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PRSS1 and PRSS2 constitute the only functional copies of a tandemly-arranged five-trypsinogen-gene cluster (i.e., PRSS1, PRSS3P1, PRSS3P2, TRY7 and PRSS2) on chromosome 7q35. Variants in PRSS1 and PRSS2, including missense and copy number variants (CNVs), have been reported to predispose to or protect against chronic pancreatitis (CP). We wondered whether a common trypsinogen pseudogene deletion CNV (that removes two of the three trypsinogen pseudogenes, PRSS3P2 and TRY7) might be associated with CP causation/predisposition.We analyzed the common PRSS3P2 and TRY7 deletion CNV in a total of 1536 CP patients and 3506 controls from France, Germany, India and Japan by means of quantitative fluorescent multiplex polymerase chain reaction.We demonstrated that the deletion CNV variant was associated with a protective effect against CP in the French, German and Japanese cohorts whilst a trend toward the same association was noted in the Indian cohort. Meta-analysis under a dominant model yielded a pooled odds ratio (OR) of 0.68 (95% confidence interval (CI) 0.52-0.89; p = 0.005) whereas an allele-based meta-analysis yielded a pooled OR of 0.84 (95% CI 0.77-0.92; p = 0.0001). This protective effect is explicable by reference to the recent finding that the still functional PRSS3P2/TRY7 pseudogene enhancers upregulate pancreatic PRSS2 expression.The common PRSS3P2 and TRY7 deletion CNV was associated with a reduced risk for CP. This finding provides additional support for the emerging view that dysregulated PRSS2 expression represents a discrete mechanism underlying CP predisposition or protection.

Avoidant Restrictive Food Intake Disorder (ARFID) was recently characterized in the DSM-5 classification. Potential differential diagnoses remain poorly reported in the literature. Our purpose was to present a possible Munchausen syndrome by proxy with undernutrition and scurvy, presenting as ARFID in a child.We describe here a case of an 8-year-old boy who presented with severe undernutrition (BMI = 11.4) and scurvy leading to joint pains. The boy had had a very selective diet since early childhood, and his condition required hospitalization and enteral refeeding. Because of his specific eating behaviour, an ARFID was initially suspected. However, observation of the mother-child relationship, analysis of the child's eating behaviour, and retrospective analysis of his personal history suggested that this was not a true ARFID, and that the selective eating behaviour had probably been induced by the mother over many years, who probably maintained a low variety diet.Munchausen syndrome by proxy is a difficult differential diagnosis, which may also affect patients with ARFID symptoms, which may also present in the affected child as apparent ARFID.Level V, descriptive study.

International audience; Background: Anal ulcerations are frequently observed in Crohn's disease (CD). However, their natural history remains poorly known, especially in pediatric-onset CD.Methods: All patients with a diagnosis of CD before the age of 17 years between 1988 and 2011 within the population-based registry EPIMAD were followed retrospectively until 2013. At diagnosis and during follow-up, the clinical and therapeutic features of perianal disease were recorded. An adjusted time-dependent Cox model was used to evaluate the risk of evolution of anal ulcerations towards suppurative lesions.Results: Among the 1,005 included patients (females, 450 (44.8%); median age at diagnosis 14.4 years (IQR, 12.0-16.1)), 257 (25.6%) had an anal ulceration at diagnosis. Cumulative incidence of anal ulceration at 5 and 10 years from diagnosis was 38.4% (CI95%, 35.2-41.4) and 44.0% (CI95%, 40.5-47.2), respectively. In multivariable analysis, the presence of extra-intestinal manifestations (Hazard Ratio (HR) 1.46, CI95% 1.19-1.80, p=0.0003) and upper digestive location (HR 1.51, CI95% 1.23-1.86, p

