRVANA (NCT02799901). The levels of Th1, Th2 and Th17 cytokines on in vitro non-specific stimulation of innate and adaptive immune cells were measured in patient sera before treatment, and at week 2 and week 6 after the beginning of the treatment, and correlated with tumorous response, progression-free survival (PFS) and occurrence of immune-related adverse events (irAEs). The results in melanoma patients were compared with those of a cohort of 9 sex and age-matched healthy donors.Results Seventeen patients were enrolled in this ancillary study. Median follow-up was 16 months (2.2–28.4). The 12-month PFS rate was 67.7%. The incidence of irAEs of any grade was 58.8%. Without in vitro stimulation no differences in cytokines levels were observed between responders and non-responders. On in vitro stimulation, metastatic patients had lower Th1 cytokine levels than healthy donors at baseline for tumor necrosis factor-α and interferon-γ (IFN-γ) (1136 pg/mL vs 5558 pg/mL, p

Membranous nephropathy (MN) is a rare autoimmune kidney disease. Most autoimmune diseases are associated with a pro-inflammatory Th17-immune response, but little is known about immune dysregulation in MN. In China, MN was associated with exposure to fine air particulate matter (PM2.5) that could act as a danger signal and redirect immune response toward the Th2 or Th17 pathway. We aimed to analyze the cytokine profile of MN patients and to study the possible environmental factors involved in this immune reorientation, as well as the consequences on the prognosis of the disease. In this prospective study, 59 MN patients filled a comprehensive lifestyle questionnaire. Peripheral blood cells from MN patients were stimulated in vitro to measure the cytokines produced in supernatant. Cytokine profiles of MN patients were compared to 28 healthy donors and analyzed regarding individual PM2.5 exposure. Compared to healthy donors, MN patients had higher serum levels of Th17 and Th2 cytokines IL-17A (62 pg/ml [IQR, 16–160] versus 31 [IQR, 13–51], P=0.035), IL-6 (66767 pg/ml [IQR, 36860–120978] versus 27979 [IQR, 18672–51499], P=0.001), and IL-4 (12 pg/ml [IQR, 0–33] versus 0 pg/ml [IQR, 0–0], P=0.0003), respectively, as well as a deficiency of Th1 and regulatory T cell cytokines IFN-γ (5320 pg/ml [IQR, 501–14325] versus 18037 [IQR, 4889–31329], P=0.0005) and IL-10 (778 pg/ml [IQR, 340–1247] versus 1102 [IQR, 737–1652], P=0.04), respectively. MN patients with high IL-17A levels lived in areas highly exposed to PM2.5: 51 μg/m3 versus 31 μg/m3 for patients with low IL-17A levels (P=0.002) while the World Health Organization recommends an exposition below 10 μg/m3. MN patients with Th17-mediated inflammation had more venous thromboembolic events (P=0.03) and relapsed more often (P=0.0006). Rituximab treatment induced Th1 and regulatory T cell cytokines but did not impact Th17 cytokines. MN patients with Th17-mediated inflammation which appears to be related to an urban environment have worse prognosis. Alternative strategies targeting dysregulated cytokine balance could be considered for these patients at high risk of relapse.

Anemia associated with Immune checkpoint inhibitor (ICI) is usually hemolytic and regenerative. Cases of non-regenerative pure red cell aplasia are rare, and typically improve upon drug discontinuation and after corticotherapy. We herein report a case of nivolumab-related erythroblastopenia refractory to steroids in a melanoma patient that improved only after treatment with cyclosporin. Nivolumab had been well tolerated for 2 months after being introduced as an adjuvant treatment. Hemoglobin level then progressively decreased from 12.7 g/dl as baseline value to a nadir of 4.3 g/dL despite transfusion with a total of 29 packed red blood cells in 3 months. Extensive workup including repeated bone marrow examinations led to the diagnosis of pure red cell aplasia. Anemia persisted despite nivolumab discontinuation and over a month of corticotherapy, but improved dramatically 3 days after cyclosporin initiation and did not recur upon cyclosporin tapering. The patient remains cancer-free 9 months after nivolumab withdrawal. This case highlights the under-recognized risk of erythroblastopenia in patients treated with ICI and proves cyclosporin is a valid alternative for the treatment of steroid-refractory cases.

