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ObjectiveWe aimed to study neurodevelopmental outcomes and healthcare utilisation at age 5–6 years in very preterm children with bronchopulmonary dysplasia (BPD).DesignProspective and national population-based study.SettingAll the neonatal units in 25 French regions (21 of the 22 metropolitan regions and 4 overseas regions).PatientsChildren born before 32 weeks’ gestation in 2011.InterventionsBlind, comprehensive and standardised assessment by trained neuropsychologists and paediatricians at age 5–6 years.Main outcome measuresOverall neurodevelopmental disabilities, behavioural difficulties, developmental coordination disorders, full-scale IQ, cerebral palsy, social interaction disorders, rehospitalisation in the previous 12 months and detailed developmental support.ResultsOf the 3186 children included, 413 (11.7%) had BPD. The median gestational age of children with BPD was 27 weeks (IQR 26.0–28.0) and without BPD was 30 weeks (28.0–31.0). At age 5–6 years, 3150 children were alive; 1914 (60.8%) had a complete assessment. BPD was strongly associated with mild, moderate and severe overall neurodevelopmental disabilities (OR 1.49, 95% CI 1.05 to 2.20; 2.20, 1.41 to 3.42 and 2.71, 1.67 to 4.40). BPD was associated with developmental coordination disorders, behavioural difficulties, lower IQ score as well as rehospitalisation in the last 12 months and developmental support. The association between BPD and cerebral palsy was statistically significant before adjustment but not in adjusted analyses.ConclusionsBPD was strongly and independently associated with many neurodevelopmental disabilities. Improving medical and neurodevelopmental management of BPD in very preterm children should be a priority to reduce its long-term consequences.

Arch Dis Child Fetal Neonatal Ed 2004;89:F139-F144. doi: 10.1136/adc.2002.020396 Objective: To evaluate the outcome for all infants born before 33 weeks gestation until discharge from hospital. Design: A prospective observational [...]

EXECUTIVE OVERVIEW Patterning of contact layers with minimal half pitch below 90nm has proven to be a very dif. cult task. In general, difficulties in contact patterning are driven by […]

Five years after adoption of the 2030 Agenda, there is a general lack of progress in reaching its Sustainable Development Goals—be it on national, regional, or global scales. Scientists attribute this above all to insufficient understanding and addressing of interactions between goals and targets. This study aims to contribute to the methodological conceptualization of the 2030 Agenda’s implementation at the national level. To this end, taking the case of Switzerland, we tested and enhanced existing approaches for assessing interactions among the 2030 Agenda’s targets and for analysing the systemic relevance of priority targets. Building on our insights, the article concludes with an eight-step proposal for creating knowledge to support national 2030 Agendas.

Étudier l’aspect scanographique de l’ossiculoplastie par ciment ossiculaire pour lyse de la branche verticale de l’enclume (BVE) et corréler ces observations aux résultats audiométriques au cours du temps.

Rapporter une complication inhabituelle des sinusites maxillaires aiguës de l’enfant : l’abcès prémaxillaire. Décrire la présentation clinique, radiologique et biologique ainsi que la stratégie thérapeutique et l’évolution.

Présenter les recommandations de pratique clinique (RCP) de la Société française d’otorhinolaryngologie–chirurgie de la face et du cou concernant l’utilisation des AINS dans les infections ORL pédiatriques.

•Script Concordance Tests (SCTs) which have been included in the 2024 French National Ranking Exams (EDN), assessing students’ clinical reasoning under uncertainty.•SCTs concept aligns with Bayesian probability, updating hypothesis likelihood based on new information, highlighting their educational value.•Key ambiguities include the specific clinical reasoning stage evaluated, appropriate Likert scale labels, and the suitability of expert panels as benchmarks.•Addressing these ambiguities could enhance SCTs' effectiveness, improve medical education, and offer a rich research avenue for refining clinical practice.

•Combined T and MEP recordings are easy to perform and improve ALS diagnosis.•The corticospinal conduction time to the lower limbs is elevated in ALS.•T-MEP-LL can help to distinguish “pure PMA” from ALS with predominant LMN lesions.

