Search Results (553)

Background/Objectives: Pulmonary diseases are common in patients with thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA). Although high prevalences of chronic obstructive pulmonary disease and lung cancer (LC) are known, the prevalence of these and other pulmonary diseases regarding their relation to the outcome of TAA and/or AAA are not determined. Methods: Pulmonary diseases present at aortic aneurysm (AA) diagnosis and follow-up periods and cause of death of 952 patients with TAA, AAA, or TAA + AAA (including thoracoabdominal AA) treated at our institution in Japan were retrospectively analyzed. Cox regression analysis was used to investigate potential risk factors of mortality. Results: The mean patient age was 72.4 years, and the median follow-up was 4.92 years. At diagnosis, 528 (55.5%) patients had pulmonary diseases, including emphysema without interstitial lung disease (ILD) or LC, LC, idiopathic pulmonary fibrosis (IPF) without LC, non-IPF ILD without LC, and interstitial lung abnormalities (ILAs) without LC in 250, 85, 65, 15, and 58 patients, respectively. During follow-up, LC and acute exacerbation (AE) of IPF developed in 50 and 12 patients, respectively. In 213 patients who died, there were 45 (21.1%) aortic disease-related deaths. Other causes of death included LC (27.7%), cardiovascular events (9.4%), pneumonia (5.6%), and interstitial lung disease (4.7%). In a multivariate Cox regression hazard model, age; larger maximum aneurysm diameter; and coexisting LC, IPF, or concomitant cancer were associated with poor prognosis. Conclusions: In patients with AA, not only age and aneurysm diameter but also coexisting LC and IPF were prognostic factors for mortality. Full article

Background: Exercise can be used as a model to understand immunometabolism. Biological data on elite athletes are limited, especially for female athletes, including relevant data on acute-phase proteins and amino acid metabolism. Methods: We analyzed acute-phase proteins and amino acids collected at South American, Pan-American, and Olympic Games for 16 Olympic sports. We compared female and male elite athletes (447 vs. 990 samples) across four states (fasting, pre-exercise, post-exercise, and resting) to understand sex-specific immunometabolic responses in elite athletes. Results: Considering all states and sports, we found that elite female athletes exhibited higher concentrations of C-reactive protein, lipopolysaccharide-binding protein, myeloperoxidase, haptoglobin, and IGF1, with ratios ranging from 1.2 to 2.0 (p < 0.001). Women exhibited lower concentrations of most amino acids, except for glutamate and alanine. Although almost 30% lower in women, branched-chain amino acids (BCAAs) showed a similar pattern in all states (ρ ≥ 0.9; p < 0.001), while aromatic amino acids (AAAs) showed higher consumption during exercise in women. Conclusion: We established sex dimorphism in elite athletes’ metabolic and inflammatory responses during training and competition. Our data suggest that female athletes present a lower amino acid response towards central fatigue development than male athletes. Understanding these differences can lead to insights into sex-related immuno-metabolic responses in sports or other inflammatory conditions. Full article

Banana fruits are rich in starch, and unripe banana flour is considered a beneficial ingredient in the food industry because it has high levels of resistant starch, which significantly aids in promoting gut health and regulating blood sugar and lipid levels. However, the associations between banana cultivars with various genotypes cultivated globally and their resistant starch properties remain unclear. Herein, we investigated resistant starches from 16 banana cultivars covering three genome groups (ABB, AAB, and AAA) in order to reveal the differences and similarities among these cultivars. The results showed that there was a genotype-specific pattern in banana resistant starch (BRS) degradation. The AAA genome BRS exhibited a high degree of resistant starch degradation. The genotypes of the banana cultivars also impacted the granular morphology of the resistant starch. The ABB and AAB genome BRS were more conducive to forming resistant starch. The BRS samples from the three genome groups displayed either B-type or C-type structures. Even within the same genome group, the BRS samples exhibited differences in thermal and pasting properties. These findings reveal the impact of genotypes on BRS content and characteristics, providing a basis for future breeding and resistant starch utilization. Full article