International audience; Background: Anti-TNF agents are the first biologic treatment option in inflammatory bowel disease (IBD). The long-term effectiveness of this strategy at the population level is poorly known, particularly in pediatric-onset IBD.Methods: All patients diagnosed with Crohn's disease (CD) or ulcerative colitis (UC) before the age of 17 between 1988 and 2011 in the EPIMAD population-based registry were followed retrospectively until 2013. Among patients treated with anti-TNF, the cumulative probabilities of anti-TNF failure defined by primary failure, loss of response (LOR) or intolerance were evaluated. Factors associated with anti-TNF failure were investigated by a Cox model.Results: Among a total of 1,007 patients with CD and 337 patients with UC, respectively 481 (48%) and 81 (24%) were treated with anti-TNF. Median age at anti-TNF initiation was 17.4 years (IQR, 15.1-20.9). Median duration of anti-TNF therapy was 20.4 months (IQR, 6.0-59.9). In CD, the probability of failure of 1st line anti-TNF at 1, 3 and 5 years was respectively 30.7%, 51.3% and 61.9% for infliximab and 25.9%, 49.3% and 57.7% for adalimumab (p = 0.740). In UC, the probability of failure of 1st line anti-TNF therapy was respectively 38.4%, 52.3% and 72.7% for infliximab and 12.5% for these 3 timepoints for adalimumab (p = 0.091). The risk of failure was maximal in the first year of treatment and LOR was the main reason for discontinuation. Female gender was associated with LOR (HR, 1.48; 95%CI 1.02-2.14) and with anti-TNF withdrawal for intolerance in CD (HR, 2.31; 95%CI 1.30-4.11) and disease duration (≥ 2 y vs. < 2 y) was associated with LOR in UC (HR, 0.37; 95%CI 0.15-0.94) in multivariate analysis. Sixty-three (13.5%) patients observed adverse events leading to termination of treatment (p = 0.57). No death, cancer or tuberculosis was observed while the patients were under anti-TNF treatment.Conclusion: In a population-based study of pediatric-onset IBD, about 60% in CD and 70% in UC experienced anti-TNF failure within 5 years. Loss of response account for around two-thirds of failure, both for CD and UC.

Avoidant restrictive food intake disorder (ARFID) was recently characterized, according to the DSM-5 classification, as a feeding and eating disorder (FED). However, ARFID remains poorly known by most pediatricians, but also by psychiatrists and primary care professionals. Despite the fact that patients with ARFID generally have a higher BMI than patients with anorexia nervosa, our purpose was to highlight the fact that they may present severe nutritional deficiencies and major somatic complications when the diagnosis is delayed. We describe here a case of a 16-year-old boy who presented with severe undernutrition (BMI = 11.5) leading to Ogilvie’s syndrome, which resolved with enteral refeeding. Because of undernutrition, very bad dental condition, and encopresis, some physicians wrongly suspected child neglect, but retrospective analysis of his personal history revealed a long-term FED and sensory specificities that led to the final diagnosis of an ARFID–autism spectrum disorder (ASD) association. A literature review was conducted on the ARFID somatic complications. The training of health professionals in the clinical forms of pediatric FED, including ARFID, is necessary, to promote early diagnosis and prevent poor nutritional outcomes. In this case the association of ARFID–ASD and the delay in access to specialized care favored by the disadvantaged social environment led to severe gastrointestinal complications. V, descriptive study.

Chronic constipation is common in children and often requires prolonged laxative treatment. Preliminary studies suggest that the probioticA prospective double-blind randomized placebo-controlled trial was conducted in 5 pediatric departments in France between June 2017 and June 2021. In all, 49 patients-ages 6 months to 4 years, and suffering from chronic constipation per Rome IV criteria-were randomly allocated to the test and control groups. For 4 weeks, all were orally administered 5 daily drops of the test (The change in SBMs relative to baseline was greater in the control group at week 4 (control: 0.27 ± 0.5; test: 0.23 ± 0.5;This double-blind randomized controlled trial did not confirm the efficacy of

International audience; BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is the most severe clinical entity associated with pediatric SARS-CoV-2 infection with a putative role of the spike protein into the immune system activation. Whether COVID-19 mRNA vaccine can induce this complication in children is unknown. We aimed to assess the risk of hyper-inflammatory syndrome following COVID-19 mRNA vaccine in children. METHODS: We conducted a post-authorization national population-based surveillance using the French enhanced pharmacovigilance surveillance system for COVID-19 vaccines. All cases of suspected hyper-inflammatory syndrome following COVID-19 mRNA vaccine in 12-17-year-old children between June 15(th), 2021 and January 1(st), 2022, were reported. Cases were reviewed according to WHO criteria for MIS-C. The reporting rate of this syndrome was compared to the MIS-C rate per 1,000,000 12-17-year-old children infected by SARS-CoV-2. FINDINGS: Up to January 2022, 8,113,058 COVID-19 mRNA vaccine doses were administered to 4,079,234 12-17-year-old children. Among them, 12 presented a hyper-inflammatory syndrome with multisystemic involvement. Main clinical features included male predominance (10/12, 83%), cardiac involvement (10/12, 83%), digestive symptoms (10/12, 83%), coagulopathy (7/12, 58%), cytolytic hepatitis (6/12, 50%), and shock (5/12, 42%). 4/12 (33%) required intensive care unit transfer, and 3/12 (25%) hemodynamic support. All cases recovered. In eight cases, no evidence of previous SARS-CoV-2 infection was found. The reporting rate was 1.5 (95%CI [0.8; 2.6]) per 1,000,000 doses injected, i.e. 2.9 (95%CI [1.5; 5.1]) per 1,000,000 12-17-year-old vaccinated children. As a comparison, 113 MIS-C (95%CI [95; 135]) occurred per 1,000,000 12-17-year-old children infected by SARS-CoV-2. INTERPRETATION: Very few cases of hyper-inflammatory syndrome with multi-organ involvement occurred following COVID-19 mRNA vaccine in 12-17-year-old children. The low reporting rate of this syndrome, compared to the rate of post-SARS-CoV-2 MIS-C in the same age-group, largely supports the vaccination in a context of an important circulation of SARS-CoV-2. FUNDING: ESPID Fellowship Award; Grandir-Fonds de Solidarité Pour L'enfance.