La famille est primordiale pour les nouveau-nés hospitalisés. Elle soutient son développement, tout en tissant des liens d’attachement solides avec lui. Les soins centrés sur l’enfant et sa famille affirment que la famille fait partie de l’équipe soignante de néonatologie. Elle est intégrée dans le processus de décision médicale et est partenaire dans les soins à son ou ses enfants. Il semble essentiel de préciser la définition de la famille. Nous allons aborder cette définition sous un aspect juridique, sociologique ou philosophique. Le Groupe de Réflexion et d’Évaluation de l’Environnement des Nouveau-nés (GREEN) de la Société française de néonatologie estime qu’il est important de clarifier la définition de la famille d’un nouveau-né hospitalisé, de décrire les difficultés liés à la séparation pour l’enfant, ses parents, sa fratrie et sa famille, de faire un état des lieux sur les pratiques, puis de proposer des recommandations et des stratégies d’application.

Le peau à peau est défini par le portage d’un enfant vêtu d’une couche et d’un bonnet entre les seins de sa mère ou contre le torse du père, peau contre peau. Les objectifs du Groupe de Réflexion et d’Évaluation de l’Environnement des Nouveau-nés étaient d’évaluer son rationnel scientifique et d’émettre des recommandations pratiques pour sa réalisation en néonatologie et en salle de naissance. Une recherche bibliographique systématique, suivant la méthodologie de la Haute Autorité de santé, montre l’existence de bénéfices sur la stabilité physiologique, le sommeil, la douleur, le développement neurologique, l’allaitement, l’attachement et le stress parental. Il est recommandé que le peau à peau soit proposé à tous les bébés prématurés hospitalisés, le plus précocement et le plus largement possible, dès stabilité clinique, avec des procédures écrites de transfert et surveillance, et un environnement soutenant. Cette pratique semble bénéficier aux nouveau-nés extrêmement prématurés et/ou intubés, mais nécessite une expertise de l’équipe. Le peau à peau précoce en salle de naissance avec la mère est bénéfique pour l’allaitement, le comportement, l’adaptation du nouveau-né à terme ou proche du terme. Le peau à peau avec le père améliore aussi le comportement de l’enfant. L’installation immédiate en peau à peau avec la mère est fortement recommandée pour le nouveau-né d’âge≥35 semaines, si son état clinique le permet. Il est recommandé à chaque équipe d’informer et soutenir les parents, d’instaurer des procédures de sécurité/surveillance adaptées pour soutenir la pratique du peau à peau en sécurité en salle de naissance.

L’ictère à bilirubine libre chez le nouveau-né à terme ou proche du terme (âge gestationnel [AG]>35semaines d’aménorrhée [SA]) touche 50 à 70 % des nouveau-nés en maternité. Dans les formes sévères l’évolution peut se faire vers une encéphalopathie aiguë hyperbilirubinémique avec risque de décès ou de séquelles importantes (ictère nucléaire). Il existe des grandes différences de pratique concernant l’ictère néonatal selon les centres et certains pays ont élaborés des recommandations pour la pratique clinique (RPC) nationales. Le but de ce travail était d’évaluer la qualité méthodologique de ces RPC.

