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BACKGROUND Post-COVID condition has now affected millions of individuals, resulting in fatigue, neurocognitive symptoms and an impact on daily life. The uncertainty of knowledge around this condition, including its overall prevalence, pathophysiology and management, along with the growing numbers of affected individuals have created an essential need in information and disease management. This has become even more critical in a time of abundant online misinformation and potential misleading of patients and healthcare professionals. OBJECTIVE The RAFAEL platform is an ecosystem created to address the information and management of post-COVID condition, integrating online information, webinars and Chatbot technology to answer to a large number of individuals in a time-limited and resources-limited setting. This paper describes the development and deployment of the RAFAEL platform and Chatbot in addressing post-COVID condition in children and adults. METHODS The RAFAEL study takes place in Geneva, Switzerland, led by primary care, pediatric and communication experts in collaboration with patients. The RAFAEL platform and Chatbot are available online, and all users are considered participants to this study. The development phase started in December 2020 and consisted of developing the concept, backend and frontend developments as well as beta testing. This was followed by the deployment, communication and partnership phases, promoting the use of the platform and Chatbot in the French speaking world. The specific strategy behind the RAFAEL Chatbot balances an accessible interactive approach with medical safety, aiming to relay correct and verified information in the management of post-COVID condition. The use of the Chatbot and the answers provided are monitored by community moderators and healthcare professionals, creating a safe fallback for users. RESULTS To date, the Chatbot has had 23’438 interactions, with 71.4% matching rate and 72.7% positive feedback rate. Overall, 4’549 unique users interacted with the Chatbot with 5.1 interactions on average per user, and 6’836 stories triggered. Use of the Chatbot and RAFAEL platform was additionally driven by the monthly thematic webinars as well as communication campaigns, with an average of 250 participants at each webinar between January and June 2022. User queries included questions about post-COVID symptoms (66.5%), of which fatigue was the most predominant query (22.9% of symptoms-related stories). Additional queries included questions about consultations (6.5%), treatment (6.2%), and general information (6.3%). CONCLUSIONS The RAFAEL Chatbot is to our knowledge the first Chatbot developed to address post-COVID condition in children and adults. Its innovation lies in the use of a scalable tool to disseminate verified information in a time- and resources-limited environment. Additionally, the use of machine-learning helps professionals gain knowledge about a new condition while addressing patients’ concerns. Lessons learned from the RAFAEL Chatbot will further encourage a participative approach to learning, and could potentially be applied to other chronic conditions.

ObjectivesPost-COVID syndrome remain poorly studied in children and adolescents. In this study, we aimed to investigate the prevalence and risk factors of pediatric post-COVID in a population-based sample, stratifying by serological status.Study designWe used data from the SEROCoV-KIDS cohort study (State of Geneva, Switzerland), which included children (aged 6 months to 17 years) selected from random samples drawn from state registries or who had a household member participating in a COVID-19 seroprevalence study conducted by our group. Children were tested for anti-SARS-CoV-2 N antibodies. Parents filled in a questionnaire on persistent symptoms in their children (lasting over 12 weeks) compatible with post-COVID syndrome.ResultsFrom December 1st, 2021 to February 16th, 2022, 1034 children were included, among whom 570 (55.1%) were seropositive. The sex- and age-adjusted prevalence of persistent symptoms among seropositive children was 9.1% (95%CI: 6.7;11.8) and 5.0% (95%CI: 3.0;7.1) among seronegatives, with an adjusted prevalence difference (ΔaPrev) of 4.1% (95%CI: 1.1;7.3). After stratification by age group, the prevalence was higher among adolescents aged 12-17 years (ΔaPrev=8.3%, 95%CI: 3.5;13.5) than among younger children (0.0%, 95%CI: −5.2;5.2 among 6-11 years old and 4.2%; 95%CI: −4.4;13.3 among 0-5 years old). The most frequently declared persistent symptoms among seropositives were smell loss, trouble concentrating and abdominal pain. Older age, having a chronic condition and lower socioeconomic conditions were identified as risk factors.ConclusionA significant proportion of seropositive children, particularly adolescents, experienced persistent symptoms. While there is a need for further investigation, growing evidence of pediatric post-COVID syndrome urges early screening and primary care management.