Appetite traits have multifactorial origins. In association with environmental and genetic factors, they could become problematic and lead to Feeding or Eating Disorders (FED). As the DSM-5 classification is not suitable for pediatric FED, another way to describe eating behavior is to distinguish the clinical profiles of "small eater" and "big eater". The aim of this study was to identify socio-demographic and medical factors associated with these profiles, and to compare problematic and non-problematic profiles. From the Pedianut study, we analyzed socio-demographic, medical and family history data among 401 children according to 4 age groups (1 year n = 101, 1-6 years n = 99, 6-12 years n = 100, 12-18 years n = 101). The information collected on eating behavior made it possible to define small eater profile (SEP) and big eater profile (BEP) using predefined grids. BEP was more frequent in adolescents (35.6%), and SEP was more frequent in children aged 1-6 years (34.3%). BEP was associated with having separated parents, being male and the oldest sibling (p 0.05). Problematic BEP was associated with eating while watching television, being a girl, and having sensory disorders (p 0.05). SEP was associated, whatever age, with non-breastfeeding, chronic illness, psychological history, sensory disorders, language delays (in the 1-6 year age group), and family history of FED (in the adolescent group) (p 0.05). This analysis of factors associated with eater profile opens new perspectives for research on risk factors associated with eating traits, which warrants further study in larger populations to delineate transition from healthy to problematic eating.

Malnutrition remains a public health problem in Europe, not only in adults, but also in paediatrics. The aim of this study was to evaluate general practitioners (GPs) practices in paediatric malnutrition screening. An anonymised questionnaire was sent to GPs in one French area. We analysed GPs’ data: sociodemographic, knowledge of malnutrition screening, practices, tools, and trainings. Overall, 102 of 174 GPs replied to the questionnaire (58.6%). 79.4% of GPs routinely measured weight, but only 33.3% measured both height and BMI, despite having tools (98,6%). 43.6% of GPs systematically reviewed growth charts. 71.3% were familiar with dietary recommendations, 30.7% with blood tests for nutritional status assessment, and 13.7% with dietary supplements. GPs who routinely measured BMI reviewed significantly more growth charts (p = 0.001) and prescribed more dietary supplements (p = 0.001). GPs do not sufficiently measure children’s height and BMI, despite the increasing availability of software. Failure to analyse growth charts can induce delays in malnutrition screening.

Background Episodic angioedema with eosinophilia (EAE, Gleich syndrome) is a rare disease, consisting of recurrent angioedema with hypereosinophilia and frequent increased serum immunoglobulin M levels. Less than 100 patients have been reported, mainly adults, sometimes with underlying lymphocytic variant of hypereosinophilic syndrome (HESL ). The aim of this study was to identify and describe pediatric cases. Methods We performed a retrospective study of all pediatric cases of EAE referred within the French National Referral Center for Hypereosinophilic Syndrome (CEREO). Next, the PRISMA guidelines were applied in order to perform a systematic review (data sources: PubMed, Web of Science). Results Among the two reported and 15 previously published cases of EAE occurring in children, the main clinical findings mimicked those of adults, including recurrent angioedema, hives, and weight gain. The median time between the first angioedema flare and the diagnosis of EAE was 5 years in published cases. Hypereosinophilia was constant, usually worsening with each attack, but seldom disappeared between flares. Total IgM serum levels were elevated in 16 patients. Four children had evidence of abnormal CD3- CD4+ T cells. First-line therapy relied on oral corticosteroids in all patients, and further lines (used in five patients) included interferon-α, methotrexate, and cyclosporin. Two children developed eosinophilic myocarditis during follow-up. Conclusion Pediatricians should be aware that EAE is a diagnosis to consider in children. T-cell immunophenotyping is warranted in this setting. Prognosis seems fair, yet eosinophil-related organ damage may occur in patients with persistent eosinophilia.

