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This research was conducted to find an alternative to the brick wall constituent material with the lowest thermal conductivity value by adding sawdust. The method of measuring the thermal conductivity value used is the steady-state hot plate method. From the test results obtained the more the addition of sawdust, the value of thermal conductivity obtained is also increasing. With the best conductivity value obtained by the author is in the addition of sawdust as much as 5 grams with a conductivity value of 0.006573945Q W/mK.

ObjectiveDespite recent progress in caring for patients born with esophageal atresia (EA), undernutrition and stunting remain common. Our study objective was to assess nutritional status in the first year after birth with EA and to identify factors associated with growth failure.Study designWe conducted a population-based study of all infants born in France with EA between 2010 and 2016. Through the national EA register, we collected prenatal to 1 year follow-up data. We used body mass index and length-for-age ratio Z scores to define patients who were undernourished and stunted, respectively. Factors with P < 0.20 in univariate analyses were retained in a logistic regression model.ResultsAmong 1,154 patients born with EA, body mass index and length-for-age ratio Z scores at 1 year were available for about 61%. Among these, 15.2% were undernourished and 19% were stunted at the age of 1 year. There was no significant catch-up between ages 6 months and 1 year. Patients born preterm (41%), small for gestational age (17%), or with associated abnormalities (55%) were at higher risk of undernutrition and stunting at age 1 year (P < 0.05). Neither EA type nor surgical treatment was associated with growth failure.ConclusionUndernutrition and stunting are common during the first year after birth in patients born with EA. These outcomes are significantly influenced by early factors, regardless of EA type or surgical management. Identifying high-risk patient groups with EA (i.e., those born preterm, small for gestational age, and/or with associated abnormalities) may guide early nutritional support strategies.

This study aimed to analyze clinical practices concerning cystic fibrosis-related diabetes (CFRD) screening in France. A web-based questionnaire was distributed between December 1, 2020 and January 31, 2021 among 47 cystic fibrosis centers including pediatric, adult, and mixed units. In accordance with guidelines, 92.8% of CF centers performed annual oral glucose tolerance tests (OGTT). Overall, 86.3% of CF centers performed 1- and 2-hour blood glucose determinations following OGTT. The OGTT was conducted before 10 years of age in 73% of pediatric centers. Continuous glucose monitoring (CGM) and laboratory glycated hemoglobin were employed for CFRD screening in 86.5% and 50% of centers, respectively. CGM was carried out in 69% of centers after glucose tolerance abnormalities had been detected in OGTT. Most CF centers used OGTT and CGM for CFRD screening. Studies are required to assess CGM usefulness as a validated tool in CFRD screening.

Lung damage in cystic fibrosis (CF) is strongly associated with lower airway infections. Early treatment of Pseudomonas aeruginosa is recommended. Pathogen detection requires sampling of lower airway secretions, which remains a challenge in nonexpectorating patients. Our hypothesis was that chest physiotherapy would improve the quality of airway secretion samples and increase the rates of pathogens detected in nonexpectorating patients. This prospective multicentre study compared three successive methods for sampling airway secretions applied through the same session: 1) an oropharyngeal swab (OP), 2) a chest physiotherapy session followed by a provoked cough to obtain sputum (CP-SP) and 3) a second oropharyngeal swab collected after chest physiotherapy (CP-OP). Haemophilus influenzae, Staphylococcus aureus and P. aeruginosa growth cultures were assessed. Accuracy tests and an equivalence test were performed to compare the three successive methods of collection. 300 nonexpectorating children with CF were included. P. aeruginosa was detected cumulatively in 56 (18.9%) children, and according to the different collection methods in 28 (9.8%), 37 (12.4%) and 44 (14.7%) children by using OP, CP-OP and CP-SP, respectively. Compared with OP, the increased detection rate was +22% for CP-OP (p=0.029) and +57% for CP-SP (p=0.003). CP-SP had the best positive predictive value (86.3%) and negative predictive value (96.0%) for P. aeruginosa compared with the overall detection. The results of this adequately powered study show differences in the rates of pathogens detected according to the sampling method used. Chest physiotherapy enhanced detection of P. aeruginosa in nonexpectorating children with CF.

