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La prise en charge de l'arthrose fait intervenir des thérapeutiques médicamenteuses et non médicamenteuses. Depuis quelques années, l'arsenal thérapeutique s'est enrichi du Plasma Riche en Plaquette (PRP). Les plaquettes renfermant de nombreux composés anti-inflammatoires et facteurs de croissance, le postulat est, qu'injectées au sein de la cavité articulaire enflammée, elles libèrent leurs composés diminuant l'inflammation locale et favorisant la régénération articulaire. Depuis 2016, notre service de Rhumatologie propose une prise en charge globale et pluridisciplinaire de la gonarthrose au sein de son hôpital de jour (HJ), associant une consultation rhumatologique, une injection de PRP, une éducation thérapeutique comprenant des consultations diététique et rééducative individualisées et une séance de balnéothérapie encadrée. Ce travail s'est attaché à évaluer l'efficacité à moyen terme (1 an) de cette prise en charge. Inclusion prospective après accord des patients hospitalisés entre novembre 2019 et avril 2020 (arrêt à cette date en raison de l'épidémie Covid) en HJ gonarthrose de notre service. Recueil de données démographiques et médicales à l'inclusion puis, par téléphone ou courriel, à 3 (M3), 6 (M6) et 12 (M12) mois. Critère de jugement principal : obtention d'une amélioration clinique pertinente (MCII) de la fonction, définie par une amélioration d'au moins 9,1 points du domaine Fonction du questionnaire KOOS. Critères de jugements secondaires : évolution à M3 M6 et M12 vs baseline des domaines du KOOS, de l'activité physique, du BMI, de la consommation d'antalgiques et d'AINS. Inclusion prospective de 98 patients (âge moyen 63,8 ± 12 ans, 66 femmes et 32 hommes, IMC moyen à 28,7 ± 5,7 Kg/m2). Évaluation de 77 patients à M3 (78,6 %), 66 à M6 (67,3 %) et 70 à M12 (71,4 %). Obtention du MCII chez plus de la moitié des patients répondeurs à 3 et 6 mois (53,2 % à M3 et 54,2 % à M6), et plus d'un tiers à M12 (38,6 %). É 3, 6 et 12 mois, amélioration significative du domaine Douleurs avec des effets taille de respectivement 0,77, 0,81 et 0,53, Fonction (effets taille de respectivement 0,79, 0,78 et 0,5) et Qualité de vie (effets taille de respectivement 0,73, 0,67 et 0,59). Amélioration du domaine Symptômes à M3 et M6, mais pas M12, et du domaine Sports et Loisirs uniquement à M3. Diminution de la fréquence de consommation d'AINS à M3, M6 et M12 et de la fréquence de consommation d'antalgiques à M3 et M6. Absence de modification de la fréquence de l'activité physique et du BMI. La prise en charge multidisciplinaire proposée permet l'obtention du MCII de façon prolongée chez une importante proportion des patients, avec une diminution de la consommation d'antalgiques et d'AINS, sans franche modification des habitudes comportementales. Toutefois, l'épidémie Covid et les différentes mesures de confinement ont probablement beaucoup impacté cette modification espérée des habitudes comportementales. La prise en charge proposée permet une amélioration fonctionnelle ainsi qu'une réduction de la consommation d'antalgiques intéressantes. La poursuite ou la création de telles filières semble donc à encourager. Il sera utile de renouveler une évaluation à distance de toute période épidémique, et de rechercher des facteurs prédictifs d'efficacité. [ABSTRACT FROM AUTHOR]

A method for extrapolating the extracellular water (ECW) resistance from wrist-ankle resistance at 50 kHz (R (50)) is proposed in this paper, in order to enable 50 kHz impedancemeters to use the BIS-Hanai equation for determination of ECW. Values of R (50) and the ECW resistance extrapolated at zero frequency R (e) were measured in a first group of 57 healthy volunteers, using a Xitron 4200 multifrequency impedancemeter and mean values (b) of the ratio R (50)/R (e) in men and women were used to determine individual values of R (e50), the ECW resistance extrapolated from R (50), which were substituted to R (e) in the BIS-Hanai equation. For validation, the method was compared against ECW measured with the Xitron (V (ex)) in a second group of 31 healthy volunteers, using values of b of first group. Values of R (e50) in this second group were found to be not significantly different from corresponding values of R (e) with p-values of Student test of 0.346 for men and 0.300 for women. ECW volumes (V (e50)) calculated from R (e50) were also found not significantly different from those of the Xitron with Student paired test p values of 0.277 in men and 0.393 in women. Our method gave a better agreement with V (ex) than two bioimpedance analysis methods from the literature, especially in women. It was also tested on a 50 kHz single frequency impedancemeter (BodyExplorer, Juwell Medical) on a third group of 21 subjects and gave ECW volumes not significantly from those of the Xitron with p = 0.531 for men and 0.096 for women. [ABSTRACT FROM AUTHOR]

