Search Results (45)

Background/Objectives: Complex endovascular solutions have expanded treatment options for complex abdominal aortic aneurysms (cAAA), particularly in elderly high-risk patients. However, these techniques are limited by anatomical constraints and costs, while the superiority over open repair (OSR) remains debatable. This study aimed to compare short- and mid-term outcomes of OSR for cAAA in patients aged ≥80 versus <80 years. Methods: Retrospective analysis was performed for patients who underwent OSR for cAAA between 2017 and 2022 at two tertiary vascular centers. A total of 226 patients (median age 71 years [IQR 66–80]; 89% male) were included, of whom 74 were aged ≥80 years. Primary endpoints were 30-day mortality, major adverse cardiovascular events (MACE), and early reintervention. Secondary endpoints included length of stay (LOS), acute kidney injury, new renal dysfunction, mid-term survival (≤5 years), and procedure-related reintervention. Propensity score matching (PSM) was performed to adjust for baseline differences. Results: Out of 1087 screened patients, 226 met the inclusion criteria: 74 octogenarians and 152 younger patients. Thirty-day mortality was significantly higher in octogenarians (9.5% vs. 0.7%; p < 0.001), as was the incidence of MACE (8.2% vs. 1.9%; p = 0.026). Rates of kidney impairment LOS and other major complications were comparable. During a median follow-up of 42.7 months, mid-term survival and freedom from reintervention did not differ significantly between groups. PSM analysis confirmed higher early mortality and cardiovascular events in octogenarians but similar mid-term outcomes. Conclusions: Although octogenarians undergoing OSR for cAAA face increased early mortality and cardiovascular complications, their mid-term survival and freedom from reintervention are comparable to younger patients. These results suggest that age alone should not represent a contraindication to open repair in appropriately selected individuals. Full article

GaN High-Electron-Mobility Transistors have gained some foothold in the power-electronics industry. This is due to wide frequency bandwidth and power handling. Gallium Nitride offers a wide bandgap and higher critical field strength compared to most wide-bandgap semiconductors, resulting in better radiation resistance. Theoretically, it supports higher speeds as the device dimensions could be reduced without suffering voltage breakdown. The simulation and experimental results illustrate the superior performance of the Gallium Nitride High-Electron-Mobility Transistors in an amplifying circuit. Using a spice model for commercially available Gallium Nitride High-Electron-Mobility Transistors, non-distorted output to an input signal of 200 ps was displayed. Real-world measurements underscore the fast response of the Gallium Nitride High-Electron-Mobility Transistors with its measured slew rate at approximately 3000 V/μs, a result only 17% lower than the result obtained from the simulation. This fast response, coupled with the amplifier radiation resistance, shows promise for designing improved detection and imaging circuits with long Mean Time Between Failure required, for example, by next-generation industrial-process gamma transmission-computed tomography. Full article

Background/Objectives: Transarterial chemoembolization (TACE) is the most widely used bridging treatment for hepatocellular carcinoma (HCC) before liver transplantation (LT) but may be associated with dropout and post-LT HCC recurrence. We aimed to identify a subgroup of HCC LT candidates at high risk of TACE-to-LT strategy failure (TLSF). Methods: All consecutive HCC LT candidates with French AFP-scores ≤ 2 who underwent at least one bridging TACE at Paul Brousse Hospital in 2013–2018 were included (n = 173). Dropout for HCC progression during waiting list and post-LT HCC recurrence was defined TLSF. Results: The one-year TLSF cumulative incidence was 15%. According to univariate analysis, pre-TACE AFP > 15 ng/mL was the only factor associated with decreased overall survival (OS) and TLSF-free survival (TLSF-FS) after the first TACE. The absence of complete radiological response (CRR) or pre-TACE AFP > 15 ng/mL were associated with reduced OS and TLSF-FS after a second TACE (n = 118). The cumulative incidence of TLSF reached 41% one year after the second TACE in patients with both AFP > 15 ng/mL and no CRR, while it was 7% for others (p < 0.001). Conclusions: HCC patients receiving bridging TACE, with pre-TACE AFP > 15 ng/mL and no CRR after two TACEs, are at high risk of delisting for HCC progression or of post-LT recurrence. Alternative therapeutic strategies should be proposed early for this better-defined population. Full article