One of the main security challenges when federating separate Internet of Things (IoT) administrative domains is effective Identity and Access Management, which is required to establish trust and secure communication between federated IoT devices. The primary goal of the work is to develop a “lightweight” protocol to enable authentication and authorization of IoT devices in federated environments and ensure the secure communication of IoT devices. We propose a novel Lightweight Authentication and Authorization Framework for Federated IoT (LAAFFI) which takes advantage of the unique fingerprint of IoT devices based on their configuration and additional hardware modules, such as Physical Unclonable Function, to provide flexible authentication and authorization based on Distributed Ledger technology. Moreover, LAAFFI supports IoT devices with limited computing resources and devices not equipped with secure storage space. We implemented a prototype of LAAFFI and evaluated its performance in the Hyperledger Fabric-based IoT framework. Three main metrics were evaluated: latency, throughput (number of operations or transactions per second), and network resource utilization rate (transmission overhead introduced by the LAAFFI protocol). The performance tests conducted confirmed the high efficiency and suitability of the protocol for federated IoT environments. Also, all LAAFFI components are scalable as confirmed by tests. We formally evaluated LAAFFI security using Verifpal as a formal verification tool. Based on the models developed for Verifpal, we validated their security properties, such as message secrecy, authenticity, and freshness. Our results show that the proposed solution can improve the security of federated IoT environments while providing zero-day interoperability and high scalability. Compared to existing solutions, LAAFFI is more efficient due to the use of symmetric cryptography and algorithms adapted for operations involving IoT devices. LAAFFI supports multiple authorization mechanisms, and since it also offers authentication and accountability, it meets the requirements of Authentication, Authorization and Accounting (AAA). It uses Distributed Ledger (DL) and smart contracts to ensure that the request complies with the policies agreed between the organizations. LAAFFI offers authentication of devices belonging to a single organization and different organizations, with the assurance that the encryption key will be shared with another device only if the appropriate security policy is met. The proposed protocol is particularly useful for ensuring the security of federated IoT environments created ad hoc for special missions, e.g., operations conducted by NATO countries and disaster relief operations Humanitarian Assistance and Disaster Relief (HADR) involving military forces and civilian services, where immediate interoperability is required. Full article

Background/Objectives: Device selection during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) remains an important issue for ensuring endograft durability. This study evaluated the early and follow-up outcomes of elective EVAR with the Endurant platform. Methods: A single-center retrospective analysis was conducted including consecutive elective EVAR procedures with the Endurant II/IIs (2008 to 2024) device. Primary outcomes were technical success, mortality and major complications at 30 days. Survival, endoleak I/III and freedom from reintervention were secondary outcomes. Cox proportional hazards models were employed for risk-adjusted follow-up outcomes. Results: In total, 361 patients were included (72.7 ± 7 years; 96% males; mean AAA diameter 62 ± 14 mm); 92% received a bifurcated device, and 89% conformed to the instructions for use. Technical success was 99.7%. Intra-operative adjunctive procedures included 4.4% proximal cuffs and 1.7% endoanchors. The thirty-day mortality rate was 0.6%, and the major complication rate was 4.1%. Survival was 81% (SE 4.8%), 72% (SE 6.4%) and 52% (SE 9.2%) at 4, 6 and 8 years, with aneurysm-related mortality at 1.7%. Freedom from endoleak Ia was 76% (SE 7.3%) at 6 years, freedom from endoleak Ib was 79% (SE 7.4%) at 7 years and freedom from endoleak III was 94% (SE 3.7%) at 5 years. Freedom from reintervention was 71% (SE 6.1%) and 55% (SE 7.9%) at 5 and 7 years, respectively. No device-related co-factor affected long-term outcomes. Conclusions: Endurant II/IIs endograft is a safe and effective EVAR solution with excellent early outcomes and low long-term aneurysm-related mortality. The need for reintervention in the long term affected less than 50% of cases. Full article