Abstract: At the population level, the control of asthma remains less than satisfactory, in spite of the availability of effective therapy and the multiplication of international recommendations. For these reasons, the ANAES has developed recommendations for follow-up, specifically for adult and adolescent patients. These recommendations emphasize the importance of the control of asthma and compliance to treatment as the principal objectives of follow-up. They also indicate the rationale for a number of conceivable clinical and paraclinical investigations in this framework as well as the approach to take in observing how well the patient tolerates and follows the prescribed treatment. They also pay attention to specific aspects dealing with occupational asthma. The work of the ANAES must now be directed at informing and forming physicians so that these recommendations will be put into practice. [Copyright &y& Elsevier]

The article reports on results of a study of in vitro bicarbonate and urea kinetics during hemodialysis and online hemodiafiltration. A description of the experimental set-up and measurement method is presented. The study concluded that patient urea concentration reduces as it is removed while bicarbonate concentration increases due to transfer from dialysate and reinjection fluid.

Study Question: Is there an added diagnosis value of buccal cell FISH analysis compared with blood lymphocyte chromosomal investigations in patients with Turner syndrome (TS)?Summary Answer: Buccal cell FISH analysis, a non-invasive technique, modified the chromosomal results obtained with the blood karyotype in 17 patients (12%) of our cohort.What Is Known Already: Few studies have evaluated buccal cell FISH analysis and compared them with blood karyotype in patients with TS.Study Design, Size, Duration: A prospective, monocentric cohort study was conducted in a rare diseases centre (CMERC) between July 2017 and August 2019.Participants/materials, Setting, Methods: In total, 142 adult patients with TS, and at least 5% 45,X cells in a previous blood karyotype, were recruited. All the patients' files were included in the CEMARA database. This national database has been declared to the French data protection agency (CNIL approval number 1187326). In compliance with French law, consent regarding non-opposition to collect and use the data was obtained from each patient. A FISH analysis on a buccal smear was performed.Main Results and the Role Of Chance: The percentage of 45,X cells was identical between the two tissues in only 32.4% of cases. The discrepancy was higher than 41% for 12% of the cohort. The percentage of 45,X cells was higher in blood in 53 (37.3%) patients, and higher in buccal cells in 43 (30.3%) of cases. In 17 (12%) cases, the blood karyotype had to be reconsidered in regard to the buccal cell analysis.Limitations, Reasons For Caution: It would have been interesting to evaluate karyotypes in cells from other tissues such as cells from skin biopsy or from the urinary tract and even from blood vessels or gonads in case of surgery and to compare them with each patient's phenotype. However, most of the time, these tissues are not available.Wider Implications Of the Findings: Although blood lymphocyte karyotype remains the gold standard for the diagnosis of TS, buccal cell FISH analysis is an efficient tool to evaluate the global chromosomal constitution in these patients, thus allowing them to have better care and follow-up. For instance, identifying a Y chromosome can prevent the occurrence of a gonadoblastoma, as gonadectomy should be discussed. On the other hand, finding normal XX cells in a patient with a previous diagnosis of homogenous 45,X TS, may be psychologically helpful and relevant for gynaecological care.Study Funding/competing Interest(s): No specific funding was sought for the study. The authors declare no competing interests.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

The aim of this paper is to present a comparison between failure analyses results performed on power SiC devices. Various devices have been submitted to SC (Short-circuit) stress and ITASC (Inverter Test with Accelerated Switching Conditions) method. Some similarities have been detected, as well as the same failure mode represented by a gate-source shorted-circuit. • Short-circuit have been performed to lead the SiC device to failure, however not in complete destruction; • ITASC method is used to define a hard switching condition up to device degradation; • The failure analysis performed on SiC devices after SC and ITASC stresses shows a same failure mode: shorted gate-source. • SC and ITASC stresses present different failure mechanisms. [ABSTRACT FROM AUTHOR]

