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Introduction Adult and child psychiatry residents encounter unique stressors in their training distinct from those in other medical specialties. Patient suicide has been identified as one of the most distressing experiences during psychiatric training. Objectives This study represents the first Tunisian investigation aiming to assess (1) the impact of patient suicide on psychiatry residents and (2) the limitations of the institutional support system in dealing with such cases. Methods A Google Forms questionnaire was distributed via email to all residents, gathering socio-demographic data, assessing traumatic impact using the PTSD Checklist for DSM-5 (PCL-5), and soliciting open-ended responses regarding personal experiences and expectations of the institutional support system. Results Fifty-three residents participated in the study. Among them, 29 residents had encountered patient suicide, with 12 directly involved. Symptoms of PTSD were detected in three residents. The physician directly involved in treating the suicidal patient reported the highest PCL-5 score. The majority of residents (27 out of 29) expressed the need for a structured support and training program tailored to healthcare professionals dealing with suicide. Conclusions The findings suggest that psychiatric residents may require additional training and support to effectively address the complex issue of patient suicide. Implementing specific training programs could significantly enhance their ability to manage such situations. Disclosure of Interest None Declared

Abstract Background Primary breast lymphoma (PBL) is a very rare form of non-Hodgkin's lymphoma (NHL), defined as a malignant primary lymphoma occurring in the breast in the absence of previously detected lymphoma localizations. Our study aims to retrospectively evaluate the epidemiological, clinical, and imaging findings and therapeutic features of breast lymphomas in patients with primary lymphoma of the breast. Materials and methods This is a retrospective study including 13 patients with primary non-Hodgkin's lymphoma of the breast treated at the Salah Azaiez Institute of Oncology from 2000 to 2019. This sample includes 1 case of follicular lymphoma, 2 cases of large T-cell lymphoma, and 10 cases of large B-cell lymphoma. Results Patients included in the study were aged between 17 and 89 years (average age of 52.6 years). All patients were referred because of a lump in the breast, and only one patient consulted with inflammatory signs in the breast. The average clinical size of the tumor was 7.2 cm, with a maximum of 15 cm. Mammography showed an oval mass with circumscribed margins in the majority of cases. Ultrasound showed in most cases a hypoechoic irregular mass or multilobulated mass with irregular margins and hypervascular on color Doppler. Magnetic resonance imaging (MRI) was performed on only three patients and showed a spiculated lesion with polycyclic limits. Eight patients underwent surgery. In our study breast lymphomas involved 10 cases of large B-cell lymphoma, one case of follicular lymphoma, and two cases of large T-cell lymphoma. In this series, 11 patients had localized stages (I + II) at diagnosis, and 2 patients had disseminated stages (stage III) of primary breast lymphoma. Seven patients underwent chemotherapy treatment alone, and five had chemotherapy with radiotherapy. The median follow-up of our patients was 53 months, ranging from 1 to 177 months. Overall survival was 71% at 3 years and 51% at 5 years. Conclusion Primary breast lymphoma is an uncommon type of breast malignancy. The optimal treatment modality is still in question because of the rarity of this disease. However, the use of combination therapy produces the most favorable results. Surgery is not yet recommended.

Progress in leveraging current and emerging high-performance computing infrastructures using traditional weather and climate models has been slow. This has become known more broadly as the software productivity gap. With the end of Moore's law driving forward rapid specialization of hardware architectures, building simulation codes on a low-level language with hardware-specific optimizations is a significant risk. As a solution, we present Pace, an implementation of the nonhydrostatic FV3 dynamical core and GFDL cloud microphysics scheme which is entirely Python-based. In order to achieve high performance on a diverse set of hardware architectures, Pace is written using the GT4Py domain-specific language. We demonstrate that with this approach we can achieve portability and performance, while significantly improving the readability and maintainability of the code as compared to the Fortran reference implementation. We show that Pace can run at scale on leadership-class supercomputers and achieve performance speeds 3.5–4 times faster than the Fortran code on GPU-accelerated supercomputers. Furthermore, we demonstrate how a Python-based simulation code facilitates existing or enables entirely new use cases and workflows. Pace demonstrates how a high-level language can insulate us from disruptive changes, provide a more productive development environment, and facilitate the integration with new technologies such as machine learning.

