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Anterior cruciate ligament (ACL) rupture is a common affliction in the athletic population. In pediatric patients, the immature skeleton with active growth plates is an issue that makes ACL reconstruction surgery technically challenging. The rerupture rate after ACL reconstruction is higher in the pediatric population than in the adult population. The addition of anterolateral ligament (ALL) reconstruction has been shown to be an effective way to reduce the rate of graft rupture and to control rotatory instability (pivot shift). Therefore, it appears necessary to combine ACL and ALL reconstruction in the pediatric population. We describe the surgical steps for combined ACL and ALL reconstruction adapted for young patients with active growth plates.

OBJECTIVE: We determined secular changes in the incidence of hospitalizations due to herpes zoster (HZh) and assessed the validity of HZ International Classification of Diseases (ICD) code algorithms for identifying HZh in a region of Quebec, Canada. METHODS: We performed a validation study as part of a retrospective cohort study of adult HZ patients hospitalized at Centre Hospitalier Universitaire de Sherbrooke during 2000-2017. Cases were identified using ICD codes from an inpatient administrative database. HZ cases identified by ICD-9 (053.xx) and ICD-10 (B02.x) codes were chart-confirmed, and performance characteristics of ICD code algorithms were calculated (positive predictive value [PPV] and sensitivity). RESULTS: Overall, 1314 hospitalizations with HZ diagnosis (HZh) with or without complications were identified during 2000-2017. Among the hospitalizations, 526 (44.4%) were due to active HZ disease or a complication related to a recent or previous HZ episode. These hospitalizations were due to active disease at the time of admission (340/526, 64.6%), HZ that developed during hospitalization (120/526, 22.8%), or a complication directly related to a recent or previous HZ episode (66/526, 12.6%). PPV was significantly higher when HZ was the primary diagnosis (276/310, 89%, 95% confidence interval [CI]: 85-92%) than when HZ was a secondary diagnosis (254/928, 27%, 95% CI: 25-30%) (p 

Resume La strategie therapeutique chirurgicale dans l’instabilite chronique de cheville est de plus en plus precise. En cas de lesion isolee symptomatique non reparable du ligament talo-fibulaire anterieur (LTFA), il existe une indication chirurgicale de reconstruction isolee du LTFA. L’utilisation habituelle d’un gracilis comme greffon nous semble inadaptee. L’interet pour le tendon plantaris comme transplant a recemment ete relance par une etude biomecanique retrouvant des proprietes comparables du LTFA et de ce tendon dans sa forme quadruplee. Nous decrivons ici une technique arthroscopique originale de reconstruction isolee du LTFA au tendon plantaris quadruple.

Resume Introduction Les resultats a 20 ans de recul apres ligamentoplastie du croise anterieur sont rares. Cette etude a ete realisee afin d’etudier la prevalence de la gonarthrose a plus de 20 ans de recul d’une ligamentoplastie du croise anterieur et de determiner les facteurs de risque. Hypothese : Les lesions meniscales, le niveau d’activite, le delai traumatisme–chirurgie, l’indice de masse corporelle, la laxite residuelle, le positionnement des tunnels et les lesions cartilagineuses traumatiques influencent l’evolution vers la gonarthrose. Materiel et methodes Cette serie retrospective multicentrique regroupait 182 patients. Elle a ete realisee dans le cadre d’un symposium SOFCOT dont deux tiers des effectifs etaient des femmes. La technique chirurgicale etait arthroscopique dans 82 % des cas et un transplant de type os–ligament patellaire–os etait utilise dans 92,8 % des cas. L’âge moyen a la chirurgie etait de 26 + 7 ans. Les scores cliniques recueillis etaient l’IKDC objectif et subjectif, le KOOS. Les signes radiographiques d’arthrose etaient classes selon l’IKDC. Les facteurs predictifs d’arthrose etudies etaient l’âge, le sexe, l’IMC, le niveau d’activite, le delai traumatisme–chirurgie, les meniscectomies, les chondropathies, le positionnement des tunnels et la laxite residuelle. Resultats Au dernier recul, pour l’IKDC objectif il y avait 48 % de genoux normaux (A), 35 % d’anormaux (B) et 17 % de pathologiques (C et D). Le score IKDC subjectif moyen etait de 82,7 + 13,1. Une arthrose moderee a severe etait presente dans 29 % des cas. Les facteurs de risque de gonarthrose identifies etaient : la meniscectomie mediale ou laterale, la laxite residuelle, l’âge a la chirurgie > 30 ans et la pratique d’un sport comprenant du pivot. La meniscectomie etait un facteur essentiel de survenue d’arthrose (17 % si les menisques etaient preserves et 46 % en cas de meniscectomie). Enfin le taux de re-rupture etait de 13 %. Conclusion La reconstruction du LCA donne des resultats satisfaisants sur la stabilisation du genou mais le devenir cartilagineux depend principalement du statut meniscal. La laxite sequellaire a egalement un role favorisant la gonarthrose. Niveau de preuve IV, etude retrospective de cohorte.

