Epidemiology and predictors of spinal injury in adult major trauma patients: European cohort study

This is a European cohort study on predictors of spinal injury in adult (≥16 years) major trauma patients, using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Predictors for spinal fractures/dislocations or spinal cord injury were determined using univariate and multivariate logistic regression analysis. 250,584 patients were analysed. 24,000 patients (9.6%) sustained spinal fractures/dislocations alone and 4,489 (1.8%) sustained spinal cord injury with or without fractures/dislocations. Spinal injury patients had a median age of 44.5 years (IQR = 28.8-64.0) and Injury Severity Score of 9 (IQR = 4-17). 64.9% were male. 45% of patients suffered associated injuries to other body regions. Age <45 years (≥45 years OR 0.83-0.94), Glasgow Coma Score (GCS) 3-8 (OR 1.10, 95% CI 1.02-1.19), falls >2 m (OR 4.17, 95% CI 3.98-4.37), sports injuries (OR 2.79, 95% CI 2.41-3.23) and road traffic collisions (RTCs) (OR 1.91, 95% CI 1.83-2.00) were predictors for spinal fractures/dislocations. Age <45 years (≥45 years OR 0.78-0.90), male gender (female OR 0.78, 95% CI 0.72-0.85), GCS <15 (OR 1.36-1.93), associated chest injury (OR 1.10, 95% CI 1.01-1.20), sports injuries (OR 3.98, 95% CI 3.04-5.21), falls >2 m (OR 3.60, 95% CI 3.21-4.04), RTCs (OR 2.20, 95% CI 1.96-2.46) and shooting (OR 1.91, 95% CI 1.21-3.00) were predictors for spinal cord injury. Multilevel injury was found in 10.4% of fractures/dislocations and in 1.3% of cord injury patients. As spinal trauma occurred in >10% of major trauma patients, aggressive evaluation of the spine is warranted, especially, in males, patients <45 years, with a GCS <15, concomitant chest injury and/or dangerous injury mechanisms (falls >2 m, sports injuries, RTCs and shooting). Diagnostic imaging of the whole spine and a diligent search for associated injuries are substantial.

Hip abductor defect repair by means of a vastus lateralis muscle shift

Scarring or detachment of the hip abductors, particularly of the gluteus medius, from their insertion may lead to severe abductor weakness, recurrent dislocations, pain, and diminished quality of life. We performed a retrospective study to evaluate whether vastus lateralis shift is associated with satisfactory results and low rate of complications. Eleven adults underwent vastus lateralis shift to bridge a well-documented abductor muscles' insertion defect. Preoperative and postoperative hip functions were assessed applying the Merle d'Aubigne score, British Medical Council scale, and Visual Analog Scale. Significant postoperative improvement was noted in mean Merle d'Aubigne score, gluteus medius muscle force, and quality of life. Vastus lateralis shift represents a viable treatment option for hip abductor deficiency, significantly improving abductor strength and overall quality of life.

Two- to 9-year clinical results of alumina ceramic-on-ceramic THA

From June 1997 to June 2003 we performed 194 total hip arthroplasties on 173 patients using alumina ceramic-on-ceramic bearings as part of a prospective United States Food and Drug Administration/Investigational Device Exemption study. The average patient age at surgery was 49.9 years. Minimum followup time was 2 years (mean 4.3 years, range 2-9 years). We evaluated survival rate, implant- and nonimplant-related complications. Clinical outcomes included the Merle d'Aubigné score. We assessed radiographs for signs of osteolysis, component loosening, and implant wear. No patients had osteolysis and there were no hip dislocations. Implant survivorship for all hips with aseptic revision of any component was 96% (CI, 91-100) at 9 year; survivorship for hips without prior surgery was 99.3%, (CI, 98-100). There was a 1.7% incidence of implant-related complications. Our data help confirm two United States FDA/IDE studies on alumina ceramic-on-ceramic total hip arthroplasty that reported low aseptic revision rates and low revision rates for instability. Total hip arthroplasty using alumina ceramic-on-ceramic implants is a safe and reliable procedure in the comparably young and active patient.

