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151. On the Design of Bolted Connections With Gaskets Subjected to Fatigue Loading

Author

Osman, M. O. M., Mansour, W. M., and Dukkipati, R. V.

Abstract

Bolted connections subjected to fatigue loading are usually considered to be the “weak point” in a design. They usually are highly preloaded to increase their resistance to external dynamic loading resulting in selecting large bolt diameters. This paper presents a design method for calculating an optimal bolt diameter required for a specific fatigue-loading situation. When load is applied to the bolted connection, the bolt tensile stress increases and the members undergo a decrease in compression. Based on the fact that the decrease in the deformation of the connected members must be equal to the increase in the deformation of the bolt, expressions are derived for maximum and minimum forces and stresses on the bolt. Using Soderberg’s failure line, an expression is developed for bolt diameter. It implies that there exists an optimal safe bolt diameter satisfying the loading conditions. Using a lower-bound value of bolt preloading produced an expression for the critical diameter of the bolt in terms of maximum and minimum dynamic force applied, the yield strength of bolt material, the factor of safety, and the stiffness constant. Examples are given to illustrate the design procedure.

Published
1977
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152. Mechanical Joints With Clearance: A Three-Mode Model

Author

Miedema, B. and Mansour, W. M.

Abstract

A momentum exchange model is developed to describe the dynamic performance of mechanisms with clearance. A following mode is incorporated in the model to account for the case when contact is maintained between the pin and the socket while they move relative to each other. The regions of occurrence of the three modes for a crank-slider mechanism are discussed. This study is a first step in correlating noise-to-impact spectra for preventive maintenance.

Published
1976
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153. Stability and Kinematic Accuracy of Hydraulic Copying Mechanisms in Metal Cutting

Author

Mansour, W. M., Osman, M. O. M., and Gladwell, G. M. L.

Abstract

The nature and the size of the cutting forces were investigated to develop a model that accounts for their fluctuation. Due to the interaction between the velocity of the power cylinder and the cutting forces, the governing equations contained periodic coefficients. Stability analysis showed that the fluctuations of the cutting forces and their averages played important roles. Dimensionless plots were developed to be used as a guide for the design and operation of copying mechanisms. The kinematic accuracy of copying was found to be influenced most by the coefficient of leakage, and the degree of under lap of the spool valve. Digital and analog approaches were used in this study.

Published
1973
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154. The Mechanism of Gyroscopic Tracking: Part 1

Author

Mansour, W. M. and Pavlov, D.

Abstract

The tracking property of the free gyro is investigated using analytical and digital approaches. A strategy of analysis is developed which can be used to assess the quality of tracking for different geometrical configurations of the template. This property has a practical potential to be implemented into instruments for sensing and identification.

Published
1973
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155. The Mechanism of Gyroscopic Tracking: Part 2

Author

Mansour, W. M., Pavlov, D., and Dokainish, M. A.

Abstract

A parametric study is conducted to assess the effect of different factors on the tracking performance. The conditions leading to the free flight mode are established. Design recommendations and proposed applications are presented.

Published
1973
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156. Analog and Digital Analysis and Synthesis of Oscillatory Tracks

Author

Mansour, W. M.

Abstract

A vibratory feeder is essentially an inclined plane which is subjected to an acceleration cycle. It is used to transport components or material, after giving them the proper orientation or mixing. Usually rapid upward motion is desired. The purpose of this paper is to provide the designer with some basic tools that enable him to analyze, and effectively choose, the basic parameters pertaining to a vibratory feeder. Programs to solve specific cases are also included. The digital and analog approaches are used with equal emphasis whenever applicable.

Published
1972
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157. Behavior of RC beams strengthened in shear with ultra-high performance fiber reinforced concrete (UHPFRC)

Author

Sakr Mohammed A., Sleemah Ayman A., Khalifa Tarek M., and Mansour Walid N.

Subjects
Engineering (General). Civil engineering (General), TA1-2040
Abstract

This paper investigates the behavior of RC beams strengthened in shear with UHPFRC. In order to ensure high quality and facilitate the strengthening process on site applications, it has been considered to apply UHPFRC as a plate pasted on concrete using epoxy. In addition to the control beam, two strengthened RC beams using prefabricated UHPFRC plates were prepared and tested. All beams had the same rectangular cross-section geometry (150mm x 300mm x 2000mm). Two different techniques were considered during the strengthening process; the first application was the addition of two 30 mm UHPFRC plates, whereas the second beam strengthened using one 60 mm UHPFRC plate. Results showed that strengthening RC beams using two UHPFRC plates improved load carrying capacity with 145 % comparing with the control beam. Moreover UHPFRC plate in case of strengthening one side of the RC beam prevented shear cracks from appearing on the strengthened side.

Published
2018
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163. Adaptive under frequency load shedding scheme using genetic algorithm based artificial neural network

Author

Elzawawy, A., Mahmoud ALI, Bendary, F., and Mansour, W.

Subjects
islanding, genetic algorithm, system frequency response, blackout, lcsh:Electrical engineering. Electronics. Nuclear engineering, under frequency load shedding, lcsh:TK1-9971, artificial neural network
Abstract

This paper presents two schemes of UFLS to keep the system frequency within safe limits. GA-based scheme is introduced as an offline method to get the proper amount of shed load achieving the minimum and steady state frequency within permissible limits. Due to the probability of generation variation and generating units outage during shedding process, ANN-based scheme is presented as an online method to adjust the proper amount of load shedding at any amount of power deficit. Multi scenarios of contingences are carried out on offline mode using GA optimization technique to collect the training patterns for ANN. The ANN-based scheme can consider the generation variations during the load shedding process. Although using this scheme may shed more loads, it maintains the frequency to be within permissible limits at various disturbance scenarios particularly at the absence of secondary control. An analytic system frequency response (SFR) model with no secondary control incorporating UFLS scheme is presented. The proposed method is compared with the classical adaptive method to prove its effectiveness. Results are presented in the form of time domain simulations via MATLAB/SIMULINK.

164. Physician-initiated prospective Italian Registry of carotid stenting with the C-Guard mesh-stent: The IRON-Guard registry. Rationale and design

Author

Setacci, C., Speziale, F., Donato, G., Sirignano, P., Setacci, F., Capoccia, L., Galzerano, G., Mansour, W., Bellandi, G., Cao, P., Casana, R., Castelli, P., Chiesa, R., Coppi, G., Cremonesi, A., Gian Franco FADDA, Farina, A., Frigatti, P., Gaggiano, A., Grego, F., Lenti, M., Mangialardi, N., Marcucci, G., Michelagnoli, S., Nano, G., Nessi, F., Novali, C., Palasciano, G., Palombo, D., Paroni, G., Pompeo, F., Rabbia, C., Sponza, M., Stella, A., and Vecchiati, E.

Subjects
Time Factors, Prosthesis Design, Embolization, Recurrence, Risk Factors, Humans, Carotid Stenosis, Prospective Studies, Registries, Tomography, Angioplasty, Italy, Prosthesis Failure, Stroke, Tomography, Optical Coherence, Treatment Outcome, Research Design, Stents, Medicine (all), Therapeutic, Cardiology and Cardiovascular Medicine, Surgery, Optical Coherence
Abstract

According to the World Health Organization, every year, 5 million peoples die for stroke and another 5 million are permanently disabled. Although there are many causes of acute stroke, a common treatable cause of acute stroke is atheromatous narrowing at the carotid bifurcation. Carotid endarterectomy is still the standard of car, even if carotid artery stenting (CAS) has become an effective, less invasive alterantive. Unfortunately, CAS procedure is not yet perfect; regardless the use of an embolic protection device (EPD), percutaneous treatment has been correlated with a risk of cerebral ischemic events related to distal embolization. The objective of the IRON-Guard Registry is to evaluate the clinical outcome of treatment by means of stenting with the C-Guard (InspireMD, Boston, MA, USA) in subjects requiring CAS due to significant extracranial carotid artery stenosis with a physician-initiated, Italian, prospective, multicenter, single-arm study. A total of 200 enrolled subjects divided over different centers are planned to be enrolled. CAS will performed by implanting of C-Guard stent. Procedure will be performed according to the physician's standard of care. Standard procedures will be followed based on the Instructions for Use, for the C-Guard device of Inspire. The primary endpoint of this study is the 30-day rate of major adverse events (MAE), defined as the cumulative incidence of any periprocedural (≤30 days postprocedure) death, stroke or myocardial infarction. Secondary endpoints are rate of late ipsilateral stroke (31 through 365 days), system technical success, device malfunctions, major adverse events (MAEs), serious device-related and procedure-related adverse events, target lesion revascularization, and in-stent restenosis rates.