BACKGROUND: Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare complication of cancer that was described almost 30 years ago. However, a minimal amount is known about this condition making...

Background COVID-19 changed the way we practice oncology in multiple ways. Because most cancer patients are comorbid or immunocompromised, we are trying as much as possible to reduce their risk of infection. Marginal just 2 years ago, telemedicine quickly became preeminent with the pandemic to reduce hospital exposure. However, using only virtual visits in oncology patients risk delaying cancer diagnosis or the identification of a complication. Case series We present here four cases where a serious medical problem evident on physical exam was overlooked during a virtual visit. Two of our patients experienced a delay in cancer diagnosis thus putting them at risk of local or distant spread. The two others were established oncology patients where a serious medical complication was missed on a virtual visit. Conclusions Now more than a year into the pandemic, telemedicine has clearly been a useful tool by limiting unnecessary hospital visits. Yet, as our cases illustrate, its use in oncology without clear boundary can undermine the quality of care. Now that effective vaccines are reducing the transmission and the severity of infection, most oncology patients can be evaluated by a real-time visit.

This paper contributes to the establishment of product lifetime extension (PLE) as a field of study through development of a framework of product lifetime extension business models (PLEBM), and offering of a taxonomy of PLEBM. The proposed taxonomy of PLEBM draws systematically on characteristics of 150 organizations which are identified in the scholarly and managerial literature as engaging in PLE. By considering the full spectrum of PLE practices systematically, we delineate these organizations on seven dimensions (i.e., key activities, key partners, channels, customer segments, customer relationships, offering, and revenue streaming) with 30 corresponding literature-based features. A clustering procedure, with key activities and key partners as input variables, revealed seven mutually exclusive PLEBMs: Relational product-as-a-service, Brick&digital product nurturers, Quality product designers, Secondhand vendors, Marketer-managed access systems, and P2P access brokers. Overall, product nature improvement through design is found less prevalent than product nurture strategies, such as maintenance (maintenance/advice/training/consulting), recovery (remanufacturing and repair), redistribution and access schemes. This study also presents a state-of-the-art overview on how organizations and consumers extend (pro-)actively product lifetimes.

The cost of materials is one of main obstacles for the development of thermochemical energy storage. Compared with traditional inorganic salt hydrates, a mineral named ettringite can easily overcome this limit thanks to its large resource from cementitious materials. Meanwhile, possession of high energy density (about 500 kWh/m3), low corrosiveness, non-toxicity and low working temperature (~ 60 °C) around or below common heat resource (solar energy, industrial waste heat, urbane heat system, and even combination with grid) makes ettringite very competitive to be used in an integrated thermal energy storage system. In this paper, the analysis on the available data for structure, preparation of material, thermal conversion, reaction enthalpies, carbonation durability, and ionic substitution of ettringite has been established. Moreover, potential research directions and solutions to improve thermal performance of ettringite-based materials are proposed.

The mismatch between renewable energy supply and demand requires energy storage technologies to work out the dilemma. In the thermal energy field, ettringite-based energy storage seems to be a good solution thanks to its high energy density and low material cost. It can store excess solar energy to meet the heating and domestic hot water demand in buildings. Therefore, the current work experimentally examines the energetic performance of an ettringite-based material made of commercial cements. The TG-DSC analysis shows the energy storage capacity of the investigated material is as high as 282 kWh/m3 original hydrated materials. Besides, the laboratory reactor tests prove the charging temperature is as low as 55–65°C for ettringite. Under operating conditions, the average energy-releasing power during the full period is about 33.3 W/kg while the maximum power is about 915 W/kg original hydrated materials, which are significantly higher than most materials from the literature. The best volumetric energy-releasing density and the corresponding prototype storage density of the fixed-bed obtained are 176 kWh/m3 original hydrated materials and 104 kWh/m3, respectively.

