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Summary: Bronchopulmonary dysplasia (BPD) of very preterm infants is a multifactorial chronic lung disease and its incidence has not decreased despite improvements in neonatal intensive care, including lung protective strategies. Pulmonary hypertension (PH) can complicate the course of BPD. Mortality in infants with BPD-associated PH is thought to be very high, but its incidence is unknown and a standard diagnostic and therapeutic strategy has not been well defined. In this article, we will first describe the current knowledge on the BPD-associated PH and the current treatments available for this pathology. We will then present the HTP-DBP Study, carried out in Paris (France) starting in 2012. The diagnosis of PH is suspected on echocardiographic criteria, but cardiac catheterization is considered the gold standard for diagnosis and evaluation of the severity of PH. Moreover, pulmonary vasoreactivity testing is used to guide the management of patients with PH. The pathogenesis of BPD-associated PH is poorly understood and even less is known about appropriate therapy. Today, optimizing ventilation and reducing the pulmonary vascular tone with specific pulmonary vasodilatator drugs are the main goals in treating HTP-associated DBP. Animal studies and a few clinical studies suggest that medications targeting the nitric oxide (NO) signaling pathway (NO inhalation, oral sildenafil citrate) could be effective treatments for BPD-associated PH, but they have not been approved for this indication. The HTP-DBP study is a French multicenter prospective observational study. The objective is to evaluate the frequency of BPD-associated PH, to describe its physiopathology, its severity (morbidity and mortality), and the effectiveness of current treatments. [Copyright &y& Elsevier]

Summary: Acute osteomyelitis, although a rare complication in neonates, is a diagnostic and therapeutic challenge. Successful treatment to avoid functional sequelae depends on early recognition of infection and rapid initiation of therapy. Although Staphylococcus aureus is the most common causative agent, coagulase-negative Staphylococcus (CONS), well known for bloodstream infection, can be involved in neonatal osteomyelitis. Risk factors of osteomyelitis include prematurity and invasive procedures, such as long-term central venous catheterization. We report on 3 cases of acute CONS osteomyelitis in preterm infants presenting with prolonged CONS bacteremia. Bacteremia persisted despite antibiotic treatment in accordance with antibiograms and despite removal of the intravascular device. All catheter cultures were negative and osteomyelitis was not located on the limb where the central catheter had been inserted in all cases. Osteomyelitis diagnosis may be difficult in neonates because of the paucity of clinical signs. In our observations, 99mTc scintigraphy was the key investigation for diagnosis and detection of multiple sites of bone infection. The place of this investigation is discussed in relation to other imaging techniques. These observations suggest that in the context of persisting CONS bacteremia, a secondary bone infection should be considered. Scintigraphy is a discriminating diagnostic tool. [ABSTRACT FROM AUTHOR]

Abstract: This study proposes a new alternative solution in preferential extraction methods or microdissection to isolate and analyse single sperm cells in case of sexual assault. After the transfer of swabs in liquid culture medium, perpetrator''s spermatozoas can be physically separated from victim''s epithelial cells by using classical techniques of micromanipulation as ICSI (IntraCytoplasmic Spermatozoa Injection), usually applied for IVF (In vitro Fertilization). [Copyright &y& Elsevier]

Abstract: This communication presents optical and spectroscopic characterizations of the first Yb3+:CaF2 waveguides fabricated by H+ implantation. The technique allows to obtain 1cm long channel waveguides, with mode sizes of about 10μm×10μm. Details on fabrication process and characterization of such waveguides are discussed. [Copyright &y& Elsevier]