165. Oral communication and poster abstracts of the 22nd National Congress of Gastroenterology joint to the 4th Maghrebian Congress of Gastroenterology. December 2018

Author

Bellabah, A., Benkirane, A., Ibrahimi, A., Nakhli, A., Sair, A., Essaid, A., Blel, A., Lahchaichi, A., Ben Slama, A., Ouni, A., Amouri, A., Jemaa, A., Cherif, A., Khsiba, A., Hssine, A., Djobbi, A., Guedich, A., Laabidi, A., Mensi, A., Ouakaa, A., Sriha, A., Choukri, A., Green, A., Belkhamsa, A., Hammami, A., Bourigua, A., Filali, A., Belabeh, A., Sentissi, A., Ait Errami, A., Nadi, A., Filankembo, A., Lamine, A., Badre, W., Ben Kaab, B., Ben Slimane, B., S, B., Hasnaoui, B., Bouchabou, B., Bouguerra, C., Baccouche, C., Ayadi, C., Bennasrallah, C., Benajah, D., Gargouri, D., Zehi, D., Issaoui, D., Cherif, D., Ben Ghachem, D., Trad, D., Bouaiti, E., Boutouria, E., Bel Hadj Mabrouk, E., Chalbi, E., Aait, E., Bouhamou, F., Haddad, F., Lairani, F., Saffar, F., Torjmen, F., Haj Kacem, F., Hamdane, F., Chabib, F. Z., Elrhaoussi, F. Z., Moumayez, F. Z., Loukil, F., Ahmed Djouldé Diallo, F., Aissaoui, F., Ajana, F., Chabib, F., Hamdoun, F., Moumayez, F., Bennani Kella, G., Bennani, G., Abid, H., Cheikhani, H., Ouazzani, H., Romdhane, H., Hassan SEDDIK, Sghir, H., Debbabi, H., Ben Jeddi, H., Garraoui, H., Letaief, H., Kchir, H., Elloumi, H., Hammami, H., Jaziri, H., Ben Abdallah, H., Chaabouni, H., Ben Romdhane, H., Yacoub, H., Gdoura, H., Sahli, H., Loghmari, H., Bouguerra, H., Maghrebi, H., Ben Nejma, H., Jlassi, H., Fourati, H., Alaoui, H., Ismail, H., Benelbarhdadi, I., Cohen, I., Errabih, I., Koti, I., Doghri, I., Elhidaoui, I., Haraki, I., Cheikh, I., Abdelaali, I., Jemni, I., Bouennene, I., Akoch, I., H, I., Boubaker, J., Krati, K., Eljery, K., Temani, K., Bellil, K., Chabbouh, K., Boughoula, K., Ouazzani, L., Ben Yaghlene, L., Kallel, L., A, L., Hamzaoui, L., Chtourou, L., Ben Farhat, L., Bouabid, L., Mnif, L., Mouelhi, L., Safer, L., Zouiten Mekki, L., Bourehma, M., El Akbari, M., El Khayari, M., Elyousfi, M., Firwana, M., Lahlali, M., Tahiri, M., Mestouri, M., Abdelwahed, M., Ben Hamida, M., Ben Chaabane, M., Moalla, M., Yakoubi, M., Sabbah, M., Serghini, M., Amri, M., Ben Abbes, M., Ben Cheikh, M., Ghribi, M., Hafi, M., Ben Abdelwahed, M., Ksiaa, M., Essid, M., Zakhama, M., Yousfi, M., Ayari, M., Belhadj, M., Cheickh, M., Kacem, M., Horma Alaoui, M., Abid, M., Bennour, M. A., Ghanem, M., Loghmari, M. H., Douggui, M. H., Azouz, M. M., Abdelli, M. N., Boudabous, M., Feki, M., Fekih, M., Mahmoudi, M., Boudabbous, M., Figuigui, M., Medhioub, M., Safer, M., Azzouz, M., Abbes, M., El Abkari, M., Aqodad, N., Azib, N., Bellil, N., Benhoumane, N., Benzoubbeir, N., Elkhabiz, N., Hemdani, N., Lahmidani, N., Abdelli, N., Ben Chaabane, N., Tahri, N., Benhoummane, N., Ben Jaafar, N., Ben Mustapha, N., Maamouri, N., Hannachi, N., Ben Alaya, N., Bibani, N., Trad, N., Elleuch, N., Kharmach, O., Bahri, O., Bousnina, O., Gharbi, O., Benjira, R., Ennaifer, R., Dabbèche, R., Jouini, R., Zgolli, R., Baklouti, R., Bouali Mohamed, R., Marouani, R., Kallel, R., Berrag, S., El Yazal, S., Jiddi, S., Mechhour, S., Morabit, S., Oubaha, S., Sentissi, S., Bouaziz, S., Soua, S., Hachicha, S., Elaboudi, S., Ajmi, S., Mallat, S., Bouchoucha, S., Mrabti, S., Ben Slama, S., Hamdi, S., Laabidi, S., Ayadi, S., Hidri, S., Bizid, S., Ben Hamida, S., Zertiti, S., Ben Amor, S., Nsibi, S., Bellakhal, S., Bahja, S., Jomni, T., Hliwa, W., Rebai, W., Ben Mansour, W., Ben Othmen, W., Dhouib, W., Hammoumi, W., Zaatour, W., Bouhlel, W., Feki, W., Triki, W., Said, Y., Zaimi, Y., Gorgi, Y., Bouhnoun, Z., Samlani, Z., Hamidi, Z., Mnif, Z., and Ben Safta, Z.

166. Optimization of a self-converging algorithm at assembly level to improve SEU Fault-Tolerance

Author

Universidad Nacional de Córdoba [Argentina] ; Universidad Nacional de Córdoba, Techniques of Informatics and Microelectronics for integrated systems Architecture (TIMA) ; CNRS - Université Joseph Fourier - Grenoble I - Institut National Polytechnique de Grenoble (INPG), Parallélisme, Réseaux, Systèmes d'information, Modélisation (PRISM) ; CNRS - Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Lorena Garcia, Marques, C.A., Mansour, W., Pancher, F., Bui, A., Sohier, D., Velazco, R., Universidad Nacional de Córdoba [Argentina] ; Universidad Nacional de Córdoba, Techniques of Informatics and Microelectronics for integrated systems Architecture (TIMA) ; CNRS - Université Joseph Fourier - Grenoble I - Institut National Polytechnique de Grenoble (INPG), Parallélisme, Réseaux, Systèmes d'information, Modélisation (PRISM) ; CNRS - Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Lorena Garcia, Marques, C.A., Mansour, W., Pancher, F., Bui, A., Sohier, D., and Velazco, R.

Abstract

ISBN : 978-1-4244-9485-9, International audience, The robustness with respect to SEUs (Single-Event Upset) of a self-converging algorithm is improved by fault-tolerance techniques implemented at software level. SEU-sensitivity evaluation was done by fault injection campaigns performed using a devoted test platform. Experimental results show that implementing fault-tolerance by modifying the assembly code leads to significant improvements of the fault tolerance.