Post-COVID syndrome (or long COVID) is a set of persistent symptoms occurring after a documented SARS-CoV-2 infection. Children and adolescents are also affected, with similar symptoms than adults. To date there is no clinical or biological parameter allowing to confirm the diagnosis, which relies on the presence of typical symptoms associated with a suggestive temporality, in the absence of any other explanation. These persistent symptoms can have a strong impact on the quality of life and schooling. In our specialized consultation for pediatric post-COVID syndrome, we offer a global and multidisciplinary follow-up to patients and their families, supporting them progressively resuming physical and mental activity, and pursuing school attendance to avoid dropout.Le syndrome post-Covid est un ensemble de symptômes persistants après une infection à SARS-CoV-2 documentée. Cette affection touche aussi les enfants et les adolescents, avec des symptômes similaires à ceux des adultes. Il n’existe à ce jour aucun paramètre clinique ou biologique pour confirmer le diagnostic qui repose sur la présence de symptômes typiques et d’une temporalité suggestive, en l’absence d’autre explication. Ces symptômes persistants peuvent avoir un fort retentissement sur la qualité de vie et la scolarité. Au sein de notre consultation multidisciplinaire dédiée au syndrome post-Covid pédiatrique, nous proposons un suivi global aux patients et à leurs familles, en les accompagnant dans la reprise progressive d’une activité physique et mentale, et en soutenant la poursuite de la scolarité pour éviter la rupture scolaire.

BackgroundIt is now established that a significant proportion of adults experience persistent symptoms after SARS-CoV-2 infection. However, evidence for children and adolescents is still inconclusive. In this population-based study, we examine the proportion of children and adolescents reporting persistent symptoms after SARS-CoV-2 infection, as assessed by serological status, and compare this to a seronegative control group.MethodsWe conducted a serosurvey in June-July 2021, recruiting 660 children and adolescents from 391 households selected randomly from the Geneva population. We tested participants for anti-SARS-CoV-2 antibodies targeting the nucleocapsid (N) protein to determine previous infection. A parent filled a questionnaire including questions on COVID-19-related symptoms lasting at least 2 weeks.FindingsAmong children seropositive for anti-SARS-CoV-2 antibodies, the sex- and age-adjusted prevalence of symptoms lasting longer than two weeks was 18.3%, compared to 11.1% among seronegative children (prevalence difference (ΔaPrev)=7.2%, 95%CI:1.5-13.0). Main symptoms declared among seropositive children were fatigue (11.5%) and headache (11.1%). For 8.6% (aPrev, 95%CI: 4.7-12.5) of seropositives, these symptoms were declared to be highly limiting of daily activities. Adolescents aged 12-17 years had a higher adjusted prevalence of persistent symptoms (aPrev=29.1%, 95%CI:19.4-38.7) than younger children. Comparing seropositive and seronegative adolescents, the estimated prevalence of symptoms lasting over four weeks is 4.4% (ΔaPrev, 95%CI:-3.8-13.6).InterpretationA significant proportion of children aged 12 to 17 years had symptoms lasting over two weeks after SARS-CoV-2 infection, with an estimated prevalence of symptoms lasting over 4 weeks of 4.4% in this age group. This represents a large number of adolescents in absolute terms, and should raise concern in the context of unknown long-term evolution of symptoms. Younger children appear to experience long-lasting symptoms less frequently, as no difference was observed between the seropositive and seronegative sample. Further studies with larger samples sizes are needed.FundingSwiss Federal Office of Public Health, Geneva General Directorate of Health, HUG Private Foundation, SSPH+, Fondation des Grangettes.

ObjectivesTo estimate the prevalence of children and adolescents reporting persistent symptoms after SARS-CoV-2 infection.DesignA random sample of children and adolescents participated with their family members to a serological survey including a blood drawing for detecting antibodies targeting the SARS-CoV-2 nucleocapsid (N) protein and a questionnaire on COVID-19-related symptoms experienced since the beginning of the pandemic.SettingThe study took place in the canton of Geneva, Switzerland, between June and July 2021.Participant660 children aged between 2 and 17 years old.Primary and secondary outcomeThe primary outcome was the persistence of symptoms beyond 4 weeks comparing seropositive and seronegative participants. The type of declared symptoms were also studied as well as associated risk factors.ResultsAmong seropositive children, the sex-adjusted and age-adjusted prevalence of symptoms lasting longer than 2 weeks was 18.3%, compared with 11.1% among seronegatives (adjusted prevalence difference (ΔaPrev)=7.2%, 95% CI: 1.5% to 13.0%). Among adolescents aged 12–17 years, we estimated the prevalence of experiencing symptoms lasting over 4 weeks to be 4.4% (ΔaPrev,95% CI: −3.8% to 13.6%), whereas no seropositive child aged 2–11 reported symptoms of this duration. The most frequently declared symptoms were fatigue, headache and loss of smell.ConclusionsWe estimated the prevalence of experiencing persistent symptoms lasting over 4 weeks to be around 4% among adolescents, which represents a large absolute number, and should raise awareness and concern. We did not observe meaningful differences of persistent symptoms between seropositive and seronegative younger children, suggesting that they may be less affected than their older counterparts.