Stepped osteotomy of the trochanter for stable, anatomic refixation

Refixation of a trochanteric osteotomy carries a high complication rate. To enhance stability and facilitate anatomic reduction of the trochanteric fragment, we have introduced a stepped osteotomy. Between April 2006 and June 2007, we performed surgical hip dislocations using the modified trochanteric osteotomy combined with a relatively aggressive rehabilitation program. Full weightbearing was allowed at a mean of 42 days (range, 33-54 days). The minimum followup was 8 months (median, 13 months; range, 8-24 months). Postoperative radiographs were assessed prospectively for consolidation or the appearance of malreduction/nonunion/malunion of the osteotomy and heterotopic ossification. In 110 of 113 hips, the trochanteric osteotomy healed in the anatomic position. Two patients had a trochanteric delayed union with loss of anatomic position, and one additional patient underwent revision surgery for a pseudarthrosis and cranial migration of the trochanteric fragment. All three complications related to healing occurred in the first 60 patients when the step height was 3 to 4 mm. After increasing the step heights to 6 mm, we observed no healing complications. Despite more aggressive postoperative mobilization, the incidence of malunion or nonunion related to the new stepped osteotomy is low and approaches zero for steps of 6 mm. It is now our technique of choice.

Femoroacetabular impingement predisposes to traumatic posterior hip dislocation

BACKGROUND Traumatic posterior hip dislocation in adults is generally understood to be the result of a high-energy trauma. Aside from reduced femoral antetorsion, morphologic risk factors for dislocation are unknown. We previously noticed that some hips with traumatic posterior dislocations had evidence of morphologic features of femoroacetabular impingement (FAI), therefore, we sought to evaluate that possibility more formally. QUESTIONS/PURPOSES We asked whether hips with a traumatic posterior hip dislocation present with (1) a cam-type deformity and/or (2) a retroverted acetabulum. METHODS We retrospectively compared the morphologic features of 53 consecutive hips (53 patients) after traumatic posterior hip dislocation with 85 normal hips (44 patients) based on AP pelvic and crosstable axial radiographs. We measured the axial and the lateral alpha angle for detection of a cam deformity and the crossover sign, ischial spine sign, posterior wall sign, retroversion index, and ratio of anterior to posterior acetabular coverage to describe the acetabular orientation. RESULTS Hips with traumatic posterior traumatic dislocation were more likely to have cam deformities than were normal hips, in that the hips with dislocation had increased axial and lateral alpha angles. Hips with posterior dislocation also were more likely to be retroverted; dislocated hips had a higher prevalence of a positive crossover sign, ischial spine sign, and posterior wall sign, and they had a higher retroversion index and increased ratio of anterior to posterior acetabular coverage. CONCLUSIONS Hips with posterior traumatic dislocation typically present with morphologic features of anterior FAI, including a cam-type deformity and retroverted acetabulum. An explanation for these findings could be that the early interaction between the aspherical femoral head and the prominent acetabular rim acts as a fulcrum, perhaps making these hips more susceptible to traumatic dislocation.

Stair climbing - An insight and comparison between women with and without joint hypermobility: A descriptive study.

Generalized joint hypermobility (GJH) is a frequent entity in rheumatology with higher prevalence among women. It is associated with chronic widespread pain, joint dislocations, arthralgia, fibromyalgia and early osteoarthritis. Stair climbing is an important functional task and can induce symptoms in hypermobile persons. The aim of this study was to compare ground reaction forces (GRF) and muscle activity during stair climbing in women with and without GJH. A cross-sectional study of 67 women with normal mobility and 128 hypermobile women was performed. The hypermobile women were further divided into 56 symptomatic and 47 asymptomatic. GRFs were measured by force plates embedded in a six step staircase, as well as surface electromyography (EMG) of six leg muscles. Parameters derived from GRF and EMG were compared between groups using t-test and ANOVA. For GRF no significant differences were found. EMG showed lower activity for the quadriceps during ascent and lower activity for hamstrings and quadriceps during descent in hypermobile women. For symptomatic hypermobile women these differences were even more accentuated. The differences in EMG may point towards an altered movement pattern during stair climbing, aimed at avoiding high muscle activation. However, differences were small, since stair climbing seems to be not demanding.