International audience; Feeding and Eating Disorders (FED) are mostly described in infants and adolescents but are less well-known in children. Information on the prevalence of FED in the general pediatric population is still limited. The aim of this study was to estimate the prevalence and the care pathway of FED in a population aged 0–18 years old, using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 classification. Two physicians interviewed 401 families using a questionnaire including demographics, BMI, dietary behavior data, and age-appropriate screening tools. Qualitative and quantitative variables were compared using the Chi2 test and Student’s t-test, respectively. After a headcount adjustment based on the French population by age group, the estimated prevalence rate was 3% [95%CI (1.7–5.1)] for Avoidant and Restrictive Food Intake Disorder (ARFID), and 9.7% [95%CI (7.2–13.0)] for Unspecified FED (UFED), which included other restrictive and compulsive FED. The median age for ARFID was 4.8 years (0.8–9 years), and 7.5 years (0.6–17 years) for UFED. The interviews did not identify cases of anorexia, bulimia, binge eating disorder, other specified FED, pica or rumination. Only 15.2% of children with an FED were receiving medical care. The development of validated pediatric screening tools, as well as the training of health professionals in children FED is necessary.

OBJECTIVES Crohn disease (CD) can affect patient's quality of life (QOL) with physical, social, and psychological impacts. This study aimed to investigate the QOL of children with CD and its relationship with patient and disease characteristics. METHODS Children ages from 10 to 17 years with diagnosed CD for more than 6 months were eligible to this cross-sectional study conducted in 35 French pediatric centers. QOL was assessed by the IMPACT-III questionnaire. Patient and disease characteristics were collected. RESULTS A total of 218 children (42% of girls) were included at a median age of 14 years (interquartile range [IQR]: 13--16). Median duration of CD was 3.2 years (IQR: 1.7-5.1) and 63% of children were in clinical remission assessed by wPCDAI. Total IMPACT-III score was 62.8 (±11.0). The lowest score was in "emotional functioning" subdomain (mean: 42.8 ± 11.2). Clinical remission was the main independent factor associated with QOL of children with CD (5.74 points higher compared with those "with active disease", 95% confidence interval [CI] 2.77--8.70, P

Objectives Neurological adverse effects (NAEs) induced by biotherapies have been reported in the literature mainly in adult patients with inflammatory bowel disease (IBD), rheumatic diseases, or psoriasis. There are scant data in children. Aims of this study are to report and describe noninfective NAE associated with anti-TNFα antibodies in pediatric IBD, and to evaluate their incidence. Methods We retrospectively collected all reports of NAE in pediatric IBD treated with anti-TNFα antibodies recorded in the French Pharmacovigilance Database. To estimate the national incidence of NAEs, we extrapolated data from the French regional inception population-based cohort EPIMAD. Results Between 2000 and 2018, 231 adverse events in pediatric IBD exposed to anti-TNFα antibodies were reported to this Database. Seventeen NAEs (7.36%) were collected: 8 severe NAE (1 demyelinating neuropathy, 1 optic neuritis, 1 acute transverse myelitis, 1 polyradiculoneuritis, 1 sensorineural hearing loss, 1 seizure, 1 stroke, and 1 glioma), 7 moderate NAE (headaches), and 2 neuropsychic events. The median delay between anti-TNFα start and NAE occurrence was 6 months (range: 13 days to 26 months). In 10 of 17 patients, anti-TNFα antibodies were stopped. Nine of 17 patients had a complete resolution (including 2 severe NAE) and 8 of 17 a partial resolution (including 6 severe NAE). We estimate the incidence of severe NAE in pediatric IBD treated with anti-TNFα antibodies at 1 case for 10,000 patients-year in France. Conclusions NAE associated with anti-TNFα antibodies in pediatric IBD are rare. In severe NAE, we recommend to discontinue anti-TNFα therapy and to consider alternative treatment.

IntroductionLow bone mineral density (BMD) is a frequent issue in children and adolescents with inflammatory bowel disease (IBD). Several studies in healthy populations have reported a positive impact of physical activity (PA) on bone health. Recently, an observational study in paediatric patients with IBD showed a significant positive relationship between daily PA and BMD. However, intervention studies investigating a causal relationship between PA and BMD are warranted to confirm these results. The aim of this randomised controlled trial will be to investigate the effect of a PA programme on BMD in paediatric patients with IBD.Methods and analysisThis trial is a multicentre (four centres), randomised, controlled, blinded end-point study. Eighty children with IBD will be randomly assigned in a 1:1 ratio to receive a programme with adapted physical exercises (intervention group) or usual PA (control group) during a 9-month period. The primary outcome is the change from baseline at 9 months (the end of the study) in whole-body BMD assessed by dual-energy X-ray absorptiometry. Secondary efficacy outcomes include the changes from baseline at 9 months in: BMD assessed in the lumbar spine and trochanter; daily PA (time spent in moderate-to-vigorous PA); body composition (fat mass and fat-free mass); fatigue resistance; quality of life and activity of IBD.Ethics and disseminationThe study was approved by the Research Ethics Committee in France (Comité de Protection des Personnes, Sud-Ouest and Outre-Mer III, Bordeaux, France, No 2018/27). All procedures will be performed according to the ethical standards of the Helsinki Declaration of 1975, as revised in 2008, and the European Union’s Guidelines for Good Clinical Practice. Written informed consent will be obtained from the parents or legal guardian and from the children. Research findings will be disseminated in peer-reviewed journals and scientific meetings.Trial registration numberNCT03774329.