L’étude présentée ici est le fruit d’une réflexion méthodologique et épistémologique sur la notion de « réseau » en histoire de l’art menée depuis 2016 dans le cadre du programme « Les académies d’art et leurs réseaux dans la France préindustrielle » (ACA-RES). En revenant à l’intrication initiale de l’art et de la sociologie, qui fait émerger un usage métaphorique du concept de réseau, le présent article envisage les différentes morphologies de ce phénomène, en appuyant son propos sur nombre d’exemples pris avant et depuis le développement des Humanités numériques il y a dix ans. Il s’agit de montrer la corrélation entre le phénomène de réseau et une technicité progressive qui s’est forgée dans les sciences humaines avec l’émergence de l’informatique et du numérique, et surtout de situer la place et le rôle de l’histoire de l’art dans ce champ de recherche. This study is the result of methodological and epistemological reflection on the notion of “network” in art history, conducted since 2016 within the framework of the ACA-RES program on Art Academies and their networks in pre-industrial France. Returning to the initial imbrication of art and sociology, which highlights a metaphorical aspect of the concept of network, this article considers the different morphologies of the phenomenon, based upon many examples selected both before and since the development of the Digital Humanities some ten years ago. The aim is to reveal the correlation between the phenomenon of the network and a developing technical focus, forged in the human sciences with the emergence of computer science and digital technology, and especially to situate the place and the role of the history of art in this research field. Die hier vorgelegte Studie basiert auf einer methodischen und epistemologischen Auseinandersetzung mit dem Begriff des „Netzwerks“ in der Kunstgeschichte, wie sie seit 2016 im Rahmen des Programms ACA-RES über die Kunstakademien und ihre Netzwerke im vorindustriellen Frankreich geführt wurde. Der Artikel verfolgt die verschiedenen Facetten des Phänomens, ausgehend von der Verschränkung von Kunst und Soziologie, die eine metaphorische Begriffsverwendung zutage gefördert hat, und führt zahlreiche Beispiele aus der Zeit vor und seit den Digital Humanities der letzten zehn Jahre an. Es geht dabei um die Korrelation zwischen dem Phänomen Netzwerk und der fortschreitenden Technologisierung der Geisteswissenschaften durch den Einsatz von Informatik und Digitalität und gleichzeitig um den Platz, dem dabei der Kunstgeschichte in diesem spezifischen Forschungsfeld zukommt. Lo studio qui presentato è il frutto di una riflessione metodologica ed epistemologica sulla nozione di rete in Storia dell’arte condotta a partire dal 2016 nel contesto del programma “Les académies d’art et leurs réseaux dans la France préindustrielle” (ACA-RES). Ritornando all’intreccio iniziale tra arte e sociologia, che fa emergere un uso metaforico del concetto di rete, il presente articolo analizza le differenti morfologie di questo fenomeno, basandosi su numerosi esempi risalenti a periodi che precedono o seguono lo sviluppo dell’Informatica Umanistica, dieci anni fa. Gli obiettivi sono quelli di mostrare la correlazione tra il fenomeno della rete e una progressiva tecnicità formatasi nelle scienze umane con l’emergere dell’informatica e del digitale e, soprattutto, di trovare il posto e il ruolo della storia dell’arte in questo campo di ricerca. El estudio presentado es el fruto de una reflexión metodológica y epistemológica sobre la noción de “red” en historia del arte iniciado en 2016 en el marco del programa ACA-RES sobre las academias de arte y sus redes en la era preindustrial francesa. Volviendo a la imbricación inicial del arte y de la sociología, que hizo emerger un uso metafórico del concepto de red, el presente artículo considera las diferentes morfologías del fenómeno, apoyándose en el número de ejemplos tomados antes y desde el desarrollo de las Humanidades digitales hace diez años. Se busca mostrar la correlación entre el fenómeno de la red y una técnica progresiva que se ha forjado en las ciencias humanas con la emergencia de la informática y de lo digital y, sobre todo, de situar el lugar y el rol de la historia del arte en este campo de estudios.

