Disorganized attachment and genetics in the development of borderline personality disorder

International audienc

Bounding the Risk Probability

International audienceFor some safety–critical applications, it is important to calculate the probability that a discrete time autoregressive (AR) process leaves a given interval at least once during a certain period of time. For example, such AR process can be interpreted as a temporally correlated safety indicator and the interval as a target zone of the process. It is assumed that the safety of the system under surveillance is compromised if the above-mentioned probability becomes too important. This problem has been previously studied in the case of known distributions of the innovation process. Let us assume now that the distributions of the innovation and initial state are unknown but some special bounds for the cumulative distribution functions and/or for the probability density functions are available. Numerical methods to calculate the bounds for the above-mentioned probability are considered in the paper

Le nouveau calendrier vaccinal est-il adapté à l’ancien prématuré ?

International audienceThe French 2013 immunization schedule having a goal of simplification with comparable efficacy, has decreased the number of injections and removed the injection performed at three months of age in the general population. Apart from the prevention of invasive pneumococcal infections for which it is recommended to maintain three dose primary immunization, vaccination of premature is not addressed in this new calendar. Can the extremely preterm infants (< 33 weeks of gestational age) benefit from this new schedule or should we keep them in three injections schedule? The objective of this paper is to clarify this point through the data available in the literature. Children born prematurely and especially the “extremely premature” born before 33 weeks are at high risk of infections, some of them are preventable by immunization. Although there is no clinical evidence, for pertussis, pneumococcus, Haemophilus influenzae b, hepatitis B, whatever the immunogenicity criteria, immunogenicity is significantly lower in preterm than in term newborn after 3 doses primary schedule. This lower immunogenicity raises concerns about the transition to two doses, about the ability to give short term protection and booster responses. Given these data, GPIP takes the position for maintaining a primary 3-dose vaccination at 2.3 and 4 months for premature infants less than 33 weeks.Le calendrier vaccinal 2013 répondant à un objectif de simplification à efficacité comparable, a diminué le nombre d’injections recommandées et a en particulier supprimé l’injection effectuée à l’âge de trois mois en population générale. En dehors de la prévention des infections invasives à pneumocoque pour laquelle il est recommandé de maintenir trois doses en primovaccination, la vaccination du prématuré n’est pas abordée dans ce nouveau calendrier. Les grands prématurés peuvent-ils bénéficier de ce nouveau calendrier ou doit-on maintenir chez eux trois injections ? L’objectif de ce travail est de préciser ce point à travers les données disponibles dans la littérature. Les enfants nés prématurément et surtout les « grands prématurés » nés avant 33 SA sont des enfants à haut risque de contracter des infections dont certaines peuvent être prévenues par la vaccination. Pour les valences coqueluche, pneumocoque, Hib, hépatite B quels que soient les critères d’immunogénicité retenus, elle est nettement moins bonne chez les grands prématurés que chez les nouveau-nés à terme. Bien qu’il n’y ait pas de preuve clinique, ceci fait craindre que le passage à deux doses ne permette pas d’une part, de protéger suffisamment à court terme et, d’autre part, laisse craindre une moins bonne réponse immunitaire après le rappel à 11 mois. Compte tenu de ces données, le GPIP prend position pour le maintien d’une primo-vaccination à 3 doses à 2,3 et 4 mois pour les prématurés de moins de 33 semaines