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Dans la continuité de nos recherches sur la médiation par le jeu de rôle, nous nous questionnons sur les modalités d'expression du transfert, compte tenu des caractéristiques de ce médium qui mêle activité de jeu et narration collective. À cet égard, nous faisons l'hypothèse qu'il mobilise une forme spécifique de transfert, à l'origine de mouvements thérapeutiques particuliers. Nous avons rencontré deux groupes d'adolescents (7 au total) dans le cadre d'une médiation thérapeutique par le jeu de rôle, menée par un psychologue et un éducateur dans une institution de scolarisation adaptée. Nous avons conçu une grille de repérage des mouvements transférentiels permettant de caractériser la nature de ces mouvements et de différencier leur scène d'émergence, entre groupe et narration. Nous avons étudié les retranscriptions de l'intégralité des séances d'atelier pour mettre en évidence les processus émergents et leur évolution de manière longitudinale. Nos résultats mettent en évidence un déploiement du transfert d'abord généralisé et marqué par des tendances massives à l'expression de l'agressivité, du déni ou du rejet de l'autre et du groupe. Au fil du temps, le mode de relation à l'objet semble évoluer, en s'appuyant sur le transfert qui s'engage avec les co-thérapeutes, et par l'intrication de ces relations aux plans actuels et narratifs. Le jeu de rôle se révèle comme un lieu de projection de la dynamique relationnelle entretenue avec l'objet, et des représentations de la relation à l'autre. Le médium révèle alors les impasses de la création du lien et de la reconnaissance de la place de l'objet, les angoisses sous-jacentes, mais il devient également un transformateur des relations, parce qu'il permet l'émergence d'un transfert d'abord diffracté dans l'enveloppe narrative, qui autorise secondairement un mouvement de reprise et un apaisement des relations de groupe. Le jeu de rôle offre des espaces de projection qui rendent compte de la souffrance liée à la situation de rencontre avec le groupe. Il est également le lieu d'où peuvent se déployer des dynamiques relationnelles protégées de la destructivité agie grâce au prisme de la narration et d'un transfert en trois temps qui contribue au processus d'historicisation, de mise en lien. Following on from our research into mediation through role-playing games, we are investigating the ways in which transference is expressed given the characteristics of this medium which combines game activity and collective narrations. From this perspective, we hypothesize that it mobilises a specific form of transference at the origin of particular therapeutic movements. We met with two groups of adolescents (7 adolescents altogether) in a therapeutic mediation through role-playing games, conducted by a psychologist and an educator in an adapted educational institution. We proposed a grid for identifying transference movements, making it possible to characterize the nature of these movements and to differentiate their scene of emergence between group and narrative. We studied the transcripts of all the workshop sessions to highlight the emerging processes and their evolution. Our results showed that the transference was initially generalised and marked by massive tendencies to express aggression, denial or rejection of the other and the group. Over time, the mode of relationship to the object seemed to evolve, drawing on the transference enabled by the psychologist and the educator and by the link between relationships at the actual and narrative levels. The role-playing game reveals itself as a place of projection of the relational dynamics and representations of the relationships. The medium then reveals the pitfall in the creation of a bond and the recognition of the object's place, and the underlying anxieties. However, it also becomes a transformer of relationships because it allows the emergence of a transference that is first diffracted in the narrative envelope, which secondly authorizes a movement of recovery and a relief of group relationships. The role-playing game offers spaces for projection that takes account of the suffering linked to the situation of encounter within the group. It is also a place where relational dynamics can unfold, protected from the destructiveness of acting through the prism of narrative and a three-stage transfer that contributes to the process of historicization. [ABSTRACT FROM AUTHOR]