Background: Performing percutaneous coronary intervention (PCI) and endovascular aneurysm repair (EVAR) at the same time represents a groundbreaking development in the multidisciplinary treatment of cardiovascular disease. This combined PCI–EVAR approach bridges a critical gap by offering treatment for patients who have both coronary artery disease and aortic aneurysms. This innovative strategy exemplifies the evolving landscape of cardiovascular care, providing a new solution for complex clinical situations that previously required separate procedures. Methods: Six patients with critical coronary artery lesions and asymptomatic infrarenal aortic aneurysms (AAAs) ≥ 6 cm diameter, as well as one patient with critical coronary artery lesions and endoleak type 1A with aneurysms ≥ 6 cm, underwent simultaneous coronary artery revascularization through percutaneous intervention (PCI) and endovascular aneurysm repair (EVAR). The occurrence of any intraoperative or postoperative complication was considered to be the primary endpoint of the study, including the abortion or failure of either PCI or EVAR, bleeding requiring a conversion to open surgical procedures, the failure of local anesthesia, postoperative myocardial or lower limb ischemia, and a postoperative serum creatinine level of >125 mmol/L or of >180 mmol/L in patients affected by chronic renal failure. The overall length of the procedure, X-ray exposure, the quantity of iodine contrast medium administered, and the length of recovery were considered to be secondary endpoints. Results: Postoperative complications included two episodes of acute renal failure in the two patients already affected by chronic renal failure, which were easily resolved with adequate daily hydration and the elimination of nephrotoxic drugs. In no cases did cardiac ischemia or lower limb ischemia occur. The average procedure duration was 198 min (range: 180–240 min), the average fluoroscopy duration was 41.7 min (range: 35–50 min), the average amount of iodinated contrast medium was 34.8 mL (range: 30–40 mL), and the mean length of hospitalization was 2.7 days (range: 2–5 days). Conclusions: In selected patients, this surgical approach has demonstrated safety, reduced hospitalization times, minimized risks associated with complications from the untreated condition if procedures were performed at different times, and facilitated the effective management of intraoperative complications due to the presence of a multidisciplinary team. However, the limited number of patients necessitates further research. Full article

We isolated a stress-tolerance-related gene from a genome library of Synechococcus sp. NKBG15041c. The expression of the gene in E. coli confers resistance against various stresses. The gene encodes a MoxR AAA+ ATPase, which was designated SyMRP since it belongs to the MRP subfamily. The recombinant SyMRP showed weak ATPase activity and protected citrate synthase from thermal aggregation. Interestingly, the chaperone activity of SyMRP is ATP-dependent. SyMRP exists as a stable hexamer, and ATP-dependent conformation changes were not detected via analytical ultracentrifugation (AUC) or small-angle X-ray scattering (SAXS). Although the hexameric structure predicted by AlphaFold 3 was the canonical flat-ring structure, the structures observed by atomic force microscopy (AFM) and transmission electron microscopy (TEM) were not the canonical ring structure. In addition, the experimental SAXS profiles did not show a peak that should exist in the symmetric-ring structure. Therefore, SyMRP seems to form a hexameric structure different from the canonical hexameric structure of AAA+ ATPase. Full article

