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Minor offenders are at risk for medico-psycho-social vulnerability, that impacts global health, schooling, professional future, and socio-familial environment; moreover, minors who are victims of violence and neglect are at greater risk of becoming offenders and minor offenders are at greater risk of suffering violence. Few data are currently available regarding global health and vulnerability factors for minors (i.e. those aged under 18) who have been placed in police custody. This study aimed to describe the judicial and social characteristics of these minors, their medical and psychological health status, with the hypothesis that most minors placed in police custody can be considered as abused or neglected, by presenting factors of vulnerability. We carried out a prospective study, including consecutive minors aged of 13 to 18 years old, who had been detained in custody at the Central Police Station of Nantes (France), from October 2012 to May 2013. The sociodemographic characteristics, scores for global health and the data collected from the welfare and judiciary services were analyzed, to identify abused or neglected minors. Ninety-nine teenagers were included: 78 males and 11 females (mean age±standard deviation: 16.5 years±1.01), who had been placed in custody for robbery, with a remarkable proportion of recidivist minors. Our study has highlighted several worrying characteristics of minors in police custody reflecting their vulnerability, as living conditions (no schooling, no fixed address) and irregular or absent medical follow-up; however their scores for global health were not different from the general population. While 49 minors (49.5 %) had already been identified by the welfare services, our study find that 35 added minors of this population should nonetheless be considered as being abused and/or neglected, based on a very high rate of minors already followed by child protection services and/or already penalized. Systematic health screening in custody could help to detect abused and/or neglected minors, in order to provide them access to appropriate medical and social cares. They could be referring to psychiatric or rehabilitation cares, and to the relevant welfare and judiciary services in order to assess if a specific protection measure is needed.

Phytophthora root and stem rot (PRSR) caused by Phytophthora sojae is the most destructive soybean soil-borne disease worldwide. Discovery of genes conferring broad-spectrum resistance to the pathogen is an urgent need to prevent the outbreak of the disease. Here we show that soybean Rps11 is a 27.7-kb nucleotide-binding site-leucine-rich repeat (NBS-LRR or NLR) gene conferring extreme broad-spectrum resistance to the pathogen. Rps11 is located in a genomic region harboring a cluster of unusually large NLR genes belonging to a single evolutionary lineage that is distinct from all other lineages in the soybean genome, and was derived from rounds of intergenic and intragenic unequal recombination. Such recombination events have resulted in promoter fusion and expansion of the LRR domain that presumably explains such broadness of the resistance spectrum. The NLR gene cluster exhibits drastic structural diversification among phylogenetically representative varieties, including gene copy number variation ranging from five to 23 copies, and absence of allelic copies of Rps11 (i.e., rps11) in any of the non-Rps11-donor varieties examined. Our study thus exemplifies innovative evolution of NLR genes and NLR gene clusters and will accelerate the deployment of Rps11 for soybean protection.

This study aimed to describe the impact of the first COVID-19 lockdown in France on the activity of a Child Advocacy Center.This cross-sectional, observational study included all children involved in the activity of the CAC during the first lockdown, from March 16 to May 10, 2020 and the next 3 months and the corresponding periods in 2018 and 2019. Cases were considered severe when a hospitalization, social alert and/or judicial report to the prosecutor was decided.Data for 1583 children were analyzed. During the lockdown, the global center activity decreased with 26.4 consultations per 100.000 children in 2018, 46 in 2019 and 20.7 in 2020 (p 0.001). Judicial activity decreased (forensic examinations and child forensic interview recordings), whereas assessment consultations increased. Cases were more severe during the lockdown than in 2019 and 2018 (12.3, 9.4 and 6.04/100.000 children, respectively, p 0.0001). The global activity of the center increased in the 3 months after the lockdown as compared with during the lockdown (38.2/100.000 versus 20.7/100.000, respectively, p 0.001) but did not differ from activity in 2018 and 2019. Severe cases were more frequent in the 3 months after the lockdown than the previous years (13.7/100.000 in 2020, 9.62 in 2019 and 8.17 in 2018, p = 0.0002).The CAC activity decreased during the lockdown in France but the increase in incidence of severe abuse cases during the lockdown and the next 3 months confirm the need for optimal screening, care and support of child abuse and neglect victims even in the context of health crisis.

International audience; The paper describes various multi-channel ASICs designed by OMEGA laboratory and WEEROC company to readout SiPM or MPPC-based detectors used in particle physics or astrophysics experiments.

Additional file 1.

Additional file 2. Sample quotations for specialist respondent-psychiatrist (SRP) managers: Main barriers (--) and facilitators (++) to implementation of the SRP function.

Simultaneous PET/MR/EEG (Positron Emission Tomography – Magnetic Resonance – Electroencephalography), a new tool for the investigation of neuronal networks in the human brain, is presented here within the framework of the European Union Project TRIMAGE. The trimodal, cost-effective PET/MR/EEG imaging tool makes use of cutting edge technology both in PET and in MR fields. A novel type of magnet (1.5T, non-cryogenic) has been built together with a PET scanner that makes use of the most advanced photodetectors (i.e., SiPM matrices), scintillators matrices (LYSO) and digital electronics. The combined PET/MR/EEG system is dedicated to brain imaging and has an inner diameter of 260 mm and an axial Field-of-View of 160 mm.It enables the acquisition and assessment of molecular metabolic information with high spatial and temporal resolution in a given brain simultaneously. The dopaminergic system and the glutamatergic system in schizophrenic patients are investigated via PET, the same physiological/pathophysiological conditions with regard to functional connectivity, via fMRI, and its electrophysiological signature via EEG. In addition to basic neuroscience questions addressing neurovascular-metabolic coupling, this new methodology lays the foundation for individual physiological and pathological fingerprints for a wide research field addressing healthy aging, gender effects, plasticity and different psychiatric and neurological diseases.The preliminary performances of two components of the imaging tool (PET and MR) are discussed. Initial results of the search of possible candidates for suitable schizophrenia biomarkers are also presented as obtained with PET/MR systems available to the collaboration.

