Thermo-oxidation behaviour of organic matrix composite materials at high temperatures

The present paper is a review of the main activities carried out within the context of the COMPTINN‟ program, a joint research project founded by a FUI program (Fonds Unifiés Interministériels) in which four research teams focused on the thermo-oxidation behaviour of HTS-TACTIX carbon-epoxy composite at „high‟ temperatures (120°C-180°C). The scientific aim of the COMPTINN‟ program was to better identify, with a multi-scale approach, the link between the physico-chemical mechanisms involved in thermo-oxidation phenomena, and to provide theoretical and numerical tools for predicting the mechanical behaviour of aged composite materials including damage onset and development

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Refractory Auto-Immune Thrombotic Thrombocytopenic Pupura Successfully Treated With Caplacizumab

International audienceThrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy characterized by mechanical hemolytic anemia, profound thrombocytopenia, and neurological manifestations. Acquired auto-immune TTP, the most prevalent cause of TTP, is induced by the presence of inhibitory anti-ADAMTS13 auto-antibodies. Modern treatment of acquired TTP relies on plasma exchange, rituximab, and steroids. Caplacizumab (Cablivi ®), a humanized single-variable domain immunoglobulin that targets the A1 domain of the ultra-large von Willebrand factor, inhibits the interaction between ultra-large vWFand platelets. In two clinical trials, caplacizumab, in addition to conventional treatment, shortened the delay to platelet count normalization in comparison to conventional treatment plus placebo, without increasing significantly hemorrhagic complications. Moreover, caplacizumab was associated with reduced occurrence of a secondary endpoint associating death, TTP recurrence, and major thromboembolic events. Here, we report the off-label use of caplacizumab in a 68-year-old patient with confirmed acquired TTP, severe thrombocytopenia, and generalized tonic-clonic seizures requiring mechanical ventilation and admission in the intensive care unit. Conventional treatment was rapidly started. Despite the intensification of plasma exchange treatment with twice-daily sessions, steroid continuation, and a second rituximab infusion on day 6, thrombotic microangiopathy worsened with thrombocytopenia at 21 g/L on day 8 from admission. We also considered using caplacizumab, which we could obtain and start on day 12 from admission, as it was available under a temporary authorization use in France. As soon as 12 h after caplacizumab initiation, we observed a significant increase of platelet count and improvement of other hemolytic parameters. We observed resolution of encephalopathy and complete recovery of motor paralysis, allowing us to stop mechanical ventilation on day 14. Caplacizumab was maintained for 128 days until day 139 from initial admission. The patient is going well 10 months after initial admission, without any neurologica

Durability and thermo-oxidation behaviour of organic matrix composite materials at high temperatures

International audienceThis paper introduces a review of the main activities carried out within the context of the ‘COMPTINN’ research program, for the activities focusing on the durability and thermo-oxidation behaviour of organic matrix composite materials at ‘high’ temperatures (120°C-180°C). The scientific aim of ‘COMPTINN’ research program was to better identify, with a multi-scale approach, the link between durability, accelerating ageing factors and physical mechanisms involved in thermo-oxidation phenomena, and to provide theoretical and numerical tools for predicting the mechanical behaviour of aged composite materials including damage onset and development. Work has been carried out on continuous carbon fibre composite with epoxy matrix. The influence of thermo oxidation on the mechanical behaviour of the matrix, the creep properties and durability of the composite, has been identified with ultra-micro indentation (UMI). Based on the evolution of the elastic indentation modulus of the resin in the thickness of a sample exposed to oxidative environment at 150°C for different durations, we have clearly validated that the thickness of the oxidised layer is linked with the exposed time. Another innovative experimental technique has also been used: a climbing drum peel test has been modified to investigate the influence of oxygen on mode I delamination propagation in a composite laminate. In this test, crack propagation is driven by oxidation under constant mechanical energy and the delamination propagation speed can be linked with the oxidation level. This enables one to identify the critical strain energy release rate associated with an oxidized interface and to predict the interaction between mechanical and environmental loadings. Thermo-oxidation is identified as the result of oxygen diffusion and oxygen reaction with the molecular structure of the resin. The predominance of chain scissions over crosslinking leads to a decrease in the glass transition temperature combined with an increase in the Young’s modulus at room temperature (called “antiplasticization” effect). This process is also at the origin of matrix shrinkage, weight loss and cracks initiation

Improve the characterization of tropical forests to improve management: policy brief

CoForChange has shown that management plans based on timber stock recovery are not enough to ensure the sustainability of these production forests. The variability of forest characteristics and their different responses to disturbance should be considered in management decisions.CoForChang