Copyright of Revue Française de Gestion is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim. We investigated the impact of empowering leadership on both perceived stress and salivary cortisol, a commonly utilized biological indicator for stress assessment. Background. Empowering leadership is gaining increasing interest in companies. However, the impact of empowering leadership on stress is still insufficiently explored, with conflicting findings within the literature on this topic. While certain studies indicate that empowering leadership reduces perceived stress, other studies have suggested that empowering leadership could be stressful. Methods. We conducted a cross-sectional study using a questionnaire among a sample of 397 participants working in a French hospital. Participants' salivary cortisol was assessed. All analyses exploring the relationships between empowering leadership, perceived stress, and salivary cortisol were performed using multiple imputation methods. Results. Empowering leadership could simultaneously increase and decrease perceived stress. Specifically, although the empowering leadership global factor showed a negative correlation with perceived stress, some specific empowering leadership behaviors were positively associated with perceived stress. However, salivary cortisol was positively related to perceived stress and strictly negatively related to empowering leadership. Furthermore, salivary cortisol could be explained by a significant interaction effect between perceived stress and empowering leadership, indicating that empowering leadership enables employees to cope with perceived stress. Conclusions. Although empowering leadership was an ambiguous antecedent of perceived stress, our findings suggested that empowering leadership was a protective factor against increased salivary cortisol. These results suggest that empowering leadership behaviors could prevent biological stress. Implications for Nursing Management. While empowering leadership showed a protective effect on salivary cortisol, it is essential for managers to adopt the full set of empowering leadership practices to guarantee protective effects on perceived stress. This trial is registered with NCT04010773. [ABSTRACT FROM AUTHOR]

The article aims at analysing the travelogues of François Pouqueville (1770 - 1838), a major representative of the European intellectual elite with undoubted merits for the rediscovery of the Balkans in modern times. By describing the everyday life of Balkan peoples his works became a means of influencing the European public about the future of the Ottoman Empire and the fate of the Greeks. The article also demonstrates the gradual evolution of the Frenchman from a relatively pro-Ottoman enlightened man to a firm opponent of the Sultan and an uncompromising supporter of the Greek liberation movement. [ABSTRACT FROM AUTHOR]

Copyright of Revue Française de Gestion is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Recherche et Cas en Sciences de Gestion is the property of EMS Editions - In Quarto SARL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study is to assess the effect of a systemic intervention on the evolution of empowering leadership and emotional exhaustion in a university hospital sub‐centre compared to a control sub‐centre, both being part of a large French university hospital complex. Background: Empowering leadership is a promising strategy for developing hospital team engagement and performance. However, the bureaucratic functioning of large hospitals, characterized by a managerial culture of control and a stratified organization, can be a barrier to empowering leadership. Methods: The intervention included empowering leadership training, direct field experimentation of empowering leadership and coaching, involving all the sub‐centre hierarchical levels for 12 months. Data were collected before and after the intervention. A total of 441 and 310 participants were, respectively, included in the intervention and control sub‐centres. Results: Empowering leadership was decreased, and emotional exhaustion was increased in the control sub‐centre, while the scores remained stable in the intervention sub‐centre. The increased emotional exhaustion in the control sub‐centre could partially be explained by the change in empowering leadership. Conclusion: In a context of decreased empowering leadership and increased emotional exhaustion, the intervention had a protective effect. Implications for the design of future interventions were discussed. Implications for Nursing Management: This study unequivocally showed the benefit of transforming hospital management towards empowering leadership, to prevent increased emotional exhaustion. Registration number: This study is registered on ClinicalTrials.gov on 4 July 2019 (NCT04010773). [ABSTRACT FROM AUTHOR]

Sodium is reabsorbed all along the renal tubules. The positive impacts of sodium-glucose cotransporter-2 inhibitors (SGLT2i), angiotensin receptor neprilysin inhibitor (ARNI) and mineralocorticoid receptor antagonists (MRA) on hard renal and/or cardiac endpoints calls for the role of diuretics in nephroprotection and cardioprotection in patients with diabetes mellitus to be reviewed. Here, we review: (a) the mechanisms of action of the available natriuretics; (b) the physiological adaptations to chronic loop diuretic usage that lead to increased sodium reabsorption in the proximal and distal convoluted tubules; (c) the physiology of sodium retention in patients with diabetes mellitus; and (d) the mechanisms of aldosterone breakthrough. We show the rationale for combined diuretics to target not only the loop of Henle, but also the proximal and distal convoluted tubules. Indeed, higher residual proteinuria in patients treated with renin-angiotensin-aldosterone system (RAAS) blockers portends poorer renal and cardiovascular outcomes. Diuretics are known to optimize the reduction of proteinuria, in addition to RAAS blockers, but may favor aldosterone breakthrough in the absence of MRA. The aim of our study is to support a combined diuretics strategy to improve the management of patients with diabetes mellitus and chronic kidney disease or heart failure. [ABSTRACT FROM AUTHOR]

In July 1782, the American peace commissioner, John Jay, provoked controversy by refusing to negotiate with a British emissary empowered to treat with the American "Colonies or Plantations" rather than with "the United States of America." The article examines the law on which Jay based his decision and its implications for the ensuing peace negotiations and the process by which the United States secured its independence from Great Britain. In so doing, the article sheds light on the concept of a law of nations and its role in early modern diplomacy. [ABSTRACT FROM AUTHOR]