Resume Introduction Les adolescents admis dans les services d’accueil des urgences pediatriques (SAUP) pour agitation sont de plus en plus nombreux. Leur agitation, multifactorielle, survient dans un parcours souvent « complexe ». Ils mettent en difficulte les structures hospitalieres d’accueil parfois inadaptees et depassees par ces moments de crises. L’objectif de cette etude etait de recenser et decrire la population admise dans un centre hospitalier universitaire (CHU) pour agitation au cours d’une annee, et de discuter la problematique de leur prise en charge. Materiel et methodes Etude retrospective de tous les adolescents admis pour agitation, au SAUP du CHU de Nantes, en 2015. Resultats Quatre-vingt-dix-neuf adolescents avaient consulte 182 fois pour agitation. Parmi eux, 85 % avaient des antecedents d’agitation, 70 % avaient un suivi psychologique en cours et 56 %, suivis par l’aide sociale a l’enfance, avaient un parcours « complexe ». La majorite des crises etait survenue au domicile parental et etait de type hetero-agressif. A l’arrivee au SAUP, 90 % etaient calmes. La duree moyenne de sejour au SAUP avait ete de 3 h 42 minutes et par la suite 31 % avaient ete hospitalises en pediatrie generale, 14 % en pedopsychiatrie et 8 % en psychiatrie pour adultes. Conclusion La proportion de parcours complexes parmi les adolescents admis aux SAUP etait importante. Ces adolescents en souffrance, au parcours complexe, illustrent le lien entre violences subies et violences agies. Le developpement d’unites d’hospitalisation de courte duree semble une solution pertinente pour permettre une mise a distance et une evaluation pluridisciplinaire, somatique, psychique et sociale de ces patients vulnerables.

Resume Introduction L’objectif de cette etude etait de creer un outil d’information et d’en evaluer l’impact sur les connaissances des medecins generalistes en matiere d’information preoccupante (IP). Materiel et methodes Etude epidemiologique prospective par questionnaires de type avant/apres aupres des 1301 medecins generalistes de Loire-Atlantique. L’outil s’appuyait sur la fiche memo 2014 de la Haute Autorite de sante (HAS) « Maltraitance chez l’enfant ». Le critere de jugement principal etait le score sur 100 a chaque questionnaire avant (Q1) et apres diffusion de l’outil (Q2). Les medianes des scores ont ete comparees, leurs associations avec certaines caracteristiques des medecins ont ete evaluees par regression lineaire multiple. Resultats Au total, 279 medecins ont repondu au Q1 et 172 au Q2. Les repondants etaient majoritairement des femmes (respectivement 68 % et 74 %), de 30 a 50 ans (respectivement 61 % et 66 %), exercant en groupe (respectivement 82 % et 84 %) et recevant entre 15 et 30 % de mineurs dans leur patientele. Au Q1, la mediane generale a ete de 65 [IQR : 40–81] versus 82 [IQR : 71–91] au Q2 ( p 50 ans, le sexe feminin et la formation sur l’enfance en danger avec des coefficients β a −16,4 [IC 95 % : −31,1 ; −1,69], +8,93 [IC 95 % : 2,58 ; 15,27] et +12 [IC 95 % : 6,33 ; 17,73] respectivement. Discussion L’outil teste a permis d’ameliorer significativement les connaissances des medecins generalistes sur l’IP. Conclusion La diffusion de cet outil d’aide au diagnostic et a la decision dans le depistage des maltraitances pourrait permettre aux medecins de mieux comprendre l’indication et l’interet de l’IP.

Resume Objectif Evaluer le resultat a long terme des implants intraoculaires a iris artificiel incorpore sutures a la sclere dans la prise en charge de l’aphakie et de l’aniridie traumatiques. Materiels et methodes L’ensemble des patients ayant ete operes d’un implant combine Morcher® entre juin 2008 et fevrier 2016 a l’Hopital Edouard-Herriot (Lyon, France) a ete inclus dans cette etude retrospective monocentrique. L’acuite visuelle, le degre subjectif d’eblouissement autoevalue, la qualite de vie et les complications chirurgicales ont ete evalues. Resultats Dix-sept yeux de 17 patients ont ete inclus, parmi lesquels 82 % d’hommes. L’âge moyen etait de 42 ans. On denombrait 23,5 % de contusion et 70,5 % de traumatismes a globe ouvert dont 41 % de ruptures de globe, et un cas survenu dans un contexte postoperatoire. Une keratoplastie transfixiante a ete realisee dans le meme temps operatoire pour huit yeux. Le suivi moyen etait de 32 mois. La meilleure acuite visuelle corrigee s’est amelioree pour 41,2 %, est restee stable pour 17,6 % et s’est degradee pour 41,2 % de nos cas. Le gain moyen d’acuite visuelle etait d’1 ± 0,25 ligne en vision de loin et de 2,2 ± 0,32 lignes en vision de pres lorsque l’acuite visuelle preoperatoire etait chiffrable. L’eblouissement s’est ameliore chez 80 % des patients evalues et est reste stable pour 20 % d’entre eux, passant en moyenne de 3,3/5 [min. 3–max. 4 ; SD : 0,48] en preoperatoire a 1,9/5 [min. 0–max. 4 ; SD : 1,197] en postoperatoire. Concernant les resultats esthetiques, 78 % des patients se declaraient assez a tres satisfaits ; 57 % rapportaient ne subir aucune limitation des activites de la vie quotidienne et 43 % une faible limitation. L’hypertonie intraoculaire et le glaucome, retrouves chez 40 % des yeux, etaient les principales complications postoperatoires. Conclusion L’implantation d’un dispositif d’iris prothetique combine a une lentille intraoculaire semble etre une methode sure et efficace pour reduire l’eblouissement et ameliorer l’acuite visuelle. Une surveillance etroite et a long terme est essentielle pour le succes de cette chirurgie.

