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The kenaf fibers were used to reinforce composites with two structures: nonwoven and bulk fibers and with treated and untreated kenaf fiber. A series of tensile tests were conducted on these composites. The use of kenaf fibers allows having composite with improved mechanical properties compared to pure polyester composite. This increase reaches 56.15% in strength and 137.85% in strain when varying the fiber weight ratio and the reinforcement structure. The interested results for both tensile strength and strain are obtained for nonwoven structure made by untreated fiber. The statistical study reveals that the most influencing parameter in tensile properties was the reinforcement weight ratio. The optimum composite was obtained when using a nonwoven structure made with untreated fiber with 11.10% fiber weight ratio.

In this paper, two extraction methods for kenaf fiber, The chemical process and the enzymatic one, were performed. These processes were used to extract fibers from the kenaf stem and the chemical, mechanical and morphologic properties of the extracted fibers were investigated. We notice that the fiber diameter decrease when increasing the concentration of the enzyme and the time treatment (101,35 µm for Enz1 and 91,37 µm for Enz4) the same result is obtained for the chemical extraction when increasing the duration, temperature or NaOH concentration. Also the fiber crystallinity index is improved due to the elimination of the noncellulosic materials from the fiber. The results obtained show that we have an increase in this index for all treated fiber however it is more important for the chemical extraction (crude fiber 57.39%, chemical-treated fiber 71.93% and 66.70% for the enzyme-treated fiber). This increase explains also the increase of fiber tenacity and the decrease of strain and we found through the tensile test that kenaf fiber has a pure elastic behavior for all treated fiber. So, the properties of extracted fibers compared to the crude fibers prove that the enzymatic extraction preserves more the fiber structure than the chemical extraction.

Abstract Background Clostridium difficile infection (CDI) is associated with a substantial Quality of life impact on patients that has not been so far measured with a generic validated instrument. Methods A prospective study was performed in 7 French acute-care settings in patients presenting with a bacteriologically-confirmed CDI. The EQ-5D-3 L was filled in by patients at 7 ± 2 days after CDI diagnosis to describe their state of health at that date as well as their state of health immediately before the CDI episode (baseline). Individual utility decrement was obtained by subtracting the corresponding utilities. The Quality Adjusted Life Year (QALY) loss was calculated by multiplying the days spent from baseline to the date of the interview, by the decrement of utility. A multivariate analysis of variance of the utility decrement according to CDI and patients characteristics was performed. Results Eighty patients were enrolled (mean age: 69.4 years, 55% females). The utility scores dropped from a mean 0.542 (SD: 0.391) at baseline to 0.050 (SD: 0.404) during the CDI episode with a mean adjusted utility decrement of 0.492 (SD: 0.398) point. This decrement increased significantly with CDI severity (Zar score ≥ 3) (p = 0.001), in patients with a positive baseline utility (p = 0.032), in women as compared to men (p = 0.041) and in patients aged more than 65 years (p = 0.041). No association with the Charlson index was found. The associated QALY loss not integrating the excess mortality was 0.028 (SD: 0.053). Conclusions The impact on quality of life of CDI episodes is major and translates in a substantial QALY loss despite their short duration.

Solid solutions (CuMo1-xWxO4 where 0 ≤ x ≤ 0.12) were synthesized by using a polymeric precursor method. The crystallization process of the polymeric precursors was investigated using TG-DTA, FTIR and XRD techniques. Crystallization of the CuMo1-xWxO4 powders was detected at 300 °C, and entirely completed at 420 °C. XRD patterns revealed that the polymorphic variety was dependent upon the tungsten content. For x ≤ 0.075, the solid solutions were isostructural to α-CuMoO4 whereas, for 0.075 < x ≤ 0.12, they were isostructural to γ-CuMoO4. The obtained homogeneous powders are constituted of relatively spherical grains with sizes in the range 0.5–2.0 µm. The phase transition of the as-synthesized CuMo1-xWxO4 powders was investigated by X-ray diffraction at elevated temperature and dilatometry. The temperature of the structural transition γ → α during heating was dependent upon the tungsten content.