The integration of large language models (LLMs) into educational settings represents a significant technological breakthrough, offering substantial opportunities alongside profound ethical challenges. Higher education institutions face the widespread use of these tools by students, requiring them to navigate complex decisions regarding their adoption. This includes determining whether to allow the use of LLMs, defining their appropriate scope, and establishing guidelines for their responsible and ethical application. In the context of computer science education, these challenges are particularly acute. On the one hand, the capabilities of LLMs significantly enhance the tools available to developers and software engineers. On the other hand, students’ over-reliance on LLMs risks hindering their development of foundational skills. This study examines these challenges and proposes strategies to regulate the use of LLMs while upholding academic integrity. It focuses on the specific impact of LLMs in programming education, where dependence on AI-generated solutions may erode active learning and essential skill acquisition. Through a comprehensive literature review and drawing on teaching experience and guidelines from global institutions, this study contributes to the broader discourse on the integration of these advanced technologies into educational environments. The goal is to enhance learning outcomes while ensuring the development of competent, ethical software professionals. Full article

Climatic changes lead to many extreme weather events throughout the globe. These extreme weather events influence our behavior, exposing us to different environmental conditions, such as poor indoor quality. Poor indoor air quality (IAQ) poses a significant concern in the modern era, as people spend up to 90% of their time indoors. Ventilation influences key IAQ elements such as temperature, relative humidity, and particulate matter (PM). Children, considered a vulnerable group, spend approximately 30% of their time in educational settings, often housed in old structures with poorly maintained ventilation systems. Extreme weather events lead young students to stay indoors, usually behind closed doors and windows, which may lead to exposure to elevated levels of air pollutants. In our research, we aim to demonstrate how real-time monitoring of air pollutants and other environmental parameters under extreme weather is important for regulating the indoor environment. A study was conducted in a school building with limited ventilation located in an arid region near the Red Sea, which frequently suffers from high PM concentrations. In this study, we tracked the indoor environmental conditions and air quality during the entire month of May 2022, including an extreme outdoor weather event of sandstorms. During this month, we continuously monitored four classrooms in an elementary school built in 1967 in Eilat. Our findings indicate that PM2.5 was higher indoors (statistically significant) by more than 16% during the extreme event. Temperature was also elevated indoors (statistically significant) by more than 5%. The parameters’ deviation highlights the need for better indoor weather control and ventilation systems, as well as ongoing monitoring in schools to maintain healthy indoor air quality. This also warrants us as we are approaching an era of climatic instability, including higher occurrence of similar extreme events, which urge us to develop real-time responses in urban areas. Full article

Background: Despite the ongoing trend of increasing donor ages in liver transplantation (LT) setting, a notable gap persists in the availability of comprehensive guidelines for the utilization of organs from elderly donors. This study aimed to evaluate the viability of livers grafts from donors aged ≥85 years and report the post-LT outcomes compared with those from “ideal” donors under 40 years old. Methods: Conducted retrospectively at a single center from 2005 to 2023, this study compared outcomes of LTs from donors aged ≥85 y/o and ≤40 y/o, with the propensity score matching to the recipient’s gender, age, BMI, MELD score, redo-LT, LT indication, and cause of donor death. Results: A total of 76 patients received grafts from donors ≥85 y/o and were compared to 349 liver grafts from donors ≤40 y/o. Prior to PSM, the 5-year overall survival was 63% for the elderly group and 77% for the young group (p = 0.002). After PSM, the 5-year overall survival was 63% and 73% (p = 0.1). A nomogram, developed at the time of graft acceptance and including HCC features, predicted 10-year survival after LT using a graft from a donor aged ≥85. Conclusions: In the context of organ scarcity, elderly donors emerge as a partial solution. Nonetheless, without proper selection, LT using very elderly donors yields inferior long-term outcomes compared to transplantation from very young donors ≤40 y/o. The resulting nomogram based on pre-transplant criteria allows for the optimization of elderly donor/recipient matching to achieve satisfactory long-term results, in addition to traditional matching methods. Full article

