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IntroductionWith advances in surgical and neonatal care, the survival of patients with oesophageal atresia (OA) has improved over time. Whereas a number of OA-related conditions (delayed primary anastomosis, anastomotic stricture and oesophageal dysmotility) may have an impact on feeding development and although children with OA experience several oral aversive events, paediatric feeding disorders (PFD) remain poorly described in this population. The primary aim of our study was to describe PFD in children born with OA, using a standardised scale. The secondary aim was to determine conditions associated with PFD.MethodsThe Feeding Disorders in Children with Oesophageal Atresia Study is a national cohort study based on the OA registry from the French National Network. Parents of children born with OA between 2013 and 2016 in one of the 22 participating centres were asked to complete the French version of the Montreal Children’s Hospital Feeding Scale.ResultsOf the 248 eligible children, 145 children, with a median age of 2.3 years (Q1–Q3 1.8–2.9, min–max 1.1–4.0 years), were included. Sixty-one children (42%) developed PFD; 13% were tube-fed (n=19). Almost 40% of children with PFD failed to thrive (n=23). The presence of chronic respiratory symptoms was associated with the development of PFD. Ten children with PFD (16%) had no other condition or OA-related complication.ConclusionPFD are common in children with OA, and there is no typical profile of patients at risk of PFD. Therefore, all children with OA require a systematic screening for PFD that could improve the care and outcomes of patients, especially in terms of growth.

En ORL, l’examen clinique et les gestes invasifs sur les voies respiratoires et leurs annexes exposent à la transmission directe du SARS-CoV-2 par inhalation ou projection oculaire de gouttelettes contaminées, ou indirecte manuportée ou par l’intermédiaire d’objets ou de surfaces contaminées. L’estimation d’un R0 de la COVID-19 à environ 3 a justifié de reporter les rendez-vous des consultations présentielles non urgentes et de développer la télé-consultation afin de limiter les risques d’infection par le SARS-CoV-2 des patients ou des agents de santé et de participer au respect du confinement. L’autorité sanitaire a recommandé de déprogrammer toute activité ORL chirurgicale ou médicale non urgente et sans préjudice de perte de chance pour les patients. Cette déprogrammation a eu pour objectif d’augmenter très significativement la capacité de soins critiques, prioriser l’accueil de malades de patients COVID-19, prioriser l’affectation des personnels et la mise à disposition des matériels nécessaires à leur fonctionnement, contribuer à la fluidité de l’aval des soins critiques au sein de leur établissement. Il s’agissait également de ne pas exposer les malades concernés à un risque d’exposition infectieuse. Cet article propose des orientations concernant les indications et modalités de réalisation de la chirurgie ORL et la gestion des reports d’intervention dans le contexte pandémique actuel. Il ne s’agit que de conseils de bonne pratique qui doivent naturellement être modulés dans chaque région en fonction de l’évolution de l’épidémie et des organisations préexistantes, et ce dans le cadre de concertations entre les équipes ORL, les unités opérationnelles d’hygiène et toutes les autres spécialités concernées.

Contexte: Les progrès des techniques de réparation arthroscopique de la coiffe des rotateurs sont dus à l'amélioration constante des ancres permettant aux chirurgiens de rattacher et de maintenir le tendon en toute sécurité en position anatomique.

The aim of this study was to analyze a series of patients who suffered a distal finger amputation and who were treated with occlusive dressings. A retrospective study was done of 19 patients from a single hospital. At the review, an independent examiner evaluated the time required for wound healing, the number of occlusive dressings used, fingertip trophic skin changes, epicritic sensitivity using the Weber two-point discrimination (2PD) test, sensitivity based on the monofilament test, complications, the presence of dysesthesia or cold intolerance, and the QuickDASH score. The mean follow-up was 12.6 months (6–25). A mean of 3.2 occlusive dressings (3–5) were used per patient, and the mean healing time was 4.3 weeks (4–5). The skin texture, fingertips and nail bed were good or excellent in 18 cases. The 2PD test was good or normal in 16 cases. Eighteen patients were satisfied or very satisfied with the outcome. The mean QuickDASH score was 5.53 (0–20.45). In the literature, the recovery of tactile sensation is good after use of occlusive dressings (2PD of 2.5 to 4.0mm). The mean sensitivity reported in various studies is better than that observed after use of a skin flap. While the sample size in our study was small, the functional outcome and appearance were good. Thus we prefer using occlusive dressings in Zone 1 and 2 fingertip amputations, and flaps in zones 3 and 4 to ensure better fingertip viability and sensation.

