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Context The measurement of parathyroid hormone(PTH) in situ (PTHis) by fine-needle aspiration (FNA) has been proposed as a tool to preoperatively help localize parathyroid glands detected on ultrasound. However, the accuracy of PTHis is highly variable according to the few available studies. Aim We aimed to develop and validate the PTHis procedure and assessed the performance of PTHis in a large series of patients with hyperparathyroidism and/or undetermined cervical lesions. Patients and methods The technique set-up consisted of PTHis measurement in thyroid samples from patients with thyroid nodules and patients with high circulating PTH levels (tertiary hyperparathyroidism). Consecutive patients were recruited at one tertiary referral centre from 2017 to 2020 and submitted to ultrasound-guided FNA-PTHis determination. Results During the method set-up, we obtained undetectable PTHis levels in all non-parathyroid tissues after sample dilutions. PTHis was higher in patients with hyperparathyroidism (n = 145; 1817 ± 3739 ng/L; range: n= 34; P < 0.0001). When evaluating PTHis performance in histologically proven samples (158 lesions from 121 patients), PTHis was detectable in 85/97 parathyroid lesions (87%; range: 22–31;140 ng/L) and undetectable in all non-parathyroid lesions (n = 61; P < 0.0001). The specificity and positive predictive value were 100%, and the sensitivity was 87.6%. False-negative lesions (n= 12) were smaller (9.4 ± 5.9 mm) and more often consisted of hyperplasias (75%) than true-positive lesions (16.1 ± 8.4 mm and 33%, P = 0.009 and P = 0.0089, respectively). The method was safe and well tolerated. Four educational cases are also provided. Conclusions PTHis determination is a safe and well-tolerated procedure that enhances the specificity of ultrasound-detected lesions. If accurately set-up, it confirms the parathyroid origin of uncharacterized cervical lesions.

In this paper, we characterize the signature of traps existing in the new AlGaN/GaN HEMT of 0.15- $\mu \text{m}$ ultrashort gate length and $8 \times 50\,\,\mu \text{m}^{2}$ gate width (GH15) through three different measurement techniques which are low frequency (LF) S-parameters, drain-current deep level transient spectroscopy (I-DLTS), and LF drain noise characterization. These three different measurements techniques were performed for varying chuck temperatures ( $T_{\mathrm {chuck}}$ ) ranging between 25 °C and 125 °C and for the same biasing condition. All measurements ensure approximatively the extraction of the same signature of traps [apparent activation energy ( $E_{a}$ ) and cross section ( $\sigma _{n}$ )] existing in the UMS device. Furthermore, we have characterized the thermal resistance ( $R_{\mathrm {TH}}$ ) using pulsed $I$ – $V$ measurement and a two-step calibration process. The determination of $R_{\mathrm {TH}}$ is important to evaluate the device and to know precisely the signature of traps $E_{a}$ and $\sigma _{n}$ defined by the Arrhenius equation. A large signal measurements using an unequally spaced multitone (USMT) signal were done in order to evaluate the performance of GH15 transistor around the optimum load impedance in terms of efficiency (max PAE ~ 55%). The leakage current which measured before and after all measurements for $V_{\mathrm {GS}} = -6$ , −7 V and for $V_{\mathrm {DS}}$ varying from 0 to 10 V was lower than $100~\mu \text{A}$ /mm. To our knowledge, results on charge-trapping and large-signal performance are reported for the first time in 0.15- $\mu \text{m}$ technology.