This work deals with the study of thermoset-thermoplastic blend forming an epoxy-amine/poly-etherimide phase separated to assess the dielectric and thermal performances. These materials would be good candidates to replace the passivation layer in semiconductors, particularly ones used as switches in power electronic applications. Polyimide and Parylene are usually quoted and studied. Mixtures based on polymers would be a novel candidate that can manage to be an insulator for the system. The modified and non-modified systems where characterized by transmission electron microscopy, scanning electron microscopy, differential scanning calorimetry, thermogravimetric analysis, dynamic mechanical analysis, dielectric analysis and analytical simulation was carried out on dielectric measurements. These complementary techniques were used first to investigate the presence of the phase separation phenomenon and second to quantify the separated nodules size. The effect of this phase separation was examined and showed enhancement in the dielectric values compared to the pure epoxy system. It was finally simulated to show a close assumption of what is found experimentally. [ABSTRACT FROM AUTHOR]

Abstract: In the paper proposed here, we are studying the dynamic avalanche from experimental results first, dynamic avalanche is identified on a punch through insulated gate bipolar transistor (PT-IGBT) module 1200V–300A from Mitsubishi. Secondly, the phenomenon is analysed thanks to simple solid state devices equations. Numerical simulations are used to confirm experimental results. Simulation results allows us locating the active area of the dynamic avalanche during turn-off under over-current conditions. A PT-IGBT cell is described with MEDICI™, a finite element simulator. A mixed-mode simulation is performed thanks to MEDICI™ and SPICE™. The circuit simulated here is a buck topology with an inductive load. Finally, a thermal analysis is performed to estimate temperature increase due to dynamic avalanche. [Copyright &y& Elsevier]

The idea of including non-uniform temperature distribution into power semiconductor device models is not new, as accurate electro-thermal simulations are required for designing compact power electronic systems (as integrated circuits or multi-chip modules). Electro-thermal simulations of a PIN-diode based on the finite-element method, show a non-uniform temperature distribution inside the device during switching transients. Hence the implicit assumption of a uniform temperature distribution when coupling an analytical electrical model and a thermal model yields inaccurate electro-thermal behaviour of the PIN-diode so far. If literature reports procedures regarding complex thermal network modelling, few papers address the problem of mixing adequately electrical and thermal issues. Instead of using a one-dimensional finite difference or element method, the bond graphs and the hydrodynamic method are used to build a 1D electro-thermal model of the PIN-diode. The paper focuses on electrical issues and the proper expression and localization of power losses to feed the thermal network model. The results by this original technique are compared with those given by a commercial finite-element simulator. The results are similar but the computation effort attached to the proposed technique is a fraction of that required by finite-element simulators. Moreover the proposed technique may be applied easily to other power semiconductor devices. [ABSTRACT FROM AUTHOR]

• Use of third-generation cephalosporins (3GCs) as definitive treatment for AmpC-producing Enterobacteriaceae is possible. • Initial severity, bacterial species, inoculum size and infection source are key parameters to evaluate antibiotic efficacy. • Prospective randomised studies are needed to allow the use of 3GC in infections caused by ESCPM bacteria. The burden of antibiotic-resistant infections among Gram-negative bacteria is increasing. Resistance to third-generation cephalosporins (3GCs) in Enterobacteriaceae is mainly conferred by the acquisition of β-lactamases or by deregulation of natural genetically-encoded β-lactamase enzymes. Enterobacteriaceae such as Enterobacter spp., Serratia marcescens, Citrobacter freundii, Providencia spp. and Morganella morganii (ESCPM group) possess chromosomally-encoded inducible AmpC β-lactamases. AmpC can be overproduced as a response to β-lactam antibiotic exposure or by constitutive dysfunction of the AmpC regulation system. This overproduction can lead to the inactivation of 3GCs. Based on small clinical studies, international guidelines and expert recommendations suggest that 3GCs should be avoided as definitive therapy for infections caused by ESCPM group organisms. In this narrative review, we discuss the published literature and evaluate the risk related to 3GC use in the case of documented ESCPM infection. [ABSTRACT FROM AUTHOR]

