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Cardiovascular diseases (CVD) remain the leading cause of mortality among older adults. Early detection is critical as the prognosis for advanced-stage CVD is often poor. Consequently, non-invasive diagnostic tools that can assess hemodynamic function, particularly of the aorta, are essential. Computational fluid dynamics (CFD) has emerged as a promising method for simulating cardiovascular dynamics efficiently and cost-effectively, using increasingly accessible computational resources. This study developed a CFD model to assess the aorta geometry using tetrahedral and polyhedral meshes. A healthy aorta was modeled with mesh sizes ranging from 0.2 to 1 mm. Key hemodynamic parameters, including blood pressure waveform, pressure difference, wall shear stress (WSS), and associated wall parameters like relative residence time (RRT), oscillatory shear index (OSI), and endothelial cell activation potential (ECAP) were evaluated. The performance of the CFD simulations, focusing on accuracy and processing time, was assessed to determine clinical viability. The CFD model demonstrated clinically acceptable results, achieving over 95% accuracy while reducing simulation time by up to 54%. The entire simulation process, from image construction to the post-processing of results, was completed in under 120 min. Both mesh types (tetrahedral and polyhedral) provided reliable outputs for hemodynamic analysis. This study provides a novel demonstration of the impact of mesh type in obtaining accurate hemodynamic data, quickly and efficiently, using CFD simulations for non-invasive aortic assessments. The method is particularly beneficial for routine check-ups, offering improved diagnostics for populations with limited healthcare access or higher cardiovascular disease risk.

Aortic dissection is a catastrophic failure of the endothelial wall that could lead to malperfusion or rupture. Computational modelling tools may help detect arterial damage. Technological advancements have led to more sophisticated forms of modelling being made available to low-grade computers. These devices can create 3D models with clinical data, where the clinical blood pressure waveforms’ model can be used to form boundary conditions for assessing hemodynamic parameters, modelling blood flow propagation along the aorta to predict the development of cardiovascular disease. This study presents patient-specific data for a rare case of severe Type A aortic dissection. CT scan images were taken nine months apart, consisting of the artery both before and after dissection. The results for the pre-dissection CT showed that the pressure waveform at the ascending aorta was higher, and the systolic pressure was lagging at the descending aorta. For the post-dissection analysis, we observed the same outcome; however, the amplitude for the waveform (systolic pressure) at the ascending aorta increased in the false lumen by 25% compared to the true lumen by 3%. Also, the waveform peak (systolic) was leading by 0.01 s. The hemodynamic parameter of wall shear stress (WSS) predicted the aneurysm’s existence at the ascending aorta, as well as potential aortic dissection. The high WSS contours were located at the tear location at the peak blood flow of 0.14 s, which shows the potential of this tool for earlier diagnosis of aortic dissection.

The primary objective in foundation design is to ensure that the foundation exhibits satisfactory behavior under regulatory loading conditions while addressing critical safety concerns. This study aims to investigate the impact of parameter uncertainties in prediction models for bearing capacity and settlement of shallow and deep foundations on resulting failure probabilities using various approximation methods. Recognizing the complexity of reliability studies, this research explores the possibility of not probabilizing all variables and simplifying calculations for future applications. Additionally, it aims to assess the effectiveness of commonly used approximation methods in geotechnical engineering for estimating failure probabilities. The study's findings would enhance foundation reliability indices and decrease the probability of failure. The parametric study has enabled us to identify the variables that are most sensitive to changes in their coefficient of variation. The influence of model selection on foundation reliability is emphasized, and a critical evaluation of model bias is crucial for reliability analysis. It is evident that conservative models may shift subsequently calculated failure probabilities by inaccurately assigning situations from the safe domain to the failure domain due to inherent conservatism.

Abstract Background The SARS CoV‐2 pandemic disrupted healthcare systems. We compared the cancer stage for new breast cancers (BCs) before and during the pandemic. Methods We performed a retrospective multicenter cohort study on the data warehouse of Greater Paris University Hospitals (AP‐HP). We identified all female patients newly referred with a BC in 2019 and 2020. We assessed the timeline of their care trajectories, initial tumor stage, and treatment received: BC resection, exclusive systemic therapy, exclusive radiation therapy, or exclusive best supportive care (BSC). We calculated patients' 1‐year overall survival (OS) and compared indicators in 2019 and 2020. Results In 2019 and 2020, 2055 and 1988, new BC patients underwent cancer treatment, and during the two lockdowns, the BC diagnoses varied by −18% and by +23% compared to 2019. De novo metastatic tumors (15% and 15%, p = 0.95), pTNM and ypTNM distributions of 1332 cases with upfront resection and of 296 cases with neoadjuvant therapy did not differ (p = 0.37, p = 0.3). The median times from first multidisciplinary meeting and from diagnosis to treatment of 19 days (interquartile 11–39 days) and 35 days (interquartile 22–65 days) did not differ. Access to plastic surgery (15% and 17%, p = 0.08) and to treatment categories did not vary: tumor resection (73% and 72%), exclusive systemic therapy (13% and 14%), exclusive radiation therapy (9% and 9%), exclusive BSC (5% and 5%) (p = 0.8). Among resected patients, the neoadjuvant therapy rate was lower in 2019 (16%) versus 2020 (20%) (p = 0.02). One‐year OS rates were 99.3% versus 98.9% (HR = 0.96; 95% CI, 0.77–1.2), 72.6% versus 76.6% (HR = 1.28; 95% CI, 0.95–1.72), 96.6% versus 97.8% (HR = 1.09; 95% CI, 0.61–1.94), and 15.5% versus 15.1% (HR = 0.99; 95% CI, 0.72–1.37), in the treatment groups. Conclusions Despite a decrease in the number of new BCs, there was no tumor stage shift, and OS did not vary.

Since EXTRA, a non-randomized phase II trial with 31 patients, explored the use of capecitabine, mitomycin and radiation therapy (RT) in the treatment of localized squamous cell carcinoma of the anal canal (SCCAC), this treatment has been considered as an acceptable alternative to infusional 5-FU. However, the differences in efficacy between capecitabine and 5-FU in chemoradiation therapy (CRT) with simultaneous integrated boost (SIB) radiation therapy (SIB-IMRT) for local SCCAC are not well documented. Patients included in this prospective monocentric cohort study were treated with SIB-RapidArc (a unique RT method treatment for all patients: identical technique, volume and constraints for at-risk organs), mitomycin C and 5-FU each day of RT for 7 weeks (group 1) or capecitabine each day of RT (group 2). Patients treated between July 2009 and August 2017 (group 1) and between November 2012 and April 2018 (group 2) for local SCCAC T2-4 classified as N, M0 or T, N1-3, M0 were included. Primary endpoints were progression-free survival (PFS) and acute toxicities. Results: One hundred forty-seven patients were included, 91 in group 1 and 56 in group 2. The two groups were statistically comparable in terms of sex, Eastern Cooperative Oncology Group Performance Status (ECOG PS) and TNM. With a median duration of follow-up of 53.5 months, the PFS rate at 3 years was 80% for group 1 and 75% for group 2 (p = 0.32). The 3-year colostomy-free survival rate was 92% for group 1 and 85% for group 2 (p = 0.11). The rate of patients with at least one grade 3 or higher acute toxicity was 35.5% in group 1 and 21.4% in group 2 (p = 0.10), with a trend of fewer acute toxicities with capecitabine. Conclusion: Capecitabine/mitomycin in combination with SIB RapidArc radiation therapy for anal cancer seems as effective as 5-FU-based chemotherapy and is well tolerated with minimal toxicity.

Background: Disinfection is performed in our laboratory using sodium hypochlorite, glutaraldehyde, alcohol, or hydrogen peroxide. All these products are known for their harmful side effects on human and ecological health. As a part of the search for new sterilization methods that respect the environment much more, we were interested in studying the antifungal activity of ozone gas on the most isolated fungi in our hospital “University Hospital Center Hassani Abdelkader of Sidi Bel Abbes”. Methods: This study focused on the antifungal activity of gaseous ozone on the most common fungal isolates in the hospital, with consideration of the duration of the exposure to ozone. Results: The fungicidal effect of ozone gas on molds was more effective compared to its effect on yeasts, it makes it possible to inhibit the reproduction and fungal growth of molds, in particular the filamentous molds and the most commonly isolated dermatophytes. A longer exposure would seem to be more effective. Conclusion: Ozone gas can be a new alternative for sterilization and disinfection techniques, especially filamentous fungi and dermatophytes.

Background and purposeThe Meta-Analysis of Chemotherapy in squamous cell Head and Neck Cancer (MACH-NC) demonstrated that concomitant chemotherapy (CT) improved overall survival (OS) in patients without distant metastasis. We report the updated results.Materials and methodsPublished or unpublished randomized trials including patients with non-metastatic carcinoma randomized between 1965 and 2016 and comparing curative loco-regional treatment (LRT) to LRT + CT or adding another timing of CT to LRT + CT (main question), or comparing induction CT + radiotherapy to radiotherapy + concomitant (or alternating) CT (secondary question) were eligible. Individual patient data were collected and combined using a fixed-effect model. OS was the main endpoint.ResultsFor the main question, 101 trials (18951 patients, median follow-up of 6.5 years) were analyzed. For both questions, there were 16 new (2767 patients) and 11 updated trials. Around 90% of the patients had stage III or IV disease. Interaction between treatment effect on OS and the timing of CT was significant (p