167. Application of Ultra-High-Performance Concrete in Bridge Engineering: Current Status, Limitations, Challenges, and Future Prospects

Author

Abdal, S, Mansour, W, Agwa, I, Nasr, M, Abadel, A, Özkılıç, YO, Akeed, MH, Abdal, S, Mansour, W, Agwa, I, Nasr, M, Abadel, A, Özkılıç, YO, and Akeed, MH

Abstract

Ultra high performance concrete UHPC is a form of cementitious composite that has been the most innovative product in concrete technology over the last three decades Ultra high performance concrete has been broadly employed for the design of numerous forms of construction owing to its excellent mechanical characteristics and durability and studies on its behavior have grown fast in the last decades While the utilization of ultra high performance concrete in bridge engineering BE is limited owing to its high costs little is recognized about the utilization of UHPC in various BE elements As a result of these issues a comprehensive review of the current UHPC development trends should be conducted to determine its present state and perspective This study presents a review of the state of the art UHPC applications in BE This review also discusses the current status limitations challenges and areas for the further investigation of UHPC in BE The aim of this research to help various construction stakeholders understand the distinctive characteristics benefits and barriers to the broad utilization of ultra high performance concrete applications The understanding of UHPC will aid in increasing its entire market share in both the national and worldwide building sectors

180. Diagnostic efficacy of monoclonal antibody based sandwich enzyme linked immunosorbent assay (ELISA) for detection of Fasciola gigantica excretory/secretory antigens in both serum and stool

Author

Zoheiry Mona K, Mahmoud Faten S, Mohamed Salwa H, Aly Ibrahim R, Diab Tarek M, Demerdash Zeinab A, Mansour Wafaa A, Attia Mohy E, and El-Bassiouny Azza E

Subjects
Fasciola gigantica, Monoclonal antibodies, Sandwich ELISA, Coproantigen, Seroantigen, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background This research was carried out to develop a reliable monoclonal antibody (MoAb)-based sandwich enzyme linked immunosorbent assay (ELISA) for the diagnosis of active Fasciola gigantica infection in both serum and stool for comparative purposes. Methods From a panel of MoAbs raised against F. gigantica excretory/secretory antigens (ES Ags), a pair (12B/11D/3F and 10A/9D/10G) was chosen due to its high reactivity and strict specificity to F. gigantica antigen by indirect ELISA. Results The two MoAbs were of the IgG1 and IgG2a subclasses, respectively. Using SDS-PAGE and EITB, the selected MoAbs recognized 83, 64, 45 and 26 kDa bands of ES Ags. The lower detection limit of ELISA assay was 3 ng/ml. In stool, the sensitivity, specificity and diagnostic efficacy of ELISA was 96%, 98.2 and 97.1%; while in serum they were 94%, 94.6% and 94.3%, respectively. Moreover, a positive correlation was found between ova count in stool of F. gigantica infected patients and the OD readings of ELISA in both stool and serum samples (r = 0.730, p < 0.01 and r = 0.608; p < 0.01, respectively). Conclusions These data showed that the use of MoAb-based sandwich ELISA for the detection of F. gigantica coproantigens in stool specimens was superior to serum samples; it provides a highly efficient, non-invasive technique for the diagnosis of active F. gigantica infection.

Published
2011
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184. Cellulose based polyurethane with amino acid functionality: Design, synthesis, computational study and application in wastewater purification

Author

Haneen Abu Rub, Abdalhadi Deghles, Othman Hamed, Khalil Azzaoui, Belkheir Hammouti, Mustapha Taleb, Avni Berisha, Omar Dagdag, Waseem Mansour, Gül Gülenay Hacıosmanoğlu, Zehra Semra Can, Larbi Rhazi, and Rub H. A., Deghles A., Hamed O., Azzaoui K., Hammouti B., Taleb M., Berisha A., Dagdag O., Mansour W., HACIOSMANOĞLU G. G., et al.

Subjects
Moleküler Biyoloji, Temel Bilimler, Yapısal Biyoloji, Life Sciences, Life Sciences (LIFE), Molecular Biology and Genetics, General Medicine, Toxic metal ions, Wastewater, Biochemistry, Foam, MOLECULAR BIOLOGY & GENETICS, Yaşam Bilimleri (LIFE), Structural Biology, BİYOKİMYA VE MOLEKÜLER BİYOLOJİ, Biyokimya, Yaşam Bilimleri, Olive waste biomass, Cytogenetic, Natural Sciences, Cellulose, BIOCHEMISTRY & MOLECULAR BIOLOGY, Molecular Biology, Moleküler Biyoloji ve Genetik, Sitogenetik
Abstract

Contamination in water is due to various environmental pollutants from natural and anthropogen activities. To remove toxic metals from contaminated water, we developed a novel adsorbent in foam form based on an olive industry waste material. The foam synthesis involved oxidation of cellulose extracted from the waste to dialdehyde, functionalization of the cellulose dialdehyde with an amino acid group, reacting the functionalized cellulose with hexamethylene diisocyanate and p-phenylene diisocyanate to produce the target polyurethanes Cell-F-HMDIC and Cell-F-PDIC, respectively. The optimum condition for lead(II) adsorption by Cell-F-HMDIC and Cell-F-PDIC were determined. The foams show the ability to quantitatively remove most of metal ions present in a real sample of sewage. The kinetic and thermodynamic studies confirmed a spontaneous metal ion binding to the foams with a second pseudo-order adsorption rate. The adsorption study revealed it obeys the Langmuir isotherm model. The experimental Qe values of both foams Cell-F-PDIC and Cell-F-HMDIC were 2.1929 and 2.0345 mg/g, respectively. Monte Carlo (MC) and Dynamic (MD) and simulations showed excellent affinity of both foams for lead ions with high adsorption negative energy value indicating vigorous interactions of Pb(II) with the adsorbent surface. The results indicate the usefulness of the developed foam in commercial applications. Environmental implication: Elimination of metal ions from contaminated environments is important for a number of reasons. They are toxic to humans via interaction with biomolecules, resulting in disruption of the metabolism and biological activities of many proteins. They are toxic to plants. Industrial effluents and/or wastewater discharged from production processes, contain a considerable amount of metal ions. In this work, the use of naturally produced materials, such as olive waste biomass, as adsorbents for environmental remediation has received great attention. This biomass represents unused resources and presents serious disposal problems. We demonstrated that such materials are capable of selectively adsorbing metal ions.