Dynamic intraligamentary stabilization and primary repair: A new concept for the treatment of knee dislocation.

BACKGROUND Traumatic knee dislocation represents a rare but devastating injury. Several controversies persist regarding type of treatment, surgical timing, graft selection, repair versus reconstruction of the medial and lateral structures, surgical techniques and postoperative rehabilitation. A new technique for primary ACL stabilization, dynamic intaligamentary stabilization (DIS) was developed at the authors' institution. The purpose of this study was to analyze the clinical and radiological outcomes of surgically treated traumatic knee dislocations by means of the DIS technique for the ACL, primary suturing for PCL, MCL and LCL. METHODS Between 2009 and 2012, 35 patients treated surgically for traumatic knee dislocation with primary anterior cruciate ligament (ACL) reconstruction with DIS, suturing of the posterior cruciate ligament (PCL) and primary complete repair of collaterals, were evaluated clinically (IKDC score, SF12 health survey, Lysholm score, Tegner score) and radiologically with a mean follow up of 2.2 years (range 1.00-3.50 years) years. Instrumented anterior-posterior translation was measured (KT-2000). RESULTS Anterior/posterior translation (KT-2000) for the healthy and injured limb was 4.8mm (range 3-8mm) and 7.3mm (range 5-10) (89N) respectively. Valgus and varus stress testing in 30° flexion was normal in 26 (75%) and 29 (83%) patients, respectively. The IKDC score was B in 29 (83%) and C in 6 (17%) patients, while the mean Tegner score was 6 (range 4-8). The mean Lysholm score was 90.83 (range 81-95) and mean SF-12 physical and mental scores were 54.1 (range 45-60) and 51.0 (range 39-62) respectively. In 2 patients, a secondary operation was performed. CONCLUSIONS Early, one stage reconstruction with DIS can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity without graft requirements.

Glenohumeral dislocation. Injury patterns and combination injuries

Hintergrund Begleitverletzungen können in bis zu 90 % der Fälle nach erstmaliger Schulterluxation auftreten. Auch wenn sie nicht immer einen Einfluss auf die Therapiewahl haben, so ist eine sorgfältige Diagnostik entscheidend. Einteilung In der Akutsituation ist eine konventionelle Bildgebung in mindestens 2 Ebenen (a.-p./Neer/evtl. axial) vor und nach Reposition zwingend. Luxationsfrakturen dürfen nicht übersehen bzw. durch das Manöver der geschlossenen Reposition sekundär disloziert werden. Bestehen ossäre glenoidale, humerale oder kombinierte Verletzungen, sollten sie gemäß Stabilitätskriterien versorgt werden. Dies kann umgehend, nach manifester Dezentrierung oder Instabilität entweder mittels Osteosythese oder als glenohumerale Stabilisation im Verlauf erfolgen. Bei einer Instabilität ist prinzipiell zur Bilanzierung einer ossären Ursache das Arthro-CT die Untersuchung der Wahl, welche auch eine Beurteilung der kapsulolabroligamentären Verletzung sowie einer traumatischen Rotatorenmanschettenläsion ermöglicht. Letztere ist jedoch besser mittels Arthro-MRT zu beurteilen. Diskussion Eine signifikante frische, meist größere oder massive, Rotatorenmanschettenläsion sollte rasch operativ angegangen werden. Medial reichende „off the track“ Hill-Sachs-Läsionen können mittels einer Hill-Sachs-Remplissage oder, wie auch glenoidale Defekte, mittels einer Kochenaugmentation versorgt werden. Langzeitresultate des Latarjet-Verfahrens zeigen 25 Jahre nach dem Eingriff die niedrigste Reluxationsrate < 4 %, eine gute Außenrotation, eine sehr hohe Patientenzufriedenheit und degenerative Veränderungen, welche vergleichbar mit der natürlichen Entwicklung nach erstmaliger Schulterluxation ohne Rezidiv sind.