A severely impaired capacity for social interaction is one of the characteristics of individuals with autism spectrum disorder (ASD). Deficits in facial emotional recognition processing may be associated with this limitation. The Build-a-Face (BAF) art therapy intervention was developed to assist with emotional recognition through the viewing and manipulating of three-dimensional facial features on a mannequin-like bust. This pilot study tested the abilities of 19 children with ASD to identify emotions depicted in facial photographs before and after a single BAF intervention session. The results indicated no statistically significant difference between the treatment and control groups; however, the treatment group had greater improvement than the control. Future research involving multiple BAF sessions is needed to test the effectiveness of BAF for promoting emotion recognition.

Durante el transcurso de una «presentación de enfermos» realizada en la Sociedad Médico-psicológica, en julio de 1927, señalamos la existencia de un curioso síntoma que se encuentra con gran frecuencia en el periodo premonitorio de la demencia precoz, hasta el punto de constituir una verdadera señal de alarma en la a menudo tórpida eclosión de esta psicosis. Le dimos el nombre de «signo del espejo» y nos propusimos estudiarlo más extensamente, con más detalle y precisión, en un próximo artículo. Nos pareció efectivamente interesante describir por primera vez ese pequeño signo clínico del cual no habíamos encontrado mención en literatura psiquiátrica alguna.

The increase in life expectancy of patients with cystic fibrosis has come with new comorbidities, particularly diabetes. The gradual development of glucose tolerance abnormalities means that 30 to 40% of adults will be diabetic. Cystic fibrosis–related diabetes is a major challenge in the care of these patients because it is a morbidity and mortality factor at all stages of the disease. Early glucose tolerance abnormalities observed from childhood, before the stage of diabetes, are also associated with a poor pulmonary and nutritional outcome. The long asymptomatic period justifies systematic screening with an annual oral glucose tolerance test from the age of 10 years. However, this strategy does not take into account the new clinical profiles of patients with cystic fibrosis, recent pathophysiological knowledge of glucose tolerance abnormalities, and the emergence of new diagnostic tools in diabetology. In this paper, we summarise the challenges of screening in the current context of new patient profiles – patients who are pregnant, have transplants, or are being treated with fibrosis conductance transmembrane regulator modulators – and put forward an inventory of the various screening methods for cystic fibrosis–related diabetes, including their applications, limitations and practical implications. [ABSTRACT FROM AUTHOR]

Summary: Objective: To assess the etiological role and the clinical characteristics of HRV and HEV infections in pediatric patients hospitalized for acute respiratory tract infections (ARTIs). Methods: RT-qPCR assays and molecular sequencing methods were used to identify HRV and HEV strains in nasopharyngeal aspirates of 309 hospitalized pediatric patients with microbiologically unexplained ARTIs and in 210 hospitalized pediatric patients without respiratory symptoms from September 2009 to June 2010 in France. Results: Among the 309 ARTI cases, 15 HEV and 172 HRV strains were identified whereas only 1 HEV and 37 HRV strains were observed in control patients (187 vs. 38: P < 10−3). HRV strains were identified in 150 of the 164 lower ARTIs whereas HEV strains were identified in only 14 of these cases. Among bronchiolitis and asthma exacerbation cases (n = 133), HEV infected cases were older (Median age (months) 36 vs. 11, P = 0.003) and were more frequently associated with a respiratory distress (P = 0.01) and a need for oxygen supply at the time of admission (P = 0.01) than cases infected by HRV strains. Conclusion: HRV and HEV strains were identified as potential etiological causes of 60.5% of microbiologically unexplained ARTIs diagnosed in hospitalized pediatric cases. A higher clinical severity was observed in HEV infected bronchiolitis or asthma exacerbation cases in comparison to HRV infected cases. [Copyright &y& Elsevier]

