Can Bcl-XL expression predict the radio sensitivity of Bilharzial-related squamous bladder carcinoma? a prospective comparative study

<p>Abstract</p> <p>Background</p> <p>Local pelvic recurrence after radical cystectomy for muscle invasive bilharzial related squamous cell carcinoma accounts for 75% of treatment failures even in organ confined tumors. Despite the proven value of lymphadenectomy, up to 60% of patients undergoing cystectomy do not have it. These factors are in favor of adjuvant radiotherapy reevaluation. objectives: to evaluate the effect of adjuvant radiotherapy on disease free survival in muscle invasive bilharzial related squamous cell carcinoma of the urinary bladder and to test the predictability of radio-sensitivity using the anti apoptotic protein Bcl-XL.</p> <p>Methods</p> <p>The study prospectively included 71 patients, (47 males, 24 females) with muscle invasive bilharzial related squamous cell carcinoma of the bladder (Stage pT2a-T3N0-N3M0) who underwent radical cystectomy in Assiut university hospitals between January 2005 and December 2006. Thirty eight patients received adjuvant radiotherapy to the pelvis in the dose of 50Gy/25 fractions/5 weeks (Group 1), while 33 patients did not receive adjuvant radiotherapy (group 2). Immunohistochemical characterization for bcl-xL expression was done. Follow up was done every 3 months for 12 to 36 months with a mean of 16 ± 10 months. All data were analyzed using SPSS version 16. Three years cumulative disease free survival was calculated and adjusted to Bcl-XL expression and side effects of the treatment were recorded.</p> <p>Results</p> <p>The disease free cumulative survival was 48% for group 1 and 29% for group 2 (log rank p value 0.03). The multivariate predictors of tumor recurrence were the positive Bcl-XL expression (odd ratio 41.1, 95% CI 8.4 - 102.3, p < 0.0001) and radiotherapy (odd ratio 0.19, 95% CI 0.05 - 0.78, p < 0.02). With Cox regression, the only independent multivariate predictor of radio-sensitivity was the Bcl-XL expression with odd ratio 4.6 and a p value < 0.0001. All patients tolerated the treatment with no life threatening or late complications during the period of follow up.</p> <p>Conclusions</p> <p>Adjuvant radiotherapy for muscle invasive bilharzial related squamous cell carcinoma of the urinary bladder has potential effectiveness and minor side effects. Moreover, Bcl-XL expression is a valuable tool for predicting those who might not respond to this adjuvant treatment.</p

Etude au séisme des structures élastoplastiques (Cas de l'oscillateur simple)

Ce travail de thèse a pour ambition d apporter quelques éclairages sur le comportement des structures inélastiques soumises à des sollicitations périodiques de type sismique. L étude sera retreinte à un système à un degré de liberté. L objectif de l étude est de dégager des zones comportementales de l oscillateur reliées à la théorie moderne des systèmes dynamiques non linéaires. Cette étude s intéresse donc à une loi de comportement simple élastoplastique dans un cadre dynamique : on peut ainsi parler de "Rhéologie dynamique" pour caractériser un tel oscillateur inélastique. Notre première motivation est d analyser le comportement dynamique d un oscillateur avec une technique utilisée dans le domaine des systèmes dynamiques non réguliers. On procède à l'étude de la stabilité et de la dynamique d'un oscillateur élastoplastique symétrique non amorti. Cette étude a permis de lier les propriétés dynamiques (cycle limite ) aux caractéristiques mécaniques (adaptation, accomodation), et un diagramme de bifurcation est mis en évidence numériquement. L'étude est enrichie par la suite par l'introduction d'un amortissement visqueux. Enfin, la dynamique d'un oscillateur élastoplastique parfait amorti et asymétrique, soumis à une excitation extérieure harmonique, est traitée. L'effet de rochet est ainsi mis en évidence. Ces analyses ont permis de proposer des recommandations qui peuvent certainement être prises en compte, comme paramètres supplémentaires, dans la philosophie de conception sismique.: The purpose of this thesis is to take into account the behavior of inelastic structures subjected to periodic loading of seismic type. The study will be limited to a system with a single degree of freedom. The aim of the study is to investigate some behavioral domains of the oscillator connected to the modern theory of the nonlinear dynamic systems. This work deals with simple elastoplastic constitutive law within a dynamic framework. The concept of Dynamic Rheology" can be used to characterize such an inelastic oscillator. Our first motivation is to analyze the dynamic behavior of an oscillator with a method used in the field of non-smooth dynamic systems. The first stage is to study stability and dynamics of an undamped symmetrical elastoplastic oscillator. This study made it possible to link the dynamic properties (limit cycles ) with the mechanical characteristics (shakedown, alternating plasticity). A bifurcation diagram is numerically highlighted. The study is enriched thereafter by introduction of viscous damping. Finally, stability and dynamics of an asymmetrical perfectly elastoplastic oscillator, subjected to a harmonic external excitation, is treated. The ratcheting phenomenon is theoretically simulated. These analyses lead to some recommendations, in term of symmetrical property that can be taken into account in the philosophy of seismic design.RENNES-INSA (352382210) / SudocSudocFranceF