Chemical composition of minerals from rocks of the Utashud Island, off the Southeast Kamchatka

A brief review of various relationships connecting seismofocal zone and volcanic belts within the Kurile island-arc system is represented. Possibilities of manifestation of the submarine volcanic activity and associated relief of the hydrothermal systems on the Pacific shelf of the South Kamchatka are considered. We propose to consider Malko-Petropavlovsk zone of transverse dislocations as seismogenerating one. The phenomenon of ultrafast deformations.

Room temperature photoluminescence of InGaAs Surface Quantum Dots

Self-assembled InGaAs quantum dots show unique physical properties such as three dimensional confinement, high size homogeneity, high density and low number of dislocations. They have been extensively used in the active regions of laser devices for optical communications applications [1]. Therefore, buried quantum dots (BQDs) embedded in wider band gap materials have been normally studied. The wave confinement in all directions and the stress field around the dot affect both optical and electrical properties [2, 3]. However, surface quantum dots (SQDs) are less affected by stress, although their optical and electrical characteristics have a strong dependence on surface fluctuation. Thus, they can play an important role in sensor applications

Role of surface trap states on two-dimensional electron gas density in InAlN/AlN/GaN heterostructures

In order to clarify the effect of charged dislocations and surface donor states on the transport mechanisms in polar AlInN/AlN/GaN heterostructures, we have studied the current-voltage characteristics of Schottky junctions fabricated on AlInN/AlN/GaN heterostructures. The reverse-bias leakage current behaviour has been interpreted with a Poole-Frenkel emission of electrons from trap states near the metal-semiconductor junction to dislocation induced states. The variation of the Schottky barrier height as a function of the AlN layer thickness has been measured and discussed, considering the role of the surface states in the formation of the two dimensional electron gas at AlN/GaN interface.

Nanocrack-induced leakage current in AlInN/AlN/GaN

Here we report on the study of nano-crack formation in Al1−xInxN/AlN/GaN heterostructures, on its association with composition fluctuation and on its local electrical properties. It is shown here that indium segregation at nano-cracks and threading dislocations originating from the non-pseudomorphic AlN interlayer could be the cause of the high reverse-bias gate leakage current of Ni/Au Schottky contacts on Al1−xInxN/AlN/GaN heterostructures and significantly affects the contact rectifying behavior. Segregation of indium around crack tips in Al1−xInxN acting as conductive paths was assessed with conductive atomic force microscopy.

Molecular dynamics modeling and simulation of void growth in two dimensions

The mechanisms of growth of a circular void by plastic deformation were studied by means of molecular dynamics in two dimensions (2D). While previous molecular dynamics (MD) simulations in three dimensions (3D) have been limited to small voids (up to ≈10 nm in radius), this strategy allows us to study the behavior of voids of up to 100 nm in radius. MD simulations showed that plastic deformation was triggered by the nucleation of dislocations at the atomic steps of the void surface in the whole range of void sizes studied. The yield stress, defined as stress necessary to nucleate stable dislocations, decreased with temperature, but the void growth rate was not very sensitive to this parameter. Simulations under uniaxial tension, uniaxial deformation and biaxial deformation showed that the void growth rate increased very rapidly with multiaxiality but it did not depend on the initial void radius. These results were compared with previous 3D MD and 2D dislocation dynamics simulations to establish a map of mechanisms and size effects for plastic void growth in crystalline solids.

Voltage limitation analysis in strain-balanced InAs/GaAsN quantum dot solar cells applied to the intermediate band concept

Several attempts have been carried out to manufacture intermediate band solar cells (IBSC) by means of quantum dot (QD) superlattices. This novel photovoltaic concept allows the collection of a wider range of the sunlight spectrum in order to provide higher cell photocurrent while maintaining the open-circuit voltage (VOC) of the cell. In this work, we analyze InAs/GaAsN QD-IBSCs. In these cells, the dilute nitrogen in the barrier plays an important role for the strain-balance (SB) of the QD layer region that would otherwise create dislocations under the effect of the accumulated strain. The introduction of GaAsN SB layers allows increasing the light absorption in the QD region by multi-stacking more than 100 QD layers. The photo-generated current density (JL) versus VOC was measured under varied concentrated light intensity and temperature. We found that the VOC of the cell at 20 K is limited by the bandgap of the GaAsN barriers, which has important consequences regarding IBSC bandgap engineering that are also discussed in this work.