Le Comité des dispositifs médicaux stériles (CODIMS) de l’Assistance publique–Hôpitaux de Paris (AP–HP) définit la liste des DM stériles (DMS) innovants et/ou coûteux dont l’utilisation est préconisée dans les établissements de l’AP–HP. Ce travail qualifie rétrospectivement le niveau de preuve des études cliniques (EC) relatives aux dispositifs évalués par le CODIMS en 2012 et 2013 et leur corrélation aux avis émis.

Arteriotomy is a critical step during end-to-side anastomosis procedures. However, it is challenging to carry out because of the concentric lamellar structure of blood vessels and the need for clean margins. We performed a review of the literature to identify the advantages and disadvantages of the available arteriotomy methods. The techniques were classified into (1) single-cut or slit arteriotomy (longitudinal and transverse) or (2) excision arteriotomy. The latter techniques can be performed from either outside-in (excision with straight microscissors, curved microscissors, Acland-Banis arteriotomy clamp, micro-arteriotomy scissors, or triangular cutting scissors, and vaporization with Excimer®laser) or inside-out (excision with punch/micropunch). Microsurgeons have multiple arteriotomy methods at their disposal. By being familiar with these methods, they can select the most appropriate one for the situation at hand.

A precise knowledge of all the isotopes produced in spallation reactions is necessary to predict induced radioactivity and chemical modifications in spallation targets. Experimental data recently obtained using the reverse kinematics technique are presented. New, more complete, preliminary experimental results on the Fe+p system are shown. These measurements of residual nuclei production in iron can be used directly to assess changes and damage created by spallation in an ADS metallic window.

Some improvements of the Intra-Nuclear Cascade code INCL4 for low energy projectiles are presented and discussed.

The synthesis and characterization of two new anthradithiophene (ADT) derivatives substituted by thiophenyl or 2‐octylthiophenyl units at the 5,11‐positions and donor (triphenylamine) or acceptor (aldehyde functions) moieties at the 2,8‐positions of their backbone are described. Optical measurements were performed to evaluate the effect of electron‐rich/‐poor substituents on their stability towards photo‐oxidation and were supported by quantum chemical calculations and cyclic voltammetry experiments.

In high-energy transport codes used to design Accelerator Driven Systems or spallation neutron sources, elementary interactions are computed through nuclear physics models. Among these, Intra-Nuclear Cascade models play a major role since the excitation energy at the end of the INC stage determines the number of evaporated particles. Therefore, in simulation of spallation targets, INC influences the total number of emitted neutrons and the isotopic distribution of produced nuclei. Recent data regarding the production of neutrons and residual nuclei in proton induced reactions make it possible to test the reliability of INC models and to improve them. A new version (INCL4) of the Liège INC model including especially a realistic nuclear density and a consistent treatment of the Pauli principle is presented.

The production cross sections and the kinematical properties of primary residual nuclei have been studied in reactions 197Au + p, 208Pb + p, d, 238U + p, d, and 238U + 208Pb at energies around 1 AGeV. The measured kinematical properties of the residues were also used to disentangle the relevant reaction mechanisms, spallation-evaporation and spallation-fission. The fragment separator FRS at GSI, Darmstadt, was used to separate and identify the reaction products. The measured quantities are important for the design and planning of future radioactive-beam facilities and accelerator-driven systems.

Comparisons between the INCL4 cascade model, recently implemented in LAHET, and Bertini model are made in thin and thick lead targets. The impact of the cascade model used on the estimation of the target activity during its irradiation by a 1 GeV proton beam and its subsequent decay is discussed.