POT1 (Protection of Telomeres 1) is a key component of the six-membered shelterin complex that plays a critical role in telomere protection and length regulation. Germline variants in the POT1 gene have been implicated in predisposition to cancer, primarily to melanoma and chronic lymphocytic leukemia (CLL). We report the identification of POT1 p.(I78T), previously ranked with conflicting interpretations of pathogenicity, as a founder pathogenic variant among Ashkenazi Jews (AJs) and describe its unique clinical landscape. A directed database search was conducted for individuals referred for genetic counselling from 2018 to 2023. Demographic, clinical, genetic, and pathological data were collected and analyzed. Eleven carriers, 25 to 67 years old, from ten apparently unrelated families were identified. Carriers had a total of 30 primary malignancies (range 1–6); nine carriers (82%) had recurrent melanoma between the ages of 25 and 63 years, three carriers (27%) had desmoid tumors, three (27%) had papillary thyroid cancer (PTC), and five women (63% of female carriers) had breast cancer between the ages of 44 and 67 years. Additional tumors included CLL; sarcomas; endocrine tumors; prostate, urinary, and colorectal cancers; and colonic polyps. A review of a local exome database yielded an allelic frequency of the variant of 0.06% among all ethnicities and of 0.25% in AJs. A shared haplotype was found in all carriers tested. POT1 p.(I78T) is a founder disease-causing variant associated with early-onset melanoma and additional various solid malignancies with a high tumor burden. We advocate testing for this variant in high-risk patients of AJ descent. The inclusion of POT1 in germline panels for various types of cancer is warranted. Full article

Taliglucerase alfa is an enzyme replacement therapy approved for Gaucher disease. We assessed the duration/compliance/safety of such home infusions in commercial use in four countries where home infusion programs are available. The treatment duration/compliance study included 173 patients (Israel, 58; US, 61; Brazil, 48; Australia, 6) who received ≥1 taliglucerase alfa home infusion through 6/2021. The median age at home therapy initiation was 38 (range, 2–87) years; 58% were females. The median treatment duration (at home) was 2.7 (range, 0.04–9.0) years. The annual compliance rate was stable (≥95%) throughout the study period. A search of the Pfizer global safety database (through 6/2021), identified 19 adverse events (AEs) as related to “definite home use” and 14 to “possible home use” of taliglucerase alfa; 42.4% of these AEs were serious; none were fatal. Twelve serious AEs in five separate case reports were considered treatment related: one case of chest discomfort/pain and hypertension and one case of erythema associated with a toe blister, for which causality could not be excluded; pain in extremity; projectile vomiting and chills, alongside excessive eye blinking; and an infusion-related AE (pruritus). In conclusion, this real-life global study demonstrated that taliglucerase alfa home infusions are safe with high compliance rates. Full article

Graphitic carbon nitride (gCN) materials have been shown to efficiently perform light-induced water splitting, carbon dioxide reduction, and environmental remediation in a cost-effective way. However, gCN suffers from rapid charge-carrier recombination, inefficient light absorption, and poor long-term stability which greatly hinders photocatalytic performance. To determine the underlying catalytic mechanisms and overall contributions that will improve performance, the electronic structure of gCN materials has been investigated using electron paramagnetic resonance (EPR) spectroscopy. Through lineshape analysis and relaxation behavior, evidence of two independent spin species were determined to be present in catalytically active gCN materials. These two contributions to the total lineshape respond independently to light exposure such that the previously established catalytically active spin system remains responsive while the newly observed, superimposed EPR signal is not increased during exposure to light. The time dependence of these two peaks present in gCN EPR spectra recorded sequentially in air over several months demonstrates a steady change in the electronic structure of the gCN framework over time. This light-independent, slowly evolving additional spin center is demonstrated to be the result of oxidative processes occurring as a result of exposure to the environment and is confirmed by forced oxidation experiments. This oxidized gCN exhibits lower H₂ production rates and indicates quenching of the overall gCN catalytic activity over longer reaction times. A general model for the newly generated spin centers is given and strategies for the alleviation of oxidative products within the gCN framework are discussed in the context of improving photocatalytic activity over extended durations as required for future functional photocatalytic device development. Full article

Hemodialysis patients are highly susceptible to poor nutritional status. Our objective was to investigate whether poor nutritional status during mRNA-SARS-CoV-2 vaccination is correlated with impaired vaccine responses. This retrospective study was conducted in two hospital-based dialysis units. The nutritional status of hemodialysis patients was assessed, using a malnutrition inflammation score (MIS) at the time of their first BNT162b2 vaccine dose. One month after the second vaccine dose, we performed a quantitative assessment of antibodies against the spike protein (anti-S1 IgG). A total of 115 hemodialysis patients, with an average age of 72 were enrolled in the study. Among them, 39 (33.9%) were female, and 67 (58.2%) had diabetes mellitus. In 43/115 (37.4%) patients, moderate to severe malnutrition (MIS > 5) was detected. Comparatively, malnourished patients showed a lower log-transformed mean level of anti-S1 IgG compared to those with normal nutrition (2.91 ± 0.83 vs. 3.25 ± 0.72, respectively, p = 0.024). In a multivariable analysis that adjusted for age, sex, and KT/V, the nutritional status assessed by an MIS remained inversely associated with an anti-S1 IgG response [B; −0.066 (−0.117 to −0.015)]. In conclusion, moderate to severe malnutrition in hemodialysis patients is associated with reduced humoral responses to BNT162b2 vaccination. Full article

COVID-19-related mortality among hematopoietic stem cell transplantation (HSCT) recipients in the pre-vaccine era ranged between 22 and 33%. The Pfizer/BioNTech BNT162b2 vaccine demonstrated significant immunogenicity and efficacy in the healthy population; however, its long-term effects on allogeneic HSCT recipients remained unclear. Our study longitudinally evaluated humoral and cellular responses to the BNT162b2 vaccine in adult allogeneic HSCT patients. A positive response was defined as antibody titers ≥ 150 AU/mL post-second vaccination. Among 77 included patients, 51 (66.2%) responded to vaccination. Response-associated factors were female gender, recent anti-CD20 therapy, and a longer interval between transplant and vaccination. Response rates reached 83.7% in patients vaccinated >12 months post-transplant. At 6 months post-second vaccination, antibody titers dropped, but were significantly increased with the booster dose. Moreover, 43% (6/14) of non-responders to the second vaccination acquired sufficient antibody titers after booster administration, resulting in an overall response rate of 79.5% for the entire cohort. The BNT162b2 vaccine was effective in allogeneic transplant recipients. Although antibody titers decreased with time, the third vaccination led to their significant elevation, with 93% of third-dose responders maintaining titers above 150 AU/mL at 3 months post-administration. Full article

Children with special needs may struggle to identify uncomfortable and unsafe situations. In this study, we aimed at developing an automated system that can detect such situations based on audio and text cues to encourage children’s safety and prevent situations of violence toward them. We composed a text and audio database with over 1891 sentences extracted from videos presenting real-world situations, and categorized them into three classes: neutral sentences, insulting sentences, and sentences indicating unsafe conditions. We compared insulting and unsafe sentence-detection abilities of various machine-learning methods. In particular, we found that a deep neural network that accepts the text embedding vectors of bidirectional encoder representations from transformers (BERT) and audio embedding vectors of Wav2Vec as input attains the highest accuracy in detecting unsafe and insulting situations. Our results indicate that it may be applicable to build an automated agent that can detect unsafe and unpleasant situations that children with special needs may encounter, given the dialogue contexts conducted with these children. Full article

As an alternative to fossil volatile hydrocarbon solvents used nowadays in perfumery, investigation on essential oil of Commiphora wildii Merxm. oleo gum resin as a source of heptane is reported here. Heptane, representing up to 30 wt-% of this oleo gum resin, was successfully isolated from the C. wildii essential oil, using an innovative double distillation process. Isolated heptane was then used as a solvent in order to extract some noble plants of perfumery. It was found that extracts obtained with this solvent were more promising in terms of sensory analysis than those obtained from fossil-based heptane. In addition, in order to valorize the essential oil depleted from heptane, chemical composition of this oil was found to obtain, and potential biological activity properties were studied. A total of 172 different compounds were identified by GC-MS in the remaining oil. In vitro tests—including hyaluronidase, tyrosinase, antioxidant, elastase and lipoxygenase, as well as inhibitory tests against two yeasts and 21 bacterial strains commonly found on the skin—were carried out. Overall, bioassays results suggest this heptane-depleted essential oil is a promising active ingredient for cosmetic applications. Full article

Cancer immunotherapy has now entered clinical practice and has reshaped the standard of care for many cancer patients. With these new strategies, specific toxicities have emerged, and renal side effects have been described. In this review, we will describe the causes of acute kidney injury in CAR T cell, immune checkpoint inhibitors and other cancer immuno-therapy recipients. CAR T cell therapy and bispecific T cell engaging antibodies can lead to acute kidney injury as a consequence of cytokine release syndrome, tumor lysis syndrome, sepsis or specific CAR T cell infiltration. Immune checkpoint blockade most often results in acute tubular interstitial nephritis, but glomerular diseases have also been described. Although the pathophysiology remains mostly elusive, we will describe the mechanisms of renal damage in these contexts, its prognosis and treatment. As the place of immunotherapy in the anti-cancer armamentarium is exponentially increasing, close collaboration between nephrologists and oncologists is of utmost importance to provide the best standard of care for these patients. Full article