Background/Objectives: In recent years, manufacturers have developed new low-profile stent grafts to allow endovascular treatment of abdominal aortic aneurysms (AAA) in patients with small access vessels. We evaluated the early and mid-term outcomes of the Incraft (Cordis Corp, Bridgewater, NJ, USA) ultra-low profile endograft implantation in a high-volume single center. Methods: Between 2014 and 2023, 133 consecutive endovascular aneurysm repair (EVAR) procedures performed using the Incraft endograft were recorded in a prospective database. Indications included infrarenal aortic aneurysms, common iliac aneurysms, and infrarenal penetrating aortic ulcers. Mid-term results were analyzed using the Kaplan–Meier method. Results: During the study period, 133 patients were treated with the Cordis Incraft endograft, in both elective and urgent settings. The Incraft graft was the first choice for patients with hostile iliac accesses, a feature characterizing at least one side in 90.2% of the patients in the study cohort. The immediate technical success rate was 78.2%. The intraoperative endoleak rate was 51.9% (20.3% type 1 A, 0.8% type 1 B, and 30.8% type 2 endoleak). Within 30 days, technical and clinical success rates were both 99.3%; all type 1A and 1B endoleaks were resolved at the 30-day follow-up CT-angiogram. After a mean follow-up of 35.4 months, the actuarial freedom from the re-intervention rate was 96.0%, 91.1%, and 84.0% at 1, 3, and 5 years, respectively. The iliac leg patency rate was 97.1%, 94.1%, and 93.1% at 1, 3, and 5 years, respectively. No statistically significant differences were observed between hostile and non-hostile access groups, nor between the groups with grade 1, grade 2, and grade 3 access hostility. Conclusions: The ultra-low profile Cordis Incraft endograft represents a valid option for the endovascular treatment of AAA in patients with hostile iliac accesses. The procedure can be performed with high rates of technical and clinical success at 30 days and the rates of iliac branch occlusion observed during the follow-up period appear acceptable in patients with poor aorto-iliac outflow. Full article

Depression is a prevalent and debilitating mental disorder that affects millions worldwide. Current treatments, such as antidepressants targeting the serotonergic system, have limitations, including delayed onset of action and high rates of treatment resistance, necessitating novel therapeutic strategies. Ginsenoside Rc (G-Rc) has shown potential anti-inflammatory and neuroprotective effects, but its antidepressant properties remain unexplored. This study investigated the antidepressant effects of G-Rc in an L-alpha-aminoadipic acid (L-AAA)-induced mouse model of depression, which mimics the astrocytic pathology and neuroinflammation observed in major depressive disorder. Mice were administered G-Rc, vehicle, or imipramine orally after L-AAA injection into the prefrontal cortex. G-Rc significantly reduced the immobility time in forced swimming and tail suspension tests compared to vehicle treatment, with more pronounced effects than imipramine. It also attenuated the expression of pro-inflammatory cytokines (TNF-α, IL-6, TGF-β, lipocalin-2) and alleviated astrocytic degeneration, as indicated by increased GFAP and decreased IBA-1 levels. Additionally, G-Rc modulated apoptosis-related proteins, decreasing caspase-3 and increasing Bcl-2 levels compared to the L-AAA-treated group. These findings suggest that G-Rc exerts antidepressant effects by regulating neuroinflammation, astrocyte–microglia crosstalk, and apoptotic pathways in the prefrontal cortex, highlighting its potential as a novel therapeutic agent for depression. Full article

Background: Endovascular aortic aneurysm repair (EVAR) represents a valid treatment modality for ruptured abdominal aortic aneurysms (rAAAs). This study aimed to present rAAA outcomes treated by EVAR using the Endurant endograft. Methods: A single-center retrospective analysis of consecutive patients treated with standard EVAR (sEVAR) or parallel graft (PG)-EVAR for infra- or juxta/para-renal rAAA using the Endurant endograft (1 January 2008–31 December 2023) was undertaken. The primary outcomes were technical success, mortality, and reintervention. Follow-up outcomes, including survival and freedom from reintervention, were assessed using Kaplan–Meier estimates. Results: Eighty-eight patients were included (87.5% sEVAR and 12.5% PG-EVAR). The mean aneurysm diameter was 73.3 ± 19.3 mm (71.4 ± 22.2 mm sEVAR and 81.7 ± 33.0 mm PG-EVAR). Among 77 patients receiving sEVAR, 26 (33.8%) received an aorto-uni-iliac device. All PG-EVAR patients were managed with bifurcated devices, one receiving a single PG, seven double PGS, and three triple PGs. Technical success was 98.8% (100.0% sEVAR and 90.9% PG-EVAR). The 30-day mortality was 47.2% (50.7% sEVAR and 27.3% PG-EVAR), with nine (10.2%) deaths recorded on the table. The mean time of follow-up was 13 ± 9 months. After excluding 30-day deaths, the estimated survival was 75.5% (standard error (SE) 6.9%) at 24 months. The estimated freedom from reintervention was 89.7% (SE 5.7%) at 24 months. Only one endoleak type Ia event was recorded during follow-up. Conclusions: Endurant showed high technical success rates and low rates of endoleak type Ia events and reinterventions, despite the emergent setting of repair. rAAA is still a highly fatal condition within 30 days, with an acceptable mid-term survival of 30-day survivors at 75.5%. Full article

