Explore the vast range of titles available.

In an aircraft design, optimisation has become a common practice, especially when structural and aerodynamics interactions are considered. Performance measures often used in an industrial setting include structural weight, drag, lift to drag ratio, fuel burn or maximum range. It is a common practice to evaluate such performance indicators only on a handful of sample points. To achieve a truly economical aircraft design it is necessary to include a fully integrated mission analysis during a multidisciplinary structural optimisation, as there is a strong coupling between a flight behaviour and actual operational conditions of an aircraft. This paper makes a case for a modular approach to a mission analysis implementation that could utilise a variety of physical models and their combinations, offsetting some of the computational demands related to a fully integrated mission analysis and allowing to focus resources where they are needed.

Background:Orbital inflammatory pseudotumors (PTIO) are any inflammatory intra-orbital expansive process.Objectives:The objective of our work is to study the clinical and radiographic characteristics of PTIO in an internal medicine department.Methods:This is a retrospective study including patients being hospitalized in the internal medicine department between 2014 and 2023 and in whom the diagnosis of PTIO was made on clinical and radiological criteria.Results:Nineteen patients were included, with a mean age of 55 years (18–81).The symptomatology was dominated by exophthalmos in all the cases, it was associated with a decrease in visual acuity(n=13), eye pain in(n=7), eye redness(n=6), oculomotor paralysis(n=6),and palpebral oedema(n=4).The ophthalmologic examination noted the presence of conjunctival hyperemia(n=6), posterior nodular scleritis(n=3), episcleritis(n=1), ischemic retinal vasculitis(n=1),The extra ocular manifestations included: dry eye syndrome (n = 5), chronic sinusitis (n = 3), peripheral neuropathy (n = 2), presence of excavated lung mass (n = 1), nodular pachymeningitis (n = 1) and clinical signs of hyperthyroidism (n = 1). The realization of an orbito-cephalic magnetic resonance imaging allowed a diagnostic orientation by objectifying exophthalmos in all cases, fatty infiltration (n = 17), oculomotor muscle infiltration (n = 15), enhancement of the optic nerve sheath (n = 5), dacryoadenitis (n = 5), and nodular scleral thickening (n = 4) and pansinusien thickening (n = 3). The orbital biopsy was done in seven cases showing non-specific inflammatory signs in five cases and allowing the diagnosis of B lymphoma in one case. The aetiologies found: granulomatous polyangiitis (n = 3), primary sjogren syndrome (n = 2), Basedow disease (n = 1) and orbital lymphoma (n = 1), PTIO was idiopathic in twelve cases.Conclusion:Orbital pseudotumor is a benign intraorbital process confined to the orbit but extra orbital involvement can occur. Clinically, orbital pseudotumor has been categorized as myositis, dacryoadenitis, or associated with several ocular damage, Diagnosis is based on careful history, magnetic resonance imaging (MRI) studies which may also provide prognostic information.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.