IMPORTANCE: Up-to-date estimates of the health outcomes of preterm children are needed for assessing perinatal care, informing parents, making decisions about care, and providing evidence for clinical guidelines. OBJECTIVES: To determine survival and neonatal morbidity of infants born from 22 through 34 completed weeks’ gestation in France in 2011 and compare these outcomes with a comparable cohort in 1997. DESIGN, SETTING, AND PARTICIPANTS: The EPIPAGE-2 study is a national, prospective, population-based cohort study conducted in all maternity and neonatal units in France in 2011. A total of 2205 births (stillbirths and live births) and terminations of pregnancy at 22 through 26 weeks’ gestation, 3257 at 27 through 31 weeks, and 1234 at 32 through 34 weeks were studied. Cohort data were collected from January 1 through December 31, 1997, and from March 28 through December 31, 2011. Analyses for 1997 were run for the entire year and then separately for April to December; the rates for survival and morbidities did not differ. Data are therefore presented for the whole year in 1997 and the 8-month and 6-month periods in 2011. MAIN OUTCOMES AND MEASURES: Survival to discharge and survival without any of the following adverse outcomes: grade III or IV intraventricular hemorrhage, cystic periventricular leukomalacia, severe bronchopulmonary dysplasia, retinopathy of prematurity (stage 3 or higher), or necrotizing enterocolitis (stages 2-3). RESULTS: A total of 0.7% of infants born before 24 weeks’ gestation survived to discharge: 31.2% of those born at 24 weeks, 59.1% at 25 weeks, and 75.3% at 26 weeks. Survival rates were 93.6% at 27 through 31 weeks and 98.9% at 32 through 34 weeks. Infants discharged home without severe neonatal morbidity represented 0% at 23 weeks, 11.6% at 24 weeks, 30.0% at 25 weeks, 47.5% at 26 weeks, 81.3% at 27 through 31 weeks, and 96.8% at 32 through 34 weeks. Compared with 1997, the proportion of infants surviving without severe morbidity in 2011 increased by 14.4% (P < .001) at 25 through 29 weeks and 6% (P < .001) at 30 through 31 weeks but did not change appreciably for those born at less than 25 weeks. The rates of antenatal corticosteroid use, induced preterm deliveries, cesarean deliveries, and surfactant use increased significantly in all gestational-age groups, except at 22 through 23 weeks. CONCLUSIONS AND RELEVANCE: The substantial improvement in survival in France for newborns born at 25 through 31 weeks’ gestation was accompanied by an important reduction in severe morbidity, but survival remained rare before 25 weeks. Although improvement in survival at extremely low gestational age may be possible, its effect on long-term outcomes requires further studies. The long-term results of the EPIPAGE-2 study will be informative in this regard.

The demand for ever shrinking semiconductor devices is driving efforts to reduce pattern dimensions in semiconductor lithography. In this work, the aim is to find a single patterning litho solution for a 28nm technology node using 193nm immersion lithography. Target poly pitch is 110nm and metal1 pitch is 90nm. For this, we have introduced a range of different techniques to reach this goal. At this node, it becomes essential to include the layout itself into the optimization process. This leads to the introduction of restricted design rules, together with the co-optimization of source and mask (SMO) and the use of customized illumination modes (freeform illumination sources; FlexrayTM). Also, negative tone development (NTD) is employed to further extend the applicability of 193nm immersion lithography. Traditionally, the printing of contacts and trenches is done by using a dark field mask in combination with a positive tone resist and positive tone development. The use of negative tone development enables images reversal. This allows benefiting from the improved imaging performance when exposing with bright field masks. The same features can be printed in positive tone resists and with improved process latitudes. At the same time intermediate metal (IM) layers are used to connect the front-end and back-end-of-line, resulting in huge area benefits compared to layouts without these IM layers. The use of these IM layers will not happen for the 28nm node, but is intended to be introduced towards the 20nm node, and beyond. Nevertheless, the choice was made to use this architecture to obtain a first learning cycle on this approach. In this study, the use of negative tone development is explored, and its use for the various dark field critical layers in a 28nm node process is successfully demonstrated. In order to obtain sufficiently large process windows, structures are printed larger than the designed target CD. As a consequence, a shrink of the structures needs to be applied to obtain the target CD after etch. Different shrink approaches are compared. Final results on wafer are discussed, focusing on critical layers as IM1, IM2, Via0 and Metal1.

Today, 22nm node devices are built using 193nm immersion lithography, possibly combined with double patterning techniques. Some stretch till the 16nm node is feasible here, using double, triple or even quadruple patterning. Alternatively, extreme ultra violet (EUV) lithography is showing promising results, and is considered to be the most likely option for this last mentioned device node. Electrically functional 22nm node devices are already available, where EUV lithography is used for the definition of the back-end layers. Fewer results are published on the patterning of front-end layers using EUV lithography. In this work, EUV lithography is used for the patterning development of the first four critical layers (active or fin, gate, contact and metal1) of a 16nm node 6T-SRAM cell. For the first time, front-end layers will need to be printed, with EUV, and transferred into an underlying substrate. The need for optical proximity correction is checked and characterized for all layers.