Published
2023

185. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Author

Alison Halliday, Richard Bulbulia, Leo H Bonati, Johanna Chester, Andrea Cradduck-Bamford, Richard Peto, Hongchao Pan, John Potter, Hans Henning Eckstein, Barbara Farrell, Marcus Flather, Averil Mansfield, Boby Mihaylova, Kazim Rahimi, David Simpson, Dafydd Thomas, Peter Sandercock, Richard Gray, Andrew Molyneux, Cliff P Shearman, Peter Rothwell, Anna Belli, Will Herrington, Parminder Judge, Peter Leopold, Marion Mafham, Michael Gough, Piergiorgio Cao, Sumaira MacDonald, Vasha Bari, Clive Berry, S Bradshaw, Wojciech Brudlo, Alison Clarke, Robin Cox, Susan Fathers, Kamran Gaba, Mo Gray, Elizabeth Hayter, Constance Holliday, Rijo Kurien, Michael Lay, Steffi le Conte, Jessica McManus, Zahra Madgwick, Dylan Morris, Andrew Munday, Sandra Pickworth, Wiktor Ostasz, Michiel Poorthuis, Sue Richards, Louisa Teixeira, Sergey Tochlin, Lynda Tully, Carol Wallis, Monique Willet, Alan Young, Renato Casana, Chiara Malloggi, Andrea Odero Jr, Vincenzo Silani, Gianfranco Parati, Giuseppe Malchiodi, Giovanni Malferrari, Francesco Strozzi, Nicola Tusini, Enrico Vecchiati, Gioacchino Coppi, Antonio Lauricella, Roberto Moratto, Roberto Silingardi, Jessica Veronesi, Andrea Zini, Emanuele Ferrero, Michelangelo Ferri, Andrea Gaggiano, Carmelo Labate, Franco Nessi, Daniele Psacharopulo, Andrea Viazzo, Giovanni Malacrida, Daniela Mazzaccaro, Giovanni Meola, Alfredo Modafferi, Giovanni Nano, Maria Teresa Occhiuto, Paolo Righini, Silvia Stegher, Stefano Chiarandini, Filippo Griselli, Sandro Lepidi, Fabio Pozzi Mucelli, Marcello Naccarato, Mario D'Oria, Barbara Ziani, Andrea Stella, Mortalla Dieng, Gianluca Faggioli, Mauro Gargiulo, Sergio Palermo, Rodolfo Pini, Giovanni Maria Puddu, Andrea Vacirca, Domenico Angiletta, Claudio Desantis, Davide Marinazzo, Giovanni Mastrangelo, Guido Regina, Raffaele Pulli, Paolo Bianchi, Lea Cireni, Elisabetta Coppi, Rocco Pizzirusso, Filippo Scalise, Giovanni Sorropago, Valerio Tolva, Valeria Caso, Enrico Cieri, Paola DeRango, Luca Farchioni, Giacomo Isernia, Massimo Lenti, Gian Battista Parlani, Guglielmo Pupo, Grazia Pula, Gioele Simonte, Fabio Verzini, Federico Carimati, Maria Luisa Delodovici, Federico Fontana, Gabriele Piffaretti, Matteo Tozzi, Efrem Civilini, Giorgio Poletto, Bernhard Reimers, Barbara Praquin, Sonia Ronchey, Laura Capoccia, Wassim Mansour, Enrico Sbarigia, Francesco Speziale, Pasqualino Sirignano, Danilo Toni, Roberto Galeotti, Vincenzo Gasbarro, Francesco Mascoli, Tiberio Rocca, Elpiniki Tsolaki, Giulia Bernardini, Ester DeMarco, Alessia Giaquinta, Francesco Patti, Massimiliano Veroux, Pierfrancesco Veroux, Carla Virgilio, Nicola Mangialardi, Matteo Orrico, Vincenzo Di Lazzaro, Nunzio Montelione, Francesco Spinelli, Francesco Stilo, Carlo Cernetti, Sandro Irsara, Giuseppe Maccarrone, Diego Tonello, Adriana Visonà, Beniamino Zalunardo, Emiliano Chisci, Stefano Michelagnoli, Nicola Troisi, Maela Masato, Massimo Dei Negri, Andrea Pacchioni, Salvatore Saccà, Giovanni Amatucci, Alfredo Cannizzaro, Federico Accrocca, Cesare Ambrogi, Renzo Barbazza, Giustino Marcucci, Andrea Siani, Guido Bajardi, Giovanni Savettieri, Angelo Argentieri, Riccardo Corbetta, Attilio Odero, Pietro Quaretti, Federico Z Thyrion, Alessandro Cappelli, Domenico Benevento, Gianmarco De Donato, Maria Agnese Mele, Giancarlo Palasciano, Daniela Pieragalli, Alessandro Rossi, Carlo Setacci, Francesco Setacci, Domenico Palombo, Maria Cecilia Perfumo, Edoardo Martelli, Aldo Paolucci, Santi Trimarchi, Viviana Grassi, Luigi Grimaldi, Giuliana La Rosa, Domenico Mirabella, Matteo Scialabba, Leonildo Sichel, Costantino L D'Angelo, Gian Franco Fadda, Holta Kasemi, Mario Marino, Francesco Burzotta, Francesco Alberto Codispoti, Angela Ferrante, Giovanni Tinelli, Yamume Tshomba, Claudio Vincenzoni, Deborah Amis, Dawn Anderson, Martin Catterson, Mike Clarke, Michelle Davis, Anand Dixit, Alexander Dyker, Gary Ford, Ralph Jackson, Sreevalsan Kappadath, David Lambert, Tim Lees, Stephen Louw, James McCaslin, Noala Parr, Rebecca Robson, Gerard Stansby, Lucy Wales, Vera Wealleans, Lesley Wilson, Michael Wyatt, Hardeep Baht, Ibrahim Balogun, Ilse Burger, Tracy Cosier, Linda Cowie, Gunaratnam Gunathilagan, David Hargroves, Robert Insall, Sally Jones, Hannah Rudenko, Natasha Schumacher, Jawaharlal Senaratne, George Thomas, Audrey Thomson, Tom Webb, Ellen Brown, Bernard Esisi, Ali Mehrzad, Shane MacSweeney, Norman McConachie, Alison Southam, Wayne Sunman, Ahmed Abdul-Hamiq, Jenny Bryce, Ian Chetter, Duncan Ettles, Raghuram Lakshminarayan, Kim Mitchelson, Christopher Rhymes, Graham Robinson, Paul Scott, Alison Vickers, Ray Ashleigh, Stephen Butterfield, Ed Gamble, Jonathan Ghosh, Charles N McCollum, Mark Welch, Sarah Welsh, Leszek Wolowczyk, Mary Donnelly, Stephen D'Souza, Anselm A Egun, Bindu Gregary, Thomas Joseph, Christine Kelly, Shuja Punekar, M Asad Rahi, Sonia Raj, Dare Seriki, George Thomson, James Brown, Ragunath Durairajan, Iris Grunwald, Paul Guyler, Paula Harman, Matthew Jakeways, Christopher Khuoge, Ashish Kundu, Thayalini Loganathan, Nisha Menon, Raji O Prabakaran, Devesh Sinha, Vicky Thompson, Sharon Tysoe, Dennis Briley, Chris Darby, Linda Hands, Dominic Howard, Wilhelm Kuker, Ursula Schulz, Rachel Teal, David Barer, Andrew Brown, Susan Crawford, Paul Dunlop, Ramesh Krishnamurthy, Nikhil Majmudar, Duncan Mitchell, Min P Myint, Richard O'Brien, Janice O'Connell, Naweed Sattar, Shanmugam Vetrivel, Jonathan Beard, Trevor Cleveland, Peter Gaines, John Humphreys, Alison Jenkins, Craig King, Daniel Kusuma, Ralph Lindert, Robbie Lonsdale, Raj Nair, Shah Nawaz, Faith Okhuoya, Douglas Turner, Graham Venables, Paul Dorman, Andrea Hughes, Deborah Jones, David Mendelow, Helen Rodgers, Aidas Raudoniitis, Peter Enevoldson, Hans Nahser, Imelda O'Brien, Francesco Torella, Dave Watling, Richard White, Pauline Brown, Dipankar Dutta, Lorraine Emerson, Paula Hilltout, Sachin Kulkarni, Jackie Morrison, Keith Poskitt, Fiona Slim, Sarah Smith, Amanda Tyler, Joanne Waldron, Mark Whyman, Milda Bajoriene, Lucy 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Noordhout A., Malmendier D., Massoz M., Saad G., Bosiers M., Callaert J., Deloose K., Blanco Canibano E., Garcia Fresnillo B., Guerra Requena M., Morata Barrado P.C., Muela Mendez M., Yusta Izquierdo A., Aparici Robles F., Blanes Orti P., Garcia Dominguez L., Martinez Lopez R., Miralles Hernandez M., Tembl Ferrairo J.I., Chamorro A., Macho J., Obach V., Riambau V., San Roman L., Ahlhelm F.J., Blackham K., Engelter S., Eugster T., Gensicke H., Gurke L., Lyrer P., Mariani L., Maurer M., Mujagic E., Muller M., Psychogios M., Stierli P., Stippich C., Traenka C., Wolff T., Wagner B., Wiegert M.M., Clarke S., Diepers M., Grochenig E., Gruber P., Isaak A., Kahles T., Marti R., Nedeltchev K., Remonda L., Tissira N., Valenca Falcao M., de Borst G.J., Lo R.H., Moll F.L., Toorop R., van der Worp B.H., Vonken E.J., Kappelle J.L., Jahrome O., Vos F., Schuiling W., van Overhagen H., Keunen R.W.M., Knippenberg B., Wever J.J., Lardenoije J.W., Reijnen M., Smeets L., van Sterkenburg S., Fraedrich G., Gizewski E., Gruber I., Knoflach M., Kiechl S., Rantner B., Abdulamit T., Bergeron P., Padovani R., Trastour J.-C., Cardon J.-M., Le Gallou-Wittenberg A., Allaire E., Becquemin J.-P., Cochennec-Paliwoda F., Desgranges P., Hosseini H., Kobeiter H., Marzelle J., Almekhlafi M.A., Bal S., Barber P.A., Coutts S.B., Demchuk A.M., Eesa M., Gillies M., Goyal M., Hill M.D., Hudon M.E., Jambula A., Kenney C., Klein G., McClelland M., Mitha A., Menon B.K., Morrish W.F., Peters S., Ryckborst K.J., Samis G., Save S., Smith E.E., Stys P., Subramaniam S., Sutherland G.R., Watson T., Wong J.H., Zimmel L., Flis V., Matela J., Miksic K., Milotic F., Mrdja B., Stirn B., Tetickovic E., Gasparini M., Grad A., Kompara I., Milosevic Z., Palmiste V., Toomsoo T., Aidashova B., Kospanov N., Lyssenko R., Mussagaliev D., Beyar R., Hoffman A., Karram T., Kerner A., Nikolsky E., Nitecki S., Andonova S., Bachvarov C., Petrov V., Cvjetko I., Vidjak V., Haluzan D., Petrunic M., Liu B., Liu C.-W., Bartko D., Beno P., Rusnak F., Zelenak K., Ezura M., Inoue T., Kimura N., Kondo R., Matsumoto Y., Shimizu H., Endo H., Furui E., Bakke S., Krohg-Sorensen K., Nome T., Skjelland M., Tennoe B., Albuquerque e Castro J., Alves G., Bastos Goncalves F., de Aragao Morais J., Garcia A.C., Valentim H., Vasconcelos L., Belcastro F., Cura F., Zaefferer P., Abd-Allah F., Eldessoki M.H., Heshmat Kassem H., Soliman Gharieb H., Colgan M.P., Haider S.N., Harbison J., Madhavan P., Moore D., Shanik G., Kazan V., Nazzal M., Ramsey-Williams V., and Gargiulo M