Dans l’histoire des collections francaises, celles issues des ecoles de dessin et des academies d’art du xviiie siecle ont un statut a part. Leur specificite tient tout d’abord a leur mode de constitution. Elles resultent d’actions collectives mettant en reseau des individus aux statuts et aux interets divers : artistes, amateurs et acteurs de la vie economique et politique. Elles traduisent une certaine identite artistique, qui lie formation et creation dans le domaine des beaux-arts et des arts manufactures. La synthese ici presentee s’inscrit dans les recherches du programme ACA-RES (Les academies d’art et leurs reseaux dans la France preindustrielle).

Dans l’histoire des collections françaises, celles issues des écoles de dessin et des académies d’art du xviiie siècle ont un statut à part. Leur spécificité tient tout d’abord à leur mode de constitution. Elles résultent d’actions collectives mettant en réseau des individus aux statuts et aux intérêts divers : artistes, amateurs et acteurs de la vie économique et politique. Elles traduisent une certaine identité artistique, qui lie formation et création dans le domaine des beaux-arts et des arts manufacturés. La synthèse ici présentée s’inscrit dans les recherches du programme ACA-RES (Les académies d’art et leurs réseaux dans la France préindustrielle). Collections from 18th century drawing schools and art academies have a unique status in the history of French collections. Their specificity relies mainly on the methods used to create them. They are the results of collective actions that created a network of individuals of varying statuses and interest: artists, art lovers, economical and political actors. They show a specific artistic identity, which links collection development to creation in the fine arts and manufactured arts domains. The synthesis written here is a part of the researches by the ACA-RES Program (“Academies of fine art and their relationships in pre-industrial France”).

Background Recently, cases of multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) have been reported worldwide. Negative polymerase chain reaction (RT-PCR) testing associated with positive serology in most of the cases suggests a postinfectious syndrome. Because the pathophysiology of this syndrome is still poorly understood, extensive virological and immunological investigations are needed. Methods We report a series of 4 pediatric patients admitted to Geneva University Hospitals with persistent fever and laboratory evidence of inflammation meeting the published definition of MIS-C related to COVID-19, to whom an extensive virological and immunological workup was performed. Results RT-PCRs on multiple anatomical compartments were negative, whereas anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin A (IgA) and immunoglobulin G (IgG) were strongly positive by enzyme-linked immunosorbent assay and immunofluorescence. Both pseudoneutralization and full virus neutralization assays showed the presence of neutralizing antibodies in all children, confirming a recent infection with SARS-CoV-2. The analyses of cytokine profiles revealed an elevation in all cytokines, as reported in adults with severe COVID-19. Although differing in clinical presentation, some features of MIS-C show phenotypic overlap with hemophagocytic lymphohistiocytosis (HLH). In contrast to patients with primary HLH, our patients showed normal perforin expression and natural killer (NK) cell degranulation. The levels of soluble interleukin (IL)-2 receptor (sIL-2R) correlated with the severity of disease, reflecting recent T-cell activation. Conclusion Our findings suggest that MIS-C related to COVID-19 is caused by a postinfectious inflammatory syndrome associated with an elevation in all cytokines, and markers of recent T-cell activation (sIL-2R) occurring despite a strong and specific humoral response to SARS-CoV-2. Further functional and genetic analyses are essential to better understand the mechanisms of host–pathogen interactions.

Cette recherche porte sur l’evaluation du Quotient de Developpement (QD) de nourrissons ayant vecu des situations de defaillances parentales precoces, avec trois groupes differents et deux groupes controles. Le test utilise, le Brunet-Lezine II, a ete propose a 30 nourrissons en pouponniere (groupe 4). Le groupe temoin etait constitue de 30 enfants eleves dans des familles sans trouble apparent de la parentalite et accueillis en creche au moins a mi-temps (groupe 5). Il n’y a pas de difference significative concernant le QD global (QDG) entre les deux groupes, mais davantage d’enfants de pouponnieres presentent des QD partiels dysharmoniques. L’analyse des QD partiels montre que l’equivalence des QDG entre les groupes 4 et 5 est due a un QD postural superieur souvent de 15 points dans le groupe 4.Une recherche parallele a ete effectuee en pouponniere. Onze enfants ont ete testes a leur arrivee puis un mois apres, afin d’etre au plus pres du vecu traumatique familial puis d’evaluer l’effet protecteur eventuel du sejour en pouponniere. Le QDG de chaque enfant a augmente de maniere significative entre les deux rencontres. Le test de developpement du Brunet-Lezine est apparu comme un bon indicateur de la souffrance psychique du nourrisson. L’evaluation duelle en collectivite ferait resurgir des manifestations anxieuses chez certains enfants lorsqu’ils n’ont plus l’etayage groupal des pairs, ce qui entrave leurs competences. En pouponniere, l’interiorisation d’un modele groupal pourrait aussi influencer la capacite d’individuation de jeunes enfants.