Introduction L’œsophagite à éosinophile (OE) est de découverte récente, de prise en charge complexe, souvent disparate, notamment chez l’enfant. Nous avons effectué une étude de nos pratiques pour élaborer un protocole commun. Méthodes Une étude rétrospective dans 5 centres hospitaliers de l’Ouest a regroupé 28 cas d’OE diagnostiqués entre 2010 et 2016 par biopsies œsophagiennes et contexte clinique évocateur, avec recueil des données médicales et relecture histologique centralisée après accord du comité d’éthique. Résultats L’âge au diagnostic est de 1,5 mois à 17 ans, 82 % de garçons, 82 % sont atopiques. Les symptômes retrouvent des blocages alimentaires (46 %) surtout pour les plus grands, des difficultés alimentaires (42 %), des retards de croissance (25 %). L’aspect endoscopique est normal pour 29 %, les biopsies des 3 tiers de l’œsophage réalisées dans 68 % des cas. Un immunomarquage centralisé à IgG 4 a été réalisé. Tous sauf un (pathologie neurologique) ont eu IgE ± Pricks tests, 50 % ont eu des patch-tests. Les allergènes retrouvés sont le lait (39 %), l’arachide (39 %), l’œuf (36 %), le blé (32 %), le poisson (29 %), le soja (25 %) et les viandes (21 %). 19 patients sont sensibilisés à au moins 1 trophallergene. Le traitement est constitué de corticoïdes topiques (39 %), régime alimentaire (29 %) ou les deux (25 %), 71 % ont eu des IPP. Un contrôle endoscopique est parfois réalisé (43 %). Discussion L’incidence de l’OE augmente (dans notre étude 23 cas entre 2013 et 2016) mais reste sous diagnostiquée, peut être du fait de symptômes aspecifiques, avec une prédominance masculine un peu plus importante dans notre étude. La FOGD peut être normale, des biopsies étagées en nombre suffisant doivent être réalisées, souvent sous AG chez l’enfant. Le bilan allergologique doit comporter PT et patch-tests du fait de la physiopathologie de la maladie. Conclusion Il est nécessaire d’uniformiser nos pratiques, mais aussi préciser la place de l’immunomarquage à IgG4. [ABSTRACT FROM AUTHOR]

Transcatheter aortic valve implantation (TAVI) is the gold standard treatment for aortic stenosis in the elderly. Pre-identification of patients likely to benefit from this procedure remains crucial. A standardised geriatric assessment is used to identify the major geriatric syndromes likely to influence postoperative outcomes. To identify factors associated with lack of TAVI management and to compare one-year survival in TAVI vs. non-TAVI patients. Retrospective study, between 2016 and 2020, at the Arras hospital. Patients aged 70 years and older with symptomatic severe aortic stenosis who had undergone geriatric assessment were included. One hundred and ninety-two (192) patients, mean age 82.3 years. The 1-year mortality rate was 18% in the TAVI group and 44% in the non-TAVI group (p < 0.001). Parameters associated with no TAVI were Euroscore (ESL) 1 (19.6 ± 10.9 vs. 23.2 ± 13.5, p = 0.020), malnutrition (14% vs. 35%, p = 0.004), walking speed < 0.8 m/s (39% vs. 75%, p = 0.001), Activities of Daily Life (ADL) score (5.4 ± 1 vs. 4.2 ± 1. 6, p < 0. 001) and Instrumental Activities of Daily Life (IADL) score (2.6 ± 1.2 vs. 1.8 ± 1.4, p = 0.002), Mini Geriatric Depression Scale (mini GDS) ≥ 1 (16% vs. 38%, p = 0.045), Mini Mental State Examination (MMSE) score (25.1 ± 3.5 vs. 21.6 ± 4.3 < 0.001). Geriatric syndromes are important determinants of TAVI candidacy. Cardiological surgical risk scores are not effective in discriminating between patients. Coordinated assessment may optimise selection. Therefore, geriatric assessment should be systematically performed as part of the pre-TAVI evaluation. [ABSTRACT FROM AUTHOR]

