Structures déployables constituées de mètres rubans : modélisations et essais expérimentaux.

Les structures déployables sont largement étudiées dans l'industrie spatiale afin de réduire le volume des systèmes spatiaux lors du lancement. Cela permet ainsi d'envoyer un ou plusieurs satellites de grande envergure à l'aide d'un unique lanceur. Avec une masse relativement faible, une grande compacité et une capacité de déploiement autonome, les mètres rubans sont au c?ur de plusieurs projets de structures spatiales déployables. Ces structures minces et élancées à section semi-circulaire présentent un comportement très complexe lié à leur géométrie. Sous l'effet de sollicitations mécaniques externes, des plis peuvent se former et se déplacer le long du ruban, mais aussi fusionner ou disparaître. La formation de ces plis permet d'emmagasiner de l'énergie de déformation qui est ensuite libérée pour déployer la structure. Du fait de ces comportements complexes, la modélisation de structures constituées de mètres rubans est compliquée. Les modèles de coques sont principalement utilisés pour modéliser les rubans, mais leur résolution à l'aide de calculs éléments finis n'est pas aisée et les temps de simulation sont généralement longs. Afin de réduire le coût en terme de temps de calcul, un modèle de poutre à section flexible a été développé par Guinot et al. et est uniquement dédié aux comportements plans du ruban. Il est basé sur les modèles de coques mais il est simplifié en prenant en compte plusieurs hypothèses cinématiques. Ce modèle a ensuite été amélioré par Picault et al. afin de prendre en compte les mouvements hors plan du ruban via l'introduction d'un paramètre de gauchissement de la section. L'implémentation de ces modèles dans un code de calculs éléments finis a permis de démontrer leur capacité à reproduire les comportements complexes du ruban (apparition, disparition, translation des plis). Un élément linéaire de poutre à section flexible constitué de deux n?uds a été développé pour une utilisation industrielle dans le logiciel Abaqus, via la subroutine UEL (User ELement). Cet élément permet ainsi de simuler le comportement de structures constituées de plusieurs rubans. Afin de valider ces modèles, les résultats des simulations numériques seront comparés aux résultats obtenus expérimentalement via des essais de flexion de rubans. Ils consistent à appliquer les conditions aux limites suivantes : encastrement total d'une des extrémités du ruban tandis qu'une rotation est imposée à la seconde. L'extrémité qui est en rotation est libre de translater selon l'axe coïncidant avec la direction de la ligne moyenne du ruban. Pour les deux extrémités, la section n'est pas libre de se déformer. L'orientation du ruban autour de l'axe coïncidant avec la direction de la ligne moyenne peut être choisie, ce qui permet de faire des essais de flexion plane mais aussi de la flexion transverse. Ces deux tests seront réalisés avec des rubans fabriqués à partir de plis UD de manière à former un empilement symétrique évitant le couplage flexion-torsion

Scaling-up energy sufficiency on a European level through a bottom-up modelling approach : lessons and perspectives

The unprecedented challenge of reaching carbon neutrality before mid-century and a large share of it within 2030 in order to keep under the 1.5 or 2 °C carbon budgets, requires broad and deep changes in production and consumption patterns which, together with a shift to renewables and reinforced efficiency, need to be addressed through energy sufficiency. However, inadequate representations and obstacles to characterising and identifying sufficiency potentials often lead to an underrepresentation of sufficiency in models, scenarios and policies. One way to tackle this issue is to work on the development of sufficiency assumptions at a concrete level where various implications such as social consequences, environmental co-benefits, conditions for implementation can be discussed. This approach has been developed as the backbone of a collaborative project, gathering partners in 20 European countries at present, aiming for the integration of harmonised national scenarios into an ambitious net-zero European vision. The approach combines a qualitative discussion on the role of energy sufficiency in a "systemic" merit order for global sustainability, and a quantitative discussion of the level of sufficiency to be set to contribute to meeting 100 % renewables supply and net-zero emissions goals by 2050 at the latest. The latter is based on the use of a dashboard, which serves as a common descriptive framework for all national scenario trajectories and their comparison, with a view to harmonising and strengthening them through an iterative process. A set of key sufficiency-related indicators have been selected to be included in the dashboard, while various interrelated infrastructural, economic, environmental, social or legal factors or drivers have been identified and mapped. This paves the way for strengthening assumptions through the elaboration of "sufficiency corridors" defining a convergent, acceptable and sustainable level of energy services in Europe. The process will eventually inform the potential for sufficiency policies through a better identification of leverages, impacts and co-benefits

Higher-dose sitagliptin and the risk of congestive heart failure in older adults with CKD