Subjects
Male, medicine.medical_specialty, Time Factors, Time Factor, medicine.medical_treatment, Carotid Stenosi, MEDLINE, Carotid endarterectomy, Rate ratio, Risk Assessment, Asymptomatic, law.invention, Randomized controlled trial, law, Risk Factors, carotid artery stenting (CAS), carotid endarterectomy (CEA), Stent, medicine, Humans, Carotid Stenosis, Stroke, Endarterectomy, Aged, Endarterectomy, Carotid, business.industry, carotid artery, Risk Factor, Articles, General Medicine, trial, medicine.disease, Settore MED/22 - CHIRURGIA VASCOLARE, Surgery, Stenosis, Treatment Outcome, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Female, Stents, Human medicine, medicine.symptom, business, Human
Abstract

Summary Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding UK Medical Research Council and Health Technology Assessment Programme.

Published
2021

186. 1-Month Results From a Prospective Experience on CAS Using CGuard Stent System: The IRONGUARD 2 Study

Author

Sirignano, Pasqualino, Eugenio, Stabile, Mansour, WASSIM AHMAD, Capoccia, Laura, Faccenna, Federico, Francesco, Intrieri, Michelangelo, Ferri, Salvatore, Saccà, Massimo, Sponza, Paolo, Mortola, Sonia, Ronchey, Placido, Grillo, Roberto, Chiappa, Sergio, Losa, Setacci, Francesco, Stefano, Pirrelli, Taurino, Maurizio, Maria Antonella Ruffino, Marco, Udini, Domenico, Palombo, Arnaldo, Ippoliti, Montelione, Nunzio, Carlo, Setacci, Gianmarco de Donato, Massimo, Ruggeri, Speziale, Francesco, Sirignano, P., Stabile, E., Mansour, W., Capoccia, L., Faccenna, F., Intrieri, F., Ferri, M., Sacca, S., Sponza, M., Mortola, P., Ronchey, S., Grillo, P., Chiappa, R., Losa, S., Setacci, F., Pirrelli, S., Taurino, M., Ruffino, M. A., Udini, M., Palombo, D., Ippoliti, A., Montelione, N., Setacci, C., de Donato, G., Ruggeri, M., and Speziale, F.

Subjects
Settore MED/22, Stroke, Time Factors, Treatment Outcome, carotid artery stenting, Humans, Carotid Stenosis, Stents, carotid artery disease, Prospective Studies, stroke
Abstract

Objectives: This study sought to evaluate 30-day safety and efficacy of dual-layer mesh-covered carotid stent systems for carotid artery stenting (CAS) in the clinical practice. Background: When compared with carotid endarterectomy, CAS has been associated with a higher rate of post procedural neurologic events; these could be related to plaque's debris prolapsing through stent's mesh. Consequently, the need for increased plaque coverage has resulted in the development of dual-layer mesh-covered carotid stent systems. Methods: From January 2017 to June 2019, a physician-initiated, prospective, multispecialty registry enrolled 733 consecutive patients undergoing CAS using the CGuard embolic prevention system in 20 centers. The primary endpoint was stroke up to 30 days; secondary endpoints were technical and procedural success; external carotid artery occlusion; and in-hospital and 30-day transient ischemic attack (TIA), acute myocardial infarction (AMI), and death rates. Results: Symptoms were present in 131 (17.87%) patients. An embolic protection device was used in 731 (99.72%) patients. Procedural success was 100%, technical success was obtained in all but 1 (99.86%) patient, who died in hospital due to a hemorrhagic stroke. Six TIAs, 2 minor strokes, and 1 AMI occurred during in-hospital stay, and external carotid artery occlusion was evident in 8 (1.09%) patients. Between hospital discharge and 30-day follow-up, 2 TIAs, 1 minor stroke, and 3 AMIs occurred. Therefore, the cumulative stroke rate was 0.54%. Conclusions: This real-world registry suggests that use of CGuard embolic prevention system in clinical practice is safe and associated with a minimal occurrence of adverse neurological events up to 30-day follow-up.

Published
2020

187. LMI static output-feedback design of fuzzy power system stabilizers

Author

Soliman, M., Elshafei, A.L., Bendary, F., and Mansour, W.

