Search

Resume Aujourd’hui, les techniques medicales permettent des avancees importantes, notamment dans le champ de la procreation pour les personnes ayant des problemes de fertilite. Les personnes transgenres beneficient de ces biotechnologies dans le cadre de leur parcours de transition, et aussi afin d’acceder au statut de parent. Nous proposons de presenter dans ce present article, les principales perspectives de reflexion avancees dans le contexte d’un seminaire de travail multidisciplinaire associant psychiatres d’enfant, psychologues du developpement et psychanalystes, biologistes de la reproduction, endocrinologistes, ethiciens, juristes et usagers transgenres. Nous en proposons une synthese a l’appui d’une revue de la litterature des enjeux ethiques, et de la dimension psychologique a l’œuvre pour les personnes transgenres et leurs enfants. Pour bien comprendre les differents enjeux, nous exposons d’abord l’etat actuel de la litterature concernant les parcours de transition, puis l’actualite des options d’aide medicale a la procreation (AMP), avant d’exposer les modifications que ces nouveautes introduisent dans notre schema de pensee de tradition monotheiste. Enfin, en parcourant les principes ethiques de Beauchamp et Childress, nous tentons de situer les implications de ces nouvelles possibilites de faire famille, et avec elles, les possibilites d’inventer des solutions utiles a la societe pour accepter, et accompagner ces nouvelles formes familiales.

Accurate and sensitive liquid-chromatography tandem mass spectrometry method for the quantification of tenofovir and emtricitabine in seminal plasma has been developed and full validated. Molecules were separated by high-performance liquid chromatography on an Atlantis T3 C18 column using a gradient of deionized water and methanol, including 0.05% formic acid (250μl/min) and detected by electrospray ionisation/tandem mass spectrometry in positive ion mode. The method was validated over a clinical range of 3.13-1000ng/mL for tenofovir and 6.25-2000ng/mL for emtricitabine. Inter and intra-assay precisions were 9.37% for tenofovir and10.88% for emtricitabine, and accuracies were between 0.48% and 8.43% for tenofovir, and between 0.64% and 13.87% for emtricitabine. The developed method was successfully applied for analysing tenofovir and emtricitabine concentrations in seminal plasma samples from a clinical study. The use of tandem mass spectrometry can be a suitable method for the analysis of this kind of matrices, providing high sensitivity and specificity to the analysis.

Objective In France, female-to-male transsexuals who have obtained a change of civil status have the right to request donor sperm insemination (DSI) for the woman with whom they live. Because this was met with some reluctance, a trial program with a follow-up study was devised with the agreement of the ethical committee. The aim was to check the quality of parenthood and the development and quality of life of the children. Patients and methods These couples were considered to be similar to any couple requesting medical assistance to procreate. There is always an interview with a specialist in psychology before gametes are given. In these cases, there was a second one with a professional who worked with transsexuals. Usually parents are left free to choose to disclose or not the gift of gametes; but in this situation, since everybody in the father's environment as a child was aware of his background history, these parents were advised to tell the truth about the DSI and the father's transsexual past. A follow-up was proposed every second year. Parents and children were not volunteers participating in a research program; they came for a consultation from which they expected some help in their particular situation. The parents had interviews with a psychiatrist and two psychologists, the children were observed in their playing and drawing, and one standard measure (the Brunet-Lezine Scale) was used. Results Forty-two children born to 32 couples were followed up from 2000 to 2012 and the program is still on-going. Though without a penis, the transmen are considered by their wives as men; the wives are not homosexual; the couples are stable (there have been only three separations); the children are very well cared for and have good relationships with their fathers, they seem normal, happy, without any major difficulty, without any gender identity variant. Fathers (with one exception) spoke easily of the DSI, but had some difficulty with their transsexualism – although willing to talk about it, they found it hard to put into appropriate words. They were helped by one father, who wrote and illustrated a booklet, telling of his childhood experience in simple words. The children coped well with this disclosure. Conclusion This trial program brought positive results. It may continue and others may be set up in spite of persistent prejudices. The “therapeutic alliance” with these couples is now good enough to allow for research beyond pure observation – with a protocol and standard measures to appreciate the mental health, gender identity and quality of life of these children as they become adolescents.

Assuming a granular material to consist of a random assembly of spheres in contact, a nonlinear but elastic constitutive law is derived. Use is made of the nonlinear force-displacement relationships of the contact loads in the normal and tangential directions. The Lame constants of this isotropic continuum, which is not necessarily homogeneous, depends on the elastic constants of the spheres, the density of the array and either the mean pressure or the volumetric strain.