Summary Background GIP-dependent primary bilateral macronodular adrenal hyperplasia with Cushing's syndrome is caused by aberrant expression of the GIP receptor in adrenal lesions. The bilateral nature of this disease suggests germline genetic predisposition. We aimed to identify the genetic driver event responsible for GIP-dependent primary bilateral macronodular adrenal hyperplasia with Cushing's syndrome. Methods We conducted a multicentre, retrospective, cohort study at endocrine hospitals and university hospitals in France, Canada, Italy, Greece, Belgium, and the Netherlands. We collected blood and adrenal samples from patients who had undergone unilateral or bilateral adrenalectomy for GIP-dependent primary bilateral macronodular adrenal hyperplasia with Cushing's syndrome. Adrenal samples from patients with primary bilateral macronodular adrenal hyperplasia who had undergone an adrenalectomy for overt or mild Cushing's syndrome without evidence of food-dependent cortisol production and those with GIP-dependent unilateral adrenocortical adenomas were used as control groups. We performed whole genome, whole exome, and targeted next generation sequencing, and copy number analyses of blood and adrenal DNA from patients with familial or sporadic disease. We performed RNA sequencing on adrenal samples and functional analyses of the identified genetic defect in the human adrenocortical cell line H295R. Findings 17 patients with GIP-dependent primary bilateral macronodular adrenal hyperplasia with Cushing's syndrome were studied. The median age of patients was 43·3 (95% CI 38·8–47·8) years and most patients (15 [88%]) were women. We identified germline heterozygous pathogenic or most likely pathogenic variants in the KDM1A gene in all 17 patients. We also identified a recurrent deletion in the short p arm of chromosome 1 harboring the KDM1A locus in adrenal lesions of these patients. None of the 29 patients in the control groups had KDM1A germline or somatic alterations. Concomitant genetic inactivation of both KDM1A alleles resulted in loss of KDM1A expression in adrenal lesions. Global gene expression analysis showed GIP receptor upregulation with a log2 fold change of 7·99 (95% CI 7·34–8·66; p=4·4 × 10−125), and differential regulation of several other G protein-coupled receptors in GIP-dependent primary bilateral macronodular hyperplasia samples compared with control samples. In vitro pharmacological inhibition and inactivation of KDM1A by CRISPR-Cas9 genome editing resulted in an increase of GIP receptor transcripts and protein in human adrenocortical H295R cells. Interpretation We propose that GIP-dependent primary bilateral macronodular adrenal hyperplasia with Cushing's syndrome results from a two-hit inactivation of KDM1A, consistent with the tumour suppressor gene model of tumorigenesis. Genetic testing and counselling should be offered to these patients and their relatives. Funding Agence Nationale de la Recherche, Fondation du Grand defi Pierre Lavoie, and the French National Cancer Institute.

Current transient spectroscopy was used to measure the impact of neutron irradiation on output current-limiting charge traps in AlGaN/GaN high electron mobility transistors with time constants from 10 ms to 1800 s. We find that coupling between discrete traps was apparent, in contrast to the commonly employed assumption of independent trap (dis)charging, and increased after 14-MeV neutron irradiation of $2 \times 10^{13}\,\,\text {n/cm}^{2}$ and above. Irradiation to a high dose of as much as $7.8 \times 10^{14}\,\,\text {n/cm}^{2}$ , which is comparable to eight years exposure to a harsh radiation environment, such as the International Thermonuclear Experimental Reactor neutral-beam injector prototype, increased trapped charge density and reduced transient drain current to as little as 75% of its equilibrium value. These changes are consistent with displacement damage estimates based on the radiation transport calculations.

Purpose Nausea and vomiting is the main cause of failure of enhanced recovery protocol (ERP) after right hemicolectomy. Methods From January 2013 to January 2018, all patients undergoing right hemicolectomy were prospectively included. Patients undergoing emergency surgery, additional complex procedure or temporary stoma, nasogastric tube (NGT) maintenance, or abdominal drainage were excluded. Failure of ERP was defined as nausea/vomiting precluding oral feeding after POD3 and/or the occurrence of postoperative ileus requiring NGT and/or length of stay (LOS) ≥ 8 days except for patients awaiting admission in rehabilitation unit. Risk factors of failure of ERP were identified using univariate and multivariate analysis. Results Among 306 patients undergoing right hemicolectomy, 140 fulfilled the inclusion criteria. Postoperative morbidity was 31%, and the mortality rate was nil. The mean postoperative hospital stay was 7 days (range 2–30). Successful ERP was achieved in 83 patients (59%). Causes of failure were major nausea/vomiting precluding oral feeding after POD3 in 36, postoperative ileus requiring NGT in 16 and LOS ≥ 8 days in 36. On multivariate analysis, preoperative anemia (OR 5.2; CI 95%, 1.3–21.1, p = 0.02) and platelet anti-aggregant/anti-coagulant (OR 4.5; CI 95%, 1.7–12.1, p = 0.003) were associated with the risk of failure of ERP. Conclusion This study shows that anemia and medication with antiplatelet/anticoagulation therapy increase the risk of failure of ERP after right hemicolectomy that translates most of the time by nausea/vomiting and postoperative ileus. The presence of these factors should lead to adapt the strategy to improve outcome rather than be considered as contraindication to ERP.