Stabilité d'un oscillateur élastoplastique sollicité par une pulsation harmonique

Cet article aborde des questions de stabilité et de dynamique d'un oscillateur élastoplastique parfait sollicité par une pulsation harmonique. On montre que le système hystérétique s'écrit comme un système autonome forcé. La frontière entre l'adaptation et l'accomodation est donnée de manière analytique. Une analyse de stabilité des solutions périodiques est alors proposée, à partir d'une méthode de perturbations. Les simulations numériques, basées sur la méthode des temps de transition, confirment les résultats annoncés théoriquement. Enfin, l'occurrence du phénomène de rochet est discutée, du point de vue de l'analyse dynamique

Energetic evaluation of a perfect damped elastoplastic oscillator

This paper deals with the dynamic behaviour of a perfect damped elastoplastic oscillator, subjected to an external seismic load. The rheological model is presented as a single-degree-of-freedom system, for the two cases: a symmetrical excitation (perfect elastoplasticity); and an asymmetry in the compression field. The energizing assessment is essentially established from the dissipated energy map during the oscillations, according to the structural parameters of the model (equivalent angular frequency, damping, parameter of the asymmetric excitation force…). A dissipation of the limit cycle energy observed for the alternating plasticity behavioural area, which is controlled by the bifurcation boundary.Keywords: Perfect Damped Elastoplastic Oscillator, Rheological model, Dissipated energy, Limit cycle, Alternating plasticity, Bifurcation boundary

Multi-scale energy exchanges between an elasto-plasticoscillator and a light nonsmooth system with externalpre-stress

International audienceVibratory energy exchanges between twocoupled oscillators is studied: the main elasto-plasticoscillator is coupled to a nonlinear energy sink(NES)with nonsmooth potential. Both oscillators are underpre-stressing terms. Two different methods are implementedfor tracing system behaviours: (i) the timeevent-driven technique which builds exact solutions ofgoverning equations of the system phase by phase and(ii) the multi-scale method which traces system behavioursat different scales of time. It detects invariant ofthe system at fast timescale and equilibrium/singularpoints at slow timescales. The pre-stressing terms producea more complex shape for the invariant, whiledetected dynamics at slow timescale let us have controlat the behaviour of the system during its quasi-steadystateregime(s) which leads to have analytical designtools for tuning parameters of nonlinear energy sink according to design purposes (passive control and/orenergy harvesting)

Intention to vaccinate chronic disease children against COVID-19; a multicenter survey

Abstract Background Vaccination against severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) has gained recognition as a crucial strategy to prevent and reduce the risk of infection, including emerging variants, due to its proven safety, immunogenicity, and effectiveness. This study aimed to evaluate the vaccination hesitancy (VH) among Egyptian parents towards SARS-CoV-2 vaccination, specifically focusing on parents with chronically ill children. Method A multicentered cross-sectional survey was conducted at outpatient clinics of El-Raml Pediatric Hospital, Ministry of Health and Population (MOHP) in Alexandria, Alexandria Main University Hospital for Maternity and Children (AMUH), Al-Galaa Teaching Hospital, General Organization for Teaching Hospitals and Institutes (GOTHI) Cairo, and Pediatric Department, Menoufia University Hospital from May 1st till December 15th, 2022. Parents of children with chronic diseases were recruited using a simple random sampling technique to respond to the validated Arabic version of parental attitudes about childhood vaccination (PACV). Results In this study, we enrolled 527 caregivers, 55.4% of them were aged 30–39 years old, 85.2% were females, and 46.9% had chronic diseases. Commonly mentioned information sources included television and radio (69.8%), and social media (35.3%). Among the parents studied, 59.6% refused vaccination. The predictors of the PACV score were governorate, Menoufia (β = 11.30, 95%CI [5.32, 17.27], p < 0.001), study setting, Menoufia University Hospital (β = -20.07, 95%CI [-25.40, -14.75] and El-Raml Hospital (β = -10.74, 95%CI [-14.50, -6.98], p < 0.001), income; not enough and loans repaid (β = 3.18, 95%CI [0.54, 5.82], p = 0.018) and not enough and loans not repaid (β = 3.57,95%CI [0.08, 7.07], p = 0.045). Conclusions The study reveals geographic and economic factors as predictors of PACV, and emphasizes the need for region-specific interventions and financial barriers to improve vaccine acceptance and child well-being