For severe earthquakes large overturning moments arise which may lead to tension in part of the area of contact of the base mat of the structure and of the soil, according to a calculation based on a linear theory. If no tensile capacity (prestressed anchors, piles) is provided, two different solution procedures are commonly used. The first method consists of enlarging the base mat using projections to avoid tension. In the second, the structure is allowed to lift off and is designed to resist the nonlinear dynamic response. On the basis of a parametric study, it is concluded that allowing the structure to lift off generally leads to a reduction of the total accelerations, of the stress resultants and of the relative displacements within the structure, while the total displacements, the vertical response and sometimes the response spectra in the higher frequency range are increased, compared to the linear elastic solution with the original base mat. The response using projections is non-uniform when compared to that with lifting-off. It is beneficial to achieve lifting-off to make use of the reduction in the strength requirements. Projecting base mats should be avoided.

After discussing the state of the art of the development of equivalent force-time relationships for aircraft impact, the results of the so-called Riera model and of a lumped-mass model are compared for rigid and deformable targets. The importance of adequate modelling of structures to enable the calculation of response spectra also in the high-frequency range is demonstrated using a typical reactor shield building and a reactor auxiliary building. For an adequate model, the influence of the aircraft-structure interaction, of the material nonlinearly, of the damping and of the mass on the response of equipment is examined.

In reactor buildings having a separate base mat and a shield-building (outer concrete shell) of large mass, large overturning moments are developed for severe earthquake loading. The standard linear elastic half-space theory is used in the soil-structure interaction model. For a circular base mat, if the overturning moment exceeds the product of the normal force (dead weight minus the effect of the vertical earthquake) and one-third of the radius, then tension will occur in part of the area of contact, assuming distribution of stress as in the static case. For a strip foundation the same arises if the eccentricity of the normal force exceeds a quarter of the total width. As tension is incompatible with the constitutive law of soils, the base mat will become partially separated from the underlying soil. Assuming that only normal stresses in compression and corresponding shear stresses (friction) can occur in the area of contact, a method of analyzing soil-structure interaction including partial lifting-off is derived, which otherwise is based on the elastic behaviour of the soil. A rigorous procedure to determine the nonlinear impedance function of a rigid plate of arbitrary shape, only in partial contact with the elastic half-space, is developed. Complex dynamic influence coefficients for displacements are used which can either be determined with the finite-element method or based on solutions of displacements on the surface of an elastic half-space at a certain distance from a rigid subdisk. Constant and variable stiffness methods of solving the non-linear equations of motion are explained which also determine the area of contact. Slipping of the entire mat or of a part thereof can also be taken into consideration. A simpler approximate method is discussed. For a given force and moment acting on the rigid plate, the area of contact is determined by iteration or based on quadratic programming techniques using the static influence coefficients for displacements. The complex-valued impedance function is estimated by substituting an equivalent circular plate for the actual area of contact. Transforming the equivalent lumped system to the centre of the plate, the non-linear stiffness and damping matrices of the soil are derived. Formulae are given for the partial lifting-off of a disk and a strip. The results of the numerical method are compared to rigorous solutions for full contact. As an example, the dynamic response of the reactor building of a 1000 Mw plant to earthquake motion is calculated using the rigorous and approximate methods. Parametric studies are carried out. The influence of the frequency on the impedance function and on the distribution of stress in the area of contact, which determines the beginning of lift-off, is discussed.

The basic elastic and geometric stiffness properties of the individual supporting columns are synthesized into a stiffness matrix compatible with an axisymmetrical shell element by a series of transformations, to be used in conjunction with a finite element representation of the cooling tower, where the displacements are decomposed into Fourier harmonics. Thus, the effect of the column supports can be rigorously accounted for in a large displacement nonlinear analysis. To complete the stiffness property of the cooling tower structure, the elastic and geometric stiffness of the reinforcing rings are also incorporated. Examples are given to show the effect of these additions on the buckling wind load and the stress distribution.

The behaviour of a typical chimney stack of a nuclear-power plant subjected to earthquake and impact loads is examined. The explicit integration procedure using convected coordinates is adopted to perform the transient analyses with large displacements and material nonlinearities of the concrete stack, of the impinging aircraft and of the soil. Thanks to the favourable effect of the partial separation of the base mat from the soil (lifting-off), the chimney does not collapse for realistic accelerations of the earthquake. Force-time relationships of the aircraft impinging on the chimney are developed. The impact of aircraft debris causes only local damage of the chimney. The direct impingement of an aircraft, however, may lead to partial collapse or total overturning of the chimney. The resulting motion, including the impact of the chimney on the reactor building, is studied. The response of the structure being hit and of the equipment located within will in many cases govern their design.