Resume Objectif Connaitre chez les medecins generalistes francais, leur perception du risque sur les champs electromagnetiques (CEM) et la sante, leurs sources d’information ainsi que le niveau de preoccupation de leurs patients. Methodologie Six cents generalistes francais, recrutes (selectionnes) selon la methode des quotas, ont repondu a 24 questions administrees via Internet selon la methode Computer-Assisted Web Interviewing (CAWI). Resultats Les principales sources de CEM etaient connues : antennes relais, telephones portables, lignes a haute tension, fours a micro-ondes et le reseau WiFi. Les trois premieres etaient le plus souvent a l’origine d’interrogations ou de plaintes chez les patients. L’information des medecins provenait plutot des medias grand public que des sources medico-scientifiques classiques. Leur connaissance sur les risques eventuels a ete jugee insuffisante. Discussion et conclusion Nous n’avons pas observe une attitude homogene des medecins par manque evident de maitrise d’une situation complexe et mal renseignee. Un reel effort d’information est indispensable et serait parfaitement recu par les medecins conscients de leur responsabilite en matiere de conseil, de diagnostic et de soin.

To assess the profile of changes in airway and respiratory tissue mechanics within a follow-up study performed in children with mitral valve disease, before and after surgical valve repair.Perioperative measurements in a prospective, consecutive cross-sectional study.University hospital, tertiary care teaching hospitalThe study comprised 24 children with congenital or post-rheumatic mitral valve insufficiency.Input impedance of the respiratory system during spontaneous breathing was measured before and 5 days and 3 weeks after mitral valve surgery. In addition, airway and respiratory tissue mechanics and pulmonary arterial pressure were assessed with the patient under general anesthesia preoperatively and immediately postoperatively. Respiratory tissue elastance and changes in airway measurements were estimated from forced oscillatory impedance data by fitting an appropriate model.Relating airway and respiratory tissue mechanics to previously established reference values obtained in age-matched healthy control patients revealed abnormal respiratory function (135±6.2% and 148±13% in respiratory elastance and resistance, respectively; p0.001). Improvement in the airway properties was observed immediately after surgery (-15.2±3.4%; p0.005) and lasted for the study period (-19±4.1%; p0.001). Respiratory tissue elastance, which correlated preoperatively to the diastolic pulmonary arterial pressure, decreased only 5 days postoperatively (-20.6±4.1%; p0.005). However, there was no evidence of a clear, immediate effect of surgery on the tissue mechanical parameters measured intraoperatively despite a decrease in diastolic pulmonary pressure.Mitral valve disease in children leads to abnormal airway and respiratory tissue mechanics. Even though surgical repair of mitral insufficiency alleviates abnormal airway function, residual lung tissue stiffening may persist even weeks after the surgery, contributing to a sustained impairment in lung function.

An in vitro exposure setup developed to expose suspended cells in Petri dishes on a large frequency band up to a few gigahertz was studied. This system was based on far-field exposure with a horn antenna in an anechoic chamber. A specific incubator was designed with a water-cooling system for constant temperature inside the setup. Four exposed Petri dishes presented a similar specific absorption rate (SAR) distribution with a whole-volume SAR of $0.56 \pm 0.40~\hbox{W/kg/W}_{\rm inc}$ at 2.45 GHz. The incubator was equipped with a stirring mechanism allowing an homogenous distribution of temperature in the biological solution. The SAR was assessed over the 1.5–3 GHz frequency range. Using the temperature control and stirring, an increase of 0.4 $^\circ {\rm C}$ in temperature was observed after 2 h exposure at 2.45 GHz, 22 W incident power. This dosimetric study demonstrated the ability of this system to expose cells in suspension at different frequencies in a controlled environment .

