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Understandings heat transfer across a solid/liquid interface is crucial for establishing novel thermal control pathways in a range of energy applications.

International audience; Objective: this paper presents an innovative graphical user interface to visualize the attitude of a sensing device in a three-dimensional space, serving a wide-range of medical applications. Material and methods: based on inertial measurement units (IMU) or on magnetic, angular rate and gravity (MARG) sensors, a processing unit provides Euler angles using a sensor fusion technique to display the orientation of the device relative to the Earth frame in real-time. The device is schematized by linking six polygonal regions, and is subject to sequential rotations by updating the graph each 350 ms. We conduct comparative studies between the two sensing devices, i.e. IMUs and MARGs, as well as two orientation filters, namely Madgwick's algorithm and Mahony's algorithm. Results: the accuracy of the system is reported as a function of (i) the sampling frequency, (ii) the sensing unit, and (iii) the orientation filter, following two elderly care applications, namely fall risk assessment and body posture monitoring. The experiments are conducted using public datasets. The corresponding results show that Madgwick's algorithm is best suited for low sampling rates, whereas MARG sensors are best suited for the detection of postural transitions. Conclusion: this paper addresses the different aspects and discusses the limitations of attitude estimation systems, which are important tools to help clinicians in their diagnosis.

The characteristics of thin liquid films flowing down a uniformly heated and inclined plane are investigated, with heat transfer across the wavy films quantified using up-to-date optical measurement techniques based on laser-induced fluorescence (LIF). A planar two-colour LIF technique provides the temperature distribution inside the films, but requires a high degree of wave regularity for the spatial reconstruction. A pointwise adaptation of the aforementioned technique, with much finer temporal sampling, provides simultaneous measurements of the average temperature over the film height and of the film thickness. Despite the loss of spatial resolution, the latter technique can be applied to diverse situations, especially when the waves lose their regularity and have large amplitudes. With these two approaches, the enhancement of heat transfer due to surface waves is traced along the film flow. A growing thermal boundary layer is found close to the inlet of the flow (i.e., first few cm), but its thickness remains small relative to the film thickness. Therefore, the heat transfer coefficient (HTC) is observed to be insensitive to the shape and amplitude of the waves at the free surface. A critical distance is necessary for the thermal boundary layer to be thick enough to interact with the flow structures associated with the waves, and the critical length scales with the Peclet number of the flow based on the specific flow rate. Several experiments are conducted to quantify the influence of the main flow parameters that control the HTC, such as the Reynolds number, the inclination angle and the wave frequency. For moderate wave amplitudes, the internal structure of the film is insensitive to the wave dynamics, and the temperature distribution is essentially dominated by thermal diffusion in the direction normal to the heated wall. Classical Nusselt theory is found to be applicable to the unperturbed (flat) film flows with some limited adjustments to predict the heat transfer rate. However, for the waves that have a larger amplitude, the classical Nusselt theory diverges from the experimental results. A sharp increase of the HTC by several tens of percent is observed over just a few cm, compared to an equivalent undisturbed liquid film with the same Reynolds number. Refined images of the temperature field are then used to better understand the mechanisms by which heat transfer is enhanced. Mixing appears in regions close to the wave front, then progressively extends to other film regions, tending to make the temperature more homogeneous. This has a strong effect on the local HTC in the troughs of the waves, with deviations of up to 40% relative to the flat film theory. Finally, a loss of wave regularity, observed after a few tens of cm from the inlet, accelerates the mixing by further altering the distribution of the temperature field over the entire liquid domain.