We have investigated the effect of glutathione (GSH) depletion on the chemosensitivity of human malignant glioma cell lines: G111, G5 and G152. All the cell lines showed a multidrug resistant (MDR) phenotype associated with MRP1 expression, high intracellular levels of GSH, and depolarized plasma membranes. Tc-99M-Sestamibi (MIBI) and Tc-99M-Tetrofosmin (Tfos) were used for monitoring the MDR mechanisms. Modulation of GSH content was performed with butoxysulfoximide (BSO) pre-treatment alone or in combination with GSH ethyl ester. MIBI and Tfos accumulation in the cells was inversely correlated to the GSH content, a higher accumulation was found after BSO pre-treatment and addition of GSH ethyl ester reversed this process. BSO could therefore play a role as a chemosensitizing drug and thus help to overcome MDR. However, higher accumulation of MIBI and Tfos was observed even in the sensitive cells suggesting another effect of BSO on the cell physiological characteristics. No sign of apoptosis has been found indicating a possible direct effect on the plasma membrane fluidity and permeability. MIBI and Tfos don't follow the expected behavior of a MDR probe in the glioma cells and given the particular morpho-physiological characteristics of these types of tumors, Tfos could be rather used as a marker of the tumor growth and proliferation.

The spallation of 197Au by 800 MeV protons was investigated in inverse kinematics at GSI, Darmstadt, by use of a 197Au beam bombarding a liquid-hydrogen target. The fragment separator (FRS) was used to select and identify the reaction products prior to βdecay. The individual production cross sections and the kinematic properties of 380 isotopes for all elements between mercury (Z=80) and neodymium (Z=60) have been measured. A comparison with a Monte-Carlo calculation based on the two-step model of the spallation reaction is given. The isotopic cross-section distribution of iridium isotopes is compared to that resulting from the aluminium-induced fragmentation of 197Au. The mean kinetic energies of the fragments are deduced from the experimental data. The importance of the new data to improve our understanding of the spallation mechanism is discussed.

Interactions of 197Au projectiles at 800 AMeV with protons leading to fission are investigated. We measured the production cross sections and velocities of all fission residues which are fully identified in atomic and mass number by using the in-flight separator FRS at GSI. The new data are compared with earlier measurements of the characteristics of fission in similar reactions. Both the production cross sections and the recoil energies are relevant for a better understanding of spallation reactions.

The diffuse scattering in the diffraction pattern of the i-AlPdMn phase has been measured on an absolute scale by X-ray and neutron scattering on single grain samples. Most of its intensity is due to long wave length phason fluctuations, interpreted as pretransitional fluctuations. The phason elastic constants have been extracted by comparison of the results with the elasticity theory of quasicrystals: we found that they are of the same order of magnitude for neutron and X-ray data. A precise comparison shows that they are independent of the thermal history of the sample.

Formation conditions of F-phase, F2-phase and F2M-phase were systematically studied at alloy composition of Al71Pd21Mn8by annealing and succeeding quenching method. The results indicated that the transformation from the F-phase to the F2M-phase occurs in two steps between 734 and 743°C; in the first step the F-phase is transformed to the F2-phase, in the second step the F2-phase is transformed to the F2M-phase. It was reconfirmed that the F-phase is a high-temperature phase stable above approximately 748°C, and the F2M-phase is a low-temperature phase stable below approximately 743°C. The present experiment also indicated that the F2-phase is a transient state between the F-phase and the F2M-phase.

The structural perfection of eight samples of icosahedral Zn–Mg–R (R=Y, Ho and Tb) single grains has been studied by high resolution X-ray diffraction. Four samples present a systematic peak shift proportional to Qpercharacteristic of a linear phason strain. Two other samples present a peak splitting proportional to Qper. Only two samples had their Bragg peak position corresponding to the ideal one, with a width increasing linearly with Qper. The perfection of one of these last two samples was investigated by synchrotron monochromatic X-ray topography. It was found to be a microstructure similar to the one exhibited by conventional crystals grown by the same technique (flux-growth).

We have measured the electron energy losses on different Al–Pd–Mn quasicrystal surface states established by low energy electron diffraction, X-ray photoelectron spectroscopy and Auger electron spectroscopy. On the well characterized and ordered Al–Pd–Mn quasicrystalline surfaces, the energy loss signal with an energy of incident electrons at 2keV shows a strong peak at 16eV and a satellite at about 33eV. As the electron primary energy is decreased to 260eV, an energy loss at 10.5eV is clearly observed. A short ion bombardment (1μA at 500eV during 1min) erases this loss at 10.5eV which can be recovered by annealing at 800K. All these observations are simply attributed to the existence of a bulk plasmon at about 16eV and a surface plasmon at 10.5eV. The ratio between these two energies is 1.52. This is quite close to the expected 2from the classical plasmon model. On the crystalline partially annealed surface, a bulk plasmon is observed at about 16.5eV. Oxygen-contaminated surface presents a bulk plasmon shifted towards higher energy of about 20eV.