During hominin evolution, an increase in the femoral bicondylar angle was the initial change that led to selection for protuberance of the lateral trochlear lip and the elliptical profile of the lateral condyle. No correlation is found during ontogeny between the degree of femoral obliquity and of the prominence of the lateral trochlear lip. Might there be a relationship with the elliptical profile of the lateral condyle? On intact femoral diaphyses of juvenile humans and great apes, we compared the anteroposterior length of the lateral and medial sides of the distal metaphysis. The two diaphyseal pillars remain equal during postnatal growth in great apes, while the growth of the lateral pillar far exceeds that of the medial pillar in humans. Increase in bicondylar angle is correlated with disproportionate anteroposterior lengthening of the lateral pillar. The increased anteroposterior length of the lateral side of the metaphysis would contribute to increasing the radius of the curvature of the lateral condyle, but not to the projection of the lateral trochlear lip. The similar neonatal and adult femoro-patellar joint shape in humans prompted an assessment of the similarity during growth of the entire neonatal and adult epiphyses. We showed that the entire epiphysis undergoes drastic changes in proportions during postnatal growth. Finally, we emphasize the need to distinguish the cartilaginous phenotype and the ossified phenotype of the distal femoral epiphysis (and of any epiphysis) during postnatal growth. This crucial distinction applies to most postcranial bones, for they almost all develop following the process of endochondral ossification. KEY WORDS femur; diaphysis; epiphysis; postcranial growth; ossification

Structures managers need a better prediction of the delayed failure of concrete structures, especially for very important structures like nuclear power plant encasement. Sustained loadings at high level (above 75% of loading capacity of the structure), can lead to structure failure after some time. In this study, a series of 4-point bending tests were performed in order to characterize the creep behaviour of pre-cracked beams under high load level. The specimens were made of normal strength concrete. A power law relationship is observed between the secondary deflection creep rate and the failure time. It is also shown that when crack propagation occurs during the creep loading, the creep deflection rate increases with the creep loading level and with the crack propagation rate.

Abstract Background Stepping-down is preceded by a shift of the center of mass towards the supporting side and forward. The ability to control both balance and lower limb movement was investigated in knee osteoarthritis patients before and after surgery. It was hypothesized that pain rather than knee joint mobility affects the coordination between balance and movement control. Methods The experiment was performed with 25 adult individuals. Eleven were osteoarthritic patients with damage restricted to one lower limb (8 right leg and 3 left leg). Subjects were recruited within two weeks before total knee replacement by the same orthopedic surgeon using the same prosthesis and technics of surgery. Osteoarthritic patients were tested before total knee replacement (pre-surgery session) and then, 9 of the 11 patients were tested one year after the surgery when re-educative training was completed (post-surgery session). 14 adult individuals (men: n = 7 and women: n = 7) were tested as the control group. Results The way in which the center of mass shift forward and toward the supporting side is initiated (timing and amplitude) did not vary within patients before and after surgery. In addition knee joint range of motion of the leading leg remained close to normal before and after surgery. However, the relative timing between both postural and movement phases was modified for the osteoarthritis supporting leg (unusual strategy for stepping-down) before surgery. The "coordinated" control of balance and movement turned to be a "sequential" mode of control; once the body weight transfer has been completed, the movement onset is triggered. This strategy could be aimed at shortening the duration-time supporting on the painful limb. However no such compensatory response was observed. Conclusion The change in the strategy used when supporting on the arthritis and painful limb could result from the action of nociceptors that lead to increased proprioceptor thresholds, thus gating the proprioceptive inputs that may be the critical afferents in controlling the timing of the coordination between balance and movement initiation control.

