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The performance of an active frequency doubler used to generate a pump signal for a solid‐state microwave amplification by stimulated emission of radiation (MASER) based on paramagnetic impurity ions in sapphire is reported. The frequency doubler has been characterised in terms of phase noise, power dependence and frequency stability (Allan variance) for an output frequency range between 20 and 40 GHz. With the measurement system referenced to a 10 MHz hydrogen MASER, the doubler exhibits a single sideband phase noise of ∼−108 dBc/Hz at 1 Hz offset frequency, from which an upper limit fractional frequency instability of about 2 × 10−16 at 1 s integration time is estimated. [ABSTRACT FROM AUTHOR]

A report is presented on the residual intrinsic phase noise properties of a millimetre-wave module used to generate W-band signals from an Xband analogue signal generator. The 90 GHz outputs of two nominally identical millimetre-wave modules are heterodyned to measure their instantaneous frequency fluctuations and hence infer the close-tocarrier phase noise. The fractional frequency stability at 1 s integration time is 2 × 10-14, which corresponds to a total single-sideband phase noise of -50 dBc/Hz at 1 Hz Fourier frequency offset from the carrier and a residual single-sideband phase noise of -52 dBc/Hz at 1 Hz offset. [ABSTRACT FROM AUTHOR]

Résumé Objectif Le dispositif Essure ® est un moyen de stérilisation tubaire par voie hystéroscopique. Notre étude a pour but d’évaluer rétrospectivement la satisfaction des patientes ayant bénéficié d’une pose d’Essure ® sans anesthésie. Patientes et méthodes L’étude descriptive a inclus toutes les patientes ayant bénéficié d’une pose d’Essure ® sans anesthésie, sous MEOPA, du premier janvier 2013 au 28 février 2014 au CHU de Besançon. L’évaluation de la satisfaction globale des patientes a été recueillie rétrospectivement par questionnaire téléphonique. Résultats Cent quarante-trois patientes ont bénéficié d’une pose d’Essure ® sans anesthésie durant la période d’étude au CHU de Besançon et, parmi elles, 120 patientes ont répondu au questionnaire téléphonique. L’âge moyen était de 41,3 ans. En ce qui concerne la satisfaction et la tolérance, 89,2 % des patientes ont déclaré être globalement satisfaites de cette procédure et 95,8 % la recommanderaient à une amie. En effet, 66,6 % des patientes ont déclaré n’avoir ressenti aucune douleur ou une douleur modérée. De plus, le MEOPA a été bien toléré chez 79,9 % des patientes. En ce qui concerne la procédure de pose d’Essure ® sans anesthésie, le taux d’échec de la pose était de 9,2 % et à 3 mois le contrôle radiologique était satisfaisant chez 94,5 % des patientes. Discussion et conclusion La stérilisation tubaire par implants Essure ® est une procédure rapide et efficace. Notre étude montre, qu’actuellement, cette technique peut être réalisée sans anesthésie, lors d’une consultation dédiée, avec un taux important de satisfaction globale des patientes. Cela permet donc de diminuer le nombre d’hospitalisation en chirurgie ambulatoire et de diminuer le coût de cette intervention. Objective The Essure ® system is a hysteroscopic sterilization method. The purpose of our study was to retrospectively evaluate the sterilization procedure with Essure ® devices without anesthesia. Patients and methods The descriptive study included all tubal sterilizations with Essure ® devices performed without anesthesia, with MEOPA, from January 1st, 2013 till February 28th, 2014 in the CHU of Besançon. The evaluation of the global satisfaction of the patients was collected by telephone survey. Results A hundred and forty-three patients benefited from Essure ® without anesthesia during the period of study in the CHU of Besançon and among them, 120 patients answered the telephone survey questionnaire. The average age was of 41.3 years. As regards the satisfaction and the tolerance, 89.2% of the patients declared to be globally satisfied by this procedure and 95.8% would recommend it to a friend. Indeed, 66.6% of the patients declared to have felt no pain or moderate pain. Furthermore, the MEOPA was well tolerated at 79.9% of the patients. As regards the procedure of Essure ® inserts without anesthesia the rate of failure was 9.2% and at 3 months the radiological control was satisfactory in 94.5% of the patients. Discussion and conclusion The tubaire sterilization by implants Essure ® is a fast and effective procedure. Our study shows, that at present, this technique can be realized without anesthesia, during a dedicated consultation, with an important rate of global satisfaction of the patients. It thus allows to decrease the number of hospitalization in ambulatory surgery and to decrease the cost of this intervention. [ABSTRACT FROM AUTHOR]

Résumé: Nous rapportons le cas d’une fasciite nécrosante survenue 10ans après la pose d’une bandelette sous-urétrale par voie rétropubienne indiquée pour une incontinence urinaire d’effort chez une patiente âgée de 50ans. Cette infection extensive a engagé le pronostic vital. Ce type de complication septique grave lié à l’implant synthétique sous-urétral est rarissime et probablement sous-estimé. Ces infections surviennent le plus souvent dans l’année qui suit l’implantation et sont invariablement liées à une exposition vaginale de la prothèse. [Copyright &y& Elsevier]