The reversible phase transformation between the crystalline multidomain structure of the rhombohedral phase to the perfect icosahedral quasicrystalline state at high temperature has been studied by in situ X-ray diffraction on a four-circle diffractometer using synchrotron radiation. The transient state known as the 5-fold modulated state has been observed and its evolution with temperature is characterised. Diffuse scattering located close to the Bragg reflections is observed in the studied temperature range. Its evolution with temperature shows a reversible transformation with an important change of shape in agreement with the proximity of a 5-fold phason instability.

Fivefold surfaces of Al–Pd–Mn quasicrystal have been prepared under ultra-high vacuum (UHV) by sputtering and annealing above 700K and characterized by electron diffraction, Auger spectroscopy and X-ray photoemission spectroscopy (LEED, AES, XPS). X-ray reflectivity at grazing incidence reveals that an in situ temperature annealing at 900K is necessary to irreversibly produce the signature of a flat and bulk terminated surface. Air-AFM investigations of surfaces prepared below or in the vicinity of this transformation temperature show a large scale structure in the micrometer range with high steps and parallel terraces. Terrace morphology is dominated by clusters with a typical size of about 10nm. Nanometer steps can coexist with this cluster structure. With UHV-STM, terrace roughness based on cluster assembly is found to extend down to the nanometer scale.

Chemical and structural surface evolution of an icosahedral AlPdMn sample was systematically studied after ultrahigh vacuum surface preparations based on ion sputtering followed by annealing. Depending on the annealing temperature we observed different surface phases. For annealing temperatures below 700K a thin crystalline surface was formed on the quasi-crystal bulk. For annealing temperatures between 700 and 900K we found a quasi-crystalline surface that can be interpreted as a bulk-terminated one. For high temperature annealing (>950K) the surface observed at high temperature was different to that obtained after cooling to room temperature. The cooled sample exhibited again a crystalline thick layer.

Le cancer broncho-pulmonaire demeure un problème de santé publique. Le gold standard du traitement est la chirurgie pouvant être remplacée et/ou associée à de la radiothérapie. La contrainte principale étant les effets délétères de la radiothérapie sur le tissu sain environnant. L’utilisation de nouveaux agents radio-sensibilisants de haut numéro atomique tels que le gadolinium (Z=64) offre un nouveau potentiel thérapeutique, afin d’augmenter l’efficacité de l’irradiation, tout en limitant la dose locale. Les nanoparticules AGuIX® à base de gadolinium sont de nouveaux composés théranostiques (ciblage tumoral versus action radio-sensibilisante) dont il est crucial d’évaluer leur toxicité, ainsi que leur comportement cellulaire in vitro et in vivo [1,2].

Abstract:: Cross sections for stripping and dissociation of deuterons interacting with Be targets in the 100–2300 MeV energy range have been measured. Comparisons with model calculations suggest a dominant contribution of the stripping process. It is also shown that the deuteron break-up cross section exhibits the same energy dependence as the nucleon-nucleon cross section.

We present detailed simulations of the MEMUS detector [1] response to both electromagnetic and hadronic background, as well as to a representative set of proposed experiments at ELFE. The aim of this study is to check the adequation of the detector to the requirements of the experiments involving exclusive channels. This study is far from complete, but preliminary design refinements can be inferred. The technical details for the detector components can be found in the write-up of the detector session[2].

The glass-forming ability (GFA) of the Ni-B-Sn ternary system has been analysed. The addition of small quantities of tin increases the GFA with relation to the Ni-B binary system. Glass formation was observed in the nickel-rich corner of the Ni-B-Sn ternary system for a tin content <15 at %. The difficulty of formation of a ternary compound Ni21 B6Sn2 (t-phase) seems to play an important role in the GFA.

Angular distributions of analyzing powersAyandAyyhave been measured ind-p elastic scattering at 70 MeV. The data are compared with Faddeev calcuiations using various tensor nucleon-nucleon interactions.