Background Plasmodium blood-stage infections can be identified by assaying for protein products expressed by the parasites. While the binary result of an antigen test is sufficient for a clinical result, greater nuance can be gathered for malaria infection status based on quantitative and sensitive detection of Plasmodium antigens and machine learning analytical approaches. Methods Three independent malaria studies performed in Angola and Haiti enrolled persons at health facilities and collected a blood sample. Presence and parasite density of P. falciparum infection was determined by microscopy for a study in Angola in 2015 (n = 193), by qRT-PCR for a 2016 study in Angola (n = 208), and by qPCR for a 2012–2013 Haiti study (n = 425). All samples also had bead-based detection and quantification of three Plasmodium antigens: pAldolase, pLDH, and HRP2. Decision trees and principal component analysis (PCA) were conducted in attempt to categorize P. falciparum parasitemia density status based on continuous antigen concentrations. Results Conditional inference trees were trained using the known P. falciparum infection status and corresponding antigen concentrations, and PCR infection status was predicted with accuracies ranging from 73–96%, while level of parasite density was predicted with accuracies ranging from 59–72%. Multiple decision nodes were created for both pAldolase and HRP2 antigens. For all datasets, dichotomous infectious status was more accurately predicted when compared to categorization of different levels of parasite densities. PCA was able to account for a high level of variance (>80%), and distinct clustering was found in both dichotomous and categorical infection status. Conclusions This pilot study offers a proof-of-principle of the utility of machine learning approaches to assess P. falciparum infection status based on continuous concentrations of multiple Plasmodium antigens.

Background: Conflicting data exist regarding the benefit of urgent coronary angiogram and percutaneous coronary intervention (PCI) after sudden cardiac arrest, particularly in the absence of ST-segment elevation. We hypothesized that the type of lesions treated (stable versus unstable) influences the benefit derived from PCI. Methods: Data were taken between May 2011 and 2014 from a prospective registry enrolling all sudden cardiac arrest in Paris and suburbs (6.7 million inhabitants). Patients undergoing emergent coronary angiogram were included. Decision to perform PCI was left to the discretion of local teams. We assessed the impact of emergent PCI on survival at discharge according to whether the treated lesion was angiographically unstable or stable, and we investigated the predictive factors for unstable coronary lesions. Results: Among 9265 sudden cardiac arrests occurring during the study period, 1078 underwent emergent coronary angiogram (median age: 59.6 years, 78.3% males): 463 (42.9%) had an unstable lesion, 253 (23.5%) only stable lesions, and 362 (33.6%) no significant lesions. Emergent PCI was performed in 478 patients (91.4% of unstable and 21.7% of stable lesions). At discharge, PCI of unstable lesions was associated with twice-higher survival rate compared with untreated unstable lesions (47.9% versus 25.6%, P =0.013), while stable lesions PCI did not improve survival (25.5% versus 26.3%, P =1.00). After adjustment, PCI of unstable coronary lesions was independently associated with improved survival (odds ratio, 2.09 [95% CI, 1.42–3.09], P P =0.824). Angina, initial shockable rhythm, ST-segment elevation, and absence of known coronary artery disease were independent predictors of unstable lesions. Conclusions: Emergent PCI of unstable lesions is associated with improved survival after sudden cardiac arrest, contrary to PCI of stable lesions. Accordingly, early PCI should only be performed in patients with unstable lesions. Four factors (chest pain, ST-elevation, absence of coronary artery disease history, and shockable initial rhythm) could help identify patients with unstable lesions who would, therefore, benefit from emergent coronary angiogram.

When misfolded proteins accumulate in the endoplasmic reticulum (ER), the cell is said to experience ER stress. This triggers an unfolded protein response (UPR) to restore the balance between misfolded proteins and ER chaperones such as BiP. UPR signalling is required for the growth of many solid cancers. In chronic ER stress, factors including CHOP have been shown to mediate cell death. Colorectal adenocarcinoma arises due to progressive changes within pre-malignant lesions. Our aim was to test the hypothesis that the expression of BiP and CHOP correlates with the progression of those pre-malignant lesions. Eighty-one patients with colon neoplasms treated at Rouen University Hospital between January 1, 2003 and January 1, 2013 were randomly selected. The expression of BiP and CHOP was estimated by immunohistochemical staining of a tissue microarray generated from colon cores: normal tissue, low-grade and high-grade adenoma, invasive colon adenocarcinoma and lymph node metastasis of colon adenocarcinoma. In parallel, nine cases comprising areas from normal epithelium to dyplasia to invasive carcinoma and included in the TMA were analysed on whole sections. As colon epithelium shows increasing evidence of pre-malignant and then malignant changes, BiP expression significantly increases (p for trend