Technology and characterization of GaN-HEMTs devices: high temperature and trapping effects

Los transistores de alta movilidad electrónica basados en GaN han sido objeto de una extensa investigación ya que tanto el GaN como sus aleaciones presentan unas excelentes propiedades eléctricas (alta movilidad, elevada concentración de portadores y campo eléctrico crítico alto). Aunque recientemente se han incluido en algunas aplicaciones comerciales, su expansión en el mercado está condicionada a la mejora de varios asuntos relacionados con su rendimiento y habilidad. Durante esta tesis se han abordado algunos de estos aspectos relevantes; por ejemplo, la fabricación de enhancement mode HEMTs, su funcionamiento a alta temperatura, el auto calentamiento y el atrapamiento de carga. Los HEMTs normalmente apagado o enhancement mode han atraído la atención de la comunidad científica dedicada al desarrollo de circuitos amplificadores y conmutadores de potencia, ya que su utilización disminuiría significativamente el consumo de potencia; además de requerir solamente una tensión de alimentación negativa, y reducir la complejidad del circuito y su coste. Durante esta tesis se han evaluado varias técnicas utilizadas para la fabricación de estos dispositivos: el ataque húmedo para conseguir el gate-recess en heterostructuras de InAl(Ga)N/GaN; y tratamientos basados en flúor (plasma CF4 e implantación de F) de la zona debajo de la puerta. Se han llevado a cabo ataques húmedos en heteroestructuras de InAl(Ga)N crecidas sobre sustratos de Si, SiC y zafiro. El ataque completo de la barrera se consiguió únicamente en las muestras con sustrato de Si. Por lo tanto, se puede deducir que la velocidad de ataque depende de la densidad de dislocaciones presentes en la estructura, ya que el Si presenta un peor ajuste del parámetro de red con el GaN. En relación a los tratamientos basados en flúor, se ha comprobado que es necesario realizar un recocido térmico después de la fabricación de la puerta para recuperar la heteroestructura de los daños causados durante dichos tratamientos. Además, el estudio de la evolución de la tensión umbral con el tiempo de recocido ha demostrado que en los HEMTs tratados con plasma ésta tiende a valores más negativos al aumentar el tiempo de recocido. Por el contrario, la tensión umbral de los HEMTs implantados se desplaza hacia valores más positivos, lo cual se atribuye a la introducción de iones de flúor a niveles más profundos de la heterostructura. Los transistores fabricados con plasma presentaron mejor funcionamiento en DC a temperatura ambiente que los implantados. Su estudio a alta temperatura ha revelado una reducción del funcionamiento de todos los dispositivos con la temperatura. Los valores iniciales de corriente de drenador y de transconductancia medidos a temperatura ambiente se recuperaron después del ciclo térmico, por lo que se deduce que dichos efectos térmicos son reversibles. Se han estudiado varios aspectos relacionados con el funcionamiento de los HEMTs a diferentes temperaturas. En primer lugar, se han evaluado las prestaciones de dispositivos de AlGaN/GaN sobre sustrato de Si con diferentes caps: GaN, in situ SiN e in situ SiN/GaN, desde 25 K hasta 550 K. Los transistores con in situ SiN presentaron los valores más altos de corriente drenador, transconductancia, y los valores más bajos de resistencia-ON, así como las mejores características en corte. Además, se ha confirmado que dichos dispositivos presentan gran robustez frente al estrés térmico. En segundo lugar, se ha estudiado el funcionamiento de transistores de InAlN/GaN con diferentes diseños y geometrías. Dichos dispositivos presentaron una reducción casi lineal de los parámetros en DC en el rango de temperaturas de 25°C hasta 225°C. Esto se debe principalmente a la dependencia térmica de la movilidad electrónica, y también a la reducción de la drift velocity con la temperatura. Además, los transistores con mayores longitudes de puerta mostraron una mayor reducción de su funcionamiento, lo cual se atribuye a que la drift velocity disminuye más considerablemente con la temperatura cuando el campo eléctrico es pequeño. De manera similar, al aumentar la distancia entre la puerta y el drenador, el funcionamiento del HEMT presentó una mayor reducción con la temperatura. Por lo tanto, se puede deducir que la degradación del funcionamiento de los HEMTs causada por el aumento de la temperatura depende tanto de la longitud de la puerta como de la distancia entre la puerta y el drenador. Por otra parte, la alta densidad de potencia generada en la región activa de estos transistores conlleva el auto