The use of ettringite-based materials for thermochemical heat energy storage has attracted researchers' attention in recent years since ettringite has advantages like low material cost and high energy storage density (~500 kWh/m3). However, carbonation, which modifies its structure and reduces the capacity of energy storage, is an important hindrance to real applications. To address this issue, the present study focuses on the carbonation kinetics of three ettringite-based and corresponding meta-ettringite-based materials (dehydrated samples) exposed to different relative humidity (RH) and CO2 concentrations. A mixture of 80 wt% pre-blended Calcium Aluminate Cement/20 wt% OPC (C80P20) proved to be the most resistant against CO2. The hydrated and dehydrated C80P20 grains carbonated slowly at 50% RH and 1 vol% CO2, consuming little ettringite after 28 days. At 90% RH, carbonation was accelerated such that all ettringite and meta-ettringite materials were depleted at 11 days with vaterite and aragonite as the main calcium carbonates. The produced CaSO4 hydrates were found as hemihydrate at 70% RH and gypsum at 90% RH. Finally, the thermal energy storage capacity (TESC) of the material was systematically quantified as essentially decreasing with the carbonation degree of ettringite-based materials.

Resume Les fractures complexes metaphyso-epiphysaires de l’extremite proximale du tibia peuvent conduire, outre le defaut de reduction articulaire, a un defaut d’axe du membre inferieur apres osteosynthese, necessitant une reprise chirurgicale. La navigation est un outil qui a fait ses preuves pour controler en peroperatoire l’axe mecanique du membre inferieur dans les osteotomies et les arthroplasties du genou. Elle est utilisable en chirurgie traumatologique, pour ces fractures complexes, en realisant une osteosynthese temporaire par une plaque a vissage verrouille, permettant la mise en place des capteurs et la realisation des manœuvres de navigation pour controler l’axe du membre inferieur. Il est possible de reprendre le montage a minima en cas d’anomalie de l’axe, en modifiant la fixation diaphysaire sans toucher aux vis metaphysaires. L’objectif de ce travail etait de presenter son utilisation au cours de 3 osteosyntheses de fractures du plateau tibial.

Pulmonary tumor embolism (PTE) is a rare manifestation of cancer. It is characterized by the presence of tumor cell emboli in the pulmonary arterioles and capillaries leading to an elevation of pulmonary vascular resistance. The ante-mortem diagnosis is difficult. We report a case of PTE associated with recurrent breast cancer that presented with neurological symptoms due to paradoxical cerebral embolism.

The strategy for surgical treatment of chronic ankle instability is becoming increasingly refined. In instances of isolated symptomatic non-repairable anterior talofibular ligament (ATFL) injury, there is a surgical indication for isolated ATFL reconstruction. However, we feel that the typical gracilis tendon graft is not always appropriate. Interest in using the plantaris tendon as a graft has picked up since a biomechanics study found the tensile strength of a quadrupled plantaris tendon is comparable to that of the ATFL. Here, we describe an original arthroscopic technique for isolated ATFL reconstruction using a quadrupled plantaris tendon (PT4) graft.

One of the main challenge in belite, ye'elimite and ferrite cement is the control of the belite phase reactivity. We propose to study two mechanisms that impact belite hydration kinetic: the first mechanism is linked to available space for hydration products and can be seen as a decrease of water accessibility to cement surface and the second concerns the cement fineness. We used a thermodynamic model that can predict phase assemblage and we found good correlations between this model and the results obtained with XRD measurement and Rietveld refinement.

Depuis les quarante dernières années, les marchés financiers se sont développés à un rythme fulgurant. Plusieurs facteurs peuvent expliquer cette croissance. Certes, la baisse des taux d’intérêt sur les placements traditionnels aura incité les épargnants à aller vers des placements offrant un plus grand potentiel de rendement. La mondialisation aura aussi permis l’accès à davantage de produits et de marchés. Il ne faut toutefois pas négliger le rôle de la déréglementation du secteur financier qui aura permis aux institutions financières d’offrir une panoplie de services et de créer de nouveaux produits de plus en plus complexes. Tous ces facteurs, combinés à l’émergence de nombreux fonds spéculatifs, auront permis de créer une économie qui repose davantage sur l’industrie financière que sur l’industrie manufacturière., In the last forty years, financial markets have grown at a very quick pace. A lot of factors can explain this growth. First the low interest rate have encouraged savers to take out their money and place it in more profitable investment. Globalization also gave investors access to new products and markets. But we must not neglect the impact of a low-rules environment which has enabled financial institutions to offer a range of services and create new and more complex products. All of these factors combined with the emergence of many hedge funds will have created an economy that relies more on the financial industry than on the manufacturing industry.