Subjects
*MATHEMATICAL optimization, *MATRICES (Mathematics), *MATHEMATICAL inequalities, *SYSTEM analysis, *SYSTEMS design, *FUZZY systems, *FUZZY automata, *FUZZY expert systems
Abstract

Abstract: The design of a model-free fuzzy power system stabilizer (PSS) lacks systematic stability analysis and performance guarantees. This paper provides a step towards the design of a model-based fuzzy PSS that guarantees not only stability but also performance specifications of power systems. A new practical and simple design based on static output feedback is proposed. The design guarantees robust pole-clustering in an acceptable region in the complex plane for a wide range of operating conditions. A power system design model is approximated by a set of Takagi–Sugeno (T–S) fuzzy models to account for nonlinearities, uncertainties and large scale power systems. The proposed PSS design is based on parallel distributed compensation (PDC). Sufficient design conditions are derived as linear matrix inequalities (LMI). The design procedure leads to a tractable convex optimization problem in terms of the stabilizer gain matrix. Simulations results of both single-machine and multi-machine power systems confirm the effectiveness of the proposed PSS design. [Copyright &y& Elsevier]

Published
2009
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189. Standard 'off-the-shelf' multibranched thoracoabdominal endograft in urgent and elective patients with single and staged procedures in a multicenter experience

Author

Nicola Tusini, Enrico Maria Marone, Gioele Simonte, Mauro Gargiulo, Piergiorgio Cao, Michele Antonello, Luca Bertoglio, Wassim Mansour, Stefano Bonardelli, Gianluca Faggioli, Arnaldo Ippoliti, Alberto Dall’Antonia, Roberto Lonardi, Antonio Fontana, Roberto Chiesa, Raffaele Cuomo, Ciro Ferrer, Stefano Gennai, Francesco Speziale, Antonio Lauricella, Giuseppe Saitta, Giovanni Pratesi, Gian Franco Veraldi, Pierleone Lucatelli, Nicola Mangialardi, Luigi Marcheselli, Luca Mezzetto, Fabio Verzini, Nicola Leone, Carmelo Ricci, Roberto Silingardi, Sonia Ronchey, Silingardi, R, Gennai, S, Leone, N, Gargiulo, M, Faggioli, G, Cao, P, Verzini, F, Ippoliti, A, Tusini, N, Ricci, C, Antonello, M, Chiesa, R, Marone, Em, Mangialardi, N, Speziale, F, Veraldi, Gf, Bonardelli, S, Marcheselli, L, Italian mbEVAR study group., Lonardi R, Saitta, G, Lauricella, A, Ferrer, C, Simonte, G, Pratesi, G, Fontana, A, Lucatelli, P, Dall'Antonia, A, Bertoglio, L, Ronchey, S, Mansour, W, Mezzetto, L, Cuomo, R., Silingardi, Roberto, Gennai, Stefano, Leone, Nicola, Gargiulo, Mauro, Faggioli, Gianluca, Cao, Piergiorgio, Verzini, Fabio, Ippoliti, Arnaldo, Tusini, Nicola, Ricci, Carmelo, Antonello, Michele, Chiesa, Roberto, Marone, Enrico Maria, Mangialardi, Nicola, Speziale, Francesco, Veraldi, Gian Franco, Bonardelli, Stefano, and Marcheselli, Luigi

Subjects
Male, Time Factors, Computed Tomography Angiography, medicine.medical_treatment, Thoracic, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Settore MED/22 - Chirurgia Vascolare, Endovascular aneurysm repair, Aortic aneurysm, 0302 clinical medicine, Postoperative Complications, Risk Factors, 80 and over, 030212 general & internal medicine, multibranched endograft, Aged, 80 and over, medicine.diagnostic_test, Endovascular Procedures, Middle Aged, Aortic Aneurysm, Treatment Outcome, Italy, Cardiothoracic surgery, Elective Surgical Procedures, Anesthesia, Female, Stents, multibranched endograft, urgent/emergent and elective treatment. TAAA repair, Elective Surgical Procedure, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Aortography, Prosthesis Design, Aged, Aortic Aneurysm, Thoracic, Blood Vessel Prosthesis Implantation, Emergencies, Humans, Retrospective Studies, Vascular Patency, Blood Vessel Prosthesis, Surgery, 03 medical and health sciences, Blood vessel prosthesis, medicine, business.industry, Retrospective cohort study, medicine.disease, urgent/emergent and elective treatment. TAAA repair, Stenosis, business
Abstract

Objective: The objective of this study was to assess immediate and midterm outcomes for urgent/emergent and elective patients with thoracoabdominal aortic aneurysms (TAAAs) treated with the first commercially available “off-the-shelf“ multibranched endograft for endovascular aneurysm repair, with a single-step or a staged surgical approach. Methods: A multicenter, nonrandomized, retrospective study was conducted of TAAA patients grouped by urgent/emergent and elective treatment with multibranched endograft for endovascular aneurysm repair at 13 Italian centers from November 2012 to August 2016. Urgent/emergent repair was classified as rupture in 16%, impending rupture in 9%, pain in 53%, or a maximum TAAA diameter ≥80 mm in 22%. Study end points were technical success, mortality, spinal cord ischemia, target visceral vessel (TVV) patency, and procedure-related reinterventions at 30 days and at follow-up. Results: Seventy-three patients (274 TVVs) were enrolled. Treatment was performed in elective (n = 41 [56%]) or urgent/emergent (n = 32 [44%]) settings, according to a single-step (n = 30 [41%]) or staged (n = 43 [59%]) approach. Technical success was 92%. Mortality within 30 days was 4% (n = 3 urgent/emergent patients) due to myocardial infarction. Spinal cord ischemia was recorded in two patients (3%; elective group). The primary patency of TVVs was 99% (three renal branch occlusions). Procedure-related reinterventions were required in five cases (7%). At least one adverse event from any cause ≤30 days was registered in 42% (n = 31). At a median follow-up of 18 months (range, 1-43 months), eight (11%) deaths (elective vs urgent/emergent, 2% vs 22%; P = .018), three (1%) cases of branch occlusion or stenosis, and five (7%) reinterventions were recorded. A survival of 88% (standard error [SE], 4%), 86% (SE, 4%), and 82% (SE, 5%) was evidenced at 12, 24, and 36 months, respectively. Urgent/emergent repair and female gender were identified as independent risk factors for all-cause mortality (P < .001 and P = .015, respectively), and the staged approach was identified as protective (P = .026). Freedom from reintervention was 86% (SE, 4%) and 83% (SE, 5%) at 12 and 24 months. Conclusions: The first off-the-shelf multibranched endograft seems safe in both urgent/emergent and elective settings. The staged surgical approach appears to positively influence overall survival. This unique device and its operators will usher in a new treatment paradigm for TAAA repair.

Published
2017

190. La tuberculose abdominale.

Author

Kooli, I., Gueddiche, A., Ghonei, O., Aouam, A., Ben Amor, S., Ben Brahim, H., Ben Mansour, W., Loussaief, C., Loughmari, M.H., Toumi, A., Safer, L., and Chakroum, M.

Abstract

Introduction La tuberculose abdominale occupe la troisième place de la tuberculose extrapulmonaire. Le diagnostic repose souvent sur les données clinico-radiologique. Le but de ce travail est d’étudier les caractéristiques épidémio-clinique, diagnostique et thérapeutique de la tuberculose abdominale. Patients et méthodes Il s’agissait d’une étude rétrospective effectuée aux services de maladies infectieuses et de gastrologie du CHU Fattouma Bourguiba Monastir Tunisie sur une période allant du 1er janvier 2000 au 31 juillet 2016. Cette étude avait inclus tous les cas de tuberculose abdominale. Les données épidémio-cliniques, radiologiques, thérapeutiques et évolutives étaient recueillies. La confirmation du diagnostic était grâce à une preuve bactériologique et/ou anatomopathologique. Résultats Il s’agissait de 47 patients d’âge moyen 41,7 (14 à 80 ans) avec une prédominance féminine (63,8 %). Les patients étaient suivis au service de gastrologie dans 27 cas (57,4 %). Un antécédent de tuberculose était noté dans 5 cas (10,6 %) et la consommation de lait cru dans 12 cas (25,5 %). Majoritairement, il s’agissait d’une tuberculose péritonéale isolée dans 30 cas (63 %) et hépatique dans 4 cas (8,5 %). Dans 36 cas, l’atteinte abdominale était isolée, la tuberculose était multifocale dans 11 cas et 4 patients présentaient une atteinte abdominale associée à des adénopathies intra-abdominales. Les signes généraux les plus fréquents étaient : une altération de l’état générale dans 26 cas (55,3 %) et une douleur abdominale dans 25 cas (53,1 %). À l’examen, on avait fréquemment noté une ascite dans 20 cas (42,6 %) et des adénopathies dans 6 cas (12,8 %). L’IDR à la tuberculine était positive dans 23 cas (48,9 %). Un SIB était noté chez 15 patients (31,9 %). L’échographie abdominale avait décelé une ascite dans 22 cas, des adénopathies dans 8 cas (17 %), une hépatomégalie dans 7 cas (14,9 %) et un épaississement des anses intestinales dans 4 cas (8,5 %). La TDM thoraco-abdominale avait montré des éléments d’orientation dans 36 cas (76,5 %). La ponction d’ascite était pratiquée chez 22 patients. Elle était à prédominance de polynucléaires neutrophiles dans 21 cas (44,68 %). La cœlioscopie diagnostique était effectuée dans 29 cas (61,7 %). Le diagnostic de tuberculose était retenu sur des arguments anatomo-pathologiques dans 46 cas (97,87 %). La recherche de BK était négative dans tous les cas. Le traitement était basé sur les anti-tuberculeux dans tous les cas. La streptomycine était utilisée dans 8 cas (17 %). La durée moyenne du traitement était de10 mois (1 à 48 mois). L’évolution était favorable dans 36 cas (76,5 %). Un cas de décès et 10 cas étaient perdus de vue. Conclusion La tuberculose abdominale pose un problème diagnostic du fait du polymorphisme clinique. Malgré le progrès des techniques d’imagerie et de la recherche bactériologique et l’apport de la cœlioscopie, le diagnostic de tuberculose abdominale demeure difficile. [ABSTRACT FROM AUTHOR]