calentamiento de los mismos por efecto Joule, lo cual puede degradar su funcionamiento y Habilidad. Durante esta tesis se ha desarrollado un simple método para la determinación de la temperatura del canal basado en medidas eléctricas. La aplicación de dicha técnica junto con la realización de simulaciones electrotérmicas han posibilitado el estudio de varios aspectos relacionados con el autocalentamiento. Por ejemplo, se han evaluado sus efectos en dispositivos sobre Si, SiC, y zafiro. Los transistores sobre SiC han mostrado menores efectos gracias a la mayor conductividad térmica del SiC, lo cual confirma el papel clave que desempeña el sustrato en el autocalentamiento. Se ha observado que la geometría del dispositivo tiene cierta influencia en dichos efectos, destacando que la distribución del calor generado en la zona del canal depende de la distancia entre la puerta y el drenador. Además, se ha demostrado que la temperatura ambiente tiene un considerable impacto en el autocalentamiento, lo que se atribuye principalmente a la dependencia térmica de la conductividad térmica de las capas y sustrato que forman la heterostructura. Por último, se han realizado numerosas medidas en pulsado para estudiar el atrapamiento de carga en HEMTs sobre sustratos de SiC con barreras de AlGaN y de InAlN. Los resultados obtenidos en los transistores con barrera de AlGaN han presentado una disminución de la corriente de drenador y de la transconductancia sin mostrar un cambio en la tensión umbral. Por lo tanto, se puede deducir que la posible localización de las trampas es la región de acceso entre la puerta y el drenador. Por el contrario, la reducción de la corriente de drenador observada en los dispositivos con barrera de InAlN llevaba asociado un cambio significativo en la tensión umbral, lo que implica la existencia de trampas situadas en la zona debajo de la puerta. Además, el significativo aumento del valor de la resistencia-ON y la degradación de la transconductancia revelan la presencia de trampas en la zona de acceso entre la puerta y el drenador. La evaluación de los efectos del atrapamiento de carga en dispositivos con diferentes geometrías ha demostrado que dichos efectos son menos notables en aquellos transistores con mayor longitud de puerta o mayor distancia entre puerta y drenador. Esta dependencia con la geometría se puede explicar considerando que la longitud y densidad de trampas de la puerta virtual son independientes de las dimensiones del dispositivo. Finalmente se puede deducir que para conseguir el diseño óptimo durante la fase de diseño no sólo hay que tener en cuenta la aplicación final sino también la influencia que tiene la geometría en los diferentes aspectos estudiados (funcionamiento a alta temperatura, autocalentamiento, y atrapamiento de carga). ABSTRACT GaN-based high electron mobility transistors have been under extensive research due to the excellent electrical properties of GaN and its related alloys (high carrier concentration, high mobility, and high critical electric field). Although these devices have been recently included in commercial applications, some performance and reliability issues need to be addressed for their expansion in the market. Some of these relevant aspects have been studied during this thesis; for instance, the fabrication of enhancement mode HEMTs, the device performance at high temperature, the self-heating and the charge trapping. Enhancement mode HEMTs have become more attractive mainly because their use leads to a significant reduction of the power consumption during the stand-by state. Moreover, they enable the fabrication of simpler power amplifier circuits and high-power switches because they allow the elimination of negativepolarity voltage supply, reducing significantly the circuit complexity and system cost. In this thesis, different techniques for the fabrication of these devices have been assessed: wet-etching for achieving the gate-recess in InAl(Ga)N/GaN devices and two different fluorine-based treatments (CF4 plasma and F implantation). Regarding the wet-etching, experiments have been carried out in InAl(Ga)N/GaN grown on different substrates: Si, sapphire, and SiC. The total recess of the barrier was achieved after 3 min of etching in devices grown on Si substrate. This suggests that the etch rate can critically depend on the dislocations present in the structure, since the Si exhibits the highest mismatch to GaN. Concerning the fluorine-based treatments, a post-gate thermal annealing was required to recover the damages caused to the structure during the fluorine-treatments. The study of the threshold voltage as a function