Neurofibromatosis type 1 (NF1) is a common genetic disorder caused by mutations in the NF1 gene. Recalcitrant bone healing following fracture (i.e. pseudarthrosis) is one of the most problematic skeletal complications associated with NF1. The etiology of this condition is still unclear; thus, pharmacological options for clinical management are limited. Multiple studies have shown the reduced osteogenic potential of Nf1-deficient osteoprogenitors. A recent transcriptome profiling investigation revealed that EREG and EGFR, encoding epiregulin and its receptor Epidermal Growth Factor Receptor 1, respectively, were among the top over-expressed genes in cells of the NF1 pseudarthrosis site. Because EGFR stimulation is known to inhibit osteogenic differentiation, we hypothesized that increased EREG and EGFR expression in NF1-deficient skeletal progenitors may contribute to their reduced osteogenic differentiation potential. In this study, we first confirmed via single-cell mRNA sequencing that EREG over-expression was associated with NF1 second hit somatic mutations in human bone cells, whereas Transforming Growth Factor beta 1 (TGFβ1) expression was unchanged. Second, using ex-vivo recombined Nf1-deficient mouse bone marrow stromal cells (mBMSCs), we show that this molecular signature is conserved between mice and humans, and that epiregulin generated by these cells is overexpressed and active, whereas soluble TGFβ1 expression and activity are not affected. However, blocking either epiregulin function or EGFR signaling by EGFR1 or pan EGFR inhibition (using AG-1478 and Poziotinib respectively) did not correct the differentiation defect of Nf1-deficient mBMSCs, as measured by the expression of Alpl, Ibsp and alkaline phosphatase activity. These results suggest that clinically available pharmacological strategies aimed at inhibiting EGFR signaling are unlikely to have a significant benefit for the management of bone non-union in children with NF1 PA.

Le paludisme est considere comme un probleme de sante publique majeur en Haiti. Cependant l’impact reel de cette endemie sur la sante y est mal connu. L’objectif de cette etude est de verifier l’importance du paludisme comme cause de consultation a l’hopital et le taux de portage de gametocytes dans la population dans une commune du departement de la Grande Anse ou la prevalence du paludisme est consideree la plus forte d’Haiti. L’analyse des statistiques hospitalieres de Corail (Grande Anse) montre que seulement 17,4 % des consultations pour fievre sont dues au paludisme confirme a l’examen microscopique. La fraction de la population la plus touchee est celle des adultes âges de 15 a 39 ans (55 % des cas). Les enfants âges de moins de 5 ans ne representent que 11 % des cas. Une enquete communautaire a montre la rarete du portage de gametocytes dans la population (0,9 %). En Haiti, les caracteristiques epidemiologiques du paludisme doivent etre mieux precisees par des etudes de terrain documentees en vue d’adapter la strategie de lutte pour une plus grande efficacite.

The Field of Competence (FOC) of specialists in Physical and Rehabilitation Medicine (PRM) in Europe follows uniform basic principles described in the White Book of PRM in Europe. An agreed basis of the field of competence is the European Board curriculum for the PRM-specialist certification. However, due to national traditions, different health systems and other factors, PRM practice varies between regions and countries in Europe. Even within a country the professional practice of the individual doctor may vary because of the specific setting he or she is working in. For that reason this paper aims at a comprehensive description of the FOC in PRM. PRM specialists deal with/intervene in a wide range of diseases and functional deficits. Their interventions include, prevention of diseases and their complications, diagnosis of diseases, functional assessment, information and education of patients, families and professionals, treatments (physical modalities, drugs and other interventions). PRM interventions are often organized within PRM programmes of care. PRM interventions benefit from the involvement of PRM specialists in research. PRM specialists have knowledge of the rehabilitation process, team working, medical and physical treatments, rehabilitation technology, prevention and management of complications and methodology of research in the field. PRM specialists are involved in reducing functional consequences of many health conditions and manage functioning and disability in the respective patients. Diagnostic skills include all dimensions of body functions and structures, activities and participation issues relevant for the rehabilitation process. Additionally relevant contextual factors are assessed. PRM interventions range from medication, physical treatments, psychosocial interventions and rehabilitation technology. As PRM is based on the principles of evidence-based medicine PRM specialist are involved in research too. Quality management programs for PRM interventions are established at national and European levels. PRM specialists are practising in various settings along a continuum of care, including acute settings, post acute and long term rehabilitation programs. The latter include community based activities and intermittent in- or out-patient programs. Within all PRM practice, Continuous Medical Education (CME) and Continuous Professional Development (CPD) are part of the comprehensive educational system.