Background and objectives Sitagliptin, a dipeptidylpeptidase-4 inhibitor, is commonlyprescribed to patientswith type 2 diabetes. As this drug is primarily eliminated by the kidney, a reduced dose is recommended for patients with CKD. Some evidence suggests that sitagliptin is associated with a higher risk of congestive heart failure, particularly at higher doses.Wecompare the 1-year risk of death or hospitalizationwith congestive heart failure in patients with CKD newly prescribed sitagliptin at \u3c50 versus ≤50 mg/d. Design, setting, participants, & measurements This population-based cohort study included older adults (\u3e66 years) with type 2 diabetes and an eGFR\u3c45 ml/min per 1.73 m2 (but not receiving dialysis) who were newly prescribed sitagliptin between 2010 and 2017 in Ontario, Canada. We used inverse probability of treatment weighting on the basis of propensity scores to balance baseline characteristics. The primary composite outcome was death or hospitalization with congestive heart failure. Secondary outcomes included hospitalization with pancreatitis or hypoglycemia, all-cause hospitalization, and glycemic control. Weighted hazard ratios were obtained using Cox proportional hazards regression, and 95%confidence intervalswere obtained using bootstrap variance estimators. Results Of 9215 patients, 6518 started sitagliptin at \u3e50 mg/d, and 2697 started sitagliptin at ≤50 mg/d. The 1-year risk of death or hospitalization with congestive heart failure did not differ significantly between groups (79 versus 126 events per 1000 person-years; weighted hazard ratio, 0.88; 95% confidence interval, 0.67 to 1.14); hospitalization with pancreatitis (weighted hazard ratio, 0.98; 95% confidence interval, 0.32 to 3.03) and hypoglycemia (weighted hazard ratio, 1.10; 95% confidence interval, 0.64 to 1.90) also did not differ significantly between groups. Patients starting sitagliptin at \u3e50 mg/d had lower mean glycated hemoglobin concentrations (weighted between-group difference, 20.12%; 95% confidence interval, 20.19 to 20.06) and a lower risk of allcause hospitalization (weighted hazard ratio, 0.81; 95% confidence interval, 0.66 to 0.98). Conclusions The risk of death or congestive heart failure was not higher in older adults with CKD starting sitagliptin at \u3e50 versus ≤50 mg/d

Pathway analysis of genome-wide data improves warfarin dose prediction

Background: Many genome-wide association studies focus on associating single loci with target phenotypes. However, in the setting of rare variation, accumulating sufficient samples to assess these associations can be difficult. Moreover, multiple variations in a gene or a set of genes within a pathway may all contribute to the phenotype, suggesting that the aggregation of variations found over the gene or pathway may be useful for improving the power to detect associations. Results: Here, we present a method for aggregating single nucleotide polymorphisms (SNPs) along biologically relevant pathways in order to seek genetic associations with phenotypes. Our method uses all available genetic variants and does not remove those in linkage disequilibrium (LD). Instead, it uses a novel SNP weighting scheme to down-weight the contributions of correlated SNPs. We apply our method to three cohorts of patients taking warfarin: two European descent cohorts and an African American cohort. Although the clinical covariates and key pharmacogenetic loci for warfarin have been characterized, our association metric identifies a significant association with mutations distributed throughout the pathway of warfarin metabolism. We improve dose prediction after using all known clinical covariates and pharmacogenetic variants in VKORC1 and CYP2C9. In particular, we find that at least 1% of the missing heritability in warfarin dose may be due to the aggregated effects of variations in the warfarin metabolic pathway, even though the SNPs do not individually show a significant association. Conclusions: Our method allows researchers to study aggregative SNP effects in an unbiased manner by not preselecting SNPs. It retains all the available information by accounting for LD-structure through weighting, which eliminates the need for LD pruning

A multi-factorial analysis of response to warfarin in a UK prospective cohort

Background Warfarin is the most widely used oral anticoagulant worldwide, but it has a narrow therapeutic index which necessitates constant monitoring of anticoagulation response. Previous genome-wide studies have focused on identifying factors explaining variance in stable dose, but have not explored the initial patient response to warfarin, and a wider range of clinical and biochemical factors affecting both initial and stable dosing with warfarin. Methods A prospective cohort of 711 patients starting warfarin was followed up for 6 months with analyses focusing on both non-genetic and genetic factors. The outcome measures used were mean weekly warfarin dose (MWD), stable mean weekly dose (SMWD) and international normalised ratio (INR) > 4 during the first week. Samples were genotyped on the Illumina Human610-Quad chip. Statistical analyses were performed using Plink and R. Results VKORC1 and CYP2C9 were the major genetic determinants of warfarin MWD and SMWD, with CYP4F2 having a smaller effect. Age, height, weight, cigarette smoking and interacting medications accounted for less than 20 % of the variance. Our multifactorial analysis explained 57.89 % and 56.97 % of the variation for MWD and SMWD, respectively. Genotypes for VKORC1 and CYP2C9*3, age, height and weight, as well as other clinical factors such as alcohol consumption, loading dose and concomitant drugs were important for the initial INR response to warfarin. In a small subset of patients for whom data were available, levels of the coagulation factors VII and IX (highly correlated) also played a role. Conclusion Our multifactorial analysis in a prospectively recruited cohort has shown that multiple factors, genetic and clinical, are important in determining the response to warfarin. VKORC1 and CYP2C9 genetic polymorphisms are the most important determinants of warfarin dosing, and it is highly unlikely that other common variants of clinical importance influencing warfarin dosage will be found. Both VKORC1 and CYP2C9*3 are important determinants of the initial INR response to warfarin. Other novel variants, which did not reach genome-wide significance, were identified for the different outcome measures, but need replication

ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients