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ImportanceBefore surgery, the best strategy for managing patients who are taking renin-angiotensin system inhibitors (RASIs) (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) is unknown. The lack of evidence leads to conflicting guidelines.ObjectiveTo evaluate whether a continuation strategy vs a discontinuation strategy of RASIs before major noncardiac surgery results in decreased complications at 28 days after surgery.Design, setting, and participantsRandomized clinical trial that included patients who were being treated with a RASI for at least 3 months and were scheduled to undergo a major noncardiac surgery between January 2018 and April 2023 at 40 hospitals in France.InterventionPatients were randomized to continue use of RASIs (n = 1107) until the day of surgery or to discontinue use of RASIs 48 hours prior to surgery (ie, they would take the last dose 3 days before surgery) (n = 1115).Main outcomes and measuresThe primary outcome was a composite of all-cause mortality and major postoperative complications within 28 days after surgery. The key secondary outcomes were episodes of hypotension during surgery, acute kidney injury, postoperative organ failure, and length of stay in the hospital and intensive care unit during the 28 days after surgery.ResultsOf the 2222 patients (mean age, 67 years [SD, 10 years]; 65% were male), 46% were being treated with angiotensin-converting enzyme inhibitors at baseline and 54% were being treated with angiotensin receptor blockers. The rate of all-cause mortality and major postoperative complications was 22% (245 of 1115 patients) in the RASI discontinuation group and 22% (247 of 1107 patients) in the RASI continuation group (risk ratio, 1.02 [95% CI, 0.87-1.19]; P = .85). Episodes of hypotension during surgery occurred in 41% of the patients in the RASI discontinuation group and in 54% of the patients in the RASI continuation group (risk ratio, 1.31 [95% CI, 1.19-1.44]). There were no other differences in the trial outcomes.Conclusions and relevanceAmong patients who underwent major noncardiac surgery, a continuation strategy of RASIs before surgery was not associated with a higher rate of postoperative complications than a discontinuation strategy.Trial registrationClinicalTrials.gov Identifier: NCT03374449.

Laser annealing was employed to trigger the solid-state reaction of a thin Co film (2.5 nm) with undoped Si. A metastable disilicide layer was obtained after one laser pulse close to the melt threshold. Its diffraction pattern, relaxed lattice parameter, and residual resisitivity are consistent with the formation of the defective CsCl structure. The CoSi2 phase was found after prolonging the thermal treatment with additional pulses or rapid thermal annealing. Because CoSi is skipped in the phase sequence, CoSi2 layers are more uniform in thickness, have an increased superconductivity and a reduced formation temperature. This approach is compatible with the SALICIDE process and can be used to form smooth contacts in superconducting or regular transistors. [ABSTRACT FROM AUTHOR]

In this study, we have conclusively used UV-nanosecond laser annealing (UV-NLA) as an alternative to classical rapid thermal annealing (RTA) for the formation of stable Ni-GeSn alloys. The phase formation sequence was similar to the one obtained with RTA. At low laser energy densities (ED) and after the consumption of Ni, the Ni-rich phase, Ni5(GeSn)3, was first obtained. This phase was followed, for higher ED, by the mono-stanogermanide phase Ni(GeSn). Surface wrinkles appeared at high ED, resulting in a sheet resistance ( $\text{R}_{\text {sh}}$ ) increase. Meanwhile, $\text{R}_{\text {sh}}$ variations were mainly governed by the phases that were present at lower ED. By combining various analyses, we did not see any Ni(GeSn) agglomeration or Sn segregation. The use of UV-NLA yielded thermally stable Ni(GeSn) contact layers.

Abstract Background In patients with septic shock, the impact of the mean arterial pressure (MAP) target on the course of mottling remains uncertain. In this post hoc analysis of the SEPSISPAM trial, we investigated whether a low-MAP (65 to 70 mmHg) or a high-MAP target (80 to 85 mmHg) would affect the course of mottling and arterial lactate in patients with septic shock. Methods The presence of mottling was assessed every 2 h from 2 h after inclusion to catecholamine weaning. We compared mottling and lactate time course between the two MAP target groups. We evaluated the patient’s outcome according to the presence or absence of mottling. Results We included 747 patients, 374 were assigned to the low-MAP group and 373 to the high-MAP group. There was no difference in mottling and lactate evolution during the first 24 h between the two MAP groups. After adjustment for MAP and confounding factors, the presence of mottling ≥ 6 h during the first 24 h was associated with a significantly higher risk of death at day 28 and 90. Patients without mottling or with mottling

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In order to assess their potential use as contact layers for Si photonics devices, Ni2P thin films were developed on a 300 mm platform. The Ni2P layers, obtained by magnetron sputtering of a Ni2P target, were stable and reproducible. The films were mainly composed of the hexagonal Ni2P phase with small amount of Ni12P5 impurities. The film density was 6.9 g/cm3 with a ratio of 62 at.% of Ni and 38 at.% of P. We implemented and integrated these Ni2P films on III-V structures to study their electrical properties on n-InP and p-InGaAs (i.e., n-doped and p-doped III-V/Si hybrid laser contact layers). The results obtained on p-InGaAs did not meet the requirements in terms of contact resistivity. On the other hand, due to its high thermal stability and low contact resistivities, Ni2P metallization exhibited the best results among the Ni-based metallizations studied for contacting n-InP layers, namely Ni, NiPt and Ni2P.