Population and study design heterogeneity has confounded previous meta-analyses, leading to uncertainty about effectiveness and safety of elective high-frequency oscillatory ventilation (HFOV) in preterm infants. We assessed effectiveness of elective HFOV versus conventional ventilation in this group.

Human papillomaviruses (HPVs) play an important role in the pathogenesis of cervical cancer. For identification of the large number of different HPV types found in (pre)malignant lesions, a robust methodology is needed that combines general HPV detection with HPV genotyping. We have developed for formaldehyde-fixed samples a strategy that, in a homogenous, real-time fluorescence polymerase chain reaction (PCR)-based assay, accomplishes general HPV detection by SybrGreen reporting of HPV-DNA amplicons, and genotyping of seven prevalent HPV types (HPV-6, -11, -16, -18, -31, -33, -45) by real-time molecular beacon PCR. The false-positive rate of the HPV SybrGreen-PCR was 4%, making it well suited as a prescreening, general HPV detection technology. The type specificity of the seven selected HPV molecular beacons was 100% and double infections were readily identified. The multiplexing capacity of the HPV molecular beacon PCR was analyzed and up to three differently labeled molecular beacons could be used in one PCR reaction without observing cross talk. The inherent quantitation capacities of real-time fluorescence PCR allowed the determination of average HPV copy number per cell. We conclude that the HPV SybrGreen-PCR in combination with the HPV molecular beacon PCR provides a robust, sensitive, and quantitative general HPV detection and genotyping methodology.

Both available and newly acquired geological and geophysical data processed in the framework of the ARMOR project have been used to construct a 3-D geometric and geological model of the Cadomian domain of northern Brittany. The major results of the data processing are presented and discussed relative to a composite profile transecting the studied domain and constructed from the surface geology, reflection seismics, magnetotelluric soundings and gravimetric data. They are then extrapolated at regional scale through a series of cross-sections compiled from the surface geology and gravimetric data and calibrated onto the composite profile. The 3-D crustal-scale models were computed according to two procedures. The first, using a STRIM Matra Datavision modeler, defines various interfaces through correlation between adjacent cross-sections and is well adapted to the 3-D representation of geological structures. The second, based on Voronoı̈ diagrams, leads to a volumetric model of the geological units and is a powerful tool for calculating 3-D geophysical responses of the model when the physical properties of the rock units are known. The tectonic implications of the computed 3-D crustal-scale geometry of the Cadomian domain are then discussed in terms of volcanic-arc thrusting, with special emphasis being placed on the obliquity of the shortening direction by reference to the thrust fault trend. Finally, the data are used to demonstrate the reactivation of some Cadomian faults during the deposition of Ordovician sandstones and following the emplacement of the Paleozoic dolerite dyke swarm of northern Brittany.

The geometrical relationships existing between the Saint-Brieuc, Saint-Malo and Guingamp units, which form the Cadomian active margin of northern Brittany, have been determined by gravity analyses and 2.5D modelling, correlated with other geophysical (magnetic, seismic, etc.) and geological observations. Automatic structural analyses were performed before modelling, to identify lateral gravity discontinuities. Averaged density measurements were used for 2.5D gravity modelling along six profiles across the arcuate geological and gravity shape of the Cadomian basement. This study allowed the third dimension to be obtained through correlating each profile with its neighbours. We propose that orthogneiss formations equivalent to the Port-Morvan orthogneiss, constitute the Saint-Brieuc upper-crustal unit, below the Lanvollon Formation. 2.5D gravity modelling outlines downward geological differences in the western and eastern parts of the Ploufragan Complex, as previously indicated by surface mapping. These results stress the necessity for distinguishing between the Guingamp and Saint-Malo units.