Summary: Objective: To assess the risk of tracheal intubation at birth in very premature neonates related to the type of maternal anesthesia in case of elective cesarean. Population and methods: All 219 live-born very premature neonates (28–32 weeks of gestation), delivered after an elective cesarean in the 27 maternity wards of 2 French semi-rural neonatal networks. Eighty-three percent (182/219) were delivered in level III maternity wards in university hospitals. Results: Of the very preterm neonates, 33.3% (73/219) were intubated in the delivery room, either for respiratory distress syndrome or a low APGAR score. Very preterm neonates delivered after maternal general anesthesia were more often intubated than those delivered after spinal anesthesia (48.7% vs 25.2%; OR: 2.8; 95% CI: 1.8–5.1). The risk of intubation related to maternal general anesthesia remained statistically significant after an adjustment for gestational age, fetal growth retardation, respiratory distress syndrome, type of maternity ward, and a propensity score that took into account maternal sociodemographic characteristics and the causes of very preterm birth (aOR: 3.4; 95% CI: 1.4–8.2). The risk of intubation related to general anesthesia was lower after adjusting for the 5-min APGAR score (aOR: 2.8; 95% CI: 1.0–7.3). Conclusion: Very preterm neonates delivered after cesarean with general anesthesia require tracheal intubation in the delivery room more often than those delivered with spinal anesthesia. This study cannot assess a causal link between anesthesia and the need for neonatal intubation. However, neonatologists have to be aware of the type of maternal anesthesia because it may interfere with the non-invasive ventilation support policy of the very preterm neonate. [Copyright &y& Elsevier]

Abstract: Genital-pelvic actinomycosis is an uncommon disease which often arises on women with long term use of intrauterine device. Its diagnostic remains difficult. Even if different clinical locations has been reported, location to the psoas muscle is exceptional. We report such a case, diagnosed on a 53 years old woman. Both a tumoral and a severe infectious syndrome appeared three months after an intra-uterine device removal. The septic syndrome led to a laparotomic approach. Unusual clinical presentation, delay between device removal and septic syndrome and lack of genital infection explain the issues to reach the final diagnosis. [Copyright &y& Elsevier]

Summary: Liver subcapsular haematoma and its consequence, spontaneous hepatic rupture, are very rare complications of pregnancy. They are mainly associated with pre-eclampsia. The diagnosis is difficult and the maternal and fetal mortality rates are high. We report the case of a spontaneous hepatic rupture on a normal liver during an uncomplicated twin pregnancy with a favorable outcome for both the mother and the newborns. [ABSTRACT FROM AUTHOR]

This article describes the experience of adopting the NCLEX-RN as an entry-to-practice exam among francophone baccalaureate nursing students in New Brunswick, Canada. The journey between 2012 and now has been difficult, and nursing leadership was necessary to inform key stakeholders regarding the inequities faced by francophone nursing students and to bring about change. Here is a description of the arduous work done by a group of concerned nurses (active and retired) to advocate for the rights of francophone nursing students., (Copyright © 2019 Longwoods Publishing.)

Aim: Fear of dystocia during breech delivery brings obstetrical teams to choose elective caesarean sections. However, some patients with breech presentations will be in labour before the date scheduled and caesarean delivery during labour increases maternal morbidity. Therefore, this situation raises the question about the relevance of labour trial for breech presentations admitted in labour. Our study aimed to determine the obstetrical prognosis of breech presentations on admission in the labour ward following their degree of cervical dilation., Materials and Methods: We conducted an observational retrospective study on 213 single breech presentations at ≥37 gestational weeks that delivered at our level 3 labour ward between1st January 2007 and 30th July 2013. Maternal, obstetrical and neonatal factors were analyzed., Results: The total caesarean rate during labour was 23.4% and significantly less important (P<0.05) in patients with cervical dilation ≥5cm on admission (14% vs. 27%). Apgar scores, cordonal arterial pH and lactates, rate of transfer to intensive care were not significantly different between the two groups., Conclusion: In our study, any patient with a breech presentation at an advanced stage of labour on admission is of very good prognosis, although statistical power is insufficient., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Objectives: Breech delivery is still a controversial situation in literature. Added complexity exists when breech presentations are associated with premature rupture of membranes (PROM) as such cases are conventionally excluded in studies dealing with PROM and are often indications for elective caesarean section. Thus, the objective of this study was to evaluate the obstetrical prognosis of breech presentations after PROM at term., Materials and Methods: We conducted a retrospective observational study at the Besançon University Medical Centre, between 1(st) January 2008 and 31(th) December 2012. Two groups of patients with breech presentations at term were constituted according to the existence or not of a PROM. The primary endpoint was the delivery mode: caesarean section or vaginal. Other endpoints were maternal characteristics, type of onset of labour and neonatal criterias., Results: Two hundred and nine patients were included. In the control group, 67.9 % of vaginal deliveries occurred versus 60 % in the group with PROM (P=0.25). No difference was found on neonatal criterias such as pH, lactate and the Apgar score at 5 minutes., Conclusion: PROM at term in breech presentation doesn't seem to change the obstetrical prognosis and should therefore not be a systematic indication for elective caesarean section., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Objectives: To evaluate the risk of materno-foetal complications in obese primiparous women (Body Mass Index (BMI)≥30) MATERIALS AND METHODS: A retrospective study was conducted in our tertiary referral labour ward from 1st January 2009 to 31st December 2010, including primiparous women delivering living cephalic singleton pregnancies after 37 weeks of amenorrhea. Two groups were compared: obese patients (BMI≥30) and non-obese (BMI<30). Obstetrical and neonatal data were collected., Results: Among 1636 primiparous women, 132 (8%) had a BMI≥30. Induction of labor, prolonged pregnancy and post-partum hemorrhage were significatively more frequent in obese group (P<0.001). Those patients have an increased risk of cesarean section (P<0.001). Mean birth weight of newborns from obese mothers is significatively higher (3493g vs 3265g, P<0.001), as is the frequency of macrosomia (16.7% vs 5.2%, P<0.001)., Conclusion: Obesity is associated with obstetrical complications in primiparous obese women, who are to be considered risky patients at their arrival in the labour ward, and specific obstetrical management must be planned to improve maternal and neonatal outcomes., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)