International audience; PURPOSE:The aim of this study was to analyse the clinical and radiographic results of 208 e-Motion® posterior cruciate-retaining, mobile bearing prostheses (BBraun-Aesculap, Tuttlingen, Germany) fitted using computer navigation, for knee osteoarthritis with a genu varum greater than 10°.METHODS:One hundred ninety-two patients were operated on with 208 e-Motion® prostheses fitted, between January 2006 and December 2011, using the OrthoPilot® computer navigation system. Average pre-operative IKS score was 70 ± 27 points (6-143) with a function score of 38 ± 20.5 (0-90) and a knee score of 32.5 ± 13 (0-63). Average flexion was 116.5° ± 13° (65-140°). Average pre-operative HKA angle was 166° ± 3° (154-169°).RESULTS:2Results are available for 134 patients, with a total of 150 knees operated on (38 lost to follow-up and 20 deceased). Average follow-up was 104.5 months (60-116 months). On last follow-up, the average IKS was 180 ± 22 points (95-200) with 86.5 ± 16 points (25-100) for the function score and 93.5 ± 8 points (55-100) for the knee score. Knee flexion was 116° ± 10.5° (80-135°) and average HKA angle was 179° ± 2° (175-184°). The pre-operative objective was achieved in 90.5% of knees.CONCLUSION:The e-Motion® mobile bearing posterior cruciate-retaining prosthesis, fitted using computer navigation, offers excellent results after an average of 8.5 years follow-up. These results are at least equivalent, even superior, to those of the posterior-stabilised prostheses usually used for this type of deformity.

More attention on renewable energy has been attracted after the achievement of Paris Agreement against climate change. Solar-based technology is supposed to be one of the most promising green energy technologies for residential buildings since its wide thermal usage for hot water and heating. However, the seasonal mismatch between its energy-production and consumption makes buildings need an energy storage system to improve the efficiency of renewable energy use. Indeed, even if different kinds of energy storage systems using sensible or latent heat already exist, thermochemical energy storage can be then recommended by considering the problems of energy dissipation during storage and low energy density for the first two methods. As potential thermochemical storage materials, ettringite (3CaO∙Al2O3∙3CaSO4∙32H2O) based materials possess high energy densities (~500 kWh/m3), low material cost (3) and low storage temperature (~60−70°C), compared to salt hydrates of similar energy density like SrBr2·6H2O (42 k€/m3, ~80°C), LaCl3·7H2O (38 k€/m3, ~100°C) and MgSO4·7H2O (5 k€/m3, ~150°C). Therefore, ettringite-based materials have the possibility to be largely used in building sector by being coupled to normal solar collector systems via reversible chemical reactions (Equation (1)): (i) charging mode: hot air or hot water (>70°C) from solar collectors dehydrates ettringite to meta-ettringite, and consequently store heat to chemical energy; ii) discharging mode: humid air is pumped to material container to rehydrate meta-ettringite, and consequently release stored chemical energy as heating. However, the lack of extensive examination leads to poor knowledge on their thermal properties and limits maturity of this technology. Therefore, the aim of this work is to characterize the capacity of an ettringite-based material (named C80P20, containing ~70 wt.% ettringite) in terms of thermal energy storage by Thermogravimetric Analysis (TGA) and Differential Scanning Calorimetry (DSC). Besides, a modular reactor adapting to thermal characterizations of C80P20 particles has been developed for various weights (up to 300 grams). In our case, the energy density of pure ettringite is around 1012 J/g while 708 J/g for C80P20 powder in TGA-DSC. First preliminary results from modular reactor demonstrate a general energy density of 150 kWh/m3 released by the hydration process of C80P20 grains (pre-dehydrated at 80 °C) at 25 °C and 85% relative humidity. Moreover, the reactor is intended to study the durability of the energy storage material over time, and also as function of the number of charging/discharging cycles.CaO∙Al2O3∙3CaSO4∙32H2O ettringite+heat↔3CaO∙Al2O3∙3CaSO4∙32-XH2Ometa-ettringite+XH2O