In this article, we present the results of on-wafer short-term (24 h) stress tests carried out on 0.25- $\mu \text{m}$ AlGaN/GaN HEMTs. Devices on-wafer were submitted to 24-h dc tests, at various gate and drain voltage values corresponding to dissipated power densities ${P}_{D}$ up to 40 W/mm, with estimated channel temperature $\cong$ 375 °C. GEN1 devices adopted a Ni/Pt/Au gate metallization and conventional plasma-enhanced chemical vapor deposition (PE-CVD) SiN passivation; in GEN2 devices, a modified gate metallization and a two-layer SiN passivation were adopted. When tested at ${P}_{d} >{25}$ W/mm, a substantial decrease of drain current $I_{D}$ and transconductance ${g}_{m}$ was measured in GEN1 HEMTs, without any significant shift of threshold voltage. Failure analysis revealed that Au and O interdiffusion took place from the sidewalls; Au gradually substituted Ni as a Schottky contact, while O, in the presence of high electric field, high temperature, and high current, promoted (Al)GaN oxidation and pitting. On the contrary, negligible degradation was found after high temperature storage of GEN1 devices without applied bias, up to 450 °C. In GEN2, process modification was effective in reducing the impact of this failure mechanism, resulting in only 5% ${g}_{m}$ decrease after 24 h at a junction temperature of 375 °C with ${P}_{D} = {38}$ W/mm. Results demonstrate the effectiveness of the adopted on-wafer screening methodology in identifying potentially dangerous failure mechanisms.

The aim of this prospective study was to assess the influence of morphological characteristics of anastomotic doughnuts on the risk of anastomotic leakage (AL) after double-stapled colorectal anastomosis.This single-center prospective study enrolled all patients undergoing double-stapled colorectal anastomosis between December 2012 and December 2015. Maximal diameter and minimal and maximal heights and widths of both colonic and rectal doughnuts were measured by surgeons in the operating room. Their influence on the risk of AL was analyzed on uni- and multivariate models.One hundred fifty-four patients were included; 92 (59.7%) were operated on for malignancy. Colorectal anastomosesand10 cm above the anal verge were performed in 96 (62.3%) and 58 (37.7%) patients, respectively. AL occurred in 17 (11.0%). The minimal height of the colonic doughnut (CD) was the only measurement significantly associated with an increased risk of AL (p = 0.026). A cutoff value of 4.5 mm for the CD determined on the ROC curve (AUC 0.685, p = 0.013) yielded the best sensitivity (61.4%) and specificity (82.4%) to predict AL. On multivariate analysis, a height of the CD4.5 mm (OR 5.743, 95% IC 1.476-22.346, p = 0.012), malignant disease (OR 8.821, 95% IC 1.051-74.006, p = 0.045), and American Society of Anesthesiologists score2 (OR 3.408, 95% IC 1.017-11.418, p = 0.047) were the only independent risk factors of AL.The CD's minimal height influences the risk of AL. Its routine measurement during operation, along with other risk factors, could help to decide which patients could benefit from a diverting stoma or the creation of a new anastomosis.

An experimental method to measure the gate metal temperature of GaN-based high electron mobility transistors is demonstrated. The technique is based on transient thermoreflectance measurements performed from the backside of the device. The thermoreflectance coefficient of the gate metal was calibrated by correlating the relative change of its optical reflectivity with the temperature change measured in the GaN layer using time-resolved Raman thermography during the device cooling transient. Simulated temperature transients were in good agreement with the experimental data. The main advantage of this new method is that it enables the direct assessment of gate metal temperature under device pulsed operation regardless of the device design.

This paper describes the test plan and the main results achieved by UMS during a space evaluation of its second generation 0.5 μm GaN RF power bar technology, called GH50-20. The space evaluation tests results are summarised: a life time higher than 5.106 h @ 200 °C is found, SEE, TID and DD radiation hardness safe area were defined, and failure rate below 10 FIT @ 200 °C was determined. The results also include demonstration of representative integrated circuits up to 130 W RF power level when operated in L-band in continuous wave (CW) mode. The GH50-20 technology has successfully passed the space evaluation program and is deemed suitable for use in space.