In Napoleon in His Cabinet at the Tuileries (1811–1812), Jacques-Louis David designed a new portrait type wherein the emperor appears to have been up all night working for the welfare of his subjects, furthering the legend of an indefatigable administrator. This essay explores the relationship between Scottish patron and French artist in the fulfilment of a commission, the process of working through post-revolutionary consular and imperial modes of portraiture, the references to civil and military affairs meant to affirm public reports about the emperor's administrative accomplishments, and the conversation about the relative value of status and money as compensation appropriate for the achievement of a new portrait identity. Despite the brilliant subtlety of David's conceit, Napoleon was content to continue to subsidize the overblown imperialist rhetoric of François Gérard and others. [ABSTRACT FROM AUTHOR]

Copyright of Christianity-World-Politics / Chrzescijanstwo-Swiat-Polityka is the property of Uniwersytet Kardynala Stefana Wyszynskiego w Warszawie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The recent empirical use of hydroxychloroquine (HCQ) in coronavirus disease 2019 (COVID‐19) revived the interest in its cardiac toxicity, increasingly sidelined over time. We aimed to assess and compare the profile of cardiac adverse drug reactions (CADRs) associated with HCQ before and during COVID‐19. We performed a retrospective comparative observational study using the French Pharmacovigilance network database between 1985 and May 2020 to assess all postmarketing CADRs associated with HCQ notified before COVID‐19 in its approved indications for lupus and rheumatoid arthritis (preCOV), and those concerning its empirical use in COVID‐19 (COV). Eighty‐five CADR in preCOV were compared with 141 CADRs in COV. The most common CADR of preCOV were cardiomyopathies (42.4%) and conduction disorders (28.2%), both statistically more frequent than in COV (P < 0.001). COV notifications significantly highlighted repolarization and ventricular rhythm disorders (78.0%, P < 0.001) as well as sinus bradycardias (14.9%, P = 0.01) as compared with preCOV. Estimated incidence of CADR was significantly higher among patients exposed to off‐label use of HCQ in COVID‐19 (2.9%) than before COVID‐19 in its approved indications (0.01%, P < 0.001). The use of HCQ in COVID‐19 sheds a new light on the spectrum of its cardiac toxicity. This fosters the value of a closer monitoring of all patients treated with HCQ, regardless of its indication, and the importance of an update of its summary of product characteristics. [ABSTRACT FROM AUTHOR]

The article examines the politicization of the U.S. intelligence community since the 2016 presidential election. Topics discussed include how General Douglas MacArthur's 1951 "Farewell Speech" undermined the constitutional principle of civilian control over the military, a brief history of the intelligence community's intervention in domestic politics, and the mistrust between President Donald Trump and the intelligence community.

Membranous nephropathy (MN) is a rare autoimmune kidney disease. Most autoimmune diseases are associated with a pro-inflammatory Th17-immune response, but little is known about immune dysregulation in MN. In China, MN was associated with exposure to fine air particulate matter (PM2.5) that could act as a danger signal and redirect immune response toward the Th2 or Th17 pathway. We aimed to analyze the cytokine profile of MN patients and to study the possible environmental factors involved in this immune reorientation, as well as the consequences on the prognosis of the disease. In this prospective study, 59 MN patients filled a comprehensive lifestyle questionnaire. Peripheral blood cells from MN patients were stimulated in vitro to measure the cytokines produced in supernatant. Cytokine profiles of MN patients were compared to 28 healthy donors and analyzed regarding individual PM2.5 exposure. Compared to healthy donors, MN patients had higher serum levels of Th17 and Th2 cytokines IL-17A (62 pg/ml [IQR, 16–160] versus 31 [IQR, 13–51], P =0.035), IL-6 (66767 pg/ml [IQR, 36860–120978] versus 27979 [IQR, 18672–51499], P =0.001), and IL-4 (12 pg/ml [IQR, 0–33] versus 0 pg/ml [IQR, 0–0], P =0.0003), respectively, as well as a deficiency of Th1 and regulatory T cell cytokines IFN-γ (5320 pg/ml [IQR, 501–14325] versus 18037 [IQR, 4889–31329], P =0.0005) and IL-10 (778 pg/ml [IQR, 340–1247] versus 1102 [IQR, 737–1652], P =0.04), respectively. MN patients with high IL-17A levels lived in areas highly exposed to PM2.5: 51 μg/m3 versus 31 μg/m3 for patients with low IL-17A levels (P =0.002) while the World Health Organization recommends an exposition below 10 μg/m3. MN patients with Th17-mediated inflammation had more venous thromboembolic events (P =0.03) and relapsed more often (P =0.0006). Rituximab treatment induced Th1 and regulatory T cell cytokines but did not impact Th17 cytokines. MN patients with Th17-mediated inflammation which appears to be related to an urban environment have worse prognosis. Alternative strategies targeting dysregulated cytokine balance could be considered for these patients at high risk of relapse. [ABSTRACT FROM AUTHOR]