Objective To describe successful therapeutic strategies in statin-induced anti-HMGCR myopathy. Methods Retrospective data from a cohort of 55 patients with statin-induced anti-HMGCR myopathy, sequentially stratified by the presence of proximal weakness, early remission, and corticosteroid and IVIG use at treatment induction, were analyzed for optimal successful induction and maintenance of remission strategies. Results A total of 14 patients achieved remission with a corticosteroid-free induction strategy (25%). In 41 patients treated with corticosteroids, only 4 patients (10%) failed an initial triple steroid/IVIG/steroid-sparing immunosuppressant (SSI) induction strategy. Delay in treatment initiation was independently associated with lower odds of successful maintenance with immunosuppressant monotherapy (OR 0.92, 95% CI 0.85 to 0.97, P = 0.015). While 22 patients (40%) presented with normal strength, only 9 had normal strength at initiation of treatment. Conclusion While corticosteroid-free treatment of anti-HMGCR myopathy is now a safe option in selected cases, initial triple steroid/IVIG/SSI was very efficacious in induction. Delays in treatment initiation and, as a corollary, delays in achieving remission decrease the odds of achieving successful maintenance with an SSI alone. Avoiding such delays, most notably in patients with normal strength, may reset the natural history of anti-HMGCR myopathy from a refractory entity to a treatable disease.

Ettringite-based thermochemical energy storage has been recommended to be used in buildings for thermal energy supply because of its low material cost (

Background Few data are available on the 20-year outcomes of anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to assess the prevalence and risk factors of knee osteoarthritis at least 20 years after ACL reconstruction. Hypothesis Factors associated with progression to knee osteoarthritis include meniscal lesions, level of physical activity, injury-to-surgery time, body mass index, residual laxity, tunnel position and cartilage injury. Material and methods One hundred and eighty two patients were included in a multicentre retrospective study conducted in the setting of a SoFCOT symposium. Females contributed two-thirds of the study population. ACL reconstruction was performed arthroscopically in 82% of cases, and a bone-patellar tendon-bone transplant was used in 92.8% of cases. Mean age at surgery was 26 ± 7 years. Clinical outcomes were assessed based on the objective and subjective IKDC scores and on the KOOS. Radiographic evidence of osteoarthritis was classified according to the IKDC. Factors evaluated for their ability to predict progression to osteoarthritis included age, sex, body mass index, level of physical activity, injury-to-surgery time, meniscectomy, cartilage injury, tunnel position and residual laxity. Results At last follow-up, the objective IKDC score was A (normal) for 48%, B for 35%, and C or D for 17% of the knees. The mean subjective IKDC score was 82.7 ± 13.1. Moderate-to-severe osteoarthritis was present in 29% of cases. The following risk factors for osteoarthritis were identified: medial or lateral meniscectomy, residual laxity, age > 30 years at surgery, and engaging in a pivoting sport. Meniscectomy was a major contributor to the development of osteoarthritis (17% of knees without vs. 46% with meniscectomy). Finally, the ACL re-tear rate was 13%. Conclusion ACL reconstruction provides satisfactory knee stability. The risk of subsequent osteoarthritis depends chiefly on the status of the menisci. Residual laxity is also associated with the development of osteoarthritis. Level of evidence IV, retrospective cohort study.

Background: Anterior cruciate ligament (ACL) reconstruction is important to prevent knee osteoarthritis. Neither of the 2 most common graft techniques—the patellar tendon (PT) or hamstring tendon (HS) graft—has demonstrated superiority in terms of the long-term osteoarthritis rate. Hypothesis: Based on the International Knee Documentation Committee (IKDC) radiographic grading system, PT grafts decrease the incidence of osteoarthritis by providing better knee stability as compared with HS grafts over 12 years of follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: All adults with a first ACL rupture who underwent surgery with a PT or HS graft technique between January 2002 and December 2003 were included in the 2014 French Society of Orthopedic Surgery and Traumatology Symposium database. Baseline characteristics were collected. The primary endpoint was the occurrence of moderate to severe osteoarthritis in each group. The secondary endpoints included clinical subjective evaluations by the IKDC score and Knee injury and Osteoarthritis Outcome Score. To control the differences in baseline characteristics, the data were analyzed with propensity score matching. Results: In the cohort, 541 patients from 18 centers were included: 311 PT and 230 HS ACL reconstructions. The baseline characteristics were similar after inverse probability weighting treatment (IPWT). The occurrence of osteoarthritis was similar after IPWT (19.3% for PT and 19.6% for HS, P = .94). Age at surgery >29 years and IKDC osteoarthritis stage B at the index surgery were identified as risk factors for moderate to severe osteoarthritis. Most functional outcomes were significantly higher in the HS group; however, the difference between groups remained Conclusion: At 12 years of follow-up, neither graft technique was superior to the other in terms of the rate of osteoarthritis.