This study presents a new design of a reduced volumetric ultra-wideband (UWB) antenna using innovative dielectric based on the use of geopolymer material which is safe and eco-friendly. The created antenna is intended to radiate in the air. The impedance mismatch due to interface dielectric/air at the aperture of the antenna imposes to choose dielectric material with an appropriate permittivity value. In this study, the authors focus on the experimental protocol that they use to elaborate a dielectric material with suitable dielectric properties over an UWB domain. An experimental phase of dielectric properties assessment is also described. The conceived antenna is inspired by K-antenna which constitutes the starting point of the proposed new antenna design, particularly because of their small dimensions. The antenna is intended to operate in a frequency band ranging from 300 MHz to 3 GHz. The authors demonstrate that the use of an appropriate innovative dielectric material like a geopolymer is an efficient way to reduce the antenna size. Furthermore, the behaviour of the antenna filled with geopolymer is validated using experimental results.

Les troubles du comportement alimentaire (TCA) de l’adolescent sont bien connus, ils le sont moins chez l’enfant pre-pubere et on manque de donnees de prevalence en population generale. L’objectif de ce travail etait d’evaluer la prevalence des TCA sur une population âgee de 0 a 18 ans, en utilisant la DSM-5. Les objectifs secondaires etaient de les correler a l’etat nutritionnel, aux antecedents, et d’evaluer le parcours de soin. Materiels et methodes : 401 familles ont ete interviewees lors de consultation de medecine generale, a l’aide d’un questionnaire. Celui-ci renseignait des donnees demographiques, les antecedents, l’IMC, et le comportement alimentaire. Des outils de depistage etaient inclus dans les questionnaires (BEBQ, BPFAS, SCOFF-5, EAT-26, TFEQ-R18). Les analyses statistiques ont ete faite a l’aide du logiciel logiciel XlstatBiomed 2020.3.1. Resultats : On retrouvait 2,7% d’ARFID d’âge moyen 4,6 ans (0,8-9) et 8,7% d’«autres troubles non classes» d’âge moyen 7,6 ans (0,6-17ans) (p=0,09). La cohorte ne comprenait aucun TCA de type anorexie, boulimie, BED, FEDNEC, Pica ou Merycisme, neanmoins les scores des tests etaient en faveur de possibles TCA debutants chez l’adolescent. Les ARFID etaient plus maigres que les autres (p Conclusion : Les TCA sont rares en pediatrie, mais insuffisamment pris en charge. On suppose que les TCA de l’enfant pre-pubere sont mal connus des medecins, notamment les ARFID. Le developpement d’outils de depistage valides en pediatrie est necessaire. La classification DSM-5 reste peu adaptee a l’enfant car elle ne prend pas en compte les degres de gravite des troubles.

Introduction et but de l’etude Vingt-cinq a 45 % des parents decrivent avoir deja eu des difficultes alimentaires avec leur enfant, dont seuls 5 a 10 % necessiteraient une prise en charge intensive [1] . La classification DSM-5 etant peu adaptee a l’enfant, une autre facon de decrire un comportement alimentaire est de distinguer des profils cliniques generaux de « petit mangeur » ou « gros mangeur ». L’objectif de cette etude complementaire realisee sur la base de donnees Pedianut (Prevalence des troubles du comportement alimentaire TCA de l’enfant et de l’adolescent) etait de rechercher si des facteurs sociodemographiques et/ou medicaux etaient associes aux profils observes. Materiel et methodes A partir de la cohorte Pedianut (401 enfants âges de 0 a 18 ans ayant fait l’objet d’une recherche systematique de TCA), les donnees sociodemographiques et antecedents personnels et familiaux des enfants ont ete etudies selon 4 tranches d’âge (0–1 an, 1–6 ans, 6–12 ans, 12–18 ans). Les informations collectees sur le comportement alimentaire ont permis, a l’aide de grilles pre-definies, de definir des profils « petit mangeur » ou « gros mangeur ». Les variables qualitatives ont ete comparees en utilisant le test de Chi2. Le test etait significatif pour p Resultats et analyse statistique On retrouvait 19,9 % de profils « petits mangeurs », predominant chez les 1–6 ans, et 24,9 % de profils « gros mangeurs », predominant chez les 12–18 ans (p Conclusion Cette analyse semiologique des TCA basee sur des profils de consommation alimentaire offre une alternative pragmatique aux limites de la classification DSM-5 chez l’enfant. L’analyse des facteurs associes aux profils petits et gros mangeurs degage des pistes de recherche de facteurs de risque de comportement alimentaire. Ces resultats preliminaires doivent etre confirmes par des etudes prospectives menees sur de plus grandes cohortes.