The behavior of the barrier height of the SiC/SiO2 interface has been investigated over a wide temperature range, from 173 K to 523 K. These data complement the literature, providing a better knowledge of this parameter, which was studied only over a more restricted temperature range, and never before for low temperatures. It is highlighted that the measured samples exhibit a barrier height temperature dependence very near to the theoretical one (≈−0.7 meVK−1). Beyond 473 K, the barrier height seems to drop faster for some samples, reaching ≈−1.4 meVK−1. If this faster decreasing rate is maintained for higher temperatures, it could limit 4H-SiC MOSFETs performances or reliability for high-temperature applications. It is expected that the data provided here will allow for more accurate modeling of the gate current and the charge injection in the oxide layer of power MOSFETs, leading to more reliable predictions of the oxide lifetime for 4H-SiC MOSFETs. [ABSTRACT FROM AUTHOR]

Introduction et but de l’étude Le diagnostic nutritionnel des patients atteints de cancer du poumon est souvent tardif. Cette prise en charge peut entraîner des conseils inadaptés à la sévérité du statut nutritionnel et limiter le bénéfice apporté. L’objectif de cette étude préliminaire était d’apprécier l’impact d’une prise en charge nutritionnelle précoce et systématique sur la limitation de la perte de poids, d’estimer la masse maigre en cours de traitement et d’analyser l’évolution du poids, facteur pouvant faire varier la masse maigre au cours de la première année de traitement. Matériel et méthodes Nous avons comparé deux cohortes de patients atteints de cancer bronchopulmonaire métastatique (stade IV) recevant une chimiothérapie de première ligne (à base de sels de platine) : une cohorte actuelle de 20 patients suivis de la première (C1) à la troisième cure (C3) pour lesquels la consultation nutritionnelle a été réalisée en systématiquement à chaque cure et une cohorte historique de 33 patients avec un suivi de C1 à C6 pour lesquels la consultation nutritionnelle a été réalisée seulement sur prescription médicale. Les paramètres étudiés étaient l’évolution du poids à chaque cure en pourcentage par rapport au poids habituel et l’estimation de la masse maigre évaluée par comparaison de scanner sur coupe axiale passant par L3 entre le diagnostic et la réévaluation. Résultats et analyse statistique Dans la cohorte actuelle, 50 % des patients étaient dénutris à C1 contre 27,3 % dans la cohorte historique. À C3, les deux cohortes présentaient un pourcentage de patients dénutris similaires (57,9 % contre 57,6 %). Dans la cohorte historique, la perte de poids moyenne était de 3,71 % à C1 ; à C3, cette perte de poids, en évolution constante, atteignait 5,67 %. Dans la cohorte actuelle la perte de poids moyenne était de 7,56 % à C1 ; à C3, cette perte de poids était de 8,53 %. Entre C1 et C3, seuls les patients de la cohorte historique continuaient de voir leur statut nutritionnel s’altérer, alors que ceux de la cohorte actuelle, en moyenne, reprenaient du poids. Il n’existe pas d’évolution nette dans l’estimation du muscle paravertébral entre le scanner du diagnostic et la sixième cure. Celle-ci semble être plus marquée après C6. La reprise de poids, relevée après C6, resterait une prise de masse grasse et n’entraînerait pas d’amélioration de la masse musculaire. Conclusion Cette étude préliminaire montre une phase délicate à l’initiation de la chimiothérapie entre la première et la troisième cure. La perte de poids était moindre en cas de prise en charge nutritionnelle précoce formalisée, certains patients reprenant même du poids. Aucune différence n’a pu être mise en évidence dans cette étude sur l’évolution de la masse maigre appréciée par scanner. [ABSTRACT FROM AUTHOR]

Previous research showed that Si devices could sustain a large number of Short Circuit (SC) events, as long as the energy dissipated during SC remains slightly below a given threshold (the so-called critical energy). In this paper, we show that this is not necessarily true for SiC MOSFETs, which can only withstand a few such SC events. This low robustness to repetitive short-circuit events is related to the gate degradation due to the cumulative carrier injection and leakage currents in the oxide. To ensure safe operation over a large number of SC events, we introduce a new parameter: the "repetitive critical energy", which corresponds to a SC energy low enough to avoid excessive temperature increase so as to limit the transient gate leakage current during SC events. Below this repetitive SC energy value, the SiC device is able to sustain a large number (more than 1000) of SC events. • A new parameter: the "repetitive critical energy" has been introduced for SiC MOSFET. • The "repetitive critical energy" corresponds to the highest short circuit energy that a device can sustain repetitively. • The repetitive critical energy is dictated by occurrence of transient gate leakage current during short circuit pulse. • The apparition of a transient gate leakage current can be used to predict a future failure of SiC MOSFET. [ABSTRACT FROM AUTHOR]