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Resume Les donnees concernant les alarmes des dispositifs de mesure continue du glucose sont peu nombreuses dans la litterature. L’objectif de cette etude etait d’obtenir un consensus sur les avantages et inconvenients des alarmes de seuil de glucose a travers un panel Delphi. Cette methode est un outil d’aide a la decision permettant de rassembler des avis d’experts sur un sujet precis. De nombreux benefices des alarmes ont ete demontres, pour le patient, lui permettant un meilleur controle de sa maladie, ou pour son entourage qui se sent rassure, et egalement dans de nombreuses situations du quotidien : au travail, a l’ecole et pendant le sport. Ces benefices sont a mettre en perspective avec les inconvenients que peuvent engendrer les alarmes. Trop nombreuses, elles peuvent gener le patient, le decourager ou entrainer une prise de decision inadaptee. Enfin, l’optionalite de l’alarme apparait essentielle, car elle permet l’adaptation aux besoins particuliers du patient.

International audience; In this work, two copper metal matrix composites (MMCs) reinforced with 20 wt.% of Ti(C,N) or Ti2AlN particles were studied. The reinforcement particles were synthesized by flash sintering under 2 bar nitrogen atmosphere causing an SHS reaction ignited by electrical current. This reaction led to produce TiC0.7N0.3 solid solution for the MMC1 reinforcement and Ti2AlN, TiN, and Ti3Al titanium aluminide for the MMC2 reinforcement. Both MMCs were densified by liquid phase sintering. The structural characterization was performed by XRD analysis while the morphology and chemical element distribution of both MMCs were analyzed by SEM and EDS. The structure of the two MMCs was relatively dense and showed good wettability. The mechanical and tribological behavior of MMCs evaluated by nanoindentation and wear testing reveals that the addition of 20 wt.% of reinforcement considerably improves the properties of copper matrix. Indeed, the MMC1 proved to be 3 times harder and 10 times more wear-resistant than the MMC2 composite.

Instrumented Indentation Testing is applied on a fluoroelastomer so as to get information about the local mechanical response of such a rubbery material. Due to their viscoelasticity, elastomers exhibit a time-dependence, responsible for a variation in their behavior as a function of the stress or strain rate. A few studies highlight modifications of the indentation hardness H and modulus E r when the load function varies. However, these works concern polymers and, to our knowledge, such an investigation has not yet been carried out on elastomeric materials. Results about the influence of the loading-unloading procedure on E r are presented here. They show elastic modulus' variations depending on the chosen protocol's time scale and reported evolutions are consistent with the expected behavior of viscoelastic materials. Furthermore, in preparation of this main study, preliminary verifications were necessary since sources of error are known to distort indentation results. A focus on the microstructure and roughness is presented in this paper and reveals, in particular, a non-negligible improvement of indentation curves (load-displacement hystereses) with an appropriate sample preparation and surface finish. These results have finally been used as a basis for the study of local gradients within a rubber sample. This study revealed a gradient (i.e. an increasing modulus) from the outer part of the sample to the inner one, attributed to thermal effects during the molding.

OBJECTIVES In this study, we first assessed costs associated with the use of antiretroviral therapy (ART) in an infectious diseases University Hospital Clinic; second, we evaluated characteristics associated with these costs and finally simulated the impact on the overall ART budget of switching first-line and second-line regimens to less-costly regimens (as effective and well tolerated). DESIGN Cohort analysis including persons living with HIV (PLHIV) aged at least 18 years on ART to estimate ART costs during 2014. METHODS The current study was conducted in the Bichat-Claude Bernard University Hospital Clinic in Paris, France, where 4501 PLHIV consulted in 2014. We used the medical database Nadis to describe patients' ART, characteristics and estimated costs. When assessing the budgetary impact of potential switches, we considered patients' history of failure, CD4 cell count, plasma viral load, resistance mutations, hepatitis B surface antigen or HLAB5701 profile. RESULTS A total of 4238 of 4501 patients were on ART (94%). The total annual cost of ART prescribed was estimated at O48 280 200 in 2014; first/second (simplification)-line regimens represented 25% (1076/4238) of the treated PLHIV and 23% (O11 209 000) of the annual cost. For these PLHIV, we considered switches from the most common ART regimens (protease inhibitor boosted by ritonavir or nonnucleoside reverse transcriptase inhibitor + two nucleoside reverse transcriptase inhibitors) to less-expensive regimens. We found savings ranging from O36 100 to 1472 600/year. Savings were the highest when we considered switching to generic-based regimens or from protease inhibitor-based triple therapy to protease inhibitor monotherapy. CONCLUSION Costs associated with ART prescriptions are very high. Switches to generic-based regimens are associated with large savings. However, those targeting protease inhibitor regimens are also associated with substantial savings and should be considered.

National audience; The local mechanical response of a fluoroelastomer is presented through nanoindentation results. It is well known that elastomers properties aretime-dependent and thus are influenced by the experimental protocol parameters such as the maximum applied load or loading rates. One should consider with great care this time-dependence in the case of nanoindentation tests as it can be in the case of global characterizations. The aim of this study is to determine the influence of the time-dependence during nanoindentation characterization of elastomers. In fine, these investigations should lead to a robust methodology, capable of giving quantitative measurements of the local mechanical properties of industrial products made of elastomers. Thus, this paper draws up a description of the nanoindentation technique applied on elastomers materials and discusses the results which are clearly dependent on the way they are driven. Finally, information provided by this study allowed the technique to be applied on a multilayered composite rubber/polymer, which proved the relevance of the technique by detecting properties gradients within the composite.; La réponse mécanique locale d’un fluoroélastomère est présentée au travers de résultats denanoindentation. Les propriétés des élastomères présentent notamment une dépendance à la vitesse desollicitation et sont ainsi impactées par les variables du protocole expérimental choisies, telles que laforce maximale appliquée ou les vitesses de chargement. Cette caractéristique, intrinsèque à ce type de matériaux, est considérée avec soin dans le cadre d’essais à échelle globale et doit, au même titre, faire l’objet d’une attention particulière lors d’essais de nanoindentation. L’objectif de cette étude est d’appréhender l’impact de la dépendance au temps des élastomères lors de leur caractérisation en nanoindentation. Infine, les investigations doivent pouvoir mener à une méthodologie robuste capable de donner des mesures quantitatives des propriétés mécaniques locales d’élastomères de pièces réelles industrielles. Ce papier dresse donc une description de la technique de nanoindentation appliquée aux élastomères et discute les résultats qui apparaissent clairement dépendants de la manière dont les essais sont conduits. Enfin, les éléments apportés par cette prospection ont été appliqués à la caractérisation d’un composite multicouche caoutchouc/polymère. Cette étude applicative a prouvé l’aptitude de la nanoindentation à détecter desgradients de propriétés au sein du composite.