International audience; The development and construction of self-scanning capability short-range ultrawideband (UWB) radar is forthcoming for the French Military for Defense. This paper is devoted to the presentation of the self-scanning radar principle and of the development, construction, and tests of the different blocks needed to implement the elementary part of the forthcoming radar. The elementary radiation source is composed of a microstrip line with photoconductive switches, an optical system to trigger the switches, a pulsed modulator used as bias voltage to load the line, and a UWB antenna to radiate high electric fields in a broad frequency band. The main proposed innovations are devoted to the integration of the photoconductive switches within the antenna and to the use of the pulsed modulator as bias source instead of a dc voltage source. This modulator allows considering the increase in the yield of the whole source as well as the increase in the radiation bandwidth. Experimental results are presented in order to compare the switching efficiency with a dc bias source against this pulsed modulator bias source. Finally, photoswitches triggered by an 80-ps/20-μJ laser source are able to generate monopolar or bipolar pulses in the kilovolt range with subnanosecond duration and a 33-MHz pulse repetition frequency. First radiated electric field results of the whole device are also reported. \textcopyright 2017 IEEE.

International audience

Due to their interesting properties, geopolymers have found various applications in different domains. The evaluation of the dielectric properties of a geopolymer matrix for RF applications is innovative. In this context, this paper focuses, first, on the evaluation of the suitability of a geopolymer matrix with dielectric materials, and then on the improvement of the real permittivity value of the obtained material. For this purpose, the precursors either dielectric powder or aluminosilicate powder were first characterized. Then, the feasibility of the geopolymer matrix was investigated. Based on the feasibility test, it was shown that these kinds of materials can be successfully filled with various types of dielectric materials, such as ZrO 2 , BaTiO 3 and Y 2 O 3 . Moreover, the optimized parameters of the synthesis process, which included a small amount of water in the formulation, were 20 °C for the synthesis temperature, 85% for the humidity level and 7 days for the setting time. The measurement of the dielectric properties evidenced, first, that the real part of the relative permittivity strongly depends on the formulation and storage process. Then, the incorporation of a high percentage of BaTiO 3 (60%) induced an increase in the real part of the permittivity value and a decrease in the loss tangent. Finally, the mixing law of Maxwell-Garnet was applied to compare the theoretical and measured values of the permittivity. It was deduced that the small difference detected at low percentages whatever the dielectric materials can be explained by the preponderant effect of the geopolymer matrix compared to ZrO 2 or BaTiO 3 , it seems that the mixing law well functioned with BaTiO 3 than ZrO 2 . This is in accordance with the better dielectric properties for samples containing BaTiO 3 .

International audience; Les bibliothèques sont amenées à acquérir des logiciels métiers variés ou à en changer selon une périodicité définie. Or, les systèmes d’information documentaires ont subi de profondes mutations au cours de la dernière décennie, parallèlement à l’essor de la documentation électronique et des nouveaux supports, ainsi qu’aux mutations du Web. De nouveaux besoins, outils et services sont apparus.Cet ouvrage apporte des réponses concrètes tant aux questions des diverses étapes d’un projet de réinformatisation à conduire, qu’à celles soulevées par l’offre logicielle actuelle et à venir.

Optoelectronic devices triggered by a laser ∞ash and operating in linear switching regime allow the generation of short pulses with small time jitters (2ps typically). An Ultra Wide Band antenna array combining as many of this photoswitches as antennas has the advantage to increase the radiation power on one hand and to ofier the agility of the radiation beam on the other hand obtained by time delay of laser illumination. During the step of antenna design, it becomes important to take into account the photoswitch integration in order to increase the peak power and the frequency band of the generated output signal. This paper presents an equivalent model of photoswitch obtained with the transient solver of CST Microwave Studio coupled within CST Design Studio. The second part of this article is dedicated to the integration of a photoswitch even within the antenna.