We present the first results obtained with a prototype of the PET read-out electronics of the trimodal PET/MRI/EEG TRIMAGE scanner. The read-out is based on the 64-channel TRIROC ASIC and on an acquisition board that will control up to 12 ASICs. The output of each ASIC is processed in parallel and sent to a host system that in the final version will receive data from 18 acquisition boards. Blocks of 64 SiPMs are one-to-one coupled to a dual-layer staggered LYSO crystal matrix and read by a single ASIC. The FPGA reads the sparse output from the ASICs and reconstructs for each event a full image of the light pattern coming from the LYSO matrix. This pattern can be then processed on-line or sent to the host PC for post-processing. Early tests were conducted by using a prototype board with single LYSO crystals of ${3.3} \textrm {mm}\times {3.3} \textrm {mm} \times {8} \textrm {mm}$ and dual layer staggered LYSO matrices. Results show that the ASIC can sustain input rates above 58 kHz on all its channels, with small variations depending on the discriminating thresholds, being this limit due its digital output stage. With the single crystals setup, we obtained an energy resolution of 10.7% at 511 keV and a coincidence time resolution of 420 ps FWHM. With the staggered matrix the obtained mean energy resolution was 16% on the top layer and 18% on the bottom layer. The flood maps obtained with the LYSO matrix setup show that the pixels on both the staggered levels are clearly identifiable.

Objectifs Presenter un cas d’administration de medicaments par un tiers chez un enfant hospitalise pour maltraitance. Methode Un garcon de 6 ans est pris en charge par le SAMU (J1) suite a un etat d’agitation aigue a l’ecole. Apres passage aux Urgences, il est hospitalise en Pediatrie (J1). C’est un enfant calme qui vit habituellement au domicile de son pere, avec ses freres et sœurs. Il presente une cachexie (IMC 12 kg/m2), des ecchymoses multiples, des lesions evoquant des griffures, des engelures aux pieds et des troubles du langage. Des antecedents d’auto et hetero-agressivite sont rapportes, souvent en lien avec la nourriture. Un traitement par ATARAX® a ete recemment prescrit pour une suspicion de depression. En Pediatrie, de nombreuses investigations sont realisees, notamment une analyse toxicologique urinaire a J6 (10h15, J6-1). Les resultats mettent en evidence plusieurs medicaments non administres par l’equipe medicale d’hospitalisation. Un suivi urinaire a J6 (18h00, J6-2), J9 et J10 est alors mis en place. Un echantillon de serum (J6 10h30), initialement conserve en serotheque, sera aussi analyse, ainsi qu’une meche de cheveux prelevee a J9. Du point de vue analytique, le depistage urinaire a ete realise par immunoanalyse (CEDIA® Thermofisher Scientific®, sur COBAS 8000, Roche Diagnostic®) et le criblage urinaire par GC-MS et UHPLC-DAD. Des analyses complementaires par LC-MS/MS ont permis la quantification des medicaments identifies. L’analyse de cheveux a ete effectuee par LC-MS/MS. Resultats Sur le prelevement J6-1, les recherches de benzodiazepines et opiaces sont positives. Les analyses chromatographiques mettent en evidence la presence de nefopam, hydroxy-midazolam, morphine, nalbuphine, hydroxyzine, cetirizine et paracetamol. Les dosages realises sur urine hydrolysee par βglucuronidase montrent les resultats suivants : nefopam 405 ng/ml, 1-hydroxymidazolam > 1000 ng/ml, morphine 1073 ng/ml, nalbuphine 98 ng/ml, hydroxyzine 283 ng/ml (cetirizine et paracetamol non doses). Sur les urines J6-2, J9 et J10, seules l’hydroxyzine et la cetirizine sont identifiees. Il en est de meme pour l’echantillon de serum : hydroxyzine 4,5 ng/ml ; cetirizine 52 ng/ml. La meche de cheveux est partagee en deux segments : 0-1 cm et 1-3,3 cm. Leur analyse retrouve la presence d’hydroxyzine avec les concentrations respectives de 52,6 pg/mg et 51,4 pg/mg. Conclusion Les analyses ont confirme l’administration de paracetamol et d’hydroxyzine au cours de l’hospitalisation. Mais, elles ont mis en evidence une administration non medicale de nalbuphine, midazolam, nefopam. La morphine peut provenir de l’administration de morphine ou du metabolisme de plusieurs medicaments : codeine, ethylmorphine, pholcodine. L’absence de pholcodine dans l’urine permet d’eliminer l’administration de ce medicament. L’administration d’heroine est peu probable. Une origine alimentaire de la morphine est possible, malgre des controles accrus des graines de pavot de l’industrie agro-alimentaire (Lachenmeier D.W. et al. Ther Drug Monit 2010 ;31(1) :11-18). L’absence dans le serum des medicaments identifies dans l’urine permet d’estimer l’administration a J5, voire J4, en tenant compte des differentes demi-vies. L’analyse de cheveux met en evidence l’absence d’administration de morphine (ou codeine ou ethylmorphine), nalbuphine, nefopam et midazolam au cours des 3 mois precedant le prelevement. L’hydroxyzine, presente dans les deux segments a des concentrations tres voisines, peut provenir d’une contamination par le sebum ou la sueur pendant l’hospitalisation ou d’une prise occasionnelle. Cliniquement, l’enfant n’a pas ete symptomatique. Mais le risque toxique etait important : depression respiratoire et/ou depression du systeme nerveux central. L’analyse de cheveux montre l’absence d’administration de medicaments pendant les 3 derniers mois, sauf l’hydroxyzine prescrite. Un proche de l’enfant avait eu acces a plusieurs medicaments retrouves dans l’urine. Ce cas montre la complexite des cas de maltraitance chez l’enfant et l’interet de realiser systematiquement des analyses toxicologiques dans tous les cas de maltraitance, quel que soit l’âge de l’enfant.