The use of shape memory polymer composites is growing rapidly in smart structure applications. In this work, an active asymmetric composite called “controlled behavior composite material (CBCM)” is used as shape memory polymer composite. The programming and the corresponding initial fixity of the composite structure is obtained during a bending test, by heating CBCM above thermal glass transition temperature of the used Epoxy polymer. The shape memory properties of these composites are investigated by a bending test. Three types of recoveries are conducted, two classical recovery tests: unconstrained recovery and constrained recovery, and a new test of partial recovery under load. During recovery, high recovery displacement and force are produced that enables the composite to perform strong two-way actuations along with multi-shape memory effect. The recovery force confirms full recovery with two-way actuation even under a high load. This unique property of CBCM is characterized by the recovered mechanical work.

Basin modelling software has been widely developed in the 80'sand is still the subject of active Research and Development in the oilcompanies, contractors and consultant agencies, and also in the universities. A complete range of software applicaCble to the basin levelare now available to explorationists, including 1-D, 2-D and soon 3-Dtools. Most of them are devoted to the validation of structural hypotheses, to the prediction of source rock maturities. or to a reconstruction of petroleum formation and migration in basins. Anotherclass of software, mostly developed in the universities, attempts todescribe the thermomechanical behaviour of the lithosphere during basin formation and subsequent inversion (DURAND et al., 1997).The question now is: how can these tools help explorationists inreducing the risks (and as a consequence the costs) of exploration?In order to discuss and answer this question, we will present a case study in which IFP software has been used to reassess the petroleum potential of the Southeast Basin and Gulf of Lyon in SE France.These two areas have been the focus of active exploration from the60's to the early 80's, without commercial results. The analysis andappraisal of failures have already been done and the different potentialpetroleum systems recognized. Then 1-D and 2-D modelling wasperformed in order to select within this 50,000 km2 area the few places where further exploration can be conducted with a minimumof technical and economic hazards.

Multilayer ceramic capacitors (MLCC) are essential components for determining the reliability of electronic components in terms of time to failure. It is known that the reliability of MLCCs depends on their composition, processing, and operating conditions. In this present work, we analyzed the lifetime of three similar X7R type MLCCs based on BaTiO3 by conducting High Accelerated Life Tests (HALT) at temperatures up to 200 °C at 400 V and 600 V. The results were adjusted to an Arrhenius equation, which is a function of the activation energy (Ea) and a voltage stress exponent (n), in order to predict their time to failure. The values of Ea are in the range of 1–1.45 eV, which has been reported for the thermal failure and dielectric wear out of BaTiO3-based dielectric capacitors. The stress voltage exponent value was in the range of 4–5. Although the Ea can be associated with a failure mechanism, n only gives an indication of the effect of voltage in the tests. It was possible to associate those values with each type of tested MLCC so that their expected life could be estimated in the range of 400–600 V.

BaTiO3 powders were prepared by co-precipitation via oxalate route. The size, morphology and particle size distribution of the oxalate powders have been optimized by the control of different synthesis parameters during the precipitation reaction (nature of salts, concentration of different solutions, aging time). The single phase BaTiO3 oxide particles were obtained after a thermal decomposition of the as-synthesized powders at 850°C for 4 hours under air atmosphere. Oxide powders with a suitable specifi c surface area were selected in order to obtain thick fi lms by the tape casting technique. The microstructure and dielectric properties of the thick films varied obviously depending on the deposition-calcination-sintering cycle used. A double depositioncalcination cycle followed by sintering, as well as a two step deposition-calcination-sintering procedure was used in order to improve the compactness and therefore, the dielectric behaviour. A higher dielectric constant value (~ 750) and lower dielectric losses (~ 2 %) were achieved at room temperature and at 1 kHz frequency for the dense, double-deposited fi lm obtained after two deposition-calcination-sintering cycles. For this film, a superior value of the dielectric constant (~ 1100), almost frequency independent in the frequency range of 100 Hz – 10 kHz was gained also at the ferroelectric-paraelectric phase transition temperature of 130°C.