Les thérapies par l'écriture pour adolescents sont aujourd'hui largement mobilisées sur le plan clinique, et très étudiées dans le champ de la recherche. Si leurs effets peuvent être mis en évidence, les mécanismes qui en sous-tendent l'émergence restent encore mal connus (Doucet et al., 2018), nécessitant des recherches à même d'identifier les processus à l'œuvre en thérapie par l'écriture. Notre étude vise précisément à mettre en évidence les processus thérapeutiques émergeant en médiation par l'écriture auprès d'adolescents en situation de placement. Nous nous sommes focalisés sur les phénomènes qui apparaissent dans la dyade patient–thérapeute, sous le prisme de l'analyse des processus de symbolisation, de réflexivité, et de leurs interactions avec la fonction médium–malléable du thérapeute (Roussillon, 2016). Par ailleurs, nous avons procédé à une comparaison de la thérapie écriture avec d'autres modèles psychothérapeutiques (Bychkova et al., 2011), pour tenter d'en dégager des spécificités. Nous avons évalué 7 dyades patient–thérapeute au cours d'une thérapie à médiation par l'écriture. Chaque dyade a fait l'objet de 3 évaluations à différents temps de la thérapie (début–milieu–fin). Nous avons analysé les processus grâce à l'Adolescent Psychotherapy Q-Set (APQ), validé par Calderon et al. (2017), puis nous avons procédé à une analyse factorielle pour mettre en évidence 3 facteurs représentant les grandes tendances de nos 21 cotations totales. Les 3 facteurs mettent en évidence des tendances thérapeutiques diversifiées ainsi que des configurations dyadiques spécifiques au sein du même cadre thérapeutique. L'APQ nous permet également de rendre compte de la nature des processus de symbolisation chez les adolescents en atelier à médiation et de décrire les modalités d'expression de la fonction médium–malléable du thérapeute. Enfin, les données révèlent que la thérapie à médiation par l'écriture est une thérapie polymorphe, dont les particularités de l'attitude thérapeutique s'adaptent, au sein des dyades, aux adolescents qui composent le groupe. Writing therapies for adolescents are now widely used in clinical settings and also well studied in research. Even if their effects can be highlighted, the mechanisms underlying their emergence remain poorly understood (Doucet et al., 2018) requiring further research to identify the processes working in writing therapy. Our study aimed to highlight the emerging therapeutic processes in writing mediation with institutionalized adolescents. We focused on the processes that appear in the patient–therapist dyad, under the prism of the analysis of symbolization processes, reflexivity, and their interactions with the "malleable–medium" (Brun et al., 2020) function of the therapist (Roussillon, 2016). Furthermore, we proceeded with a comparison of writing therapy with other psychotherapeutic models (Bychkova et al., 2011) in order to identify specific tendencies. We evaluated seven patient–therapist dyads in a writing mediation therapy. Each dyad was assessed at three different times of therapy (beginning - middle - end). We analyzed the processes using the Adolescent Psychotherapy Q-Set (APQ), validated by Calderon et al. (2017), and then performed a factor analysis to identify three factors representing the major trends of the 21 sorts. The three factors highlight diversified therapeutic trends, specific dyadic configurations within a single therapeutic writing workshop. The APQ also allowed us to account for the nature of the symbolization processes in the adolescents of the group and to describe the modalities of expression of the therapist's "malleable–medium" function. Finally, the data revealed that this writing therapeutic mediation is a polymorphic therapy whose particularities of the therapeutic attitude are adapted, within the dyads, to the adolescents who make up the group. [ABSTRACT FROM AUTHOR]

Objectives. Muscle shortening and spastic cocontraction in ankle plantar flexors may alter gait since early childhood in cerebral palsy (CP). We evaluated gastrosoleus complex (GSC) length, and gastrocnemius medialis (GM) and peroneus longus (PL) activity during swing phase, in very young hemiparetic children with equinovalgus. Methods. This was an observational, retrospective, and monocentric outpatient study in a pediatric hospital. Ten very young hemiparetic children (age 3 ± 1 yrs) were enrolled. These CP children were assessed for muscle extensibility (Tardieu scale XV1) in GSC (angle of arrest during slow-speed passive ankle dorsiflexion with the knee extended) and monitored for GM and PL electromyography (EMG) during the swing phase of gait. The swing phase was divided into three periods (T1, T2, and T3), in which we measured a cocontraction index (CCI), ratio of the Root Mean Square EMG (RMS-EMG) from each muscle during that period to the peak 500 ms RMS-EMG obtained from voluntary plantar flexion during standing on tiptoes (from several 5-second series, the highest RMS value was computed over 500 ms around the peak). Results. On the paretic side: (i) the mean XV1-GSC was 100° (8°) (median (SD)) versus 106° (3°) on the nonparetic side (p=0.032, Mann–Whitney); (ii) XV1-GSC diminished with age between ages of 2 and 5 (Spearman, ρ = 0.019); (iii) CCIGM and CCIPL during swing phase were higher than on the nonparetic side (CCIGM, 0.32 (0.20) versus 0.15 (0.09), p<0.01; CCIPL, 0.52 (0.30) versus 0.24 (0.17), p<0.01), with an early difference significant for PL from T1 (p=0.03). Conclusions. In very young hemiparetic children, the paretic GSC may rapidly shorten in the first years of life. GM and PL cocontraction during swing phase are excessive, which contributes to dynamic equinovalgus. Muscle extensibility (XV1) may have to be monitored and preserved in the first years of life in children with CP. Additional measurements of cocontraction may further help target treatments with botulinum toxin, especially in peroneus longus. [ABSTRACT FROM AUTHOR]