Resume Introduction Etude retrospective evaluant les caracteristiques cliniques et les traitements des patients atteints de la maladie de Leber-Coats. Materiels et methodes Les patients atteints de maladie de Leber-Coats, suivis a l’hopital Edouard-Herriot a Lyon entre janvier 2004 et septembre 2013, ont ete inclus. Les caracteristiques cliniques suivantes ont ete recueillies : sexe, âge de diagnostic, signe d’appel, stadification de Shields, traitements utilises et evolution de l’acuite visuelle. Resultats Dix enfants ont ete inclus dans notre etude. L’âge moyen de diagnostic etait de 5 ans et demi. La maladie etait unilaterale dans 9 cas sur 10. Le signe d’appel etait la baisse de vision dans 7 cas sur 10, le strabisme dans 3 cas sur 10, une microphtalmie dans 1 cas. Le diagnostic a ete fait fortuitement au cours d’un suivi de cataracte congenitale familiale dans 2 cas. Dans aucun cas, la leucocorie n’a ete le signe d’appel de la maladie. Les stades de Shields ont ete repartis de la maniere suivante : stade 1, 2A et 2B : 1 cas sur 10 chacun, stade 3A1 : 7 cas sur 10, stade > 3A1 : aucun cas. La photocoagulation laser a ete realisee jusqu’au stade 2B inclus, associee a une cryoapplication pour le stade 3A. Les patients diagnostiques aux stades 1 et 2A avaient un bon pronostic visuel. La presence d’une importante exsudation lipidique maculaire (stade > 2A) etait un facteur de mauvais pronostic. Conclusion Ces donnees epidemiologiques permettent de mieux caracteriser le pronostic de ces patients. Le diagnostic a un stade precoce de la maladie semble etre en rapport avec une meilleure acuite visuelle finale.

International audience; We present results of a prospective, multicenter, phase II study evaluating rituximab, bendamustine, bortezomib and dexamethasone as first-line treatment for patients with mantle cell lymphoma aged 65 years or older. A total of 74 patients were enrolled (median age, 73 years). Patients received a maximum of six cycles of treatment at 28-day intervals. The primary objective was to achieve an 18-month progression-free survival rate of 65% or higher. Secondary objectives were to evaluate toxicity and the prognostic impact of mantle cell lymphoma prognostic index, Ki67 expression, [18F]fluorodeoxyglucose-positron emission tomography and molecular minimal residual disease, in peripheral blood or bone marrow. With a median follow-up of 52 months, the 24-month progression-free survival rate was 70%, hence the primary objective was reached. After six cycles of treatment, 91% (54/59) of responding patients were analyzed for peripheral blood residual disease and 87% of these (47/54) were negative. Four-year overall survival rates of the patients who did not have or had detectable molecular residual disease in the blood at completion of treatment were 86.6% and 28.6%, respectively (P

Microsatellites are a tract of repetitive, short DNA motifs (usually 1 to 6 bp) abundant in eukaryotic genomes. They are robust molecular markers in many areas of studies. Development of microsatellite markers usually involves three steps: (1) obtaining microsatellite-containing sequences, (2) primer design, and (3) screening microsatellite loci for polymorphism. The first and third steps require considerable resources. Next generation sequencing technologies have greatly alleviated the constraint of the first step. In this study, we leveraged the availability of genome assemblies of multiple individuals in many species and designed a comparative genomics approach to bioinformatically identify polymorphic loci. Our approach can eliminate or greatly reduce the need of experimental screening for polymorphism and ensure that the flanking regions do not have length difference that would confound interpretation of genotyping results using microsatellite markers. We applied this approach on Phytophthora sojae, a soybean pathogen, and identified 157 high-quality, informative microsatellite markers in this oomycete. Experimental validation of 20 loci supported bioinformatics predictions. Our approach can be readily applied to other organisms of which the genomes of multiple individuals have been sequenced.

International audience; Petiroc2A is a 32-channel SiPM readout ASIC, which has been designed for applications requiring precise timing and energy measurement such as time-of-flight positron emission tomography. In this work, experimental results of Petiroc2A are presented. Time and charge measurements for Petiroc2A have been performed at CERN with various SiPM models from FBK, Hamamatsu and Sensl. Scintillators used for the tests are mostly LSO:Ce,Ca crystals with dimensions ranging from 2 × 2 × 3 mm3up to 3 × 3 × 20 mm3. Petiroc2A yields a single-photon time resolution (SPTR) of 90.7 ps FWHM when tested with FBK NUV 1 × 1 mm2SiPM. Meanwhile, the obtained coincidence time resolution (CTR) values when tested with FBK NUV-HD 4 × 4 mm2SiPM and 2 × 2 × 3 mm3LSO:Ce,Ca are 85.5 ps FWHM when measured externally and 127.3 ps FWHM when measured using the ASIC internal TDC. Using longer scintillators, 3 × 3 × 20 mm3LSO:Ce, Ca and Hamamatsu S13360-3050PE SiPM with negative output, Petiroc2A yields a CTR value of 222.5 ps FWHM when measured with internal TDC. Using the same configuration outputting positive SiPM signal, Petiroc2A measured a nearly similar CTR, 225.3 ps FWHM. Similar setup yields, an energy resolution of 12.9% for 511 keV photon after correction when measured internally by Petiroc2A.