The seismic response of a structure which, in addition to earthquake loading, is subjected to the impact force resulting from pounding by an adjacent building, is determined. At first, simple models are used to examine the characteristics of the pounding phenomenon. The pounding structure is modelled as a nonlinear 1-DOF system and the neighbouring building is represented by an impact-spring-dashpot mechanism. Parametric studies, varying the structural parameters, are performed both for steady-state and transient excitions. Finally, the pounding of a typical reactor building by an adjacent auxialiary building during an earthquake is analysed using a simple 2-DOF system and a very detailed dynamic model. The stresses and in-structure response spectra are compared to those for the case in which no pounding occurs, as well as to the results obtained for aircraft impact. Different types of running devices which reduce the response of pounding are examined.

Phenomena related to horizontally travelling waves are normally not considered in soil-structure interaction. Only vertically incident S- and P-waves are commonly assumed. To determine the influence of this very basic assumption, the responses of a massless basemat, of a massless structure, of a basemat with mass and of a mass-spring system connected to a basemat with mass are parametrically analysed for harmonic and transient excitations for all wave forms (SH-, P-, SV- and Rayleigh waves). Comparisons of the results of the same structures, calculated for the standard vertically incident body waves of the same amplitudes are made. Various possibilities of combining P- and SV-waves to create specified horizontal and vertical free-field motions are examined. By way of illustration, a reactor building and the through-soil coupling of a reactor and a reactor auxiliary building are examined in detail, using the J-145 record of the 1971 San Fernando earthquake as a travelling wave. The effect of a flexible basemat on the structural response is discussed.

Bartter's syndrome, chondrocalcinosis and nephrogenic hypomagnesemia in an adult. Bartter's syndrome, chondrocalcinosis and nephrogenic hypomagnesemia in an adult. Bartter's syndrome, initially described in children, becomes a controversial entity when it is observed in adults, as it cannot be dissociated easily from the pseudo Bartter's syndrome caused by an abuse of diuretics or provoked by surreptitious vomiting. Yet its association with chondrocalcinosis, about ten cases of which have already been published and which is not reproducible by prolonged diuretic treatment, seems to give it some authenticity. The link between the two conditions might well be the low blood magnesium level observed significantly in both diseases and constantly when they are associated. This hypomagnesaemia is of renal origin and it may reflect a complex tubular disorder which also includes a defect of chloride reabsorption by the tubule. We report here a case of diffuse chondrocalcinosis and Bartter-like syndrome in a 38-year old woman, leading to the discovery of nephrogenic hypomagnesaemia.

Hyperbolic natural-draught cooling towers to be erected in seismically active zones are routinely analysed for earthquake excitation. The axisymmetric shell is discretized with higher order finite element frusta, with an isoparametric expansion in the meridional direction and a Fourier expansion in the circumferential direction. The stiffening-ring beam, the foundation-ring beam if present, and the supporting columns are synthesized into a dynamic stiffness matrix compatible with the axisymmetric shell element. The same also applies to the model of the soil which is represented as a spring and also as a damper with frequency-independent coefficients. For uniform earthquake excitation, arising from vertically propagating waves, only the first and zeroth symmetric harmonics are excited in a linearly elastic analysis of the horizontal and vertical components, respectively, of the earthquake. Under the assumption that classical modes exist, only the first or first two modes have to be considered. The calculation is performed directly in the time domain.

After administration of RU 486 to pregnant cynomolgus monkeys, placental morphology varied from normal to pathological. In all cases (n = 5) circulating and placental PAPP-A levels were markedly suppressed by 76.0 per cent and 55.5 per cent, respectively. When fetal demise occurred within 24 h prior to caesarian section, morphological changes consistent with an active inflammatory (polymorphonuclear leukocytosis) reaction was readily observed at the utero-placental interface, degrading the chorionic villi. Whereas heparin-Sepharose fractionated aqueous extracts of placentae inhibited human neutrophil (or granulocyte) elastase (HGE) activity, extracts of placenta being degraded by host phagocytic-proteolytic defense system were rich in HGE activity. This study establishes: (1) the cynomolgus monkey as a model for PAPP-A studies, (2) that haemochorially implanted placentae produce PAPP-A, a heparin-binding inhibitor of HGE, (3) that administration of progesterone receptor antagonist suppressed placental PAPP-A synthesis, and (4) disrupted protease-protease inhibitor equilibrium at the feto-maternal interface. Thus supporting a role for progesterone in placental PAPP-A production and maintenance of a placental barrier against maternal phagocytic-proteolytic defenses.