The presence of geoheritage of international value is the basis of any candidature as a UNESCO Global Geopark. Within the framework of the elaboration of a roadmap for the creation of a UNESCO Global Geopark in South-East Tunisia, a geological and geomorphological study was carried out. The selected geoheritage can be divided into two main families : palaeontological and sedimentological sites, which provide complete documentation of the opening of the southern Tethysian margin, from the Triassic to the Cretaceous, and geomorphological and landscape sites (cultural geomorphosites), which offer an exceptional range of adaptations of human societies to the morphoclimatic context. This analysis of the geoheritage is the basis for the implementation of a strategy of geoconservation, geotouristic enhancement and, ultimately, the creation of a geopark in the Djebel Dahar. It demonstrates the importance of the interrelationships between the cultural, tangible and intangible, heritage and the geomorphological context.

Abstract The ROBoCoP project is launched within the EU COST Action CA16113 “CliniMARK” aiming to increase the number of clinically validated biomarkers and focused on chronic obstructive pulmonary disease (COPD) biomarker development and validation. ROBoCoP encompasses two consecutive studies consisting of a pilot study followed by a field study. The pilot study is a longitudinal exposure assessment and biomarker study aiming at: 1-understanding the suitability of the candidate biomarkers in surveying populations at risk such as workers exposed to COPD causing agents; 2-determining the best sampling plan with respect to the half-life of the candidate biomarkers; 3-implementing and validating the sampling procedures and analytical methods; 4-selecting the best suitable biomarkers to be measured in the field. Each study participant is surveyed every day during the 6–8 h work-shifts for two consecutive weeks. The field study has an implementation research designe that enabled us to demonstrate the applicability of the standardized protocol for biomarker measurements in occupational settings while also assessing the biomarkers’ validity. ROBoCoP will focus on particulate matter (PM) exposure measurements, exposure biomarkers and a series of effect biomarkers, including markers of lipoperoxidation: 8-isoprostane, malondialdehyd in exhaled breath condensate (EBC) and urine, potential markers of nitrosative stress: NO2 −, NO3 − and formate anion in EBC; markers of DNA oxidation: 8-hydroxy-2’deoxyguanosine in EBC and urine, marker of genotoxicity: micronuclei in buccal cells, and oxidative potential in exhaled air (OPEA). OPEA appears particularly promising as a clinical biomarker for detecting COPD, and will be tested independently and as part of a biomarker panel. COPD diagnosis will be performed by an experienced occupational physician according to international diagnostic standards and confirmed by a pulmonologist. This research will include approximatively 300 underground subway workers randomly selected from the personnel registry of a large Parisian transport company. Underground subways are suggested as the most PM polluted urban transport environment. We believe this occupational exposure is relevant for biomonitoring of workers and early detection of respiratory diseases.

The fate of ocean carbon is determined by the balance between primary productivity and heterotrophic breakdown of that photosynthate. Here the authors show that diatoms produce a polysaccharide that resists bacterial degradation, accumulates, aggregates and stores carbon during spring blooms.