Background:Raynaud phenomenon (RP) is one of the most common manifestations of connective tissue diseases (CTD). Hygiene measures are crucial for its management. Yet, compliance to these measures require good knowledge of the symptoms.Objectives:To evaluate knowledge of CTD patients in Arab countries regarding RP.Methods:A descriptive cross-sectional study carried out during the month of December 2023, based on an anonymous Google Forms questionnaire shared with patients who are members of arab support groups for Systemic Sclerosis, Systemic Lupus Erythematosus and Sjogren Syndrome. Questions were either open and non-suggestive or with suggested choices.Results:Forty-six patients answered. The mean age was 41,08 years [22;90]. Countries of participants were as follows: Tunisia (n=30); Jordan (n=4); Egypt (n=4); Morocco (n=3); Algeria (n=2); Syria (n=2); Libya (n=1); Irak (n=1) and Oman (n=1). Patients’ CTDs were: Systemic sclerosis (n=19); Systemic Lupus Erythematosus (n=22) and Sjogren Syndrome (n=5). The mean duration of RP was 10,66 years [1;45].For the question “What do you know about RP?”, answers were as follow: N=nothing (n=23);it is a change of finger’s coloration to blue then white then back to normal (n=10); it is a reaction to cold (n=9); the mechanism is constriction of finger vessels (n=8); the mechanism is abnormal low blood flow in fingers (n=6); it can be caused by stress (n=5); it can cause necrosis (n=3);it is a symptom of my autoimmune disease (n=3); it is an autoimmune disease (n=1). The mean score was 0,48 [0;2].Twenty-six patients didn’t know if smoking worsens RP (56,5%) and two though it doesn’t (4,3%). Forty patients knew that cold weather may worsen RP (87%).Measures reported by patients in order to prevent RP were: wearing gloves (n=15); no measures (n=14); staying in warm spaces (n=12); avoiding touching cold surfaces (n=8); avoiding stress (n=6); using hand moisturizers (n=3); using hot water (n=4); wearing thick clothes (n=4); avoiding smoke (n=1). The mean score was 0;96 [0;4].Twenty-eight patients reported that their doctors didn’t explain RP (60%) and 24 do not recall being informed about hygienic measures (52,1%). Seventeen patients confirmed not adhering to these measures (37,7%). Reasons reported were: to avoid people’s questions (n=5); I don’t have heating facilities in my house (n=3); I am not allowed wearing gloves at work (n=1); I don’t have access to warm water (n=2); I can’t control stress (n=2);Regarding psychological impact of RP, feelings described were: bad body image (n=8); fear (n=6); anxiety (n=6); loneliness; (n=3); weakness (n=3); deprivation (n=2); sadness (n=1).Absence of education by the doctor was associated with lower patient knowledge score (p=0,028), lower knowledge of measures score (p=0,001) and lower adherence to hygiene measures (p=0,027). No significant correlation was found between the CTD and the different RP knowledge scores.Conclusion:Overall knowledge regarding RP was not satisfying in our patients. This seems to be partially explained by the lack of patient education, and may lead to less adherence to hygiene measures. More academic and personalized training for professionals managing patients with RP can help solve this problem.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.

This paper presents the extension and validation of omni-failure envelopes for first-ply failure (FPF) and last-ply failure (LPF) analysis of advanced composite materials under general three-dimensional (3D) stress states. Phenomenological failure criteria based on invariant structural tensors are implemented to address failure events in multidirectional laminates using the “omni strain failure envelope” concept. This concept enables the generation of safe predictions of FPF and LPF of composite laminates, providing reliable and fast laminate failure indications that can be particularly useful as a design tool for conceptual and preliminary design of composite structures. The proposed extended omni strain failure envelopes allow not only identification of the controlling plies for FPF and LPF, but also of the controlling failure modes. FPF/LPF surfaces for general 3D stress states can be obtained using only the material properties extracted from the unidirectional (UD) material, and can predict membrane FPF or LPF of any laminate independently of lay-up, while considering the effect of out-of-plane stresses. The predictions of the LPF envelopes and surfaces are compared with experimental data on multidirectional laminates from the first and second World-Wide Failure Exercise (WWFE), showing a satisfactory agreement and validating the conservative character of omni-failure envelopes also in the presence of high levels of triaxiality.

Ferroptosis is a regulated form of cell death driven by the lethal accumulation of lipid peroxides in cell membranes. Several regulators of ferroptosis have been identified using cancer cell lines. However, the cellular pathways of ferroptosis in neurons remain poorly characterized. In this study, we used a mouse embryonic stem cell‐derived motor neuron model to investigate how motor neurons respond to ferroptosis inducers. Pharmacological and genetic inhibition of glutathione peroxidase 4 (GPx4) induced ferroptosis in motor neurons, while system xc− inhibition by erastin had no effect. RNA‐seq analysis showed that the expression levels of several genes were altered during RSL3‐induced ferroptosis. Subsequent bioinformatic analysis revealed alterations in several biological pathways during ferroptosis, including synaptogenesis and calcium signaling. Finally, we found that edaravone, an FDA‐approved drug for treating amyotrophic lateral sclerosis (ALS) disease, rescued motor neurons from RSL3‐induced ferroptosis. Our data highlight the crucial role of GPx4 in ferroptosis regulation and demonstrate that stem cell‐derived motor neuron culture is a valuable model to study ferroptosis at the single‐cell level in a neuronal context. Ferroptosis is a form of regulated cell death driven by lipid peroxides. Here, we used mouse stem cell‐derived motor neurons to investigate which cellular pathways are altered during ferroptosis in motor neurons. We identified several biological pathways that were altered in motor neurons during RSL3‐induced ferroptosis. The results demonstrate the usefulness of the stem cell‐based model in studying neuronal ferroptosis.

