13 research outputs found
Total regression of hepatocellular carcinoma bone metastases, after liver transplantation, with sorafenib-everolimus
No full textHepatocellular carcinoma (HCC) represents the 5th commonest malignancy worldwide. Liver transplantation consist a radical and most efficient treatment for HCC. Tumor recurrence or metastases after liver transplantation is not uncommon. Hereby is presented a case of a patient transplanted for alcoholic liver disease and HCC and presented with bone metastases a few months later. Treatment with sorafenib and everolimus showed full regression of the metastases. In conclusion, the point of this report is to advertise a single case of total regression of bone lesions due to HCC recurrence, with the combination of mammalian target of rapamycin and sorafenib, along with radiation
Total regression of hepatocellular carcinoma bone metastases, after liver transplantation, with sorafenib-everolimus
No full textA meta-analysis of the impacts of operating in-vehicle information systems on road safety
No full textThis study aims to estimate the overall impact of distraction due to operating in-vehicle information systems (IVIS) and similar devices while driving on road crashes. While similar research has been undertaken investigating the issue, varying results have been reported so far. Therefore a two-step approach was adopted: initially a review of the literature was conducted to identify key high quality studies and the parameters that they examined. Afterwards, meta-analyses were applied in order to estimate the overall effects of operating IVIS while driving on the absolute proportion of crashes (i.e. the proportion of total crashes due to IVIS). After applying a random effects meta-analysis to the findings of existing studies, it was found that 1.66% of crashes occur due to operating devices in total. In addition, it is indicated that about 0.6% of safety-critical incidents for professional drivers are due to in-vehicle device operation. The odds of crashes influenced by IVIS operation were also estimated and were found to be very low. From the findings of the present review and the meta-analysis, it is suggested that device operation as a risk factor while driving is a less researched aspect of driver distraction than others, and more studies would improve result estimates and transferability, especially for professional drivers. This study summarizes concisely the current effect of driver interaction with in-vehicle information systems on crashes, which might become considerably pertinent in view of the increasing deployment of vehicles with increasing levels of automation.Safety and Security Scienc
Dynamic Response Of Two Interacting Extensible Barsin Frictional Contact
No full textIn this paper, a new model is developed to describe the nonlinear dynamics of twoaxially deformable bars sliding relative to each other in which the interaction is governed byfriction. The first bar is fixed at one end and is subjected to a distributed normal force perpen-dicular to its axis to activate friction at the common interface, while the second bar is allowed toslide relative to the fixed one. A semi-analytical solution method is developed in which only thenonlinear interaction is addressed numerically. The dynamic behaviour of the bars is expressedas a summation of vibration modes including the necessary rigid body mode to allow for thepermanent sliding of one bar relative to the other. This results in a computationally efficientscheme without compromising the accuracy of the solutions. The developed model can be usedin pile driveability studies. In this case the fixed bar resembles the soil column while the secondbar describes the dynamics of the driven pile.Offshore EngineeringDynamics of StructuresEngineering Structure
Review and ranking of crash risk factors related to the road infrastructure
No full textThe objective of this paper is the review and comparative assessment of infrastructure related crash risk factors, with the explicit purpose of ranking them based on how detrimental they are towards road safety (i.e. crash risk, frequency and severity). This analysis was carried out within the SafetyCube project, which aimed to identify and quantify the effects of risk factors and measures related to behaviour, infrastructure or vehicles, and integrate the results in an innovative road safety Decision Support System (DSS). The evaluation was conducted by examining studies from the existing literature. These were selected and analysed using a specifically designed common methodology. Infrastructure risk factors were structured in a hierarchical taxonomy of 10 areas with several risk factors in each area (59 specific risk factors in total), examples include: alignment features (e.g. horizontal-vertical alignment deficiencies), cross-section characteristics (e.g. superelevation, lanes, median and shoulder deficiencies), road surface deficiencies, workzones, junction deficiencies (interchange and at-grade) etc. Consultation with infrastructure stakeholders (international organisations, road authorities, etc.) took place in dedicated workshops to identify user needs for the DSS, as well as “hot topics” of particular importance. The following analysis methodology was applied to each infrastructure risk factor: (i) A search for relevant international literature, (ii) Selection of studies on the basis of rigorous criteria, (iii) Analysis of studies in terms of design, methods and limitations, (iv) Synthesis of findings - and meta-analysis, when feasible. In total 243 recent and high quality studies were selected and analysed. Synthesis of results was made through 39 ‘Synopses’ (including 4 original meta-analyses) on individual risk factors or groups of risk factors. This allowed the ranking of infrastructure risk factors into three groups: risky (11 risk factors), probably risky (18 risk factors), and unclear (7 risk factors).Safety and Security Scienc
Installation of large-diameter monopiles: Introducing wave dispersion and non-local soil reaction
No full textDuring the last decade the offshore wind industry grew ceaselessly and engineering challenges continuously arose in that area. Installation of foundation piles, known as monopiles, is one of the most critical phases in the construction of offshore wind farms. Prior to installation a drivability study is performed, by means of pile driving models. Since the latter have been developed for small-diameter piles, their applicability for the analysis of large-diameter monopiles is questionable. In this paper, a three-dimensional axisymmetric pile driving model with non-local soil reaction is presented. This new model aims to capture properly the propagation of elastic waves excited by impact piling and address non-local soil reaction. These effects are not addressed in the available approaches to predict drivability and are deemed critical for large-diameter monopiles. Predictions of the new model are compared to those of a one-dimensional model typically used nowadays. A numerical study is performed to showcase the disparities between the two models, stemming from the effect of wave dispersion and non-local soil reaction. The findings of this numerical study affirmed the significance of both mechanisms and the need for further developments in drivability modeling, notably for large-diameter monopiles.Dynamics of StructuresOffshore Engineerin
Targeting hepatocarcinogenesis model in C56BL6 mice with pan-aurora kinase inhibitor Danusertib
No full textConduction system pacing in heart failure: Time for a paradigm shift?