In order to obtain an image of the subsurface of the Armorican Massif, two detailed aeromagnetic surveys were combined to obtain an aeromagnetic map at 350m altitude with an interpolated grid of 250m×250m. The map shows good correlation between the magnetic anomalies and known geological structures and also distinguishes between long- and short-wavelength anomalies. The long-wavelength anomalies are associated with the overall subsurface arcuate structure of the Cadomian belt. The short-wavelength anomalies are commonly associated with the Lanvollon acid volcanic rocks and syntectonic diorites, with one set of short-wavelength anomalies in the east of the Saint-Malo region being associated with dykes that are exposed onshore and continue offshore.

The French Cadomian belt (northern Armorican Massif) constitutes an excellent area for studying Panafrican orogenic processes in Europe for which geophysical methods are useful for obtaining a realistic interpretation of the geological structures at depth. Magnetic modelling of the area to the west of Saint-Brieuc Bay was carried out to determine the geometry of the Cadomian geological units. Modelling was computed along profiles extracted from the regional aeromagnetic map. The shape of the magnetic bodies was determined with the help of interpretative geological sections and the total magnetization of the magnetic bodies was determined from a data base of about 350 rock sample measurements. The measured susceptibility (χ) ranges from 0.15×10−3SIto 221.5×10−3SI(the induced magnetization IM=40A/M×χ.) The natural remanent magnetization (NRM) is weak and shows varied directions; it is therefore negligible at the formation scale, and only the magnetic susceptibility was taken into account for modelling. A computed mean IM was attributed to each magnetic body in the model.

The Armor seismic profile (AR1, AR2) crosscuts the major units of the Cadomian Domain (600–540Ma) of Northern Brittany and extends the offshore SWAT 10 profile (BIRPS–ECORS program). We thus have a combined 95-km-long NNW–SSE section for describing the regional-scale structure of the Cadomian crust in the area. Following reprocessing and migration of the southern end of the SWAT 10 profile so that it could be compared with the AR1–AR2 Armor profile, a structural interpretation of the composite profile was carried out taking into account gravity modelling and magnetotelluric soundings.

Extracorporeal membrane oxygenation (ECMO) is a technique of extracorporeal oxygenation used in newborn infants with refractory hypoxemia after failure of maximal conventional medical management, when mortality risk is higher than 80%. We retrospectively reviewed all the neonates treated by ECMO between October 1991 and September 1997 in our newborn intensive care unit.

Objective: We report an electrophysiological method to differentiate amyotrophic lateral sclerosis (ALS) from cervical spondylotic myelopathy (CSM).

Palladium-catalyzed acryloxylation of several cycloalkenes in the presence of the Pd(OAc)2/p-benzoquinone/MnO2 catalytic system is reported. This oxidation reaction yields allylic acrylates as the sole products through the intermediacy of an η³-allyl complex. However, with 1,5-cyclooctadiene (3), cyclooct-4-enone (4) is the major reaction product. Its formation results from oxidation, which is also observed in the palladium-catalyzed acetoxylation of 3. It has been shown that this is the result of a 1,2-trans addition (acryloxy-palladation), followed by a β-hydride elimination, which yields an enol acrylate or acetate. A second Markovnikov-oriented 1,2-trans-acryloxy-palladation on the latter yields a palladium complex, rearrangement of which gives 4.

We have identified the genetic defect that leads to a deficiency of apoC-II in the proband from the Paris kindred. Analysis of the apoC-IIParisDNA by Southern blot hybridization revealed no major gene rearrangements, but sequencing of polymerase chain reaction-amplified apoC-IIParisDNA revealed an A to G transition that changed the initiation AUG (methionine) codon to GUG (valine). Potential initiation of translation at the closest inframe methionine codon eliminates the entire signal peptide and the first 8 amino-terminal residues of apoC-II which would prevent apoC-II secretion into plasma. In agreement with this, no apoC-II was detected in the patient's plasma by radioimmunoassay or by two-dimensional gel electrophoresis and immunoblotting. Direct sequencing of amplified patient DNA from 12 different polymerase chain reaction samples demonstrated the presence of the A to G substitution in all, indicating that the proband is a homozygote for the defect. We propose that in the apoC-IIParisgene, a mutation in the initiation methionine codon prevents the normal initiation of apolipoprotein synthesis and leads to a deficiency of apoC-II. This initiation methionine mutation represents a new type of molecular defect that can result in Type I hyperlipoproteinemia.