Background Pulmonary hypertension (PH) due to left heart failure (HF) is the most common form of PH. However, treatment is unclear because there are conflicting results about safety and efficacy of PH-targeted therapies. Objectives To assess the effects of PH-targeted therapy on exercise capacity in HF patients. Methods MEDLINE, EMBASE and the Cochrane Library were searched from January 1990 to July 2017 for randomized controlled trials comparing PH-targeted therapies to conventional therapy in HF. The primary outcome was to assess the effects on exercise capacity. Secondary outcomes included mortality, hospitalisation, NT-proBNP levels, echocardiographic and hemodynamics parameters and discontinuation rate. Results 22 studies were included (n = 5448), including 3, 8 and 11 studies with low, high and unknown risk of bias, respectively. PH-targeted therapies were associated with an improvement of exercise capacity (standardized mean difference 0.29;95%CI:0.08-0.50, p = 0.006). Pre-specified subgroup analyses found that this improvement was predominantly observed in studies evaluating phosphodiesterase-5 inhibitors and prostanoids and in patients with reduced ejection fraction. Moreover, systolic pulmonary artery pressure measured by echocardiography was improved (mean difference: -7.5mmHg; [95%CI]: -14.9,-0.1, p = 0.05), which was also entirely driven by studies evaluating phosphodiesterase-5 inhibitors. However, PH-targeted therapies were associated with an increased treatment discontinuation rates and a potential increase in mortality compared to standard treatment. Conclusions In conclusion, PH-targeted therapies and especially phosphodiesterase-5 inhibitors may improve exercise capacity in patients with HF. However, an increase in adverse outcomes was likely. Moreover, most studies were at high or unknown risk of bias, precluding confident conclusions about the effects of PH-targeted therapies.

Research on product lifetime extension (PLE) is of emerging interest in the circular economy (CE), but the extant literature is deficient in various aspects. First, it lacks a systematic analysis of the structure which underlies organizational efforts to PLE. Second, the literature has overlooked the role of two key agents in circular economy, namely, businesses and consumers. Third, the literature lacks a systematic study of the product lifetime extension strategies. Fourth, although several studies have proposed taxonomies of organizations in the circular economy, they lack quantitative rigor, ecological validity, and generalizability. The purpose of this study is to address these deficiencies in the circular economy literature. Specifically, this article develops and empirically validates a methodology to classify a specific type of circular business model, namely product lifetime extension business models, involving organizations and consumers, to bring quantitative rigor to conduct and presentation of taxonomy research in the field of the circular economy.

International audience; ObjectiveThe aim was to analyze the gait of knee osteoarthritis patients before osteotomy.Material/patients and methodsTwenty-four patients aged 52.4 years±6.8, 15M/9F, were comparatively analyzed to 24 matched controls. Deficiencies and disabilities were evaluated by means of: numeric pain scale, Lysholm, Koos and Womac and SF-36 scores. They were also asked to estimate their self-perception of gait on a 4-level scale. Spatiotemporal gait parameters were also measured at comfortable speed, using an optical system (otpogait).ResultsDisabilities were attested by the following data: numeric pain scale of pain 5.7±2.2/10, Lysholm score 58%, SF-36 physical score 31.8%, SF-36 mental score 53.2%, Womac score 46.5/96. As compared to controls, patients perceived their gait alteration (P

International audience; PURPOSE: High tibial osteotomy (HTO) is used to treat young and active patients with knee osteoarthritis (OA) and varus deformity. The medial compartment OA alters the patients' gait.METHODS: A prospective study was carried out in 21 consecutive patients operated for HTO due to knee OA with varus deformity. There were 14 men and 7 women, with a median age of 51.9 years (38-64). Their gait was analyzed preoperatively and at 1 year postoperatively, and compared to a healthy control group. Clinical assessment (KOOS, WOMAC, Lysholm, and SF-36 scores) was also performed preoperatively and postoperatively.RESULTS: Patients with medial compartment OA had altered gait relative to the control population. Their walking speed was slower, step length was shorter, and single-leg stance time was shorter, while the double-leg stance time was longer (P