Aim To characterise children with cerebral palsy (CP) and pathological drooling in France, and to describe care pathways, assessment and treatment. Method A transversal, observational, descriptive survey of the practices and opinions of 400 health professionals potentially involved in the care of children with CP, was carried out nationally across France in 2013. Results The response rate was 36%. Seventy-five questionnaires were returned and analysed (52%). A small proportion of children were specifically treated for drooling (<25%). Assessments were carried out in 75% of cases and 91% of professionals prescribed treatments. Use of assessment tools varied widely. The most common treatment was oro-facial rehabilitation (95% of professionals), followed by anticholinergic drugs (Scopolamine ® ) (94%) botulinum toxin injections (BT) (66%) and surgery (34%). Scopolamine was considered to be less effective than BT and to have more side effects. Conclusion The rate of pathological drooling in children with CP is likely underestimated and under treated in France. There is a lack of knowledge regarding assessment tools. Aside from rehabilitation, current practice is to prescribe medication as the first-line treatment, however professionals consider that BT is more effective and has less side effects. [ABSTRACT FROM AUTHOR]

The design of concrete structures is based on calculation rules, which often do not take into account the very early age behaviour of the material. However, during this period, structural concrete is subjected to strains due to the hydration process of cement. If these strains are restrained by concrete itself or surrounding boundaries, stresses start to build up that can lead to the formation of cracks. Among the parameters involved in the stress build up, the stiffness evolution is of major importance. This paper reports the use of eight different techniques aimed at stiffness evolution assessment, applied on the same concrete mix, in a round robin experimental test within three laboratories. The observations are compared after having expressed the results at the same equivalent age. Both the loading stress rate and amplitude are observed to have an effect of limited importance on the determination of the quasi-static elastic modulus, which might be explained by very short term creep. Ultrasonic measurements provide values of E-modulus that are higher than the values provided by the quasi-static tests at the time of the concrete setting. Similar mechanisms associated to very short term creep could explain the difference between the quasi-static and high-frequency elastic modulus. [ABSTRACT FROM AUTHOR]

The management of mucopolysaccharidoses (MPS) requires a multidisciplinary approach and all medical and paramedical specialties may be involved because of the multiorgan nature of the disease. For this reason, patients should ideally be managed in a reference center and their management should be coordinated by an experienced physician who has access to the various specialists through a multi-disciplinary approach. The management is focused on assessments of the numerous features of the disease, study their progression and the effectiveness and pitfalls of specific and non-specific treatments. The main concerns of reeducation and rehabilitation should be to preserve global function through specific goals to be set along with the child and its family. This is a very demanding approach for the patient and family in which education plays a fundamental role in order to ensure optimal management. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents a real-time relation between the evolution of fluid permeability and the crack width opening in a saturated concrete sample. The standard Brazilian test has been enhanced so that one single controlled crack (up to 300μm) is generated in the specimen. The procedure has been then adapted so that the simultaneous monitoring of the cracking process and the evolution of a fluid flow through the specimen are possible. Poiseulle's cubic law is commonly used in numerical analyses for describing the percolation of a fluid in a crack: this law is then corrected accordingly to our experimental observations thus taking into account the actual morphology of the opening crack. The effect of the size of the specimen (diameter and thickness) on the percolation process as well as threshold effect are also investigated and discussed. [Copyright &y& Elsevier]