Endovascular aneurysm repair (EVAR) has become the preferred approach over open repair for abdominal aortic aneurysms (AAAs) due to its minimally invasive nature. The common femoral artery (CFA) is the main access vessel for EVAR, with both surgical exposure and percutaneous access being utilized. However, in emergent cases, percutaneous access can be challenging and may result in complications such as bleeding or dissection thrombosis, leading to the need for surgical conversion. This study aimed to share experiences in implementing a decision-making algorithm to reduce surgical conversions due to percutaneous access failures. A total of 74 aortic patients treated with EVAR in emergency settings were included in this retrospective study. This study focused on various outcomes such as perioperative mortality, morbidity, procedure time, surgical exposure time, and surgical conversion rate. After the implementation of the decision-making algorithm, decreases in surgical conversions and operating time were observed. Percutaneous access was found to be more challenging in cases with specific anatomical characteristics of the CFA, such as severe atherosclerosis or smaller vessel diameter. This study highlighted the importance of carefully assessing patient anatomical features and utilizing a decision-making algorithm to optimize outcomes in EVAR procedures. Further research is needed to continue improving practices for managing aortic aneurysms and reducing complications in femoral artery access approaches. Full article

After the 2007 financial crisis, many central banks adopted policies to lower their interest rates; the dynamics of these rates cannot be captured using classical models. Recently, Meucci and Loregian proposed an approach to estimate nonnegative interest rates using the inverse-call transformation. Despite the fact that their work is distinguished from others in the literature by their consideration of practical aspects, some technical difficulties still remain, such as the lack of analytic expression for the zero-coupon bond (ZCB) price. In this work, we propose novel approximate closed-form solutions for the ZCB price in the zero lower bound (ZLB) framework, when the underlying shadow rate is assumed to follow the classical one-factor Vasicek model. Then, a filtering procedure is performed using the Unscented Kalman Filter (UKF) to estimate the unobservable state variable (the shadow rate), and the model calibration is proceeded by estimating the model parameters using the Particle Swarm Optimization (PSO) algorithm. Further, empirical illustrations are given and discussed using (as input data) the interest rates of the AAA-rated bonds compiled by the European Central Bank ranging from 6 September 2004 to 21 June 2012 (a period that concerns the ZLB framework). Our approximate closed-form solution is able to show a good match between the actual and estimated yield-rate values for short and medium time-to-maturity values, whereas, for long time-to-maturity values, it is able to estimate the trend of the yield rates. Full article