The reaction of a Ni 0.9 Pt 0.1 7 nm-thick thin film with the underlying Si(001) substrate as a function of the annealing temperature was studied using in situ XRD techniques as well as ex situ advanced XRD and TEM imaging on quenched samples. It was found that the Ni 0.9 Pt 0.1 /Si system initially evolves accordingly to diffusion controlled reactions via the development of nano-crystalline Ni-rich Ni 1 − x (Pt) Si x phases that combine the ability of fast kinetic growth and texture inheritance. The system remains then stable over some tens of degrees before Ni(Pt)Si nucleation occurs, once the related energetic barrier is overcome. It was additionally found that this newly observed phase sequence remains valid up to Ni 0.9 Pt 0.1 deposited layer thicknesses of about 16 nm, which is remarkable for such systems. [ABSTRACT FROM AUTHOR]

Lympho-epithelial interactions between intestinal T resident memory cells (Trm) and the epithelium have been associated with inflammatory bowel disease (IBD) activity. We developed ex vivo autologous organoid-mucosal T cell cocultures to functionally assess lymphoepithelial interactions in Crohn’s Disease (CD) patients compared to controls. We demonstrate the direct epithelial cell death induced by autologous mucosal T cells in CD patients but not in controls. These findings were positively correlated with T cell infiltration of the organoids. This potential was inhibited by limiting lympho-epithelial interactions through CD103 and NKG2D blocking antibodies. These data directly demonstrate for the first time the direct deleterious effect of mucosal T cells on the epithelium of CD patients. Such ex-vivo models are promising techniques to unravel the pathophysiology of these diseases and the potential mode of action of current and future therapies.

Summary of the photographic exhibition Tribal Canoe Journeys : Naviguer vers la souveraineté at the Librairie La Géothèque, 14 rue Racine, Nantes, between 1st and 30th September 2021 and interview with the artist Joe wahalatsu? Seymour.

Through examples of recently produced American films belonging to different genres – neowestern, drama, comedy and even science fiction - this article intends to show that white (anti)-heroes are still present and central to the narrative, and are presented in the end as better Indians than the Indians themselves. More importantly, the way whiteness is represented can only be fully understood by analyzing the construction of the Indian characters who, like an intaglio portrait, shape the character of the White Savior, validating his existence and enhancing it. Today still, whiteness depends on the inherent subordination of Indianness and feeds on its disappearance.

Aux abords de la réserve fictive de Red Crow, les morts reviennent subitement à la vie. Seule la population autochtone semble immunisée contre l’épidémie et doit gérer la vague d’individus réfugiés blancs souhaitant se mettre à l’abri. Quand, au début des années 2010, le réalisateur mi’gmaq Jeff Barnaby imagine ce scénario, il est loin de penser que son film Blood Quantum sera tristement d’actualité lors de sa sortie prévue en mars 2020. S’il respecte les codes classiques du film d’horreur, derrière son apparence de pur divertissement, Blood Quantum insuffle également un sous-texte historique qui invite le public à interroger les relations tumultueuses du Canada envers les peuples autochtones depuis la colonisation. D’une réponse aux pandémies – passées, présentes et futures –, Blood Quantum devient alors une puissante métaphore historique assortie d’une critique environnementale et sociale plus globale dont l’onde de choc, dans le contexte actuel, peut atteindre tout le monde.

This work illustrates the potential of dark-field X-ray microscopy (DFXM), a 3D imaging technique of nanostructures, in characterizing novel epitaxial structures of gallium nitride (GaN) on top of GaN/AlN/Si/SiO 2 nano-pillars for optoelectronic applications. The nano-pillars are intended to allow independent GaN nanostructures to coalesce into a highly oriented film due to the SiO 2 layer becoming soft at the GaN growth temperature. DFXM is demonstrated on different types of samples at the nanoscale and the results show that extremely well oriented lines of GaN (standard deviation of 0.04°) as well as highly oriented material for zones up to 10 × 10 µm 2 in area are achieved with this growth approach. At a macroscale, high-intensity X-ray diffraction is used to show that the coalescence of GaN pyramids causes misorientation of the silicon in the nano-pillars, implying that the growth occurs as intended ( i.e. that pillars rotate during coalescence). These two diffraction methods demonstrate the great promise of this growth approach for micro-displays and micro-LEDs, which require small islands of high-quality GaN material, and offer a new way to enrich the fundamental understanding of optoelectronically relevant materials at the highest spatial resolution., (© Maya Wehbe et al. 2023.)