To date, Lugol chromo-endoscopy is the reference technique to detect an esophageal neoplasia in patients with prior esophageal squamous-cell carcinoma (ESCC), but is not easy to perform without general anesthesia, which can limit its use in routine practice. The objective of this study were to compare the accuracy of white light, narrow band imaging (NBI), and Lugol to detect esophageal neoplasia in patients with a history of cured ESCC, in a prospective study. Thirty patients were prospectively included between June 2006 and June 2009. They all had a history of cured ESCC. Esophageal mucosa was examined first using white light, second NBI, and third after Lugol staining. Histology was obtained in all abnormalities detected by white light, NBI, and/or Lugol. Five neoplastic lesions in five different patients were identified at histology, four cancers, and one high-grade dysplasia. NBI and Lugol both detected all esophageal neoplastic lesions, whereas white light detected the four cancers but missed the high-grade dysplasia. In this feasibility study, NBI and Lugol both detected all identified esophageal neoplasia in very high-risk patients of ESCC. This result suggests that NBI could be used instead of Lugol to detect an esophageal neoplasia in patients with high risk of ESCC, but needs to be confirmed in a larger study.

Infantile fibrosarcoma is a rare malignant tumor that usually occurs during the 1st year of life. It accounts for approximately 5-10% of all sarcomas in infants younger than 1 year of age. It usually has indolent progression and metastatic spread is rare. We report the case of a patient who had infantile fibrosarcoma of the trunk. At birth, the baby presented a soft tissue mass of the scapulothoracic region. Histopathological examination after complete surgical resection at first suggested an angioma. Reanalysis of the histology after a metastatic relapse resulted in the diagnosis of infantile fibrosarcoma, which was confirmed by the presence of the specific translocation seen in infantile fibrosarcoma (ETV6/NTRK3). This patient's progression was uncommon because he developed 3 metastatic relapses. The treatment consisted of surgery, chemotherapy, and radiation therapy. The patient is alive with persistent complete remission. We discuss the diagnostic and therapeutic issues of infantile fibrosarcoma. There is a risk of erroneous diagnosis in newborn infants between benign angiomatous tumor and infantile fibrosarcoma. The fusion transcript ETV6-NTRK3 resulting from the specific chromosomal translocation t(12;15)(p13;q25) is now a useful diagnostic tool for infantile fibrosarcoma. Surgery with wide resection is the mainstay of treatment. However, infantile fibrosarcoma is a chemosensitive tumor. If initial surgery cannot be done without mutilation or is impossible, preoperative chemotherapy should be given. The role of radiation therapy is still debated.

A survey conducted from May 2010 to October 2013 in five from ten departments of Haiti among 5,342 persons aged from 1 to 107 years showed a gametocytic rate = 3.2%. However, it varies greatly from one Department to another, ranging from 0.5% in Grande Anse Department to 5.9% in Southeast Department. Malaria is present in Haiti in heterogeneous coastal foci. Gametocytes occur at all ages, but two times most often in male under 20 years. Entomological studies in Haiti are needed to better characterize the relationships between man and the vector Anopheles albimanus, adapting the fight more effectively.

We report five cases of abdomino-pelvic PEComas diagnosed in the last 10 years in the Rouen University Hospital. Four are hepatic and one is in a pelvic location which is unusual due to its strongly pigmented aspect. The tumors derived from "perivascular epithelioid cells" are rare. They are characterized by spindle or epithelioid cells in an immediate perivascular location. The immunochemistry is positive for HMB45, MelanA and smooth muscle Actin. The criteria for malignancy are infiltrative growth pattern, necrosis, high cellularity, high nuclear grade and mitotic activity. There are 8% of recurrence and 20% of metastasis (lung, bones, liver). This study presents the clinical, pathologic, immunohistochemical and molecular aspects of these PEComas and discusses the main differential diagnosis of the pigmented one.

a lymphogranulomatose venerienne (LGV) est une maladie sexuellement transmissible due a la bacterie Chlamydia trachomatis. Elle est rare dans les pays industrialises ou elle touche principalement la population homosexuelle masculine. La manifestation clinique la plus commune au niveau du rectum est la rectite ulcerante. Nous rapportons un cas de LGV rectale de presentation atypique sous une forme pseudo-tumorale.