The conventional average acceleration approach relies on K-band range observation, containing an unknown bias, which leads to possible degradation of the precision of Earth’s gravity field modelling. It also suffers from correlated errors caused by three-point numerical differentiation. In this study, an improved approach is proposed that makes use of K-band range-rate observations instead and overcoming the influence of correlated errors by introducing a whitening filter. GRACE-Follow On data spanning the period from January 2019 to December 2022 were processed by the proposed approach and a series of time-varying gravity field models was derived, referred to as SSM-AAA-GFO in this paper. This model series is compared comprehensively with three official model series. Results demonstrate that all model series are highly coincident below degree 30 and reflect similar time-varying gravity field signals in both large and small basins. After filtering, SSM-AAA-GFO shows uncertainty, in the form of equivalent water height below 2.5 cm, which is comparable with three official model series. The comparison results confirm the effectiveness of the proposed approach for precisely modelling a time-varying gravity field based on K-band range-rate observations. Full article

The objective of this study was to identify differentially expressed genes and their potential influence on the carcinogenesis of serous-type ovarian cancer tumors. Serous cancer is an epithelial ovarian cancer subtype and is the most common type of ovarian cancer. Transcriptomic profiles of serous cancer and non-cancerous datasets were obtained from the Gene Expression Omnibus (GEO-NCBI). Differentially expressed genes were then derived from those profiles; the identified genes were consistently upregulated in three or more transcriptomic profiles. These genes were considered as the serous ovarian cancer gene set for further study. The serous gene set derived from the transcriptomic profiles was then evaluated for ontological functional analysis using the Molecular Signatures Database. Next, we examined the mutational impact of this serous gene set on the transcriptomic profile of high-grade serous ovarian (HGSO) adenocarcinoma using the cBioPortal database. Results from OncoPrint revealed that 26 genes were amplified in more than 5% of HGSO cancer patients. Interestingly, several of these genes are involved in cell cycle processes, including genes ATPase family AAA domain containing 2 (ATAD2), recQ-like helicase 4 (RECQL4), cyclin E1 (CCNE1), anti-silencing function 1B histone chaperone (ASF1B), ribonuclease H2 subunit A (RNASEH2A), structural maintenance of chromosome 4 (SMC4), cell division cycle associated 20 (CDC20), and cell division cycle associated 8 (CDCA8). The receiver operating characteristic (ROC) curve results also revealed higher specificity and sensitivity for this subtype of tumors. Furthermore, these genes may affect the recurrence of serous ovarian carcinogenesis. Overall, our analytical study identifies cell cycle-related genes that can potentially be targeted as diagnostic and prognostic markers for serous ovarian cancer. Full article

Objective: To evaluate how access to an office-based laboratory (OBL) and ambulatory surgery center (ASC) impacted vascular care during the Coronavirus Disease 2019 (COVID-19) pandemic. Methods: Vascular procedures performed by our group during the 6-week period before COVID-19 restrictions (group 1) and in the first 6-week period during the COVID-19 restrictions (group 2) were reviewed. The number of procedures performed was categorized as hospital inpatient (HIP), hospital outpatient (HOP), OBL, ASC, and vein center (VC). The procedures were also grouped by type: aneurysm (AAA), carotid (CAR), peripheral arterial disease (PAD), amputation/wound care (AMP), vascular access (VA), deep vein thrombosis (DVT), and venous reflux (CVI). The number of healthcare provider contact points for each patient undergoing care at the HOP, OBL, and ASC were also collected and compared between groups 1 and 2. Differences between groups were determined using the two-way ANOVA. Results: There were no statistically significant differences between groups 1 and 2 for procedure location or type of procedure (p > 0.05). Patient contact with healthcare providers decreased between groups 1 and 2 for ambulatory care. However, projecting the number of contacts for patients in group 2 if they had to have ambulatory care in the HOP setting (913) compared to contacts in the OBL and ASC setting (588) was statistically significant (p < 0.05). No patient or staff member at the OBL or ASC developed COVID-19 infection because of the care received at these venues. Conclusions: The ability to provide essential care for patients in an ambulatory environment was enhanced using our OBL and ASC without compromising safety, efficacy, or transmission of the virus to patients or staff during the height of the COVID-19 pandemic and limited their contact with healthcare workers and therefore reduced the consumption of personal protective equipment by healthcare personnel. Full article