We investigated the effect of thin viscoelastic polymer coatings around aggregate particles on the mechanical properties of “micro-concretes” with a maximum aggregate diameter of 10 mm. Aggregate particles > 5 mm were pre-treated with a latex at dosages of up to 2% by mass and dried prior to using the treated aggregate in the micro-concrete mix. Cured prisms were tested in flexion. The results show that thin polymer coatings on aggregates have a significant effect on micro-concrete cracking behaviour at much lower polymer dosages than are commonly used in polymer-modified mortars. We observed a significant improvement in post-peak energy absorption relative to the use of the same amount of polymer dispersed in the bulk paste. But, under the conditions tested here, reductions in the strengths and moduli of the composites due to the polymer additions appear to have more than outweighed the observed positive effects of increases in fracture energy and characteristic length.

The addition of a finely-ground ion-exchange resin makes it possible to modify the hydration kinetics of C3S pastes. Analyses of the liquid phase in pastes and more dilute suspensions show that the resin exchanges calcium ions for sodium ions very rapidly during the early stage of hydration and therefore the concentration of silica in solution increases. The resin impacts the hydration of C3S by other mechanisms which depends on the resin quantity added. For a high resin quantity, the induction period is very short, but the longer-term hydration is enhanced compared to a reference sample without resin. We hypothesize that the surface of the resin can provide sites for the nucleation and growth of C–S–H hydrates and/or portlandite far away from the surface of the C3S grains. This consequently increases the quantity of hydrates that can precipitate before a continuous hydrate layer forms over the surfaces of C3S particles.

Effects of dissipation on the gradient drift modes in partially magnetized E × B plasmas are studied with emphasis on the sheath effects. It is shown that the dissipation induced instabilities driven by the density gradient and E × B drifts persist in conditions where the criteria for standard Simon-Hoh instability in E × B plasmas are not satisfied.Effects of dissipation on the gradient drift modes in partially magnetized E × B plasmas are studied with emphasis on the sheath effects. It is shown that the dissipation induced instabilities driven by the density gradient and E × B drifts persist in conditions where the criteria for standard Simon-Hoh instability in E × B plasmas are not satisfied.

For C040 technology and below, photolithographic depth of focus control and dispersion improvement is essential to secure product functionality. Critical 193nm immersion layers present initial focus process windows close to machine control capability. For previous technologies, the standard scanner sensor (Level sensor - LS) was used to map wafer topology and expose the wafer at the right Focus. Such optical embedded metrology, based on light reflection, suffers from reading issues that cannot be neglected anymore. Metrology errors are correlated to inspected product area for which material types and densities change, and so optical properties are not constant. Various optical phenomena occur across the product field during wafer inspection and have an effect on the quality and position of the reflected light. This can result in incorrect heights being recorded and exposures possibly being done out of focus. Focus inaccuracy associated to aggressive process windows on critical layers will directly impact product realization and therefore functionality and yield. ASML has introduced an air gauge sensor to complement the optical level sensor and lead to optimal topology metrology. The use of this new sensor is managed by the AGILE (Air Gauge Improved process LEveling) application. This measurement with no optical dependency will correct for optical inaccuracy of level sensor, and so improve best focus dispersion across the product. Due to the fact that stack complexity is more and more important through process steps flow, optical perturbation of standard Level sensor metrology is increasing and is becoming maximum for metallization layers. For these reasons AGILE feature implementation was first considered for contact and all metal layers. Another key point is that standard metrology will be sensitive to layer and reticle/product density. The gain of Agile will be enhanced for multiple product contribution mask and for complex System on Chip. Into ST context (High mix logic Fab) in term of product and technology portfolio AGILE corrects for up to 120nm of product topography error on process layer with less than 50nm depth of focus Based on tool functionalities delivered by ASML and on high volume manufacturing requirement, AGILE integration is a real challenge. Regarding ST requirements “Automatic AGILE” functionality developed by ASML was not a turnkey solution and a dedicated functionality was needed. A “ST homemade AGILE integration” has been fully developed and implemented within ASML and ST constraints. This paper describes this integration in our Advanced Process Control platform (APC).