Objective: To assess long-term metabolic outcomes in children with diabetes mellitus that was diagnosed when they were <6 years old. Study design: A cohort of 66 children with diabetes mellitus that had a duration of at least 5 years and was diagnosed before they were 6 years old. Thirty-four children were treated at diagnosis with multiple daily subcutaneous insulin injections (MDI), and all these children, except 3, were switched to continuous subcutaneous insulin infusion (CSII; group A). Thirty-two children received CSII as initial treatment (group B). Results: Hemoglobin A1c values were significantly lower in patients receiving CSII than MDI during all the 8 years of follow-up except one (year 1: 6.9% ± 0.9% versus 7.6% ± 1%, P = .011 ; year 4: 7.4% ± 0.8% versus 8.1% ± 0.9%, P = .006; year 7: 7.6% ± 0.5% versus 8.3% ± 0.8%, P = .001). The incidence of severe hypoglycemia was greatly decreased for the CSII group (9.8 versus 22.3 episodes/100 patient-years, P = .016). In group A, hemoglobin A1c values increased during the study period, and in group B, they increased only during the first 2 years and remained constant thereafter. Only 9.1% of patients did not use or abandoned CSII. Conclusion: CSII in children <6 years of age enables better long-term metabolic control and lowers the risk of severe hypoglycemia better than MDI, especially when initiated at diagnosis. [Copyright &y& Elsevier]

Objectif: Constituer une cohorte régionale des patients diabétiques de type 1 à début pédiatrique pour étudier la prévalence des complications aiguës et chroniques et leurs facteurs prédictifs. Patients et méthodes: Utilisation du dossier informatisé CARéDIAB (Champagne-Ardenne Réseau Diabète) créé en 2003. Résultats: A partir des 738 patients diabétiques de type 1 inclus, sélection d’une cohorte de 301 patients pédiatriques devenus adultes en 2010 ; au diagnostic âge 10,1±4,1 ans (0,3–17), sexe ratio 1,02, âge actuel 27,6±10,4 ans (18–65), évolution 17,5±10,5 ans. L’HbA1c est 11,9±2,6 % à la découverte puis 7,4±1,3 % la 1re année avec une dégradation progressive jusqu’à la 8e année d’évolution (HbA1c moyenne globale 8,9±1,5 % à partir de 6464 valeurs). 1/3 des patients ont une HbA1C<8 % tout au long du suivi. L’IMC est normal pour 2/3 des patients à l’âge de 20 ans corrélé avec celui à 28–39 ans (r=0,68). Les événements aigus: [–] hypoglycémies sévères : 7,8 épisodes /100 patients années, aucun pour 63 %, corrélation avec l’HbA1c moyenne (r=0,37). [–] acido cétoses : 5,8 épisodes/100 patients années, aucun pour 67 %, corrélation avec l’HbA1c moyenne (r=0,75). La rétinopathie diabétique survient chez 42 patients (14 %), début 31,4±11,4 ans après une évolution de 21,4±10,8 ans. 19 patients ont une rétinopathie avant 20 ans d’évolution corrélée avec l’HbA1c moyenne (r=0,55). Pan-photocoagulation pour 12 femmes, 4 hommes (p=0,039). En analyse multivariée, seule l’HbA1c moyenne est un facteur prédictif indépendant de rétinopathie diabétique parmi ceux testés (durée évolution, âge au diagnostic, IMC, sexe). Conclusion: Dans cette cohorte, l’HbA1C moyenne augmente progressivement dès les premières années d’évolution, 1/3 des patients ont un résultat satisfaisant. Il existe une corrélation entre l’HbA1c moyenne et les acido-cétoses, les hypoglycémies sévères, la rétinopathie avant 20 ans d’évolution. Le dossier informatisé du réseau CARéDIAB offre un support pour l’évaluation du suivi de ces patients. [Copyright &y& Elsevier]