PET Vascular prostheses are susceptible to physical modification and chemical degradation leading sometimes to global deterioration and rupture of the product. To understand the mechanisms of degradation, we studied 6 vascular prostheses that were explanted due to medical complications. We characterized their level of degradation by comparing them with a virgin prosthesis and carried out physicochemical and mechanical analyses. Results showed an important reduction of the fabric’s mechanical properties in specific areas. Moreover, PET taken from these areas exhibited structural anomalies and was highly degraded even in virgin prostheses. These results suggest that vascular prostheses have weak areas prior to implantation and that these areas are much more prone to in vivo degradation by human metabolism. Manufacturing process could be responsible for these weaknesses as well as designing of the compound. Therefore, we suggest that a more controlled manufacturing process could lead to a vascular prosthesis with enhanced lifespan.

Missionary law in the colonies, when seen in the context of the relationships between Church and State under the Third Republic, has many original features : it rarely entered the sphere of action of metropolitan lawyers (who simply applied the solutions adopted under the Concordat regime). Local lawyers were often left to deal with it, when anything happened at all. Beyond issues such as the control of worship (for example, the authorisations that were granted, or the buildings that were especially designated, to conduct worship), the question of the property rights of the mission returned time and again. Through lawsuits, transactions, settlements and conflicts, we witness how the colonial Domain and the ‘missions’ met before a judge who, most of the time, was embarrassed to adjudicate. Can we then conclude that the difficulties encountered in introducing the laws of 1901, 1904 and 1905 are tied to the repeated difficulties to introduce property law—which is just as problematic to define ? This is the hypothesis that we will present.

Share ! The word sums up years of cross-fertilization, ranging from stages of silence to intense collaboration, driven by a friendly relationship that helped us tackle common themes or new avenues : on the office of the judge, the public prosecutor’s office, the Europe of dictatorships, the law under Vichy, and so on. But it was on the history of administrative law and the law of the « Haute » police that Professor Stolleis was a model, « pushing » us to delve deeper into the « administrative law » of the Ancien Régime, its projection onto colonial territories, and its construction by « made-law » judges.

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Patients with cancer who have thrombocytopenia may experience acute coronary syndromes (ACS), and the use of aspirin (ASA) poses an increased risk of bleeding. The purpose of this study was to test the hypothesis that the benefit of ASA therapy in the treatment of ACS would extend to cancer patients with thrombocytopenia and outweigh the risks of severe bleeding.The records of all cancer patients diagnosed with an ACS in 2001 and referred for cardiology consultation were reviewed. Patients were divided into 2 groups on the basis of platelet count, >100 cells k/μL and ≤100 cells k/μL. Data were collected on the use of ASA therapy, bleeding complications, and survival rates. The authors assessed group differences by using the Wilcoxon rank sum test or 2‐tailed Fisher exact test, as appropriate. Univariate and multivariate logistic regression models were used to assess factors potentially associated with 7‐day survival.In cancer patients with ACS and thrombocytopenia, those who did not receive ASA had a 7‐day survival rate of 6% compared with 90% in those who did receive ASA (P < .0001). There were no severe bleeding complications. Patients with a platelet count (>100 cells k/μL) who received ASA had a 7‐day survival rate of 88% compared with 45% in those who did not receive ASA (P = .0096).Therapy with ASA was associated with a significantly improved 7‐day survival after ACS in cancer patients, with or without thrombocytopenia, and not associated with more severe bleeding. Cancer 2007;109:621–627. © 2006 American Cancer Society. [ABSTRACT FROM AUTHOR]