Phlegmonous gastritis is an extremely rare and life-threatening condition. We report the case of a 32-week pregnant women presenting a peritonitis owing to phlegmonous gastritis caused by a group A streptococcus and successfully managed by conservative surgical treatment and antibiotics. Multiple endoscopies with biopsies illustrate progressive and complete gastric recovery.

Background and study aims Celiac disease can manifest with nonspecific symptoms, including functional gastrointestinal disorders such as dyspepsia. The aim of our study was to assess the usefulness of duodenal endoscopic markers of villous atrophy for the selection of dyspeptic patients for histological assessment. Patients and methods Esophagogastroduodenoscopy was performed in dyspeptic patients, in patients considered to be at risk of having celiac disease, and in healthy controls. At least three duodenal biopsies were performed for histological assessment of villous atrophy in all patients and controls. We looked for the following four duodenal endoscopic markers of celiac disease: reduction in the number of folds, scalloping of folds, mosaic-pattern mucosa, and nodular mucosa. Results A total of 175 people were enrolled (75 patients with dyspepsia; 75 patients who were "at risk" of having celiac disease; and 25 healthy volunteers, or "controls"). Of the dyspeptic patients, four had endoscopic markers of celiac disease with no histologically confirmed villous atrophy, while one patient without endoscopic markers was found to have Marsh type I villous atrophy. Of the patients at risk of having celiac disease, 16 had at least one endoscopic marker and 10/16 were found to have histological villous atrophy. In this group, the sensitivity and specificity of the endoscopic markers were 100 % and 90.8 % respectively. "At-risk" patients with two or more endoscopic markers all had histologically confirmed villous atrophy. Neither endoscopic markers nor villous atrophy were found in any of the control patients. Conclusions Additional endoscopic markers are valuable for diagnosis in patients with clinical symptoms suggestive of celiac disease. In contrast, endoscopic markers of villous atrophy are not useful for selecting a subgroup of dyspeptic patients for screening for celiac disease by duodenal histological assessment. These patients should be screened using other protocols.

Resume Les adenocarcinomes ampullaires (ADKA) representent 1/3 des tumeurs duodeno-pancreatiques resecables. Leur taux de survie a 5 ans est de 50 % et le principal facteur pronostique est le stade tumoral. Cependant, parmi les 3 sous-types histologiques d’ADKA (intestinal, bilio-pancreatique et mixte), un pronostic favorable a ete rapporte pour le sous-type intestinal. Objectifs Ce travail a eu pour but d’evaluer l’impact pronostique du sous-type histologique et du profil immunohistochimique des cytokeratines (CK) 7 et 20 des ADKA. Patients et methodes Les donnees cliniques de 54 cas d’ADKA etaient colligees de facon retrospective. Les documents macroscopiques et histologiques correspondants etaient revus et des immunomarquages anti-CK7 et anti-CK20 etaient effectues. Resultats Les trois sous-types histologiques etaient representes dans les proportions suivantes : intestinal 26 %, bilio-pancreatique 65 % et mixte 9 %. Aucune correlation entre le sous-type histologique et le stade tumoral n’etait trouvee. Le taux de survie a 5 ans variait de 100 % pour le sous-type intestinal a 35 % pour le sous-type bilio-pancreatique. Une forte correlation (p Conclusions Une valeur pronostique favorable du sous-type histologique intestinal est retrouvee dans notre etude. L’IH CK7/CK20 represente une aide diagnostique dans la determination de ce sous-type histologique et semble avoir egalement un impact pronostique dans les ADKA.

Malaria is considered to be a major problem of public health in Haiti. However the impact of Plasmodium falciparum on health is poorly known in this country. The objective of this study is to verify the incidence of malaria as the cause of hospital consultation and to evaluate the rate of P. falciparum gametocytes carriage among the population living in a municipality within the Department of Grand'Anse where the prevalence of malaria is considered one of the strongest in Haiti. Analysis of hospital statistics of Corail (Grand'Anse) showed that only 17.4% of consultations of patients presenting with fever are due to microscopically confirmed malaria. The fraction of the population most affected is that of adults aged 15-39 years (55% of cases). Children under five represent only 11% of the cases. A community survey showed the rarity of the carriage of gametocytes in asymptomatic persons (0.9%). In Haiti, the epidemiological characteristics of malaria must have specified and documented field studies in order to adapt a strategy for fighting against this parasitic disease with greater efficiency.