Résumé Introduction Nous avons tenté d’apprécier (i) la fréquence des consultations pour malaise au service d’accueil des urgences (SAU) d’un centre hospitalier universitaire (CHU), (ii) l’épidémiologie clinique, et (iii) le coût des malaises, en s’intéressant aux facteurs associés à l’hospitalisation. Méthodes Cette étude rétrospective a été menée à partir des données des patients ayant consulté pour « malaise » au SAU du CHU de Reims, (01/01/12–31/03/12). Tous les dossiers ont été reclassés en syncope/lipothymie/perte de connaissance brève, d’une part, et en syncope selon la définition anglo-saxonne reprise par la Haute Autorité de santé (HAS), d’autre part. Résultats Trois cent quarante et un patients parmi les 5953 patients de la période de l’étude (5,7 %) ont consulté pour malaise. Les données de 296 patients ont été analysées. Cette population comportait 62,8 % de femmes, avec un âge médian de 43 ans. L’examen clinique était normal dans 57 % des cas. Il s’agissait de lipothymies sans perte de connaissance complète, non prises en compte dans la classification HAS dans 48 % des cas. Les patients restaient une durée médiane de 4 heures au SAU et 67 patients (22,6 %) ont été hospitalisés. Le coût minimal a été estimé à 280 000 euros. Les facteurs de risque associés à une hospitalisation étaient un âge ≥ 60 ans ou la présence d’une perte de connaissance complète, à l’inverse de la présence de circonstances favorisant l’hypertonie vagale. Conclusion Un âge ≥ 60 ans et/ou la présence d’une perte de connaissance complète semblent associés à l’hospitalisation. Introduction We assessed (i) the frequency of consultations for faintness in the Emergency department (ED) of a University hospital centre (UHC), (ii) clinical epidemiology and (iii) cost of faintness, taking a particular interest into the determining risk factors for hospitalization. Methods This epidemiological study has been conducted retrospectively, from data obtained for every patient having consulted for faintness in ED of Reims UHC (01/01/12–03/31/12). Every medical record was classified as syncope/lipothymia/brief consciousness loss on one hand and as syncope according to the definition of the French Health High Authority (FHHA). Results Three hundred and forty-one patients out of 5953 (5.7%) were referred for faintness during the study period. Medical records were analysed for 296 patients. Sixty-two point eight percent were women, with a median age of 43 years. Physical examination was normal for 57% of patients. For 48% of cases, there was no complete consciousness loss thus corresponding to lipothymia, which is not taken into account by the FHHA definition. Median length of stay in the ED was 4 hours and 67 patients (22.6%) were hospitalized. Minimal estimated cost was 280,000 euros. Risk factors independently associated with hospitalization were age ≥ 60 and complete consciousness loss unlike predisposing circumstances to vagal hypertonia. Conclusion Age ≥ 60 and complete consciousness loss seemed to be associated with hospitalization. [ABSTRACT FROM AUTHOR]

• The multiphysic platform OLYMPE development has progressed at CEA with lopps coupling TF design and various detailed analyses. • EMD loop converges towards a consistent TF design with respect to magnetic field map. • THD loop converges towards to a consistent TF design with respect to thermohydraulic performances. • THDC loop converges towards to an optimized TF design with respect to overall magnet & cryoplant cost merits. • MECD loop converges towards to a consistent TF design with respect to mechanical performances. In the framework of tokamak design studies, the magnet system dimensioning stands as a crucial point, magnets being strong drivers for reactor performances. In this aim superconducting magnets design path to manufacture and integration should undergo several stages of development, including the detailed analysis for defined operation cases. Those studies are linked to several physic domains (electromagnetics, mechanics, thermohydraulics, thermal) that all show interdependances between each other. In this objective, the platform OLYMPE was developed at CEA, aiming at addressing those complex multi-physic problems in an integrated simulation tool, expected to improve the efficiency of the design workflow involving macroscopic and detailed analyses. The different OLYMPE submodules will be described and their dedicated simulation domain explained, together with the logic that led to the choice of specific modules interconnection. In fact several combinations of those modules are built in coupled mode so to ensure converging design loops. Their major role is to assess the refinement of magnet design at detailed scale in the objective to increase magnet design accuracy. Namely illustrating examples will be given with following loops: - TF system design coupled with thermohydraulics: it ensures the compliance of TF design with temperature margin criterion. - TF system design coupled with electromagnetics: it ensures the compliance of TF design with topologically-induced magnetic field map. - Overall TF design coupled with thermohydraulics and cryogenics: it ensures the optimization of TF design and its operation conditions with overall system merits (e.g. cost factor). - TF system design coupled with mechanics: it ensures the compliance of TF design with local stress criterion. The outcomes and methodological merits of these loops will be illustrated by applications on DEMO configurations, and performances cross-checks or comparisons with simpler models will also be provided to quantify the accuracy enhancement. Furthermore the management of the overall input database and the GUI interface will be presented in the aim of improving tool operability. Finally discussions on this emerging OLYMPE tool qualities will also be exposed, including calculation performances merits and further development perspectives. [ABSTRACT FROM AUTHOR]