Anemia associated with Immune checkpoint inhibitor (ICI) is usually hemolytic and regenerative. Cases of non-regenerative pure red cell aplasia are rare, and typically improve upon drug discontinuation and after corticotherapy. We herein report a case of nivolumab-related erythroblastopenia refractory to steroids in a melanoma patient that improved only after treatment with cyclosporin. Nivolumab had been well tolerated for 2 months after being introduced as an adjuvant treatment. Hemoglobin level then progressively decreased from 12.7 g/dl as baseline value to a nadir of 4.3 g/dL despite transfusion with a total of 29 packed red blood cells in 3 months. Extensive workup including repeated bone marrow examinations led to the diagnosis of pure red cell aplasia. Anemia persisted despite nivolumab discontinuation and over a month of corticotherapy, but improved dramatically 3 days after cyclosporin initiation and did not recur upon cyclosporin tapering. The patient remains cancer-free 9 months after nivolumab withdrawal. This case highlights the under-recognized risk of erythroblastopenia in patients treated with ICI and proves cyclosporin is a valid alternative for the treatment of steroid-refractory cases. [ABSTRACT FROM AUTHOR]

Background: Studies have shown disparate results on the consequences of morphine use in ST-segment elevation myocardial infarction (STEMI). No study has evaluated alternative treatments that could be at least non-inferior to morphine without its potentially damaging consequences for myocardial function and platelet reactivity. The aim of this study was to evaluate whether nitrous oxide/oxygen plus intravenous acetaminophen (NOO-A) is non-inferior to morphine to control chest pain in STEMI patients. Methods: This multicenter, open-label, cluster-randomized, controlled, non-inferiority study compared NOO-A with morphine in 684 prehospital patients with ongoing suspected STEMI of < 12 h duration and a pain rating score ≥ 4. The primary endpoint was the proportion of patients achieving pain relief (numeric rating score ≤ 3) after 30 min. Secondary safety endpoints included serious adverse events and death at 30 days. Results: The median baseline pain score was 7.0 in both groups. The primary endpoint occurred in 51.7% of the NOO-A group and 73.6% of the morphine group (absolute risk difference − 21.7%; 95% confidence interval − 29.6 to − 13.8). At 30 days, the rate of serious adverse events was 16.0 and 18.8% in the NOO-A and morphine groups respectively (p = NS). The rate of death was 1.8% (NOO-A group) and 3.8% (morphine group) (p = NS). Conclusion: Analgesia provided by NOO-A was inferior to morphine at 30 min in patients with acute STEMI in the prehospital setting. Rates of serious adverse events did not differ between groups. Trial registration: ClinicalTrials.gov: NCT02198378. [ABSTRACT FROM AUTHOR]

This study examines the phenomenon of 'liberating leadership', an emerging trend promising self-mastery and collective unity, resonating with the literature on post-heroic leadership. We evaluate the claims of liberating leadership from a psychodynamic perspective, using a Lacanian approach. We examine how post-heroic forms of leadership reconfigure symbolic and imaginary aspects of follower identification, with ambivalent effects. Drawing empirically on the case of a Belgian banking department, we trace how a 'liberating' leader was able to garner intense psychological attachment among followers, accompanied by the 'dark sides' of personal exhaustion and breakdown, normative pressure to be overly happy, and the scapegoating of contrarian managers representing symbolic prohibition. [ABSTRACT FROM AUTHOR]

During the 18th century, the translation of a large number of literary and scholarly genres was an intellectually engaging, and sometimes profitable, activity. On the other hand, the activity of translating has always been selective, and driven by specific agendas. Jean D'Alembert was both an object of translations, and a translator. The present article reviews the German‐speaking reception of D'Alembert as a philosophe and representative of French Enlightenment by reviewing the translations of his texts into German. This review shows a highly selective and problematic approach to his philosophical œuvre. In particular, we will discuss some of the obstacles presented by the German philosophical tradition for a more comprehensive reception of D'Alembert as a philosophe in the German‐speaking world. Against this background, we briefly discuss D'Alembert's “Observations sur l'art de traduire” as expression of enlightened culture when it comes to an engagement with foreign ideas and authors. [ABSTRACT FROM AUTHOR]

Copyright of Recherche et Cas en Sciences de Gestion is the property of EMS Editions - In Quarto SARL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the article, the authors present the case of a 26-year-old primigravida female who takes almotriptan to treat her migraine with aura to discuss the possible overuse of triptan during pregnancy and as possible cause of placental hypoperfusion. In the case, the fetus showed decrease in growth curve and reduced amniotic fluid. Also cited are the possible signs of hypoperfusion like recurrent uterine artery notch and advanced placental calcification.