Cette recherche porte sur la mise en relation du Quotient de developpement (QD) de nourrissons avec les differents niveaux de dysfonctionnements educatifs de leur famille. Le test utilise, le Brunet-Lezine, a ete propose au cours de visites a domicile, ce qui a permis d’observer les effets de cette passation sur la dynamique familiale. Le QD, considere comme un marqueur fiable de risque pour le developpement de l’enfant, est abaisse de maniere significative dans les familles les plus desorganisees. Dans les familles moins desorganisees, c’est essentiellement le QD sociabilite qui est inferieur a celui des autres groupes temoins (enfants eleves en pouponniere, en creche, et dans des familles normales). Par ailleurs, les dysfonctionnements les plus frequemment rencontres dans le groupe familial ont ete un holding, un handling et une presentation de l’objet inadequats, une imprevisibilite parentale, un environnement desorganise ou envahi, une identification des parents a l’observateur avec un risque de forcage, et un manque d’intimite avec une absence de pare-excitation. Les visites a domicile apparaissent comme un outil indispensable pour travailler avec les familles en grande difficulte educative.

Impairment of oxygen supply occurs in many pathological situations. In the case of cancer, both chronic and acute hypoxic areas are found in the tumor. Tumor hypoxia is associated with poor clinical prognoses and is correlated with tumor growth and metastasis development. Pyruvate is a common metabolite, as it is an end-product of glycolysis and an energy substrate for the mitochondrial Krebs cycle. It is also well known for its protective properties against stressful conditions, particularly hypoxia. Its presence determines cellular fate when there is a lack of oxygen. Interestingly, pyruvate metabolism is altered during cancer development. For years, this was assumed to be a consequence of malignant transformation. However, it now is becoming clear that pyruvate could contribute to cancer progression. The role of pyruvate during hypoxia has been widely studied in non-tumor tissues and cells; it is less documented whether or not the protective effect of pyruvate could also take place in cancer cells. If so, pyruvate might be deleterious for cancer patients. The present paper reviews data that highlight the role of pyruvate in cancer cells and tumors during hypoxic stress.

Pyruvate is located at a crucial crossroad of cellular metabolism between the aerobic and anaerobic pathways. Modulation of the fate of pyruvate, in one direction or another, can be important for adaptative response to hypoxia followed by reoxygenation. This could alter functioning of the antioxidant system and have protective effects against DNA damage induced by such stress. Transient hypoxia and alterations of pyruvate metabolism are observed in tumors. This could be advantageous for cancer cells in such stressful conditions. However, the effect of pyruvate in tumor cells is poorly documented during hypoxia/reoxygenation. In this study, we showed that cells had a greater need for pyruvate during hypoxia. Pyruvate decreased the number of DNA breaks, and might favor DNA repair. We demonstrated that pyruvate was a precursor for the biosynthesis of glutathione through oxidative metabolism in HepG2 cells. Therefore, glutathione decreased during hypoxia, but was restored after reoxygenation. Pyruvate had beneficial effects on glutathione depletion and DNA breaks induced after reoxygenation. Our results provide more evidence that the α-keto acid promotes the adaptive response to hypoxia followed by reoxygenation. Pyruvate might thus help to protect cancer cells under such stressful conditions, which might be harmful for patients with tumors.

Le petit village de Gouise dans l’Allier n’a pas d’eglise. Or les conduites de compensation developpees par ses habitants, ces vingt dernieres annees, sont revelatrices du role joue dans la societe francaise par l’eglise, bâtiment qui sert aussi bien a celebrer une messe pour le bicentenaire de la Revolution qu’a justifier le demontage et le deplacement dans le village d’un prieure roman. Ces pratiques montrent ainsi que l’eglise du village federe et incarne aujourd’hui l’existence d’une communaute locale dans un lieu donne.

Resume Introduction L’objectif de cette etude etait de connaitre l’etat d’esprit des decideurs hospitaliers universitaires quant a la communication sur la qualite des soins dans les etablissements de sante et a leur volonte de la favoriser. Methodes Une enquete d’opinion a ete realisee en octobre 2004 via un questionnaire adresse par courrier a 128 professionnels de la sante representant les directions de tous les centres hospitaliers universitaires (CHU). La construction du questionnaire a repose sur nos objectifs: rapidite de reponse des sondes (questionnaires de moins de 2 pages), neutralite (questionnaire a questions ouvertes et permettant des reponses a choix multiples), coherence des reponses et identification des idees et/ou raisonnements, anonymat. Resultats Sur 128 questionnaires envoyes le 7 octobre 2004, 44 questionnaires ont ete renvoyes le 20 novembre 2004 par 18 directeurs generaux, 8 presidents de commission medicale d’etablissement, 12 doyens de facultes de medecine, 6 responsables de l’information medicale. Le taux de reponse etait de 34%. A la question de savoir si les publications, portant classement des etablissements de sante, repondaient a une attente legitime de la population d’information et de transparence, les reponses des professionnels etaient a 82% affirmatives. Tous les repondeurs ont conteste le fait que ces publications constituaient une information comprehensible du grand public car issues d’exploitation de donnees d’activite ne permettant pas d’apprecier la qualite, la performance, la securite ou l’expertise. Le critere du volume d’activite peut etre qualifie de reconnu et valide. Conclusion Une veritable «specialite de l’exploitation des donnees hospitalieres» doit se construire pour valider des publications portant classement des etablissements de soins. Ces publications ne sont comprehensibles que par un public de professionnels avertis qui denonce massivement les exploitations des donnees telles qu’elles sont faites et les carences methodologiques de la presse grand public.

