Le fluotournage est un procédé de fabrication de tubes sans soudures par déformation plastique à froid. Il consiste à réduire l'épaisseur d'une préforme tubulaire montée sur un mandrin en utilisant plusieurs molettes en translation parallèlement au tube. Grâce à la conicité des molettes, l'épaisseur du tube diminue, donc celui-ci s'allonge dans la direction de fluotournage. Le TA6V est un alliage de titane de type α-β. Ses très bonnes propriétés mécaniques et sa faible densité en font l'alliage de titane le plus utilisé dans l'industrie aéronautique. Toutefois, le fluotournage d'un tel alliage représente un vrai défi, car il est connu pour avoir une faible ductilité à température ambiante. Afin d'optimiser les conditions opératoires, permettant ainsi de très grandes déformations du TA6V, le matériau fluotourné a d'abord été analysé, tant du point de vue microscopique (MEB, EBSD) que macroscopique (propriétés mécaniques). De plus, un fluotour expérimental instrumenté a été conçu afin d'analyser les mécanismes de déformation lors de la mise en forme. Celui-ci a permis d'identifier les phénomènes microstructuraux à l'origine de la déformation et de déterminer une loi de comportement valide pour la simulation numérique. Cette dernière a enfin servi à l'optimisation des conditions opératoires. / Flowforming is a means to produce seamless tubes by plastic deformation at room temperature. It consists in a tubular part, mounted on a mandrel, and a couple of rollers. While the mandrel is rotating, the roller translate along the tube axis. Because of the conical shape of the roller, the tube thickness reduces by cold plastic deformation, thus the tube elongates. Thanks to the high compressive stresses and to the incremental nature of the deformation process, flowforming can lead to a high thickness reduction and thus to high elongation of the deformed tubes. Ti-6Al-4V (also known as Ti64) is an α-β titanium alloy. Because of its high strength and its low density, Ti64 is the most widely used titanium alloy in aerospace industry. Nevertheless, flowforming of this alloy is a great challenge, considering its well known poor ductility at room temperature. In order to increase the "tube spinnability" of Ti64, first the flowformed material has been extensively investigated at microscopic scale (SEM, EBSD) as well as at macroscopic scale (mechanical properties). In addition, an experimental flowforming machine, equipped with load sensors, has been designed. It has provided valuable informations about the strain mechanism occuring during flowforming; furthermore, this experimental set-up has allowed to buid an adequate constitutive law for the plastic flow. Then, this law has been used to optimize the processing parameter, in order to avoid failure during the process.

L’implantation valvulaire aortique percutanée (TAVI) a émergé comme une alternative à la chirurgie pour les patients avec sténose sévère et haut risque chirurgical. Cette technique s’étend à une population plus large (e.g. anatomie plus complexe, risque chirurgical plus bas), ainsi qu'au traitement Valve-in-Valve (ViV) des bioprothèses (BPs) chirurgicales défaillantes. Cependant, deux complications majeures en limitent la généralisation. En TAVI « classique », la présence de fuites péripothétiques a été associée à une mortalité augmentée. Les effets du surdimensionnement de la prothèse percutanée pour assurer son étanchéité, ou de la forme de l’anneau souvent non circulaire, sur la performance hémodynamique, sont mal connus. En ViV, la présence de hauts gradients est fréquente et associée à une mortalité augmentée. Les BPs de taille nominale ≤ 21 mm et le mode de dégénérescence par sténose, facteurs mis en cause dans la sténose résiduelle et associés à une mortalité augmentée, ne sont pas assez spécifiques et il n’existe actuellement aucune recommandation pour le traitement des petites BPs. Par ailleurs, le bénéfice hémodynamique réel du ViV par rapport aux statuts avant ViV n’a pas été étudié.L’objectif général de ce travail doctoral est de comprendre les interactions entre la prothèse percutanée et l’anneau aortique ou la BP à traiter, impliquées dans la performance hémodynamique, en particulier dans des conditions d’implantation complexes, afin d’étendre les indications du TAVI. En ViV, le défi est de préciser les facteurs associés à sa performance et son utilité hémodynamique et de proposer des stratégies d’implantation afin d’optimiser le succès de la procédure. / Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgery for patients with severe aortic stenosis and high surgical risk. This technique is extending to a wider population (e.g. with more complex anatomy or lower surgical risk), as well as to patients with degenerated surgical bioprostheses (BPs). However, two major concerns