Published
2017
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191. Development and Validation of a Novel Holistic Skin Quality Assessment Scale.

Author

Martschin C, Bahhady R, Li J, Loureiro W, Mansour W, Metelitsa A, Minocha K, Somenek M, Taghetchian K, and Tienthavorn T

Abstract

Background: Radiant skin is a common patient request and the result of multiple contributing factors. Currently, there is no standardized methodological approach that facilitates assessment of skin quality from a holistic perspective., Aim: To develop a holistic methodological process to assess skin quality using a scale that helps identify treatment priorities, facilitates conversation with the subject, and helps manage expectations, supports long-term treatment plans, and tracks treatment progress over time., Methods: Ten global experts (dermatologists and esthetic physicians) identified the main measurable aspects that contribute to skin quality, and these were combined to form the Skin Quality Assessment Scale (SQS). The scale comprises four overarching skin quality domains containing nine measurable aspects: texture (pores, lines, scars); discoloration (redness, pigmentation, dullness); firmness (laxity); and hydro-lipid balance (oiliness, dryness). Each aspect is graded on a 4-point severity scale (0 = none to 3 = severe). The SQS was validated by a large group of practicing clinicians., Results: Practicing clinicians (> 40, 78% dermatologists) were surveyed; prior to reviewing the scale, 67% did not use any scale but 81% believed a holistic SQS was needed. After reviewing the scale, 100% agreed the scale provides a holistic assessment of skin quality. In addition, 95% agreed the scale helps assess all key aspects of skin quality with subjects and 98% deemed it valuable for their clinic., Conclusions: The SQS represents a holistic assessment tool that engages with and manages subjects' expectations, identifies treatment priorities, creates a long-term treatment plan, and visualizes the skin quality improvement over time., (© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Published
2024
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192. Giant cell tumor of the cervical spine: A very uncommon cause for cervical spine compression.

Author

Gader G, Gharbi MA, Mansour W, Badri M, Harbaoui A, and Zammel I

Abstract

Giant cell tumors (GCTs) are rare neoplasms, primarily found in long bones, typically affecting the epiphysis of the distal femur, proximal tibia, and distal radius. However, their occurrence in the cervical spine is exceedingly rare. Here, we present a case report of a 21-year-old female patient who presented with progressive neck pain, radiating numbness, and right hemiparesis. Radiographic imaging revealed a lytic lesion in the C3 vertebral body, further characterized by magnetic resonance imaging (MRI) and computed tomography (CT) scans. The patient underwent surgery for stabilization of the cervico-occipital hinge, decompression, and biopsy. Histopathological examination confirmed the diagnosis of a giant cell tumor. Postoperatively, the patient showed improvement in motor impairment, cervical pain, and numbness. She was proposed for adjuvant treatment based on Denosumab. However, she returned 1 month after surgery with worsened motor deficit, developing tetraparesis. Control MRI revealed a tumor flare-up. The decision was made not to reoperate on the patient and to accelerate the administration of Denosumab. Meanwhile, she experienced a pulmonary embolism leading to her demise. This case underscores the importance of considering giant cell tumors in the differential diagnosis of cervical spine lesions and emphasizes the successful and prompt management through a multidisciplinary approach involving surgical intervention and adjuvant therapy., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Published
2024
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193. Intramedullary arachnoid cyst of the dorsal spine: Report of a rare spinal cord condition.

Author

Gader G, Bahroun S, Mansour W, Kharrat MA, Harbaoui A, and Zammel I

Abstract

Arachnoid cysts are rare subtypes of spinal cord tumors, usually found in extradural or intradural extramedullary locations. Intramedullary arachnoid cysts are exceedingly rare, with only a few cases reported in the literature. Although these cysts are histologically benign, they can cause significant functional impairment and lead to severe neurological deficits if left untreated. Their rarity presents challenges in diagnosis and management, highlighting the need for awareness and early intervention. We present a new case of a thoracic spinal cord intramedullary arachnoid cyst in a patient who displayed progressive neurological symptoms. Diagnosis was facilitated by detailed clinical evaluation and advanced imaging techniques, such as MRI. The patient underwent surgical intervention, resulting in marked postoperative improvement. This case is discussed in relation to the existing literature, offering a comprehensive review of the etiopathogenesis, clinical presentation, radiological characteristics, and therapeutic strategies for intramedullary arachnoid cysts. We emphasize the need for a tailored surgical approach to effectively decompress the spinal cord, alleviate symptoms, and minimize the risk of recurrence., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Published
2024
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194. From PERFORM to PERFORM2Scale: lessons from scaling-up a health management strengthening intervention to support Universal Health Coverage in three African countries.

Author

Raven J, Mansour W, Aikins M, Bulthuis S, Chikaphupha K, Dieleman M, Kok M, Martineau T, Ssengooba F, Wyss K, and Vallières F

Subjects
Humans, Malawi, Ghana, Qualitative Research, Leadership, Uganda, Delivery of Health Care organization & administration, Capacity Building, Interviews as Topic, Universal Health Insurance
Abstract

Strengthening management and leadership competencies among district and local health managers has emerged as a common approach for health systems strengthening and to achieve Universal Health Coverage (UHC). While the literature is rich with localized examples of initiatives that aim to strengthen the capacity of district or local health managers, particularly in sub-Saharan Africa, considerably less attention is paid to the science of 'how' to scale-up these initiatives. The aim of this paper is thus to examine the 'process' of scaling-up a management strengthening intervention (MSI) and identify new knowledge and key lessons learned that can be used to inform the scale-up process of other complex health interventions, in support of UHC. Qualitative methods were used to identify lessons learned from scaling-up the MSI in Ghana, Malawi and Uganda. We conducted 14 interviews with district health management team (DHMT) members, three scale-up assessments with 20 scale-up stakeholders, and three reflection discussions with 11 research team members. We also kept records of activities throughout MSI and scale-up implementation. Data were recorded, transcribed and analysed against the Theory of Change to identify both scale-up outcomes and the factors affecting these outcomes. The MSI was ultimately scaled-up across 27 districts. Repeated MSI cycles over time were found to foster greater feelings of autonomy among DHMTs to address longstanding local problems, a more innovative use of existing resources without relying on additional funding and improved teamwork. The use of 'resource teams' and the emergence of MSI 'champions' were instrumental in supporting scale-up efforts. Challenges to the sustainability of the MSI include limited government buy-in and lack of sustained financial investment., (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)

Published
2024
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195. Evaluation of a novel lateral flow immunochromatographic assay for the rapid detection of KPC, NDM, IMP, VIM and OXA-48 carbapenemases in Gram-negatives.