Amplitudes of motor evoked potentials (MEPs) are usually much smaller than those of motor responses to maximal peripheral nerve stimulation, and show marked variation between normal subjects and from one stimulus to another. Consequently, amplitude measurements have low sensitivity to detect central motor conduction failures due to the broad range of normal values. Since these characteristics are mostly due to varying desynchronization of the descending action potentials, causing different degrees of phase cancellation, we applied the recently developed triple stimulation technique (TST) to study corticospinal conduction to 489 abductor digiti minimi muscles of 271 unselected patients referred for possible corticospinal dysfunction. The TST allows resynchronization of the MEP, and thereby a quantification of the proportion of motor units activated by the transcranial stimulus. TST results were compared with those of conventional MEPs. In 212 of 489 sides, abnormal TST responses suggested conduction failure of various degrees. By contrast, conventional MEPs detected conduction failures in only 77 of 489 sides. The TST was therefore 2.75 times more sensitive than conventional MEPs in disclosing corticospinal conduction failures. When the results of the TST and conventional MEPs were combined, 225 sides were abnormal: 145 sides showed central conduction failure, 13 sides central conduction slowing and 67 sides both conduction failure and slowing. It is concluded that the TST is a valuable addition to the study of MEPs, since it improves detection and gives quantitative information on central conduction failure, an abnormality which appears to be much more frequent than conduction slowing. This new technique will be useful in following the natural course and the benefit of treatments in disorders affecting central motor conduction.Keywords:collision technique; corticospinal tract; magnetic transcranial stimulation; transcranial cortical stimulation; quantification of central motor conduction defects

Transcranial stimulation has become an established method in the evaluation of corticospinal tract function. Clinical studies mainly address slowing of conduction through measurement of increased central conduction time (CCT) and 'failures' of conduction through observation of marked reductions in the size of the motor evoked potential (MEP). While CCT is of great interest in detecting subclinical slowing of conduction, the method discloses only gross failures of conduction, since the size of the MEP varies markedly between normal subjects and from one stimulus to another, leading to a broad range of normal values. Furthermore, transcranial stimulation does not appear to achieve depolarization of all spinal motor neurons leading to the target muscles, since in most normal subjects, MEPs are smaller in amplitude than the responses evoked by peripheral nerve stimulation. We have developed a triple stimulation technique (TST) which, through two collisions, links central to peripheral conduction and suppresses desynchronization of MEPs. This technique shows that transcranial stimulation does achieve depolarization of all, or nearly all, spinal motor neurons supplying the target muscle in healthy subjects. Our data thus demonstrate that the amplitudes of MEPs are (i) smaller than those of peripheral responses, mostly due to phase cancellation of the action potentials caused by the desynchronization occurring within the corticospinal tract or at spinal cell level and (ii) variable between normal subjects and from one stimulus to another, mostly due to variability of this desynchronization. This technique provides new insights into normal corticospinal tract conduction. It will improve detection and quantification of central motor conduction failures.Keywords:transcranial cortical stimulation; corticospinal tract; collision technique; magnetic and electrical stimulation; quantification of central motor-conduction defects

THE amplitudes of motor evoked potentials (MEPs) were mapped by transcranial magnetic stimulation (TMS) using the triple stimulation technique (TST) in 11 normal individuals. Stimuli were given while the subjects were (a) distracted, (b) concentrating on their target (recorded) hand, and (c) concentrating on their contralateral hand. Within seconds, the proportion of excited motor units increased, similarly in all subjects, by an average of 70 from (a) to (b), and by 48 from (a) to (c). At the optimal stimulation site, results obtained with the TST were compared to those of conventional MEPs. The TST proved superior in detecting the rapid changes of the motor output caused by the non-specific mental tasks studied.