Objective To investigate a temporal association between vaccination and subdural hematoma, the main feature of abusive head trauma. Study design From a prospective population-based survey carried out in 1 administrative district in France between January 2015 and April 2017, including all infants between 11 and 52 weeks old who underwent a first cerebral imaging (computerized tomography scan or magnetic resonance imaging), we conducted a nested case-control study. Vaccine exposure was compared between cases (infants with subdural hematoma) and 2-3 paired controls, without subdural hematoma or any other imaging findings compatible with abusive head trauma. Cases and controls were matched on chronological (±7 days) and gestational (≤33 vs >33 weeks) ages, respectively. Vaccination status was collected in the personal national pediatric health booklet. Results Among the 228 prospectively surveyed infants, 28 had subdural hematoma including 22 with abusive head trauma. The mean chronological age at imaging was 5.3 months among the 28 cases and the 62 controls, who did not differ significantly in median time since last vaccination (1.4 vs 1.3 months, P = .62) or frequency of at least 1 vaccination since birth (86% vs 89%; matched-pairs OR 0.77, 95% CI 0.17-3.86) or within 7 days (0.94, 0.08-6.96), 14 days (0.70, 0.12-2.92), or 21 days (0.48, 0.08-1.98) before cerebral imaging. Conclusions We found no significant temporal association between vaccination and subdural hematoma diagnosis, which must continue to be considered a red flag for abusive head trauma and child abuse.

Fracture corridors are zones of high density of persistent fractures within a rock bearing scarcer diffuse fractures. They occur at all scales from cm to km. The underground hydraulic properties of fracture corridors are well characterized but their structural architecture is poorly constrained because of their sub-seismic resolution. Particularly, their distribution laws and geomechanic conditions of growth remain poorly known. The aim of this study is to decipher the tectonic condition and the geometry for fracture corridors affecting the Devonian sandstones of Huamapampa formation (Icla syncline, Bolivia). This formation is the stratigraphic and structural analogue for many gas field located in the area of the Icla Syncline. We proceeded a structural analysis in the field at metric scale, an analysis of Digital Outcrop Models from photogrammetry at pluri-metric scale, and 3D structural models with Gocad at the Syncline scale. We show that fracture corridors of the Icla Syncline are early and transverse, and they formed at the early onset of the folding. They formed as anastomosing sets as a function of the stratigraphic distribution of the layered sandstones. Fracture corridors are observed at all scales with a vertical persistence depending on the mechanical stratigraphy.

International audience; The benefit of radiotherapy (RT) after chemotherapy in limited-stage diffuse large B-cell lymphoma (DLBCL) remains controversial. We conducted a randomized trial in patients with nonbulky limited-stage DLBCL to evaluate the benefit of RT after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Patients were stratified according to the modified International Prognostic Index, including lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, age, and disease stage. The patients received 4 or 6 consecutive cycles of R-CHOP delivered once every 2 weeks, followed or not by RT at 40 Gy delivered 4 weeks after the last R-CHOP cycle. All patients were evaluated by fluorodeoxyglucose-positron emission tomography scans performed at baseline, after 4 cycles of R-CHOP, and at the end of treatment. The primary objective of the trial was event-free survival (EFS) from randomization. The trial randomly assigned 165 patients in the R-CHOP arm and 169 in the R-CHOP plus RT arm. In an intent-to-treat analysis with a median follow-up of 64 months, 5-year EFS was not statistically significantly different between the 2 arms, with 89% ± 2.9% in the R-CHOP arm vs 92% ± 2.4% in the R-CHOP plus RT arm (hazard ratio, 0.61; 95% confidence interval [CI], 0.3-1.2; = .18). Overall survival was also not different at 92% (95% CI, 89.5%-94.5%) for patients assigned to R-CHOP alone and 96% (95% CI, 94.3%-97.7%) for those assigned to R-CHOP plus RT ( = not significant). R-CHOP alone is not inferior to R-CHOP followed by RT in patients with nonbulky limited-stage DLBCL. This trial was registered at www.clinicaltrials.gov as #NCT00841945.

International audience; This experiment was designed to better understand the differences in enteric methane (CH4) emissions of ruminants in tropical and temperate areas. Two double 4 4 Latin squares using adult sheep were evaluated simultaneously in a temperate and a tropical site. At each site, two breeds (four Texel, temperate origin, and four Blackbelly, tropical origin) and four hay types (two C3 grasses and two C4 grasses grown, respectively, in temperate and tropical sites) were tested. High-(H) and low-quality (L) grass hays were tested within each type of grass. No difference in dry matter (DM) intake (g/kg BW/d) was observed between sites. Intake of C4 grass was lower than that of C3 grass. A breed site interaction was observed. In the tropical site, dry matter intake (g/kg BW/d) was higher in Blackbelly compared to Texel, whereas no difference was observed in the temperate site. The total-tract DM, OM (organic matter), NDF (neutral detergent fiber) and ADF (acid detergent fiber) digestibility values recorded in the temperate site were lower (P < 0.01) than those reported in the tropical site. Methane yield (g/kg DM intake) was not affected by site, whereas a breed site interaction was observed. In the tropical site, methane emission was lower for Blackbelly compared to Texel, whereas the opposite was observed in the temperate site. Differences in methane emissions between the temperate and tropical sites could only be the result of diet and breed interactions with the environment.