International audience; The charges in wide bandgap Gallium Nitride (GaN) High Electron Mobility Transistors (HEMT) can be identified by means of various methods such as electrical transient and pulsed measurements, or noise spectroscopy methods, usually performed at different temperatures to extract activation energies. These traps can be passivated or activated according to electrical or thermal conditions over the lifetime. Therefore, the distinction between harmful traps (with consequences on performances) and harmless traps (without impact on electrical behaviour) must be performed. In this paper, devices stressed by HTOL (High Temperature Operating Life) are characterized by time domain electrical techniques (transient and pulsed), and with low frequency noise (LFN) experimental tools. By performing characterizations on the gate and on the drain, it is also possible to identify the drain current sensitivity to charges located in specific regions of the transistor (command or channel zones). The proposed case study discriminates the traps in the GaN buffer and at the vicinity of the AlGaN/GaN interface. The HTOL stress impacts the traps at the interface border zone in the AlGaN layer. This causes a drift in the threshold voltage Vth, also with a hysteresis depending on direction of increasing or decreasing sweep of the gate voltage during the characterization. Also the Schottky diode leakage current profile at the transition voltage between forward and reverse biasing mode has been analysed versus temperature. The thermal sensitivity of the drift of the threshold voltage and of the transition voltage is attributed to the kinetics of ionization and neutralization of the donor traps with the applied gate voltage. This drift of Vth, and the action of many other traps or charges, cause the drain current to vary over time. These results are finally compared to those obtained by HTRB stress (High Temperature Reverse Bias), presenting similar degradation signatures over a longer stress period.

International audience; We have developed new benign palladium nanoparticles able to catalyze the Suzuki-Miyaura cross-coupling reaction on human thyroglobulin (Tg), a naturally iodinated protein produced by the thyroid gland, in homogenates from patients' tissues. This represents the first example of a chemoselective native protein modification using transition metal nanoobjects in near-organ medium.

This paper reports the recent qualification for space application of power GaAs & GaN HEMT technologies. A summary of the qualification process of technologies capable to address MMIC applications up to l00GHz is presented. The first part will present the technology descriptions of GaAs based PPH15X-20 & PH10 and GaN based GH25-10 - which is to our knowledge the first GaN on SiC MMIC technology space evaluated. In a second part, key figures of the qualification plan will be summarized.

This paper describes the main characteristics of the new GaN-on-SiC technology in development at UMS. This technology is based on a $0.15 - \mu \mathrm{m}$ gate-length and it is in the phase of industrial qualification for a target release by the end of the year. The results of two out of four demonstrators already successfully designed on the new technology are also reported: a 29.5–36 Ghz 9W HPA and a 15.5–18.5 GHz 20W HPA.

International audience; This paper proposes an investigation focused on the Schottky diode related electrical behaviors on GaN high frequency technologies. As the Schottky diode represents the electrical input terminal (the command) of High Electron Mobility Transistors (HEMTs), this study also correlates with some first order degradation in the active channel (current IDS). Non-invasive methods and related models have been used to determine the accurate Schottky Barrier Height (SBH) of the diode in terms of mean value and dispersion; this approach is convenient to evidence different failure mechanisms on virgin and stressed devices that can be correlated with DC or transient electrical parameters. It is shown that according to given temperature windows and IGS ranges, linear relationships can be extracted between the mean SBH and the inhomogeneities of the SBH that appear in forward-biased diode mode. This original approach permits to determine an increase or a decrease of the global SBH after a stress period. Electrical behaviors issued from the proposed non-destructive technique and from electrical modelling of the diode at different temperatures are found to be consistent with Transmission Electron Microscope (TEM) investigations. T-CAD models have also been used and tuned to account for the impact of interface fixed charge density changes on the electrical signatures of the HEMTs.

Systemic sclerosis per se should not be considered as an a priori contraindication for a pre-transplantation assessment in patients with advanced interstitial lung disease and/or pulmonary hypertension. For lung or heart-lung transplantation, a multidisciplinary approach, adapting the pre-transplant assessment to systemic sclerosis and optimizing systemic sclerosis patient management before, during and after surgery should improved the short- and long-term prognosis. Indications and contraindications for transplantation have to be adapted to the specificities of systemic sclerosis. A special focus on the digestive tract involvement and its thorough evaluation are mandatory before transplantation in systemic sclerosis. As the esophagus is almost always involved, isolated gastro-oesophageal reflux disease, pH metry and/or manometry abnormalities should not be a systematic per se contraindication for pre-transplantation assessment. Corticosteroids may be harmful in systemic sclerosis as they are associated with acute renal crisis. A low dose corticosteroids protocol for immunosuppression is therefore advisable in systemic sclerosis.

This paper deals with a power drift occurring during the first hours of aging tests on a 0.15 μm GaN-based technology. Its purpose is to characterize the kinetic and the electrical features of this parasitic effect. Output power drift has been monitored by substituting interim RF power measurements by pulsed-IV measurements during high temperature reverse bias tests. Moreover, the kinetic of the output power drift has been assessed by reducing the time between interim measurements. Additional aging tests were performed at different temperatures to found out if the degradation is temperature activated. An interpretation is proposed about an increase of trap density responsible for drain lag effect after aging test at temperature higher than room temperature.