Background: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. Objectives: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. Methods: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD or no established CVD, male ≥ 55 or female ≥ 60 years, and one additional CVRF. The primary endpoint was an ordinal COVID-19 severity outcome including need for hospitalization, supplemental oxygen, intensive care unit (ICU), mechanical ventilation, ICU or mechanical ventilation plus vasopressors, and death. Secondary endpoints included incident adverse CV events. Ordinal logistic regression models estimated associations of CVD/CVRF with COVID-19 severity. Effect modification by recent cancer therapy was evaluated. Results: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54–74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11–1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all p

IntroductionThis study examined the role of echocardiographic and cardiac histomorphology parameters in predicting mortality in patients with cardiac AL amyloidosis.MethodsPatients with endomyocardial biopsy-proven cardiac AL amyloidosis treated at MD Anderson Cancer Center between 6/2011 and 6/2020 were identified. Stored echocardiographic images and endomyocardial biopsy samples were processed for myocardial strain analysis and a detailed histomorphology characterization.ResultsOf 43 patients; 44% were women and 63% white. Median age was 65 years; 51% underwent stem cell transplantation (SCT). Thirty patients (70%) died during follow up (median follow up: 4.1 years). Lower LA strain (

Objectives: To assess the clinical impact of Cardiovascular Magnetic Resonance (CMR) in clinical decision making of cancer patients with a suspected cardiomyopathy in a tertiary cancer center.Background: Cardiomyopathies of diverse etiologies are frequently encountered in a Cardio-Oncology practice. The clinical impact of CMR after a presumptive diagnosis of cardiomyopathy has not been studied in cancer patients.Methods: We reviewed data on cancer patients with presumptive diagnosis of cardiomyopathy who underwent CMR in a tertiary cancer center. The clinical impact of CMR was defined as either change in clinical diagnosis or management post CMR results. Univariate and multivariate logistic regression models were used to assess whether any of the baseline characteristics were predictive of the clinical impact of CMR.Results: A total of 110 consecutive patients were identified. Clinical impact of CMR was seen in 68 (62%) patients. Change in the clinical diagnosis and management was seen in 56 (51%) and 41 (37%) of patients, respectively. The most common change was prevention of endomyocardial biopsy in 26 patients (24%). Overall, patients with higher left ventricular ejection fraction (LVEF) by echocardiography (echo), clinical impact was influenced more by CMR (LVEF of 37.2 ± 12.3% vs. 51.5 ± 11.6%, p < 0.001). Cancer diagnosis of multiple myeloma was associated with change in the management post CMR (adjusted OR of 25.6, 95% CI 4.0–162.4, p = 0.001). Suspicion of infiltrative cardiomyopathy was associated with a higher likelihood of change in diagnosis. Having an LVEF≥40 by echo was associated with change in diagnosis and management by CMR.Conclusions: Utilization of CMR has a significant clinical impact in cancer patients with suspected cardiomyopathy. Patients with cancer diagnosis of multiple myeloma, suspicion of infiltrative cardiomyopathy and those with higher LVEF by echo seem to benefit more from CMR.

We describe a case of testicular teratoma with metastasis to the right ventricle. The mass nearly completely resolved with chemotherapy, obviating the need for upfront surgery. We review the workup of intracardiac metastatic tumors. (Level of Difficulty: Intermediate.)

Background and Objectives: Cancer and coronary artery disease (CAD) often coexist. Compared to quantitative coronary angiography (QCA), fractional flow reserve (FFR) has emerged as a more reliable method of identifying significant coronary stenoses. We aimed to assess the specific management, safety and outcomes of FFR-guided percutaneous coronary intervention (PCI) in cancer patients with stable CAD. Materials and Methods: FFR was used to assess cancer patients that underwent coronary angiography for stable CAD between September 2008 and May 2016, and were found to have ≥50% stenosis by QCA. Patients with lesions with an FFR > 0.75 received medical therapy alone, while those with FFR ≤ 0.75 were revascularized. Procedure-related complications, all-cause mortality, nonfatal myocardial infarction, or urgent revascularizations were analyzed. Results: Fifty-seven patients with stable CAD underwent FFR on 57 lesions. Out of 31 patients with ≥70% stenosis as measured by QCA, 14 (45.1%) had an FFR ≥ 0.75 and lesions were reclassified as moderate and did not receive PCI nor DAPT. Out of 26 patients with p = 0.03). Conclusions: Further studies are needed to define the optimal therapeutic approach for cancer patients with CAD. Using an FFR cut-off point of 0.75 to guide PCI translates into fewer interventions and can facilitate cancer care. There was an overall reduction in mortality in patients that received a stent, suggesting increased resilience to cancer therapy and progression.

Pediatric, adolescent and young adult (AYA) patients receiving novel cancer immunotherapies may develop associated toxicities with overlapping signs and symptoms that are not always easily distinguished from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection/clinical sequelae. We describe 2 diagnostically challenging cases of SARS-CoV-2 and Multi-Inflammatory Syndrome-Adult (MIS-A), in patients with a history of acute lymphoblastic leukemia following cellular therapy administration and review evolving characterization of both the natural course of SARS-CoV-2 infection and toxicities experienced in younger cancer immunotherapy patients. Vigilant monitoring for unique presentations and epidemiologic surveillance to promptly detect changes in incidence of either condition may be warranted.

Background: QT prolongation and torsades de pointes pose a major concern for cardiologists and oncologists. Although cancer patients are suspected to have prolonged QT intervals, this has not been investigated in a large population. The purpose of this study was to analyze the QT interval distribution in a cancer population and compare it to a non-cancer population in the same institution.Methods: The study was a retrospective review of 82,410 ECGs performed in cancer patients (51.8% women and 48.2% men) and 775 ECGs performed in normal stem cell donors (47.9% women and 52.1% men) from January 2009 to December 2013 at the University of Texas MD Anderson Cancer Center. Pharmacy prescription data was also collected and analyzed during the same time period. Correction of the QT interval for the heart rate was performed using the Bazett and Fridericia formulas.Results: After QT correction for heart rate by the Fridericia formula (QTcF), the mean and 99% percentile QTc for cancer patients were 414 and 473 ms, respectively. These were significantly longer than the normal stem cell donors, 407 and 458 ms, p < 0.001, respectively. Among the cancer patients, the QTc was longer in the inpatient setting when compared to both outpatient and emergency center areas. The most commonly prescribed QT prolonging medications identified were ondansetron and methadone.Conclusion: Our study demonstrates significantly longer QTc intervals in cancer patients, especially in the inpatient setting. Frequently prescribed QT prolonging medications such as antiemetics and analgesics may have a causative role in QT prolongation seen in our cancer hospital.

Objectives: To evaluate the role of platelet count and thromboelastogram (TEG) in the treatment of thrombocytopenic cancer patients with suspected coronary artery disease (CAD).Background: Cancer patients with CAD and thrombocytopenia are often treated non-invasively (i.e., without coronary angiography when clinically indicated) due to perceived high risk of bleeding. We sought to evaluate coagulability based on TEG and determine if platelet count and TEG could predict bleeding risk/mortality among cancer patients undergoing coronary angiography (CA).Methods: Baseline demographics, platelet count, and TEG parameters were recorded among cancer patients that underwent CA and had a concomitant TEG. Logistic regression and univariate proportional hazards regression analysis were performed to determine the impact of platelet count and coagulability on 24-month overall survival (OS).Results: All patients with platelet count 50,000/mm3 groups, as well as the improved survival, suggest that with appropriate clinical indication and risk/benefit assessment, a cut-off of 50,000/mm3 platelets can be considered for CA in cancer patients.