We present the results of measurements of 1.04 GeV proton elastic and inelastic scattering on the 144,150,152Sm isotopes. The use of HFB p- and n-densities gives a quite good description of the elastic scattering data. Neutron transition strengths are deduced for the 21+and 31−levels in 144Sm. The channel coupling in the fairly well deformed 152Sm nucleus is shown to be important. It can be well accounted for in a microscopic way in the Glauber model.

There is evidence of an innervation of the mucosal immune system by peptidergic fibers. The modulation of the mitogenic response of the murine Peyer's patch lymphocytes by several peptides present in the gastrointestinal tract, namely, the carboxy-terminal octapeptide of cholecystokinin (CCK-8), the entire molecule cholecystokinin-pancreozymin (CCK-PZ), the calcitonin gene-related peptide (CGRP) and the vasoactive intestinal peptide (VIP), was studied. The proliferative response of the T lymphocytes induced by 2.5 μg/ml concanavaline A (Con A) was dose dependently inhibited by CGRP and VIP, with a maximal inhibition of 40% and 55% with 10−7M CGRP and VIP, respectively. On the contrary, CCK-PZ exerted a significant stimulatory effect, 48% increase in thymidine incorporation being observed with 62.5 mU/ml (Crick units) CCK-PZ. CCK-8 was found to have no effect on the T cell proliferation. None of the peptides tested were able to modify the mitogenic response of Peyer's patch B lymphocytes induced by 20 μg/ml lipopolysaccharide (LPS), except for CCK-PZ which induced a significant inhibition of the mitogenesis with a maximal effect of 45% inhibition at 500 mU/ml. These preliminary results show that CGRP, VIP and CCK-PZ can affect the murine Peyer's patch T and B lymphocyte response and suggest that they could be implicated in the modulation of the local immune response in the intestine.

The mechanism of action of pichilan, a (1->3)-β-D-glucan on nitric oxide production by a murine macrophage cell line, MALU cells, was examined. Different metabolic pathways were investigated in order to understand pichilan-induced NO secretion. We demonstrate in the present paper that neither the acid arachidonic metabolism, the cAMP nor Ca2+accumulation occured in the pichilan mechanism of action on NO secretion. On the other hand, we observed that a phorbol ester, PMA, modulated the NO secretion. An inhibition of 36% of the NO secretion was observed; consequently, pichilan could regulate the NO secretion by way of the protein kinase C. Furthermore, we demonstrated that TNF production stimulated by pichilan activation induced NO secretion by MALU cells. TNF would be the main modulator of NO secretion by pichilan or LPS-activated MALU cells. Moreover, we can note that pichilan and LPS did not act similarly on nitrite secretion by MALU cells.

AbstractHigh intensity proton beams can produce very intense neutron flux through spallation reactions on a heavy target. These neutrons could be used to drive a subcritical blanket in which long-lived nuclear waste could be transmuted into stable or short-lived isotopes. Because a good knowledge of the spallation process is essential for designing and optimizing the target-blanket assembly, there has been recently a revival of experimental and theoretical studies on spallation reactions. We present here some of the efforts devoted to this subject.

The structure of an orthorhombic phase called T-Al3 Mn, Pd, with the composition Al72· Pd3·2 Mn24·5, has been determined by single-crystal X-ray diffraction. The space group is Pnma and the magnitudes of the cell parameters are a = 14.717 A, b = 12.510 Å and c = 12.594 A. The final reliability factor is R = 0.022 and for 2734 independent reflections. The structure exhibits a strong chemical ordering and is compared to the isomorphic phase T-Al3 Mn and to the closely related R-Al60 Mn11 Ni4 phase. The possibility of a phase transformation occurring through the motion of phason defects, between the T-Al3 (Mn, Pd) orthorhombic phase and another orthorhombic phase, isomorphic to the R-Al60 Mn11 Ni4 phase, is briefly discussed.

Two icosahedral Al Pd Mn samples extracted from the same Czochralskigrown single quasicrystal have been studied by high-resolution synchrotron X-ray diffraction. While the first sample had an almost planar surface resulting from cleavage, the second had a planar surface obtained by mechanical polishing. In Q both samples the width of the diffraction peak profiles increases linearly with, per the perpendicular component of the six-dimensional reciprocal lattice vector. However, the broadening is larger in the polished sample, indicating that phason strain has been introduced during the polishing process.

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