Resume OBJECTIF : Notre travail consiste a verifier l’influence de l’âge et du sport pratique sur le profil musculaire isocinetique du genou d’adolescents. POPULATION ET METHODE : Les sportifs realisent une evaluation bilaterale de flexion et d’extension du genou sur machine isocinetique aux deux vitesses 60 et 180°.s–1 en mode concentrique. Le pic de couple, la puissance moyenne et le ratio ischio-jambiers/quadriceps sont les parametres isocinetiques retenus. Les tests sont effectues sur 38 footballeurs âges de16,6 ans (± 1,4) et 22 gymnastes âges de 18 ans (± 2,8). Ces sportifs sont divises en trois groupes :15 ans, 17 ans et 20 ans. RESULTATS : Les footballeurs presentent des valeurs isocinetiques significativement superieures (p CONCLUSION : Pour notre population, la maturation musculaire ameliore les valeurs de force absolu des sportifs les plus âges comparativement aux plus jeunes. La pratique du football favorise davantage la force absolue des membres inferieurs comparativement a la gymnastique.

Un homme de 45 ans est hospitalise aux urgences chirurgicales pour douleurs abdominales evoluant depuis 72 heures. Il a comme antecedent une appendicectomie, il y a 16 ans. Initialement diffuses, les douleurs siegent de maniere elective en fosse iliaque droite. La palpation abdominale trouve une defense sans contracture. Le patient est apyretique et ne presente pas d’autre signe fonctionnel. Biologiquement, il existe un syndrome inflammatoire avec une CRP (C Reactive Proteine) a 300 et une polynucleose neutrophile a 12 000 elements/ml. Un examen tomodensitometrique abdomino pelvien (General Electric Lightspeed 16) sans et avec injection de produit de contraste avec etude au temps portal est realise (fig. 1a, 1b et 1c) . Il met en evidence une volumineuse masse du bas-fond caecal. Celle-ci est heterogene, associant une partie tissulaire a centre necrotique et une partie plus homogene hypodense, bien limitee de type kystique dont la paroi se rehausse apres injection. Il n’y a pas de calcification intratumorale ou capsulaire. Il existe une discrete infiltration de la graisse mesenterique peri lesionnelle sans epanchement intraperitoneal. Devant ces anomalies, une exploration chirurgicale est decidee. Elle met en evidence une masse suspecte du caecum a laquelle est accolee une collection d’aspect colloide. Le peritoine parietal est infiltre dans toute la gouttiere parieto-colique droite. L’examen anatomopathologique confirme le diagnostic de mucocele et retrouve une lesion maligne de type adenocarcinome mucineux du grele distal au contact de la valvule de Bauhin (fig. 2) . Cette mucocele serait secondaire a l’envahissement tumoral du moignon appendiculaire restant apres l’appendicectomie (fig. 3 et 4) . Il n’a pas ete visualise de cellule epitheliale suspecte au sein de la mucocele.

A consensus exists about the need of assessing effects of unprogressive acquired brain injury (stroke, traumatic brain injury, brain anoxia and encephalitis) on recovery of driving. It is a dynamic process in which the assessment is only one step. It should be completed in terms of conclusion by an individual support focused on the person. Identifying the place of rehabilitation, the accompanying terms, and the place of the person were concerns in context of the guidelines developed on behalf of the French Rehabilitation Medicine Society SOFMER, the French Higher Health Authority (HHA) and other groups of interest. Aim With the aim of maintaining an optimal independence, to determine practical modalities of supporting people, whatever conclusions of the assessment (pass or fail). Method Seventy-seven studies from literature analyzed among 326 references allow the development of a preliminary draft by a multidisciplinary work group. A formal notice was based on a reading group's recommendations then submitted to HHA. Result In case of successful assessment: information on the administrative and financial procedures for the regularization of driving license. If technical aids are needed, it is necessary to learn these control facilities, and useful information for their implementation (choice, cost, financing…) are made. In case of failed assessment: the person must be informed of his clinical case and his possible evolution, especially further improvement of driving abilities, and possibilities of cognitive rehabilitation would be considered. Without anosognosia, an on-road retraining of driving may be proposed, but the efficacy cannot be guaranteed. It should not exceed 10 hours, and should be stopped, after few sessions without progress. In case of permanent inability of driving recovery, the person, still supported by a trusted person if possible, should be informed of available driving alternatives, also of financial help mobilized in order to maintain the mobility and the social involvement. Discussion/conclusion The person's place is central. The role of the information is essential with oral and writing modalities of transmission, with criteria of progressivity, considering experiences and feelings.