Discipline Clinique. Introduction et but de l’etude La malnutrition reste un probleme de sante publique en Europe, non seulement en geriatrie et dans les maladies chroniques de l’adulte, mais aussi en pediatrie. La prevalence de la denutrition en pediatrie est estimee a 5 a 10 % en milieu hospitalier. Les pratiques de depistage de la denutrition chez l’enfant au cabinet du medecin generaliste sont mal connues. Ce travail a eu pour objectif de dresser un etat des lieux du depistage de la denutrition chez l’enfant en medecine de ville. Materiel et methodes Un questionnaire anonymise a ete envoye par mail et courrier aux medecins generalistes liberaux de Seine-Maritime. Le questionnaire comprenait 12 questions a choix simple ou multiples et 1 question ouverte. Les donnees etudiees concernaient les medecins (âge, sexe, % de patientele pediatrique), leurs connaissances (criteres cliniques utilises pour evaluer la denutrition, conseils ou bilans nutritionnels), leurs pratiques (prise de poids taille IMC, lecture des courbes de croissance), leurs outils (IMC calcule sur disque ou logiciel informatique, type de courbe de croissance papier ou numerique), et leurs attentes en terme de formation. Resultats et Analyse statistique 102 medecins ont repondus au questionnaire (sex ratio 1,16, majorite de plus de 50 ans 57,8 %), ayant une patientele pediatrique comprise entre 5 a 15 % pour 55,9 % d’entre eux. Les criteres cliniques utilises pour evaluer la denutrition etaient l’examen clinique 92 %, le poids 79 %, l’IMC 97 %, le PB/PC 6 %, l’indice de Waterlow 1 %. 82 % ne connaissaient pas l’indice de Waterlow et 72 % ne connaissaient pas le PB/PC. 79,4 % des medecins mesuraient systematiquement a chaque consultation le poids, 33,3 % mesuraient systematiquement la taille et l’IMC. 72,2 % avaient un logiciel qui calcule l’IMC, 5,5 % n’avaient que le disque d’IMC pediatrique, 16,7 % les deux, et 5,5 % n’avaient ni disque d’IMC pediatrique ni logiciel. Parmi les 43,6 % qui regardaient systematiquement les courbes de croissance a chaque consultation, une majorite (77,5 %) utilisaient les courbes de croissance du carnet de sante, et 20,6 % les courbes du logiciel informatique. Au total, 79,2 % reportaient systematiquement les poids/taille dans le carnet de sante, la raison principale de ne pas le faire etant l’oubli du carnet de sante par les familles. Un total de 71 % se sentaient a l’aise pour donner des conseils dietetiques et 31 % pour faire un bilan nutritionnel. 13,7 % prescrivaient parfois des complements alimentaires chez l’enfant. Seuls 9,8 % des medecins ont participe a des reunions d’information sur le depistage de la denutrition chez l’enfant et 89 % souhaiteraient plus de formation a ce sujet dans le departement. Conclusion La mesure de la taille et la determination de l’IMC restent insuffisamment realisees, malgre la diffusion croissante des logiciels. Les courbes de croissance ne sont pas remplies et regardees systematiquement, ce qui expose a un retard de depistage, alors que le non remplissage du carnet de sante expose a une perte d’information. Il existe une attente des medecins en termes de formation. La mise en œuvre du dossier medical partage devrait permettre l’harmonisation des supports de recueil des indicateurs nutritionnels.

The study presented in this article belongs within the context of a design of a new kind of short-range Ultra Wide-Band (UWB) Radar with an autonomous scanning capability. The generation of short pulses is performed with an optoelectronic device triggered by a laser flash and operating in linear switching mode. By adding as many optical systems as antennas, we create a transmitting array with increased radiated energy. Each of those elements are fed with bursts composed of UWB optogenerated pulses with a slightly different pulse repetition frequency allowing beam-scanning capability. This article presents in detail all the parts needed to implement the elementary radiation source and offers a mathematical method of calculation to trace back to the generated feeding signal.

Ustekinumab is approved for the treatment of psoriasis in adolescents and for the treatment of moderate to severe Crohn's disease (CD) in adults, but data are lacking in pediatric CD. We report a case of severe psoriasis induced by biotherapies in an adolescent with CD that improved after switching to ustekinumab (90 mg at weeks 0, 2, and 4 and then every 8 weeks). The patient had not experienced CD relapse after 1 year of follow-up. Ustekinumab can be an alternative therapy for psoriasis induced by biotherapies when conventional treatment fails and can maintain remission of CD.