Ce travail se propose d'analyser la situation de L'Eglise catholique dans la societe francaise a l'epoque actuelle, en etudiant sur le terrain la gestion et l'utilisation des eglises catholiques. Cette analyse tient compte de deux facteurs majeurs : le statut legal des edifices cultuels en France (surtout celui des eglises catholiques) et l'histoire recente du catholicisme. Le statut des eglises est defini par le systeme juridique issu de la loi du 9 decembre 1905. L'histoire du catholicisme est marquee par le concile Vatican II et sa reforme liturgique, et par les options recentes du catholicisme francais pour une nouvelle visibilite, apres la periode « d'enfouissement » qui a suivi ce concile. Dans la gestion et l'utilisation des eglises, l'Eglise catholique se trouve confrontee aux points de vue de trois types d'acteurs : usagers (a quelque titre que ce soit), proprietaires publics (le plus souvent les communes) et administration du Patrimoine (l'Etat). Les usagers n'ont pas de possibilite juridique d'agir dans ce domaine, mais leur opinion conditionne et justifie l'action des autres categories d'acteurs. Toutes les categories souhaitent la sauvegarde des eglises et leur maintien au culte, mais pour des motifs divers. Les utilisateurs les considerent generalement comme leur patrimoine culturel et identitaire, les communes partagent ce point de vue, mais sont aussi preoccupees de gerer au mieux des edifices lourds a entretenir et peu utilises, l'administration du Patrimoine veut aussi les maintenir au culte catholique, mais pour conserver le plus possible leur « authenticite » culturelle. L'Eglise catholique doit tenir compte des perceptions des usagers, du droit du proprietaire le plus souvent public, mais aussi de l'autorite de l'administration du patrimoine, dans le cas tres frequent d'edifices proteges au titre des Monuments historiques. Ce dernier point la met en concurrence avec les experts de l'Etat sur l'interpretation de ses propres symboles. Elle doit aussi et surtout organiser le culte dans les eglises et y accueillir la communaute des fideles, dans le cadre defini par la reforme liturgique de Vatican II. Prise entre le synchronique du culte ici et maintenant et le diachronique de sa presence comme institution majeure de sens depuis les origines dans la societe francaise, L'Eglise catholique doit maintenir la tension entre les deux pour pouvoir demeurer aujourd'hui une ressource de sens particulierement pertinente parmi celles qui se disputent le « marche » du sens en France. Le nombre des pretres et des fideles catholiques diminue regulierement. Malgre cela, la societe francaise continue d'adresser a l'Eglise catholique des demandes d'utilisations des eglises, publiques ou privees. L'Eglise catholique accede assez largement a ces demandes en tentant de controler aussi bien les utilisations culturelles que sociales. Demandes et reponses montrent que L'Eglise catholique tient dans la societe francaise une place tout a fait particuliere, qu'on pourrait assimiler a un des elements d'une religion civile « catho-laique ». Elle demeure une institution majeure de reference, meme si un tres petit nombre de Francais se considerent comme ses adherents et qu'un nombre encore plus petit se sent lie par ses recommandations en matiere de morale, en particulier sexuelle.

The intervention of pyruvate in glucose metabolism was investigated during hypoxic stress in tumour cell cultures having respiratory capacities under normoxic conditions. Results obtained with nuclear magnetic resonance (NMR) spectroscopy showed that, under normoxic conditions, rat glioma C6 and human hepatoma Hep G2 cell cultures metabolised [(13)C(1)]glucose into lactate, alanine, glutamate and other less abundant metabolites, as already known from the literature. In the absence of pyruvate, during hypoxia or cyanide poisoning, both cell types dramatically decreased the label into glutamate and accumulated [(13)C(3)]glycerol-3-phosphate. The compound was further identified by 31P NMR spectroscopy. The accumulation of the label in glycerol-3-phosphate, however, did not occur when the cells were incubated in the presence of pyruvate. The fate of the latter, followed under normoxic conditions by incubating cells with [(13)C(3)]pyruvate and natural glucose, showed that the label was mainly found in alanine, lactate and glutamate. Anoxic conditions increased the label in lactate and reduced that of glutamate. The data show a metabolic effect of pyruvate during mitochondrial blockade due to severe lack of oxygen in tumour cell lines.