Introduction La maladie d’Erdheim-Chester (MEC) est une histiocytose non langerhansienne caracterisee par une infiltration tissulaire par des histiocytes spumeux CD68+ CD1a−. La mise en evidence d’une mutation somatique BRAF V600E dans ces histiocytes ainsi que l’association frequente de la MEC a une histiocytose langerhansienne (forme mixte) est a l’origine de l’elaboration d’une nouvelle classification des histiocytoses integrant les mutations de la voie des MAP kinases [1] . Il en resulte l’hypothese que la MEC pourrait etre, comme l’histiocytose langerhansienne, une maladie du ou des progeniteurs medullaires. Nous avons cherche a etudier si la MEC s’associait a d’autres maladies hematologiques. Patients et methodes Parmi les 133 patients ayant une MEC et ayant ete vus a au moins une reprise entre 1992 et janvier 2015, la presence d’une pathologie myeloide etait systematiquement recherchee. Le diagnostic de MEC reposait sur des criteres precedemment decrits [2] . Etait consideree comme pathologie myeloide tout syndrome myeloproliferatif ou myelodyplasique repondant aux criteres diagnostiques internationaux [3] . La presence d’une gammapathie monoclonale etait egalement notee, de meme que la presence d’un diagnostic de myelome sur l’etude du myelogramme ou d’une autre pathologie hematologique (LLC, LNH ou maladie de Hodgkin). Les groupes avec et sans pathologie myeloide etaient compares par Fisher exact test et Mann-Whitney test, la survie entre les 2 groupes etait comparee par log-rank test. Resultats Neuf patients (6,7 %) presentaient une pathologie myeloide : myelodysplasie (n = 2), myelofibrose primitive (n = 2), thrombocytemie essentielle (n = 2), leucemie myelomonocytaire chronique (n = 2), polyglobulie de Vaquez (n = 1). Les 9 patients (100 %) etaient de sexe masculin d’âge median au diagnostic de 64 ans. Trois patients (33 %) presentaient une histiocytose mixte. Neuf patients presentaient une infiltration peri-renale (100 %), 6 une infiltration peri-aortique (66 %), 2 une exophtalmie (20 %), 2 une atteinte du systeme nerveux central (20 %) et 1 un xanthelasma peri-orbitaire (11 %). Chez 4 patients (44 %) la mutation JAK2 V617F etait retrouvee, et chez 5 (55 %) la mutation BRAF V600E. Deux patients presentaient les deux mutations associees. Le sexe masculin (100 % vs 72 %, p = 0,11), l’âge au diagnostic (64 vs 57 ans, p = 0,13) et l’association a une forme mixte (33 % vs 10 %, p = 0,06) n’etaient pas significativement differents dans les groupes avec et sans pathologie myeloide. De meme, la survie n’etait pas modifiee par la presence d’une pathologie myeloide (p = 0,71). Par ailleurs, 15 patients parmi les 133 (12 %) presentaient un pic monoclonal au diagnostic, et parmi eux 2 patients (13 %) avaient un syndrome myeloproliferatif. Une patiente presentait un myelome stade 1. Une patiente avait un diagnostic ancien de LNH en remission. Conclusion La MEC est associee a une prevalence elevee de pathologies hematologiques essentiellement myeloides, notamment de syndromes myeloproliferatifs renforcant l’hypothese que la MEC pourrait etre une maladie du ou des progeniteurs medullaires. Des etudes en cours sur les cultures de progeniteurs medullaires tenteront de repondre a ces questions. Les pathologies myeloides doivent etre recherchees lors du diagnostic et du suivi de la MEC et des formes mixtes.