Triroc is the latest addition to SiPM readout ASICs family developed at Weeroc, a start-up company from the Omega microelectronics group of IN2P3/CNRS. This chip is developed under the framework TRIMAGE European project which is aimed for building a cost effective tri-modal PET/MR/EEG brain scan. To ensure the flexibility and compatibility with any SiPM in the market, the ASIC is designed to be capable of accepting negative and positive polarity input signals. This 64-channel ASIC, is suitable for SiPM readout which requires high accuracy timing and charge measurements. Targeted applications would be PET prototyping with time-of-flight capability. Main features of Triroc includes high dynamic range ADC up to 2500 photoelectrons and TDC fine time binning of 40 ps. Triroc requires very minimal external components which means it is a good contender for compact multichannel PET prototyping. Triroc is designed by using AMS $0.35 ~\mu\hbox{m}$ SiGe technology and it was submitted in March 2014. The detail design of this chip will be presented.

Resume Objectif Le contexte demographique actuel en anesthesistes-reanimateurs en France contribue a faire reconsiderer la prise en charge anesthesique des patients operes de la cataracte sous anesthesie topique. Cette etude prospective observationnelle avait pour objectif d’evaluer le besoin de recourir a un anesthesiste pendant la chirurgie de la cataracte realisee sous anesthesie topique. Patients et methodes Les patients operes entre le 2 novembre 2011 et le 31 juillet 2012 etaient inclus apres indication d’anesthesie topique pour phacoemulsification posee par le chirurgien et confirmee par l’anesthesiste. Chaque patient etait monitore et surveille en salle d’intervention par une infirmiere anesthesiste. Un anesthesiste etait joignable a tout moment a la demande du chirurgien ou de l’infirmiere anesthesiste. Les antecedents medicaux etaient enregistres ainsi que l’evenement « appel de l’anesthesiste », avec le motif et le traitement realise. Resultats Cinq cent soixante-quinze phacoemulsifications ont ete realisees chez 486 patients. L’evenement « appel de l’anesthesiste » a ete enregistre 20 fois : 18 fois pour une hypertension arterielle, une fois pour une anxiete et une fois pour le recours a une anesthesie generale non urgente suite a une complication chirurgicale. Les episodes d’hypertension arterielle ont ete traites efficacement en suivant le protocole d’administration de nicardipine. L’hypertension arterielle non equilibree en periode pre-operatoire etait le seul facteur de risque clinique predictif d’appel de l’anesthesiste. Conclusions Ces resultats remettent en question l’utilite de la consultation d’anesthesie chez tous les patients operes de phacoemulsification sous anesthesie topique, puisqu’elle n’aboutit pas a un acte d’anesthesie. La prise en charge des complications medicales per-operatoires peut s’envisager sous la forme de protocoles etablis conjointement par les chirurgiens et les anesthesistes. Cette pratique permettrait de liberer du temps medical anesthesique, sans nuire a la securite des patients.

Numerical outcrops are key data for modeling the 3D spatial organization of fractures. Many studies were devoted to model diffuse fractures in 3D but few ones were focused on modelling the spatial organization of fracture corridors. Fracture corridors are particular geological structures within which the fracture density is particularly high. Recently, it was highlighted that the internal architecture of fracture corridors is more complex than expected: 1) the fracture density may vary within the fracture corridors; 2) other geological structures such as breccia are also encountered. Fractures have major impacts on fluid flow in carbonate. Geostatistical approaches were proposed to generate 3D fracture networks for reservoir characterization. They require information about fracture size, orientation and density. As only 1D data are available in subsurface studies, 3D fracture models obtained from outcrop studies are then of paramount importance for reservoir analog characterization. In this study, 3D Digital Outcrop Models (DOM) were acquired from outcrops in the South-East of France. They were used as a support for interpreting and modelling fracture networks to study the fracture patterns in fracture corridors. Semi-automated techniques were proposed to extract fracture planes and traces from DOM. This dataset was used to constrain 3D models of fractures.

Mid- to late-Holocene sea-level records from low-latitude regions serve as an important baseline of natural variability in sea level and global ice volume prior to the Anthropocene. Here, we reconstruct a high-resolution sea-level curve encompassing the last 6000 years based on a comprehensive study of coral microatolls, which are sensitive low-tide recorders. Our curve is based on microatolls from several islands in a single region and comprises a total of 82 sea-level index points. Assuming thermosteric contributions are negligible on millennial time scales, our results constrain global ice melting to be 1.5–2.5 m (sea-level equivalent) since ~5500 years before present. The reconstructed curve includes isolated rapid events of several decimetres within a few centuries, one of which is most likely related to loss from the Antarctic ice sheet mass around 5000 years before present. In contrast, the occurrence of large and flat microatolls indicates periods of significant sea-level stability lasting up to ~300 years., Past sea-level records serve as an important baseline of natural variability in sea level and global ice volume prior to the Anthropocene. Here, the authors reconstruct relative sea-level changes over the last 6000 years based on coral microatolls, which are the most accurate low-tide recorders.