An innovative radar imaging system, based on the capability of a flxed UWB array to radiate short pulses in difierent directions along time with the principle of electronic beam steering, is presented in this paper. To demonstrate its concept, the analysis presented in this paper is based on simulation results. As function of the use of either only one antenna or several antennas in reception, two radar imaging algorithms have been developed and are detailed in this paper. These algorithms permit to obtain an image of the analyzed scene thanks to the transient beam pattern of the array used in emission. Finally, with a same analyzed scene, these algorithms have been compared with the time reversal method and the back projection algorithm, in association with a SAR imaging system. The conditions of applicability of these methods are also discussed.

The NeTTUN (New Technologies for Tunnelling and Underground Works) Project is run by a consortium of 21 Industrial, Research & Development laboratories and Small and Medium Enterprises organizations across 9 countries in Europe; the ultimate goal is to enable groundbreaking change in the construction, management and maintenance of tunnels. NeTTUN aims at developing a fully automated system, that installed on Tunnel Boring Machine (TBM) provides identification of large obstacles that can obstruct the digging (e.g. other tunnels, cavities, boulders, foundations, archaeological remains, etc) as well as soil changes (e.g. from gravel to fractured rock).

International audience; OBJECTIVE: To study the prevalence of Barrett esophagus (BE) (gastric and/or intestinal metaplasia) in adolescents treated for esophageal atresia (EA).SUMMARY OF BACKGROUND DATA: EA patients are at high risk of BE.METHODS: This multicenter prospective study included EA patients aged 15 to 19 years. All eligible patients were proposed an upper endoscopy with multistaged esophageal biopsies under general anesthesia. Histological suspicion of metaplasia was confirmed centrally.RESULTS: One hundred twenty patients [mean age, 16.5 years (±1.4)] were included; 70% had been treated for gastroesophageal reflux disease (GERD) during infancy. At evaluation, 8% were undernourished, 41% had received antireflux surgery, and 41% presented with GERD symptoms, although only 28% were receiving medical treatment. Esophagitis was found at endoscopy in 34% and confirmed at histology in 67%. BE was suspected after endoscopy in 37% and was confirmed by histology for 43% of patients (50 gastric and 1 intestinal metaplasia). No endoscopic or histological anomalies were found at the anastomosis site. BE was not significantly related to clinical symptoms. In multivariate analysis, BE was associated with EA without fistula (P = 0.03), previous multiple antireflux surgery (P = 0.04), esophageal dilation (P = 0.04), suspicion of BE at endoscopy (P < 0.001), and histological esophagitis (P = 0.02).CONCLUSIONS: Patients with EA are at high risk of persistent GERD and BE. The development of BE is related to GERD history. Long-term systematic follow-up of the esophageal mucosa including multistaged biopsies is required, even in asymptomatic patients. (NCT02495051).

The Meadowbank Gold Project of Cumberland Resources Limited is located 70 km north of Baker Lake in the arid, arctic environment of Nunavut Territory, Canada. With a site annual average temperature of -11C, and 310 mm/year precipitation, the extrapolation of constituent loading rates from laboratory tests is particularly precarious. Three different scales of kinetic leaching tests were performed on waste rock samples: 1-kg and 100-kg laboratory leaching cells and 250-kg field cell tests. Field tests yielded considerably slower rates of buffering capacity depletion and sulfide oxidation than laboratory-derived rates, although the differences were not consistent between the various test scales. Additional

A new ultrawide-band (UWB) antenna named the "scissors antenna" has been designed specially for transient ultrawide-band applications. The scissors antenna, which is composed of conducting wires, radiates ultrashort pulses with very low dispersion. The radiation of this antenna has been characterized by a transient measurement method suitable for characterizing UWB antennas with very low dispersion. After a presentation of the scissors antenna, this measurement method is described. The last part of the paper presents a comparison between the radiation characteristics of the scissors antenna obtained by the transient measurements and those obtained by the classical harmonic measurements.

Cet article relate l’experience d’un groupe de mediation dans un centre d’hebergement pour personnes sans domicile fixe. Par l’intermediaire de la mise en place d’un atelier d’ecriture emerge une reappropriation de la parole singuliere, condition d’un premier travail sur l’identite de soi en tant que sujet mais aussi en tant qu’acteur existant au sein d’un groupe. Par extension, il s’agit, pour une population en rupture, de restaurer un lien social en souffrance.

A new experimental transient approach is proposed for multifilar connector characterization and more particularly for the scattering parameters evaluation and the maximum electrical field radiation estimation. This paper describes the analysis principle used to calculate the scattering parameters (S/sub ij/) of the connector, and the method proposed for electrical field magnitude estimation. Thereafter, the experimental setup and the calibration procedure for the multifilar measurement is explained. Finally, measurements using a vector network analyzer show the efficiency of the transient test setup.