Metallized ceramic substrate with mesa structure for voltage ramp-up of power modules

International audienceAs the available wide bandgap semiconductors continuingly increase their operating voltages, the electrical insulation used in their packaging is increasingly constrained. More precisely the ceramic substrate, used in demanding applications, represents a key multi-functional element is being in charge of the mechanical support of the metallic track that interconnects the semiconductor chips with the rest of the power system, as well as of electrical insulation and of thermal conduction. In this complex assembly, the electric field enhancement at the triple junction between the ceramic, the metallic track borders and the insulating environment is usually a critical point. When the electrical field at the triple point exceeds the critical value allowed by the insulation system, this hampers the device performance and limits the voltage rating for future systems. The solution proposed here is based on the shape modification of the ceramic substrate by creating a mesa structure (plateau) that holds the metallic tracks in the assembly. A numerical simulation approach is used to optimize the structure. After the elaboration of the structures by ultrasonic machining we observed a significant increase (30%) in the partial discharge detection voltages, at 10 pC sensitivity, in a substrate with a mesa structure when comparing to a conventional metallized ceramic substrate

Acral lentiginous melanoma with HER2/ErbB2 amplification

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New Insights into the Biology and Diagnosis of Splenic Marginal Zone Lymphomas

Splenic marginal zone lymphoma (SMZL) is a small B-cell lymphoma, which has been recognized as a distinct pathological entity since the WHO 2008 classification. It classically presents an indolent evolution, but a third of patients progress rapidly and require aggressive treatments, such as immuno-chemotherapy or splenectomy, with all associated side effects. In recent years, advances in the comprehension of SMZL physiopathology have multiplied, thanks to the arrival of new devices in the panel of available molecular biology techniques, allowing the discovery of new molecular findings. In the era of targeted therapies, an update of current knowledge is needed to guide future researches, such as those on epigenetic modifications or the microenvironment of these lymphomas

Brentuximab-vedotin in combination with cyclophosphamide, doxorubicin, prednisolone for the treatment of aggressive CD30-positive cutaneous T-cell lymphomas

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Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review

The co-occurrence of several lymphomas in a patient defines composite/synchronous lymphoma. A common cellular origin has been reported for both contingents of such entities. In the present review, we aimed to gather the available data on composite lymphomas associating a classical Hodgkin lymphoma (cHL) with another lymphoma, to better understand the plasticity of mature B and T-cells. This review highlights that >70% of patients with a composite lymphoma are ≥55 years old, with a male predominance. The most reported associations are cHL with follicular lymphoma or diffuse large B-cell lymphoma, with over 130 cases reported. The cHL contingent is often of mixed cellularity type, with a more frequent focal/weak CD20 expression (30% to 55.6%) compared to de novo cHL, suggesting a particular pathophysiology. Moreover, Hodgkin cells may express specific markers of the associated lymphoma (e.g., BCL2/BCL6 for follicular lymphoma and Cyclin D1 for mantle cell lymphoma), sometimes combined with common BCL2/BCL6 or CCND1 rearrangements, respectively. In addition, both contingents may share similar IgH/IgK rearrangements and identical pathogenic variants, reinforcing the hypothesis of a common clonal origin. Finally, cHL appears to be endowed with a greater plasticity than previously thought, supporting a common clonal origin and a transdifferentiation process during lymphomagenesis of composite lymphomas

Quantifying preferences around vaccination against frequent, mild disease with risk for vulnerable persons: A discrete choice experiment among French hospital health care workers

International audienceThe individual determinants of vaccine acceptance among health workers (HCWs) have been described in the literature, but there is little evidence regarding the impact of vaccine characteristics and contextual factors (e.g., incentives, communication) on vaccination intentions. We developed a single profile discrete choice experiment (DCE) to assess the impact of seven attributes on stated vaccination intention against an unnamed disease, described as frequent with rapid clinical evolution and epidemic potential (similar to influenza or pertussis). Attributes evaluated vaccine characteristics (effectiveness, security profile), inter-individual aspects (epidemic risk, controversy, potential for indirect protection, vaccine coverage) and incentives (e.g., badge, hierarchical injunction). A total of 1214 French hospital-based HCWs, recruited through professional organizations, completed the online DCE questionnaire. The relative impact of each attribute was estimated using random effects logit models on the whole sample and among specific subgroups. Overall, 52% of included HCWs were vaccinated against influenza during 2017-18 and the average vaccination acceptance rate across all scenarios was 58%. Aside from the management stance, all attributes' levels had significant impact on vaccination decisions. Poor vaccine safety had the most detrimental impact on stated acceptance (OR 0.04 for the level controversy around vaccine safety). The most motivating factor was protection of family (OR 2.41) and contribution to disease control (OR 2.34). Other motivating factors included improved vaccine effectiveness (OR 2.22), high uptake among colleagues (OR 1.89) and epidemic risk declared by health authorities (OR 1.76). Social incentives (e.g., a badge I'm vaccinated) were dissuasive (OR 0.47). Compared to HCWs previously vaccinated against influenza, unvaccinated HCWs who were favorable to vaccination in general were most sensitive towards improved vaccine effectiveness. Our study suggests that vaccine safety considerations dominate vaccine decision-making among French HCWs, while adapted communication on indirect protection and social conformism can contribute to increase vaccination acceptance

Faire durer l'événement

The aim of this study was to investigate the relationship between the Matura exam and EFL teaching and learning in Croatian secondary schools. Previous similar studies established the presence of the washback effect of the Matura exam, with the emphasis on its influence on speaking and writing skills. The focus of this study was the influence the Matura exam has on listening activities in the EFL classroom. The results showed that the Matura exam influenced the process of EFL teaching and learning in the sense that a certain amount of classroom time was spent preparing for the exam. The results also showed that listening skill has not been neglected in the language classroom and that the students regularly prepared for the Listening part of the Matura exam.Cilj ovog istraživanja bio je utvrditi odnos između državne mature u Hrvatskoj i poučavanja i učenja engleskog kao stranog jezika u srednjim školama. Prethodna istraživanja potvrdila su prisutnost povratnog učinka državne mature, s naglaskom na utjecaj na vještinu govorenja i pisanja. Ovo istraživanje usredotočeno je na utjecaj državne mature na aktivnosti slušanja u nastavi engleskoga kao stranoga jezika. Rezultati su pokazali da državna matura utječe na proces poučavanja i učenja engleskoga kao stranoga jezika jer je određeno vrijeme u nastavi posvećeno pripremama za državnu maturu. Rezultati su također pokazali da vještina slušanja nije zanemarena u nastavi stranoga jezika te da se učenici redovito pripremaju za test slušanja na državnoj maturi