The importance of poly-unsaturated fatty acids (PUFAs) in food is crucial for the animal and human development and health. As a complementary strategy to nutrition approaches, genetic selection has been suggested to improve fatty acids (FAs) composition in farmed fish. Gas chromatography (GC) is used as a reference method for the quantification of FAs; nevertheless, the high cost prevents large scale phenotyping as needed in breeding programs. Therefore, a calibration by means of Raman scattering spectrometry has been established in order to predict FA composition of visceral adipose tissue in rainbow trout Onchorhynchus mykiss. FA composition was analyzed by both GC and Raman micro-spectrometry techniques on 268 individuals fed with three different feeds, which have different FA compositions. Among the possible regression methods, the ridge regression method, was found to be efficient to establish calibration models from the GC and spectral data. The best cross-validated R2 values were obtained for total PUFAs, omega-6 (Ω-6) and omega-3 (Ω-3) PUFA (0.79, 0.83 and 0.66, respectively). For individual Ω-3 PUFAs, α-linolenic acid (ALA, C18:3), eicosapentaenoic acid (EPA, C20:5) and docosahexenoic acid (DHA, C22:6) were found to have the best R2 values (0.82, 0.76 and 0.81, respectively). This study demonstrates that Raman spectroscopy could be used to predict PUFAs with good correlation coefficients on adipocytes, for future on adipocytes physiology or for large scale and high throughput phenotyping in rainbow trout. [Display omitted] • Fatty acids composition was predicted in rainbow trout Onchorhynchus mykiss. • Three different feeds allowed to obtain different fatty acids composition. • Raman spectroscopy was used to analyze adipose tissues from rainbow trout. • Ω-3 eicosapentaenoic and docosahexenoic fatty acids have great R2 values. • Calibration models can be used for large scale and high throughput phenotyping. [ABSTRACT FROM AUTHOR]

Abstract: Peroxisome proliferator-activator receptors (PPAR) are involved in cholesterol homeostasis through the regulation of bile acids synthesis, composition, and reclamation. As ileal bile acid-binding protein (I-BABP) is thought to play a crucial role in the enterohepatic circulation of bile acids, we investigated whether I-BABP gene expression could also be affected by PPAR. Indeed, treatment with the PPARα-PPARβ/δ agonist bezafibrate led to the up-regulation of I-BABP mRNA levels in the human intestine-derived Caco-2 cells. Cotransfections of the reporter-linked human I-BABP promoter (hI-BABP−2769/+44) together with PPAR and RXR expression vectors demonstrated that the fibrate-mediated induction of the I-BABP gene is dependent on PPARα or PPARβ/δ. Using progressive 5′ deletions of the hI-BABP promoter and sequence analysis, we identified a putative PPAR-binding site located at the position −198 and −186 upstream of the transcription initiation site. Electrophoretic mobility shift assays showed that the PPAR/RXR heterodimer can specifically bind to this PPRE-like motif. The deletion of the PPRE within the hI-BABP promoter abolished the PPAR-mediated transactivation in transient transfection assays. The regulation of the I-BABP promoter by PPAR appears species-specific, as the mouse I-BABP promoter, which lacks a conserved PPRE, was not responsive to exogenous PPAR expression in the presence of bezafibrate. Our findings show that the I-BABP gene may be a novel target for PPAR in humans and further emphasize the role for PPAR in the control of bile acid homeostasis. [Copyright &y& Elsevier]

An attempt is made to develop an integrated model of a watershed to be used as a tool to facilitate debates and consultations between stakeholders and thus to enhance the participatory process. Based on a comprehensive knowledge and expertise of geological, hydrogeological and hydrological features of the catchment basin, as well as on extensive consultation of the stakeholders involved in its water resource management, a conceptual model of the socio-hydrosystem of the middle Hérault valley (100 km2) was proposed. A simulator was then developed using Matlab/Simulink© software to ensure the numerical translation of the conceptual model. This simulator is problem-solving oriented, investigating the hydrosystem responses according to various scenarios, computing groundwater and river flow. Compared to observed data, the first numerical results are convincing regarding the simulated groundwater and river water levels. In that sense, the simulator is seen as a powerful tool to explore cumulative impacts of water-resource management at the catchment scale. [Copyright &y& Elsevier]