Refractory cancer represents a challenge for oncologists in providing treatment options without excessive toxicity and has led to the investigation of immune mechanisms. Immune checkpoint inhibitors (ICIs) directly interfere with the tumor cells' ability to evade the innate and adaptive immune system by targeting specific proteins such as cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4), programmed cell death protein-1 (PD-1), and programmed cell death protein-ligand 1 (PD-L1), which are involved as negative regulators of T-cell function. Their growing success has led to the investigation for frontline treatment in several types of cancers. Even though these ICIs have demonstrated efficacy in the treatment of a variety of cancers, their use has been associated with the development of rare but severe adverse events. These events are the result of targeting specific checkpoint proteins on normal cells of the body as well as secondary downstream off-target effects on normal tissue. Similar to combined conventional cancer treatment, treating with combined ICIs are also associated with a higher risk of adverse events. Although cardiotoxicities related to immunotherapy are reportedly rare, they can be severe and associated with life-threatening conditions such as fulminant heart failure, hemodynamic instability, and cardiac arrest. Oncologists must carefully weigh the risk versus the therapeutic benefit of these agents in determining the best option for improving overall survival and minimizing morbidity and mortality of their patients. Our review focuses on the approved ICIs, their mechanism of action, their oncologic efficacy, and the associated potential for cardiovascular toxicity.

Autoimmune myocarditis is a rare but often fatal toxicity of checkpoint inhibitor immunotherapy. To improve the understanding of this complication, we performed immune profiling on post-mortem tissue from a patient with metastatic melanoma who had steroid-responsive hepatitis, steroid-refractory myocarditis, and shrinking lung metastases after ipilimumab treatment. Histological analysis of heart tissue demonstrated findings consistent with giant cell myocarditis (GCM). The immune infiltrate in the heart was largely comprised of CD4+ T cells, whereas the liver had very few T cells, and CD8+ T cells were predominant in the responding lung metastases. TCR sequencing identified high T cell clonality in the lung metastases. The TCR repertoire showed low clonality in the heart and minimal overlap with the liver (1.2%), but some overlap with lung metastases (9.9%). Transcriptional profiling identified several potential mediators of increased inflammation in the heart. These findings provide new insights into the pathogenesis of autoimmune myocarditis with ipilimumab.

Background. Exclusion of underlying coronary artery disease (CAD) is essential in the diagnosis of chemotherapy-induced cardiomyopathy. Presence and severity of CAD can also impact the choice of therapy in cancer patients. The value of cardiac computed tomographic angiography (CCTA) in this setting has not been reported. Methods. We collected data on the clinical presentation and indications for CCTA performed from January to December 2008 at the University of Texas MD Anderson Cancer Center (MDACC). All examinations were performed using a 64-detector scanner. CCTA results and subsequent treatment decisions were examined. Results. A total of 80 patients underwent CCTA during the study period for the following indications (not mutually exclusive): cardiomyopathy of unknown etiology in 33 pts (41.3%), chest pain in 32 (40.0%), abnormal stress test in 16 (20.0%), abnormal cardiac markers in 8 (10.0%), suspected cardiac mass or thrombus in 7 (8.8%). Chemotherapy-induced cardiomyopathy was diagnosed in 18 pts (22.5%). Severe CAD was detected in 22 pts (27.5%); due to concomitant advanced cancer or patient refusal, only 12 underwent coronary angiogram. Of these, 4 pts (5% of total) underwent coronary artery bypass grafting. A total of 41 pts (51.3%) had their cancer management altered based on CCTA findings. Conclusion. CCTA is useful in evaluating cancer pts with structural heart disease and can have an impact on the management of cancer and cardiac disease.

Tyrosine kinase inhibitors (TKIs) which target angiogenesis are promising treatments for patients with metastatic medullary and differentiated thyroid cancers. Sorafenib, sunitinib, and pazopanib are commercially available drugs which have been studied in these diseases. Vandetanib is the first drug approved in the United States for treatment of medullary thyroid cancer. These TKIs are used as chronic therapies, and therefore it is imperative to understand the adverse event profile in order to avoid excessive toxicity and maintain patients on therapy as long as it proves beneficial. Here we review common toxicities, management of these, and other challenging situations that arise when using TKIs in patients with thyroid cancer.