remain limiting. Regarding “classical TAVI”, periprosthetic leaks have been associated with increased mortality. Oversizing is used to secure the device within the aortic annulus which is often non circular. The effects of oversizing and annulus shape on the hemodynamic performance are unknown. Regarding ViV implantations, elevated post-procedural gradients are common and have been associated with increased mortality. The principal factors associated with this residual stenosis as well as with increased risk of mortality, have been BPs label size ≤ 21 mm and mode of failure by stenosis. These factors are not specific enough and there is currently no recommendation for the treatment of small BPs. Besides, the actual hemodynamic benefit associated with ViV has not been evaluated (vs. pre ViV status).The general objective of this work is to understand the interactions between the transcatheter prosthesis and the aortic annulus or the BP to be treated, which impact the hemodynamic performance, especially in complex conditions of implantation, in order to extend the indications of TAVI. In the context of ViV, the objective is to specify the factors associated with the hemodynamic performance and utility of the treatment. The final aim is to provide strategies of implantation in order to optimize the success of the procedure.

The nature of food insecurity has been changing in the world. While research on food insecurity in developing countries used to focus on undernourishment (i.e. lack of calorie consumption) and related outcomes, today, many developing countries face at least a “double burden of malnutrition” with persistently high rates of undernourishment and increasing rates of overweight, obesity and related non-communicable diseases (NCDs). An important driver of overweight and obesity in developing countries is the „nutrition transition“, i.e. the trend towards the consumption of more energy-dense, highly processed foods and more sedentary lifestyles. Two essays of this Ph.D. thesis analyse drivers and consequences of the nutrition transition in developing countries with a particular focus on the role of supermarkets, which have been rapidly spreading in many countries. We provide evidence that the presence of supermarkets causally affects dietary choices and nutritional outcomes. Data collection for this research was carried out in small Kenyan towns of the kind that accommodate most of the country’s urban population. We designed our sample to be quasi-experimental in nature and employ instrumental variable techniques to allow for endogeneity of supermarket purchases. Kenya’s supermarket landscape is dynamic and so far, it has followed the ‘traditional pattern’ of the so-called supermarket revolution. Supermarket purchases are found to contribute to the nutrition transition by shifting consumption towards processed and away from unprocessed foods. At the same time, calorie availability increases as calories are sourced at lower prices in supermarkets. We find that supermarket purchases increase adult Body Mass Index and their probability of being overweight or obese. Yet, we also find that buying in a supermarket tends to decrease underweight among children and adolescents (age 5-19) in terms of stunting (height-for-age). In a third essay, we use secondary household survey data from Malawi to analyse ‘one of the other faces of malnutrition’. The world food price crisis of 2007/08 and other global and regional price and income shocks that followed have spurred interest in producing timely predictions on their implications for food security. A critical research gap remains with comparing simulation outcomes across studies that use different, established methods on the same subject. This is to establish if and to which extent they might result in different and potentially conflicting policy recommendations. We address this gap building on three simulation studies set in Malawi, which analyse welfare in terms of food security and income effects using the same 2004/05 household survey data but resort to methodologies of different complexity. We harmonize simulation scenarios across methods and systematically modify relevant parameters for our comparative assessment. We find differences between methods to depend on the scenario under consideration and to grow with increasing rates of simulated price changes. The differences we find are driven by differences in conceptualising price changes. In case of Malawi, for a reasonable set of observed price changes, mean outcomes on district levels are fairly robust to underlying methodologies. We illustrate that is it important to improve our understanding of how changes in the underlying methodologies change results and to analyse the sensitivity of simulation outcomes to different model assumptions.