Ce travail fait suite a celui de F. Lemoine [1]. Il concerne la modelisation des depots realises par projection d'une poudre metallique dans un faisceau laser Nd:YAG. Son originalite concerne notamment l'utilisation de faibles puissances laser (P < 800 W). Dans ce domaine, nous avons montre l'existence, en fonction de la puissance laser, de deux seuils associes a la masse des revetements realises. L'etude theorique est fondee sur le calcul de la fluence (J/cm- 2 ) fournie au substrat et l'utilisation d'un modele de transfert de chaleur a l'interieur de celui-ci. Les hypotheses emises et verifiees sont que: i) le premier seuil correspond a la puissance laser minimale a mettre en oeuvre afin de porter a fusion la surface du substrat, ii) le second seuil correspond quant a lui a la puissance requise pour porter la poudre a sa temperature de fusion lors de sa chute.

Specific aspects of irradiated fuel result from the increasing retention of gaseous and volatile fission products with burnup, which, under overpower conditions, can lead to solid fuel pressurization and swelling causing severe PCMI (pellet clad mechanical interaction). In order to assess the reliability of high burnup fuel under RIAs, experimental programs have been initiated which have provided important data concerning the transient fission gas behavior and the clad loading mechanisms. The importance of the rim zone is demonstrated based on three experiments resulting in clad failure at low enthalpy, which are explained by energetic considerations. High gas release in non-failure tests with low energy deposition underlines the importance of grain boundary and porosity gas. Measured final releases are strongly correlated to the microstructure evolution, depending on energy deposition, pulse width, initial and refabricated fuel rod design. Observed helium release can also increase internal pressure and gives hints to the gas behavior understanding.

This paper concerns the modeling of cladding using an Nd:YAG laser operating at low powers typically less than 800 W. Experimental observation of the evolution of the mass of the clads shows two power thresholds. The theoretical study relies on a calculation of the fluence provided to the substrate and on a model of heat transfer into the substrate. We suggest that the first threshold is the power required for substrate melting. The second power is the threshold when the powder is directly melted by the beam and is therefore a liquid when contacting the substrate.

A survey conducted from May 2010 to October 2013 in five from ten departments of Haiti among 5,342 persons aged from 1 to 107 years showed a gametocytic rate = 3.2%. However, it varies greatly from one Department to another, ranging from 0.5% in Grande Anse Department to 5.9% in Southeast Department. Malaria is present in Haiti in heterogeneous coastal foci. Gametocytes occur at all ages, but two times most often in male under 20 years. Entomological studies in Haiti are needed to better characterize the relationships between man and the vector Anopheles albimanus, adapting the fight more effectively.

International audience; An alternative fuel production was investigated through catalytic hydroliquefaction of three different carbonaceous sources: solid municipal wastes (MW), primary sludges (PS), and microalgae (MA). The reaction was carried out under hydrogen pressure, at different temperatures (330, 380 and 450 C), with a Raney nickel catalyst and two different hydrogen donor solvents: a ''fossil solvent'' (tetralin) and a ''green solvent'' (2-methyl-hydro-furan). The feeds analyses (TDA-TGA, ICP-AES, lipids quantification) showed thatMWand PS had similar characteristics and physico-chemical properties, but different from those of MA. The hydroliquefaction of these feeds allowed to obtain high oil yields, with a significant energetic value, similar to that of a biopetroleum. 2-methyl-hydro-furan was more efficient than tetralin for the treatment of the strongly bio-degraded biomasses MW and PS, while better results were obtained with tetralin in the case of MA.

Of great interest in the use of Nd:YAG lasers is the possibility of transporting the beam inside an optical fiber. Pointed out in this work is the lower degradation of the beam quality using an optical fiber rather than using mirrors. The influence of the nature of the fiber (graded- and step-index fiber) on the focal point diameter, the position. etc., is compared. From this is demonstrated the interest of a graded-index fiber in materials processing such as cutting or welding and, in the case of laser cladding, the interest of a step-index fiber. It is concluded that materials processing applications can be successful using the two fibers according to the results needed.