The study objective was to ascertain outcomes with the Swedish adjustable gastric band (SAGB) on an intention-to-treat basis in multiple centers across the French social health insurance system. SAGB results at 3-year follow-up are reported. The noncomparative, observational, prospective, consecutive cohort study design sought a 500-patient minimum recruitment geographically representative of continental France. Safety (adverse events [AEs], device-related morbidity, and mortality) and effectiveness (change in body mass index [BMI, kilograms per square meter], percentage excess weight loss, comorbidities, quality of life [QoL]) were assessed. Adjustable gastric band survival was calculated. Thirty-one surgeons in 28 multidisciplinary teams/sites enrolled patients between September 2, 2007 and April 30, 2008. SAGB was successfully implanted in 517 patients: 88.0 % female; mean age, 37.5 years; obesity duration, 15.3 years (baseline: mean BMI, 41.0; comorbidities, 773 in 74.3 % of patients; Bariatric Analysis and Reporting Outcome System (BAROS), 1.4; EuroQoL 5-Dimensions (EQ-5D), 0.61; EuroQoL–visual analog scale (EQ–VAS), 52.3). At 3 years: BMI, 32.2 (mean change, −9.0; p  < 0.0001); excess weight loss, 47.4 %; comorbidities, 161 in 27.2 %; BAROS, 3.6 (+2.2, p  < 0.0001); EQ-5D, 0.84 (+0.22, p  < 0.0001); EQ–VAS, 73.4 (+21.4, p  < 0.0001). SAGB-induced weight loss was associated with substantially improved QoL. One death occurred and was unrelated to the treatment. No AE was reported in 68.3 % of patients, and no confirmed device-related AE in 77.0 %. Overall AE rate was 0.19 per patient year. Device retention was 87.0 %. Analysis of patients lost to follow-up showed a nonsignificant effect on overall study results. In a prospective, consecutive cohort, “real-world”, nationwide study, the Swedish Adjustable Gastric Band was found safe and effective at 3-year follow-up.

In neutropenic patients with acute perianal sepsis in the setting of hematological malignancy, the classical clinical features of abscess formation are lacking. Additionally, the role of surgical intervention is not well established. In this review, we discuss the challenges and controversy regarding diagnosis and optimal management when clear surgical guidelines are absent. In the literature, there is great diversity in the surgical approach to these patients, which leads to a high percentage of diagnostic errors, risks of complications, and unnecessary interventions. We review the literature and assess whether surgical intervention produces better outcomes than a non-surgical approach. Studies published on perianal sepsis in neutropenic cancer patients were identified by searching PubMed using the following key words: “perianal sepsis/abscesses, anorectal sepsis/abscess, neutropenia, hematological malignancy, cancer”. No randomized or prospective studies on the management of acute perianal sepsis in hematological malignancies were found. The largest retrospective study and most comprehensive clinical data demonstrated that 42 % of patients were treated successfully without surgical intervention and without morbidity or mortality related to treatment chosen. Small retrospective studies advocated surgical intervention, while the majority of successes were in a non-operative treatment. It is difficult to formulate a conclusion given the small retrospective series on management of neutropenic patients with hematological malignancies. While there is no evidence mandating a routine surgical approach in this category of patients, non-surgical management including careful follow-up to determine whether the patient’s condition is deteriorating or treatment has failed is an acceptable approach in selected patients without pathognomonic features of abscess. Comprehensive and well-designed prospective studies are needed to firmly establish the guidelines of treatment protocols.

BackgroundOsteo-aticular tuberculosis represents 2 to 5% of all tuberculosis. Tuberculous spondylitis arise at any age. Dorsolumbar location is most frequently touched and clinical presentation is not specific. The MRI presents a superior to other radiological exams in the exploration of tuberculous spondylitis.ObjectivesThe purpose of our study is to specify epidemiological, clinical, biological and therapeutic peculiarities of Tuberculous Spondylitis in Tunisian patients.MethodsA retrospective and descriptive analysis including patients with tuberculous spondylitis followed in the department of internal medicine during a period of 15 years from January 2000 till January 2015. Tuberculin skin test, imaging techniques, mycobacterium cultures, histopathologic examination, treatment and clinical outcome were reported. Diagnosis was retained in front of positive bacteriological or histopathological exams and/or association of clinico-biological or radiologic arguments with therapeutic proof.ResultsWe identified 13 patients with tuberculous spondylitis. It was about 9 women and 4 men with a middle-age at the time of diagnosis of 53, 4 years with extremes between 13 and 90 years. The mean diagnosis delay was 7,4 months. Main initial symptoms were back pain in 11 cases, mobility limitation in 6 cases and dysphagia in a case. Blood tests showed leukocytisis in a case an elevated C-reactive protein levels in 9 cases. Tuberculin skin test was positive in 7 cases. Bacterial diagnosis was positive in a case. Granuloma with necrosis was noted at the histopathologic examination of the bonedraining biopsy in 3 cases. Radiologic exams contained standard spinal radiographs in 7 cases, Computed tomography scanning in 7 cases and magnetic resonance imaging in 6 cases. The imaging examination showed signs of lytic destruction of vertebral body with vertebral collapse in all cases, and multiple abscesses in 5 cases. Spondylitis was located in thoracic vertebra in 6 cases, lumbar vertebra in 6 cases and cervical vertebra in a case. Other locations of the tuberculosis were noted in 5 cases and were represented by lymph nodes, meningeal, peritoneal, retropharyngeal and urogenital tuberculosis. All the patients were treated by a tuberculosis quadritherapy. A patient received corticosteroids for spine involvement. The median duration of the treatment was of 16 months. The outcome was favourable in all cases with stabilization of the radiological involvement. The mean follow up was of 15,7 monthsConclusionsTuberculosis always rages under an endemic mode in developing contries. Inspite of the absence of immunosuppression, tuberculosis spondylitis was associated to other tuberculous locations in 5 cases. The beginning is often insidious with a late diagnosis. The association of clinical, biological and radiological arguments with therapeutic proof allowed to carry the diagnosis.Disclosure of InterestNone declared

ObjectiveNoninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) is the term to describe what was previously known as encapsulated follicular variant of papillary thyroid carcinoma. This new paradigm shift was agreed upon by experts in the field. The objective of this study is to evaluate cases previously diagnosed as follicular adenomas, follicular variant of papillary thyroid carcinoma and hyperplastic nodules to be reclassified as NIFTP according to the new criteria. Furthermore, the clinical follow-up of these NIFTP cases is evaluated.MethodsThis retrospective study reviewed potential NIFTP cases over the last 13 years, at Jordan University Hospital.ResultsA total of 811 thyroid surgery reports were identified and revised to identify the potential NIFTP cases. The review yielded 173 cases identified as potential NIFTP cases. Further pathological slide review resulted in a revised diagnosis of 32 cases of NIFTP according to the new criteria. The NIFTP cases comprised 4% of the total number of thyroidectomy cases and 16.1% of the total pool of previously diagnosed papillary thyroid carcinoma cases at our institution. While 111 cases retained their original diagnosis. Follow-up showed that all patients are alive and well with no evidence of disease.ConclusionPatients with NIFTP are not uncommon and the diagnosis is made only after a thorough evaluation of excision. Therefore, initial conservative management of solitary thyroid nodules suspicious for NIFTP in the form of lobectomy is recommended to avoid unnecessary total thyroidectomies. Our follow-up of NIFTP cases is similar to all previous reports.