The aim of this study was to create a specific tool and evaluate its impact on the knowledge of primary care physicians (PCPs) in reporting child abuse to child protective services (CPS).Prospective "before/after" study assessing the knowledge of general practitioners (GPs) registered at the medical board in a French administrative area through anonymous questionnaires. The tool was adapted from the guidelines published in 2014 by the French Health authorities. The main criterion was the median score (/100) calculated for each questionnaire before (Q1) and after (Q2) the dissemination of the tool. These median scores were compared and associations between scores and some PCPs' characteristics were tested through multiple linear regression.A total of 279 GPs answered the first questionnaire (Q1) and 172 answered the second (Q2). PCPs who answered were mainly women (68% and 74%), were between 30 and 50 years old (61% and 66%), practiced in association with other physicians (82% and 84), and had 15-30% children in their patient population. For Q1, the general median was 65 [IQR: 40-81] versus 82 [IQR: 71-91] for Q2 (P0.001). The PCPs' characteristics leading to significant variations in the scores for Q1 were age older than 50 years, being female, and having been trained in diagnosis and management of child abuse, with the β coefficient at -16.4 [95% CI: -31.1; -1.69], +8.93 [95% CI: 2.58; 15.27] and +12 [95% CI: 6.33; 17.73], respectively.This study confirms the significant impact of this new tool on PCPs' knowledge concerning reporting suspected child abuse to the CPS.Wider dissemination of this tool could increase PCPs' awareness and comprehension of when and how to make a report to the CPS.

Teenagers admitted to the emergency room for a violent attacks episode are increasingly numerous. The source of agitation is multifactorial for these teenagers, often with a complex course. They jeopardize hospital wards, which are often ill-suited for and overwhelmed during these outbursts. This study aims to identify and describe all the teenagers admitted to the hospital over 1 year for a violent outburst and discuss their management.Retrospective and descriptive study of teenagers admitted to the pediatric emergency department of the Nantes University Hospital for a violent outburst in 2015.During this 1-year study, 99 teenagers out of a total of 182 consultations were admitted for a violent outburst. We noted that 85% of them had a previous history of a violent outburst, 70% of them were seeing a psychologist, and 56% were followed by the child welfare services. Most of the outbursts took place at home and were hetero-aggressive. Upon arrival at the pediatric emergency ward, 90% of the teenagers had calmed down. The mean time spent in the emergency ward was 3h42min. Finally, 31% of the teenagers were hospitalized in the general pediatric unit, 14% in the children's psychiatric department, and 8% in the adult psychiatry ward.We observed a high proportion of complex cases in the teenagers admitted to our emergency department for a violent outburst. These teenagers in distress, with a complex previous history, illustrated the relation between violence against themselves and their own violent behavior toward others. Developing short-stay units for a temporary isolation could be an advantageous multidisciplinary approach to allow somatic, psychological, and social evaluation of these vulnerable patients.

International audience; The lack of a reliable in vitro system to assess reprotoxicity is an emerging problem in the context of European law for Registration, Evaluation, Authorization and Restriction of Chemicals (REACH, 2007), as it requires a reduction in animal utilization for testing. Furthermore, in vitro reprotoxicological tests would be more relevant and greatly improved by integrating both hepatic metabolism and the blood–testis barrier. Here, we took advantage of an integrated insert in a dynamic microfluidic platform (IIDMP) to co-cultivate hepatocytes in biochip and Sertoli cells in the bicameral chamber. This microfluidic tool has been previously demonstrated to be helpful in cell function and/or quality improvement. We demonstrate that permeability of the Sertoli barrier is reduced by dynamic coculture in our system. Exometabolomics analysis reveals that interactions between hepatocytes and Sertoli cells may have been mediated by the polyamines increase and/or mid-chain fatty acid decrease in the circulating medium. These metabolic changes may be involved in permeability reduction by contributing to modifying junction protein quantity and localization. The present study gives an example of IIDMP as an in vitro partitioning/transport model for cell culture and toxicological testing. Further, based on both our previous results using an intestinal–hepatic cell coculture and the present study, IIDMP seems to be well-suited for (i) assessing the dose–response effect of chemicals within the rodent or human male reproductive tract, and (ii) improving the quality of reprotoxicological assays by including hepatic metabolism. Copyright © 2016 John Wiley and Sons, Ltd. Copyright © 2016 John Wiley and Sons, Ltd.

To evaluate the long-term outcomes of artificial iris intraocular lenses sutured to the sclera for managing traumatic aphakia and aniridia.All consecutive cases receiving a MorcherSeventeen eyes of 17 patients were included, among which 82% were male. The mean age was 42 years. The injuries consisted of 23.5% contusion and 70.5% open globe injuries, of which 41% were globe ruptures. There was one postoperative case. A penetrating keratoplasty was performed at the same time for eight eyes. The mean follow-up was 32 months. Best-corrected visual acuity improved in 41.2%, remained the same in 17.6% and decreased in 41.2% of our cases. Distance vision averaged 1±0.25 line better and near vision 2.2±0.32 lines better when visual acuity was quantifiable before surgery. Glare improved in 80% of patients and remained stable in 20%, decreasing on average from 3.3/5 [min. 3-max. 4; SD: 0.48] before surgery to 1.9/5 [min. 0-max. 4; SD: 1.197] after surgery. Regarding the esthetic results, 78% of the patients declared themselves reasonably to very satisfied; 57% reported no limitation of activities of daily living, and 43% reported mild limitation. Ocular hypertension and glaucoma, found in 40% of eyes, were the main postoperative complications.Implantation of prosthetic iris device combined with an intraocular lens appears to be safe and effective in reducing glare disability and improving visual acuity. Close, long-term monitoring is essential for the success of this surgery.