No full textHeart failure (HF) is a major clinical challenge characterized by significant morbidity and mortality. Electrical conduction abnormalities play a critical role in HF pathophysiology and progression, often leading to suboptimal outcomes with conventional pacing techniques. Con-duction system pacing (CSP), encompassing His bundle pacing and left bundle branch area pacing, has emerged as a novel approach. Despite data come from observational studies, recent guidelines recommend that a specific population may benefit from CSP. However, significant practical considerations and challenges need to be clarified before CSP can be routinely implemented in clinical practice. The reliance on observational studies means that long-term clinical outcomes for HF patients remain uncertain until data from randomized controlled trials (RCTs) become available. Current CSP practices face challenges with lead implantation, mechanical stress on leads, and the need for more advanced tools and artificial intelligence integration to improve procedure efficacy and safety. Future large-scale RCTs are essential to identify optimal candidates and address these technical challenges, potentially leading to a paradigm shift in HF management. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024
Highly Robust Double Memristive Device Based on Perovskite/Molybdenum Oxide-Sulfide Compound Heterojunction System
No full textHalide organic–inorganic perovskites (HOIPs) are a promising class of materials for neuromorphic computing and processing systems demonstrating a variety of resistive switching (RS) mechanisms. HOIPs have been used as active layers in two- and three-terminal synaptic devices reporting high performance in metrics of speed and energy consumption. Nevertheless, halide perovskites suffer from poor ambient stability and reproducibility. In this work, a highly robust double memristor based on two active layers forming a stacking heterojunction is demonstrated. In particular, the functional layer consists of a molybdenum oxide-molybdenum sulfide compound (MoO3-MoS2) and a quadruple cation perovskite (RbCsMAFA) deposited on top showing favorable band alignment for the specific application. The double memristor based on the MoO3-MoS2/RbCsMAFA heterojunction exhibits impressive and stable resistive switching behavior with endurance of 100 cycles, high retention of 2 × 104 s, high environmental stability maintaining its memristive behavior for 1 month, and excellent artificial synaptic functions. The robust device also exhibits good thermal stability maintaining the memristive characteristics at 85 °C, as well as good photonic memristive behavior with an improved ON/OFF ratio under constant illumination. Here it is proven that the proposed double memristor is a promising candidate for artificial synapses and neuromorphic computing systems. © 2025 The Author(s). Advanced Electronic Materials published by Wiley-VCH GmbH
Major clinical outcomes in symptomatic vs. asymptomatic atrial fibrillation: a meta-analysis
No full textBackground and Current guidelines suggest that asymptomatic atrial fibrillation (AF) is independently associated with increased risks of stroke Aims and mortality compared with symptomatic AF. Considering that recent investigations have provided conflicting results, the present study aimed to evaluate the association between symptom status and clinical outcomes in patients with AF. Methods Medline, Cochrane Library, and Scopus were searched until 25 March 2024. Triple-independent study selection, data extraction and quality assessment were performed. Evidence was pooled using random-effects meta-analyses. Results Thirty-six studies (217 850 participants) were included. Based on the frequentist analysis, symptomatic individuals had no significant difference in the risk of all-cause mortality [hazard ratio (HR) .97, 95% confidence interval (CI) .80–1.17], cardiovascular mortality (HR 1.04, 95% CI .72–1.49), thromboembolism (HR 1.06, 95% CI .87–1.28), stroke (HR 1.06, 95% CI .84–1.34), hospitalization (HR 1.34, 95% CI .89–2.02), and myocardial infarction (HR .98, 95% CI .70–1.36), compared to the asymptomatic group. Symptomatic patients had a 33% increased risk of new-onset heart failure (HR 1.33, 95% CI 1.19–1.49) and a 30% lower risk of progression to permanent AF (HR .70, 95% CI .54–.89). The Bayesian analysis yielded comparable results, yet the association between symptom status and new-onset heart failure was not significant (HR 1.27, 95% credible interval .76–1.93; Bayes factor = 1.2). Symptomatic patients had higher odds of receiving antiarrhythmic drugs (odds ratio [OR] 1.64, 95% CI 1.33–2.03) and ablation therapy (OR 1.47, 95% CI 1.06–2.05) compared to asymptomatic cases. Conclusions The risk of major clinical outcomes did not differ between individuals with and without AF-related symptoms. Asymptomatic patients had a greater hazard of progression to permanent AF. © The Author(s) 2024