of this annealing time has revealed that in the case of the plasma-treated devices it become more negative with the time increase. On the contrary, the threshold voltage of implanted HEMTs showed a positive shift when the annealing time was increased, which is attributed to the deep F implantation profile. Plasma-treated HEMTs have exhibited better DC performance at room temperature than the implanted devices. Their study at high temperature has revealed that their performance decreases with temperature. The initial performance measured at room temperature was recovered after the thermal cycle regardless of the fluorine treatment; therefore, the thermal effects were reversible. Thermal issues related to the device performance at different temperature have been addressed. Firstly, AlGaN/GaN HEMTs grown on Si substrate with different cap layers: GaN, in situ SiN, or in situ SiN/GaN, have been assessed from 25 K to 550 K. In situ SiN cap layer has been demonstrated to improve the device performance since HEMTs with this cap layer have exhibited the highest drain current and transconductance values, the lowest on-resistance, as well as the best off-state characteristics. Moreover, the evaluation of thermal stress impact on the device performance has confirmed the robustness of devices with in situ cap. Secondly, the high temperature performance of InAlN/GaN HEMTs with different layouts and geometries have been assessed. The devices under study have exhibited an almost linear reduction of the main DC parameters operating in a temperature range from room temperature to 225°C. This was mainly due to the thermal dependence of the electron mobility, and secondly to the drift velocity decrease with temperature. Moreover, HEMTs with large gate length values have exhibited a great reduction of the device performance. This was attributed to the greater decrease of the drift velocity for low electric fields. Similarly, the increase of the gate-to-drain distance led to a greater reduction of drain current and transconductance values. Therefore, this thermal performance degradation has been found to be dependent on both the gate length and the gate-to-drain distance. It was observed that the very high power density in the active region of these transistors leads to Joule self-heating, resulting in an increase of the device temperature, which can degrade the device performance and reliability. A simple electrical method have been developed during this work to determine the channel temperature. Furthermore, the application of this technique together with the performance of electro-thermal simulations have enabled the evaluation of different aspects related to the self-heating. For instance, the influence of the substrate have been confirmed by the study of devices grown on Si, SiC, and Sapphire. HEMTs grown on SiC substrate have been confirmed to exhibit the lowest self-heating effects thanks to its highest thermal conductivity. In addition to this, the distribution of the generated heat in the channel has been demonstrated to be dependent on the gate-to-drain distance. Besides the substrate and the geometry of the device, the ambient temperature has also been found to be relevant for the self-heating effects, mainly due to the temperature-dependent thermal conductivity of the layers and the substrate. Trapping effects have been evaluated by means of pulsed measurements in AlGaN and InAIN barrier devices. AlGaN barrier HEMTs have exhibited a de crease in drain current and transconductance without measurable threshold voltage change, suggesting the location of the traps in the gate-to-drain access region. On the contrary, InAIN barrier devices have showed a drain current associated with a positive shift of threshold voltage, which indicated that the traps were possibly located under the gate region. Moreover, a significant increase of the ON-resistance as well as a transconductance reduction were observed, revealing the presence of traps on the gate-drain access region. On the other hand, the assessment of devices with different geometries have demonstrated that the trapping effects are more noticeable in devices with either short gate length or the gate-to-drain distance. This can be attributed to the fact that the length and the trap density of the virtual gate are independent on the device geometry. Finally, it can be deduced that besides the final application requirements, the influence of the device geometry on the performance at high temperature, on the self-heating, as well as on the trapping effects need to be taken into account during the device design stage to achieve the optimal layout.