Resume Introduction L’epidermolyse bulleuse acquise (EBA) est une dermatose bulleuse auto-immune sous-epidermique rare, secondaire a la production d’anticorps anti-collagene VII. La reaction du greffon contre l’hote (GVH) survenant apres transplantation allogenique de moelle osseuse peut, dans sa forme chronique, etre associee a diverses maladies auto-immunes. Dix observations de dermatoses bulleuses auto-immunes survenues apres greffe de moelle allogenique sont rapportees dans la litterature. Nous en decrivons un nouveau cas, a type d’EBA. Observation Une femme de 46 ans developpait une maladie bulleuse quatre ans apres le traitement d’un lymphome non hodgkinien de type T par une allogreffe de sang de cordon compliquee d’une GVH cutanee et digestive aigue, puis d’une GVH chronique pulmonaire. Elle presentait quelques lesions bulleuses cutanees des membres superieurs, de l’abdomen et du visage, et de nombreuses erosions de la cavite buccale. L’etude en immunofluorescence directe d’une biopsie cutanee mettait en evidence des depots d’IgG et de C3 le long de la membrane basale epidermique. La recherche d’anticorps anti-membrane basale sur peau clivee par le NaCl molaire etait positive en IgG4 sur le versant dermique et la recherche d’auto-anticorps anti-collagene VII par immunofluorescence indirecte sur cellules transfectees etait positive. Un diagnostic d’EBA etait pose. Apres echec de la dapsone et de l’association mycophenolate–prednisone, un traitement par rituximab se montrait efficace. Discussion L’EBA peut s’integrer dans les manifestations auto-immunes associees a la GVH chronique. La destruction de la membrane basale et des cellules basales epidermiques dans la GVH pourrait induire l’apparition de pathologie bulleuse auto-immune. Mais chez notre patiente dont la GVH chronique s’exprimait seulement aux poumons, il est difficile d’eliminer la survenue fortuite d’EBA a distance de la GVH aigue.

Resume Les pathologies pleurales liees a l’exposition aux fibres sont maintenant bien connues pour les fibres d’amiante, bien que le mecanisme d’action de ces fibres ne soit pas encore totalement elucide. Le developpement des fibres minerales artificielles et des nanotubes de carbone, dont les caracteristiques morphologiques sont proches des fibres d’amiante, remet en premiere ligne les hypotheses physiopathologiques associant exposition aux fibres et pathologies pleurales. Les plaques pleurales se developpent uniquement dans la plevre parietale, et des les annees 1990, des observations cliniques ont montre que le developpement precoce du mesotheliome se produisait egalement au niveau de la plevre parietale. La particularite de la plevre parietale par rapport a la plevre viscerale est la presence de « stomatas ou stomas » qui sont des orifices de communication entre la cavite pleurale et les vaisseaux lymphatiques de la plevre parietale. Des observations morphologiques en thoracoscopie et des etudes experimentales ont permis de montrer que les fibres etaient presentes dans la plevre parietale au niveau de zones anthracosiques particulieres ( blackspots ) et qu’elles s’accumulaient au niveau des stomas, allant jusqu’a les obstruer et provoquant localement une reaction inflammatoire, avec liberation de cytokines, pouvant faire le lit du mesotheliome. Cependant, malgre les donnees experimentales et les observations en pathologie humaine, les mecanismes responsables de la translocation des fibres dans la plevre parietale ne sont pas encore clairement etablis.

Resume La decouverte des mutations de l’EGFR a l’occasion du developpement des inhibiteurs de tyrosine kinase de l’EGFR (ITK-EGFR) a revolutionne la prise en charge therapeutique des cancers bronchiques non a petites cellules metastatiques. En effet, cette decouverte a fait emerger le concept d’addiction oncogenique et a permis, par des methodes tres diverses, de decouvrir d’autres anomalies moleculaires cibles de nouvelles therapeutiques. Il peut s’agir comme pour l’EGFR de mutations sur d’autres recepteurs transmembranaires a tyrosine kinase (HER2, DDR2), mais aussi de kinases intracytoplasmiques (PI3K, BRaf). Il peut s’agir d’autres mecanismes comme les rearrangements (ALK, ROS1, RET) et les amplifications geniques (c-met, FGFR). Ces anomalies peuvent etre recherchees sur les plates-formes de l’INCa et permettre l’acces a de nouveaux traitements comme le crizotinib ou a des molecules utilisees dans d’autres pathologies ou en cours de developpement auxquels les malades peuvent acceder par des essais therapeutiques. Cette revue a pour objectif de mettre en avant les similarites et les differences entre l’EGFR et les autres addictions oncogeniques tant sur le plan moleculaire, de la demarche diagnostique ou de la prise en charge therapeutique.

This paper investigates the wet etching of InSb surfaces by two different oxidant agents: Br 2 and H 2 O 2 and the consecutive oxides generation onto the surfaces. The strong dependence between the chemical composition of the etching baths and the nature of the final surface chemistry of this low band-gap III–V semiconductor will be especially highlighted. One aqueous etching solution combined hydrobromic acid and Bromine (HBr–Br 2 :H 2 O) with adjusted concentrations. The other solution combines orthophosphoric and citric acids with hydrogen peroxide (H 3 PO 4 –H 2 O 2 :H 2 O). Depending on its composition, each formulation gave rise to variable etching rate. The dosage of Indium traces in the etching solution by atomic absorption spectroscopy (AAS) gives the kinetic variation of the dissolution process. The variations on etching rates are associated to the properties and the nature of the formed oxides on InSb surfaces. Surface characterization is specifically performed by X-ray photoelectron spectroscopy (XPS). A clear evidence of the differences between the formed oxides is highlighted. Atomic force microscopy is used to monitor the surface morphology and pointed out that very different final morphologies can be reached. This paper presents new results on the strong variability of the InSb oxides in relation with the InSb reactivity toward environment interaction.