Wire arc additive manufacturing (WAAM) is a metal 3D printing method that allows the cost-effective and efficient production of large-scale elements, and has thus gained great interest from architects and structural engineers. Integration of this novel technology into the construction industry, however, requires the development of a clear understanding of the mechanical behaviour of WAAM materials. To this end, a comprehensive experimental study into the mechanical properties and microstructure of WAAM plates made of normal- and high-strength steels has been undertaken and is reported herein. A total of 137 as-built and machined tensile coupons were tested, extracted in various directions relative to the print layer orientation from WAAM plates of two nominal thicknesses, built using different deposition strategies. The influence of the geometric undulations inherent to the WAAM process and deposition strategy on the resulting mechanical properties was investigated. Microstructural characterisation was also performed by means of optical microscopy (OM) and electron backscatter diffraction (EBSD). The WAAM normal-strength steel plates exhibited a principally ferritic-pearlitic microstructure, while the WAAM high-strength steel plates displayed a mixed microstructure featuring ferrite, bainite and martensite. The EBSD analysis revealed a weak crystallographic texture, which explained the observed mechanical properties being almost isotropic. No significant differences in tensile properties were observed with the different deposition strategies, except for some variation in ductility. The geometric undulations of the as-built coupons resulted in some reduction in effective mechanical properties and a degree of anisotropy. Overall, the examined WAAM material exhibited consistent mechanical properties, a Young’s modulus comparable to conventionally-produced steel plates, marginally lower strength, reflecting the slower cooling conditions than is customary, and good ductility.

Powder bed fusion (PBF) is a commonly employed metal additive manufacturing (AM) process in which components are built, layer-by-layer, using metallic powder. The component size is limited by the internal build volume of the employed PBF AM equipment; the fabrication of components larger than this volume therefore requires mechanical joining methods, such as laser welding. There are, however, very limited test data on the mechanical performance of PBF metal with laser welded joints. In this study, the mechanical properties of PBF built 316L stainless steel parts, joined together using laser welding to form larger components, have been investigated; the microstructure of the components has also been examined. 33 PBF 316L stainless steel tensile coupons, with central laser welds, welded using a range of welding parameters, and with coupon half parts built in two different orientations, were tested. The porosity, microhardness and microstructure of the welded coupons, along with the widths of the weld and heat-affected zone (HAZ), were characterised. The PBF base metal exhibited a typical cellular microstructure, while the weld consisted of equiaxed, columnar and cellular dendrite microstructures. Narrow weld regions and HAZs were observed. The PBF base metal was found to have higher proof and ultimate strengths, but a similar fracture strain and a lower Young’s modulus, compared with conventionally manufactured 316L stainless steel. The strengths were dependent on the build direction – the vertically built specimens showed lower proof strengths than the horizontal specimens. The laser welds generally exhibited lower microhardness, proof strengths and fracture strains than the PBF base metal which correlated with the observed structure. This work has demonstrated that PBF built parts can be joined by laser welding to form larger components and provided insight into the resulting strength and ductility.

OBJECTIVE: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia. Little is known about the extrapulmonary manifestations of this organism that are dominated by central nervous system (CNS) involvement. We aimed to identify the epidemiological and clinical peculiarities of M. pneumoniae infection with neurological manifestations and to analyze its therapeutic and evolutionary modalities. PATIENTS AND METHODS: Patients with neurological manifestations due to M. pneumoniae infection admitted in our department were scanned in the light of demographic, clinical, radiological features and response to treatment. RESULTS: Totally we conducted 15 patients with an average age 21.7±8 years. There were 8 men and 7 women. The average consultation time was 4±3 days. The most common symptoms were headache (73.3%), fever (60%), altered state of consciousness (20%) and focal signs (13.3%). Respiratory manifestations were associated in 7 cases (46.7%). The clinical entity was meningitis in 11 cases (73.3%), meningoencephalitis in 2 cases (13.3%), encephalitis and peripheral facial palsy in 1 case each (6.7%). All patients received probabilistic antibiotic therapy that was adapted after serology results. The molecules used were rovamycin in 5 cases (26.7%), doxycycline in 2 cases (13.3%) and chloramphenicol in 1 case (6.7%). The outcome was favorable without any sequelae in all cases. CONCLUSIONS: This study aims to prompt clinicians to consider extrapulmonary M. pneumoniae infection in the differential diagnosis for patients presenting with acute neurologic and respiratory symptoms.