Ouabain or a closely related isomer, and 'ouabain-like compound' (OLC), has been identified in plasma, by Hamlyn et al., using several physico-chemical and biological methods. Using a radioimmunoassay, the same authors later characterized an identical compound in adrenal cortex tissue and culture medium from adrenocortical cells. Nevertheless, other groups, using different immunosera, were not able to detect OLC in adrenal cortex and adrenocortical cells medium. In this report, we confirm the presence of OLC in bovine adrenal cortex and in fasciculata cells culture medium. The compound that we obtained has the same chromatographic properties as ouabain on HPLC using two types of elution systems. It presents the same mass spectrum and is able to bind to erythrocytes membranes Na(+)-K(+)-ATPase. In primary cultures of adrenocortical cells, its biosynthesis is increased after addition of pregnenolone or progesterone suggesting that these compounds may represent intermediate substrates in the biosynthetic pathway. Rhamnose readily enters the adrenocortical cell and increases slightly the biosynthesis of OLC. The present studies confirm that bovine adrenocortical cells in primary culture release an OLC with no differences with authentic ouabain using, HPLC, mass spectrometry and radioreceptor assay and suggest that OLC may be a product related to the adrenocortical steroidogenic pathway.

In steroidogenic tissues, cytochrome P-450(17) alpha catalyzes both steroid 17 alpha-hydroxylation and 17,20-lyase reactions. The ratio of the two activities, hydroxylase over lyase (H/L) depends upon the tissue of origin; this ratio is low in the testis whereas it is high in the adrenal cortex. To examine the factors responsible for this specific regulation, two approaches were followed: (i) the purified enzyme was incorporated into liposomes made of microsomal lipids of testis or adrenal cortex; and (ii) the effects of disorganization of the microsomal membrane on the activities were observed. The results show that the cytochrome 17,20-lyase activity is stimulated by the presence of lipids from testicular origin. In the adrenal microsomes, this activity appears to be dependent upon the local membrane organization. Specific component(s) associated with the neutral fraction of the microsome lipid extract may be responsible for the repression of lyase activity in the adrenal.

To assess the perception of risk of general practitioners (GPs) about electromagnetic fields (EMF), their sources of information, as well as their patients' level of concern.Six hundred French GPs were selected according to the quotas method. They were asked to answer 24 items via an electronic questionnaire using the Computer-Assisted Web Interviewing (CAWI) method.The GPs know the main EMF sources: cell phone towers, cell phones, power-lines, microwave ovens and WiFi networks. Patients mostly complain or worry about the first three sources and ask their GP for information about these. GPs themselves search for information in the mainstream media rather than in the usual scientific and medical press. As a consequence, their knowledge about potential risks of EMF is deemed rather crude.The GPs are sensitive to environmental concerns, particularly regarding EMF exposure. However, according to the results analysis, they do not have the same approach because of an obvious lack of mastery in a complex and poorly informed situation. A serious educational effort is essential and would be welcomed by practitioners, who are aware of their responsibilities in terms of counseling, diagnosis and care.

Electromagnetic radiations are a form of conveying energy without any material support. Very heterogeneous by the energy that they transmit and by their possibilities of interacting with matter and in particular biological structures, they can be described either as electromagnetic waves (“wave” model), or as a flux of photons* (“particle” model).

Static electric and magnetic fields are permanently present in the environment. Whereas the static electric field is associated with the presence of fixed electrical charges, the magnetic field is due to the physical movement of electrical charges. Unlike the other categories of fields covered in this work, static fields do not vary over time.

Fears concerning possible effects on health were first expressed in 1993 on account of the rapid development of wireless communications and following a highly mediatised lawsuit in the United States against a mobile phone manufacturer accused of being responsible for the death of a woman from cancer. Since then, widespread research has been carried out in order to assess the potential health risks associated with radiofrequency* (RF).

Electromagnetic fields, environment and health / , Electromagnetic fields, environment and health / , کتابخانه دیجیتال جندی شاپور اهواز