This paper deals with the deep characterization of a novel electrical parasitic effect in AlGaN/GaN technology so called “electrical runaway mechanism.” It is characterized by an anomalous gate current behaviour. Electrical measurements versus temperature show that the runaway mechanism threshold is temperature independent on the contrary to the gate current progression as a function of ${\mathrm {V}}_{\mathrm{DS}}$ . Optoelectrical measurements show that the physical mechanism inducing the runaway mechanism occurs below the gate area. Then, reliability aging tests performed in the frame of a 0.5- $\mu \text{m}$ GaN technology present the runaway mechanism as a wear out mechanism. Finally, the runaway mechanism has been associated with tunnel conduction through gate metal and AlGaN layer.

This prospective study aimed to compare outcomes after laparoscopic peritoneal lavage (LPL) and sigmoid resection with primary colorectal anastomosis (RPA). From June 2010 to June 2015, 40 patients presenting with Hinchey III peritonitis from perforated diverticulitis underwent LPL or RPA. Patients with Hinchey II or IV peritonitis and patients who underwent an upfront Hartmann procedure were excluded. Primary endpoint was overall 30-day or in-hospital postoperative morbidity after surgical treatment of peritonitis. Twenty-five patients underwent RPA and 15 LPL. Overall postoperative morbidity and mortality rates were not significantly different after RPA and LPL (40 vs 67 %, p = 0.19; 4 vs 6.7 %, p = 1, respectively). Intra-abdominal morbidity and reoperation rates were significantly higher after LPL compared to RPA (53 vs 12 %, p

GaN technology has gained a lot of attention in Europe over the last few years for various domains including RF electronics. After a few years of active observation, United Monolithic Semiconductors (UMS) has taken the decision to introduce a GaN technology family in its portfolio. Based on its extensive experience of III–V technology and the intensive support and collaboration with partners and European research institutes, UMS has developed the capability to produce state-of-the-art GaN devices and circuits. The present paper will summarize the current status achieved and illustrate it with a few representative examples. Aspects covering material, devices, and circuits will be addressed.

This paper shows a specific approach based on infrared (IR) thermography to face the challenging aspects of thermal measurement, mapping, and failure analysis on AlGaN/GaN high electron-mobility transistors (HEMTs) and MMICs. In the first part of this paper, IR thermography is used for the temperature measurement. Results are compared with 3D thermal simulations (ANSYS) to validate the thermal model of an 8x125pm AIGaN/GaN HEMT on SiC substrate. Measurements at different baseplate temperature are also performed to highlight the non-linearity of the thermal properties of materials. Then, correlations between the junction temperature and the life time are also discussed. In the second part, IR thermography is used for hot spot detection. The interest of the system for defect localization on AIGaN/GaN HEMT technology is presented through two case studies: a high temperature operating life test and a temperature humidity bias test.

Bilateral adrenalectomy is the reference treatment for Cushing's syndrome (CS) related to primary bilateral macronodular adrenal hyperplasia (PBMAH). It is, however, responsible for definitive adrenal insufficiency.The objective of the study was to evaluate the clinical interest of unilateral adrenalectomy (UA) of the larger gland for the treatment of CS related to PBMAH.This was a retrospective study in four tertiary French centers including all 15 patients with PBMAH and CS who underwent UA of the larger gland between 2001 and 2015.Urinary free cortisol, plasma cortisol, ACTH, body mass index, blood pressure, plasma glucose, and lipids were registered pre- and postoperatively and on follow-up. Median follow-up was 60 months (interquartile range 39-105), including 8 of 15 patients followed up for at least 5 years.A normal or low urinary free cortisol was obtained in 15 of 15 patients (100%) postoperatively. Six patients (40%) became adrenal insufficient, of whom three of six recovered a quantitatively normal cortisol secretion on follow-up. Decrease of both body mass index and blood pressure were observed at 1 year, and decrease of blood pressure was persistent 5 years postoperatively. Diabetes was cured in four of six patients. Two patients experienced a recurrence of hypercortisolism, and one was treated with mitotane, whereas the other underwent a second adrenal surgery 9 years after initial UA.UA induced remission of hypercortisolism in all patients, with sustained significant clinical improvement. The rates of both definitive adrenal insufficiency and 5-year recurrence were low. UA appears an interesting alternative to bilateral adrenalectomy as a first-line treatment in PBMAH responsible for overt CS.