Directly based on the principle of cardiopulmonary bypass (CPB), short-term circulatory support was developed to supplement heart and/or respiratory failure.Circulatory support is represented by two techniques closely related in their implantation but whose objectives are different. Extracorporeal membrane oxygenation (ECMO) aims to supplement failing lungs, while extracorporeal life support (ECLS) aims to support heart failure. ECMO will primarily affect oxygenation and decarboxylation of blood, while ECLS has a circulatory and a respiratory effect. By extension, the acronym ECMO is used for all short-term circulatory support techniques (under 1 month). To distinguish the two types of assistance, cannulation sites will be identifed. Venoarterial ECMO (ECMO-VA) is used to discuss about ECLS (heart failure or cardiopulmonary failure) and venovenous ECMO (ECMO-VV) to discuss about ECLS (respiratory failure only). The main difference from the commonly used CPB is that ECMO has no cardiotomy reservoir to store the blood. ECMO is therefore a closed circuit. This detail is important because this system is more dependent on the preload and afterload than CBP. The other difference is that CBP will be used over several hours while ECMO may be used for several days or weeks. In 1953, the frst heart–lung machine was used in humans . In 1972, the frst successful use of ECMO outside the operating room was reported . Initially developed for neonatal and paediatric use, these technologies have gradually been applied to adults, with disappointing initial results. A multicentre study evaluating its interest in respiratory failure found no difference from the control group .

As a student, trainee, or mental health practitioner, one may already have some inclination that understanding the law matters in the practice of psychiatry. But what is it exactly that makes the law so important? And why in psychiatry in particular ?State and federal laws have a signifcant impact on the practice of medicine. The practice of psychiatry is particularly affected as it is the most heavily legally regulated of all medical specialties . The reason is relatively simple: far more than any other medical discipline, the law grants psychiatrists the ability to deprive people of their civil liberties. Psychiatrists may force interventions on patients against their will—including hospitalization, medication, or even electroconvulsive therapy (ECT). Further, in a variety of settings, psychiatrists are tasked with determining whether patients lack the capacity to make certain decisions for themselves —including decisions related to medical care, fnances, and estate planning—and are in need of surrogate decision-makers. In some states, any physician may enact such privileges; however, in practice, psychiatrists are most often called upon to make these determinations . Thus, the privilege to override individuals’ rights to autonomy is subject to careful legal oversight and protections. So how does the law impact the practice of psychiatry? State and federal laws delineate the limited circumstances within which psychiatrists may deprive patients of their civil liberties. Patient autonomy is generally protected except in cases involving serious concerns about safety or well- being.

Human papillomaviruses (HPVs) are important pathogens, as they are the cause of all cervical cancers and of subsets of vulval, anal, oral, and penile cancers. The viral genome is an 8 kb double-stranded circular DNA, which can replicate in various types of epithelial cells. HPV DNA shows changes of its methylation profile during the viral life cycle, namely “sporadic” and “polymorphic” DNA methylation associated with low transcription in basal cells of epithelia, and a lack of methylation in suprabasal cells associated with strong transcription. While these epigenetic changes of HPV DNA during the viral life cycle are still poorly understood, it has emerged that during progression of low-grade precursor lesions to malignant carcinomas, the HPV DNA becomes hypermethylated, probably since the viral genome recombines with the chromosomal DNA of the infected host cell. This methylation signal is intensely studied as a candidate biomarker for the diagnosis of HPV-associated lesions that have the potential to progress to cancer.