This paper describes a study of the corrosion behavior of black steelreinforcement embedded in mortars made with a belite-ye’elimite-ferrite (BYF) cement, apromising replacement for Portland cement, with a significantly lower carbon footprint. Steeldoes passivate in BYF mortars, however the corrosion behavior at early ages differs to thatof reinforced Portland mortars. The passivation of steel embedded in BYF and Portlandmortars is discussed based on the physico-chemical evolution of hydrated cements.

A new multi-scale experimental approach is proposed to continuously relate the microstructure and the macroscopic mechanical properties of plaster pastes during their settings. (1)H NMR relaxometry is used to follow continuously and not destructively, the degree of hydration and the microstructure evolution during the setting and hardening of plaster paste. Transmission of shear and compressional ultrasonic velocities enable the determination of macroscopic mechanical properties of the material during the setting. On the basis of similar behaviors of Young's modulus and NMR-population of confined water as function of the degree of hydration, we conclude that NMR gives a better understanding of the evolution of the microstructure at the origin of a better control of the macroscopic mechanical properties.

We report a comprehensive proton NMR relaxation study of the water confined in the evolving porous structure of hardened gypsum prepared with different water-to-plaster ratios (w/p) and increasing additions of crushed gypsum. This study gives some new information on the microstructure, the water distribution, and the hydration kinetics without any drying or perturbing preparation. The bi-exponential transverse magnetization decay reveals the existence of two water populations in slow exchange. However, the different behaviors of these populations during saturation and desaturation experiments show evidence of a fast exchange of each population with the surface. Two modes of organization of the microstructure of this material are identified through an original model of exchange as a function of the water-to-plaster ratio (0.4or = w/por = 0.6 and 0.7or = w/por = 1). A clear gap is shown in the exchange rate value above w/p = 0.6 that could be representative of a percolation threshold. Both the method and the theory presented can be applied more widely to other porous media with reactive surface areas.

The goal of this study was to identify the relationships between the learning choices made by pupils and their personal characteristics, including cognitive style (field dependence–independence), a motivational variable (feeling of self-efficacy), and a cognitive variable (task representation). The participants were 64 twelve-year-old sixth graders from a suburban middle school in France (35 boys and 29 girls). Cognitive style or FDI was measured with the Group Embedded Figures Test, a perceptual test that requires finding a simple geometrical figure embedded in a complex geometrical one. Five learning conditions (autonomy, tutoring, verbal instruction, silent demonstration, and verbal demonstration) were then proposed in random order to the pupils. They were asked to select a learning method to solve a motor problem: a badminton service. The results indicated an absence of relationships between the choice of a learning condition and cognitive style. Three variables partially predicted the learning-condition choice: feeling of self-efficacy, task representation, and motor performance. The present results can be interpreted in the light of studies on children’s help-seeking behavior in problem-solving situations.

Introduction L’osteotomie tibiale de valgisation (OTV) est utilisee dans le traitement de la gonarthrose sur genu varum chez des patients jeunes et actifs. La gonarthrose est responsable d’une perturbation de la marche qui pourrait etre modifiee apres osteotomie. L’objectif principal de cette etude etait d’analyser differentes allures de marche de facon objective et subjective avant et apres OTV et de la comparer a une population controle saine. Les objectifs secondaires etaient d’evaluer l’evolution de la marche en postoperatoire. Materiel et methodes Une etude prospective a ete conduite sur 21 patients operes consecutivement d’une OTV par ouverture mediale pour gonarthrose femoro-tibiale mediale moderee avec deformation en varus. Il s’agissait de 14 hommes et 7 femmes âges en moyenne de 52,3 ans (38–64). L’analyse de la marche a ete realisee en preoperatoire, a 4 mois et a 12 mois postoperatoire et comparee a une population controle saine. L’analyse etait realisee sur le systeme valide Optogait. Une evaluation radiologique etait effectuee en preoperatoire et postoperatoire. Resultats Le varus preoperatoire etait de 7° en moyenne tandis que le valgus postoperatoire etait de 3° en moyenne. Les patients atteints de gonarthrose en varus avaient une alteration de leur marche comparee a une population controle saine. A allure normale ou rapide, l’OTV n’a pas modifie les caracteristiques objectives de marche au recul d’un an, tout en ameliorant la perception subjective du patient (p Conclusion La gonarthrose sur genu varum est responsable d’une modification de la marche. L’OTV ne modifie pas les parametres spatiotemporels dans l’analyse de la marche lorsque l’allure est confortable ou elevee. Cependant les patients declarent une amelioration de la perception de leur marche.