Author

Jaidane N, Vanparis O, Mansour W, Volland H, Oueslati S, and Naas T

Subjects
Humans, Chromatography, Affinity methods, Gram-Negative Bacterial Infections microbiology, Gram-Negative Bacterial Infections diagnosis, Sensitivity and Specificity, Anti-Bacterial Agents pharmacology, Immunoassay methods, beta-Lactamases genetics, Bacterial Proteins genetics, Gram-Negative Bacteria enzymology, Gram-Negative Bacteria drug effects
Published
2024
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196. Adding Insult to Injury: Sleep Deficiency in Hospitalized Patients.

Author

Mansour W and Knauert MP

Subjects
Humans, Sleep Deprivation complications, Inpatients, Sleep Wake Disorders therapy, Sleep Wake Disorders physiopathology, Hospitalization
Abstract

Sleep deficiency is a common problem in the hospital setting. Contributing factors include preexisting medical conditions, illness severity, the hospital environment, and treatment-related effects. Hospitalized patients are particularly vulnerable to the negative health effects of sleep deficiency that impact multiple organ systems. Objective sleep measurement is difficult to achieve in the hospital setting, posing a barrier to linking improvements in hospital outcomes with sleep promotion protocols. Key next steps in hospital sleep promotion include improvement in sleep measurement techniques and harmonization of study protocols and outcomes to strengthen existing evidence and facilitate data interpretation across studies., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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197. An innovative deformation coordination method for analyzing distortion effects on box girders.

Author

Wang C, Shi M, Huang J, Zhang Y, Li W, Mansour W, Ke L, and Wang P

Abstract

A deformation coordination method is proposed in this study to account for the distortion effects on a box girder. The differential equation for distortion in vertical web box girders is derived based on the deformation coordination condition of the distortion angle, considering both external loads and internal forces. Subsequently, a comparative analysis is conducted to explore the similarities and differences between the differential equations derived from the proposed deformation coordination method, the plate element analysis method and the total potential energy variation method. The accuracy of the proposed approach is verified through bench-scale tests and numerical simulations. The findings indicate that the derived governing distortion differential equation and distortion attenuation coefficients in the proposed method align with those obtained from the plate element analysis method and the total potential energy variational method, which enhances the applicability to allow for the distortion equations to be obtained simply by calculating the distortion displacements. The analytical findings regarding the distortion warping normal stresses on the cross-sections of the box girders demonstrate favorable correspondence with the experimental results, displaying an acceptable error ranging from - 0.3% to 5.4%. Moreover, the peak of distortion warping normal stresses on the mid-span cross-section increases with higher span-to-depth ratios and height-to-thickness ratios of the web. Consequently, augmenting the thickness of the box wall proves to be an effective means of reducing the distortion effect in box girders., (© 2024. The Author(s).)

Published
2024
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198. Intradural extramedullary cervical cavernoma.

Author

Gader G, Mansour W, Kharrat MA, Hdhili H, Chelly I, Bahri K, and Zammel I

Abstract

Background: Spinal cavernomas (SCs) account for about 5% of all spinal vascular malformations. Intradural SCs occur in just 3% of cases and are typically intramedullary., Case Description: A 58-year-old female presented with progressive left occipital neuralgia, left cervicobrachial neuralgia, and paresthesia of all four extremities. The magnetic resonance imaging (MRI) revealed an intradural extramedullary C2-C4 lesion causing significant spinal cord compression. Gross total tumor excision was accomplished through a midline laminectomy pathologically; the lesion proved to be a cavernoma. The postoperative follow-up MRI obtained 4 months postoperatively showed complete tumor resection., Conclusion: A 58-year-old female successfully underwent gross total excision of a C2-C4 intradural extramedullary SC., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)

Published
2024
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199. Open Surgical Conversion of Popliteal Endograft Infection: Case Reports and Literature Review.

Author

Ascione M, Dajci A, Cangiano R, Marzano A, Molinari A, Miceli F, Di Girolamo A, Leanza C, Oliva A, Di Marzo L, and Mansour W

Abstract

Background: Endovascular treatment of popliteal aneurysms (PA) has increased in the last few years, quickly becoming the main treatment performed in many vascular centers, based on the acceptable and promising outcomes reported in the literature. However, endograft infections after endovascular popliteal aneurysm repair (EPAR) are the most dangerous complications to occur as they involve serious local compromise and usually require open surgical conversion and device explantation to preserve the affected extremity., Case Report: We report two patients who were admitted to the emergency room of our hospital for pain and edema in the lower leg. Both patients had undergone exclusion of a ruptured PA a few years before by endovascular graft. CTA testing showed a significant volume of fluid-corpuscular collection related to perianeurysmal abscess collection in both cases. Blood cultures and drained material cultures were positive for Staphylococcus capitis in the first case and S. aureus in the second. Prophylactic antibiotics were administered for 10 days, then patients underwent an open surgical conversion with the complete explantation of endovascular material and a femoro-popliteal bypass using an autologous vein in the first case and a biological bovine pericardium prosthesis in the second case. The infective department of our hospital had defined a discharged specific antibiotic therapy for each patient, based on intraoperative microbiological samples. Furthermore, we have examined the literature and found six more cases described in case report articles that refer to popliteal graft infections by different microorganisms, mostly presenting acute limb ischemia as the first symptom and suggesting endograft explantation with open conversion and autologous vein bypass as the commonest therapeutic choice., Conclusions: The open surgical conversion of popliteal endograft infection is the best strategy to manage peripheral infection after an endovascular popliteal aneurysm repair procedure.

Published
2024
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200. Sex as a Predictor of Outcomes for Symptomatic Carotid Stenosis: A Comparative Analysis between CAS and CEA.

Author

Sirignano P, Margheritini C, Mansour W, Aloisi F, Setacci C, Speziale F, Stabile E, Taurino M, and On Behalf Of The Ironguard-Study Investigators

Abstract

Purpose: Reporting gender-related outcomes for symptomatic carotid lesion revascularization after both endarterectomy (CEA) and carotid artery stenting (CAS) procedures in an unselected group of patients treated by Italian Vascular Specialists., Material and Methods: A retrospective study was conducted on patients presenting with recently symptomatic carotid stenosis treated by CAS and by CEA. The primary endpoint was the 30 days any stroke occurrence rate; secondary endpoints were technical success, occurrence of transient ischemic attack (TIA), acute myocardial infarction (AMI) and death. Demographic, clinical and procedural data were all noted in order to identify the outcome's determining factor., Results: A total of 265 patients (193 males and 72 females) were enrolled, and of these 134 (50.5%) underwent CEA and 131 CAS (49.5%). At 30 days, the overall new stroke rate was 3.4% (one fatal), and no TIA, AMI or deaths were observed. Among strokes, seven major and two minor strokes were reported, with six after CEA and three after CAS ( p = 0.32; OR: 2; CI95%: 0.48-8.17). The timing of revascularization has been found to be slightly associated with new stroke occurrence: seven out nine strokes were observed in patients treated within 14 days from symptom onset (5.5% vs. 1.4%; p = 0.08, OR: 3.8, CI95%: 0.77-18.56). Lastly, female patients presented a significantly higher risk of post-operative stroke compared to male patients: 6.9% vs. 2.1% ( p : 0.05; OR: 3.52; CI95%: 0.91-13.52)., Conclusions: Our experience seems to suggest that both CEA and CAS provide safe and effective results in treating patients presenting with symptomatic carotid stenosis. Regardless of the type of revascularization, female sex is an independent risk factor for stroke recurrence after treatment.

Published
2024
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