Supplementary Table 2. Representativeness of Study Participants

The electromagnetic properties and microwave absorption capabilities of mono- and bilayer composite samples, comprising a polymeric matrix and a magnetic powder filler (either metallic or ceramic), are evaluated in an anechoic chamber under realistic radar conditions. The study examines the influence of the filler type and the filling factor on performance. The findings reveal exceptional broadband microwave absorption, positioning these materials as prime candidates for stealth technology applications. Experimentally, absorption levels reach up to -40 dB, while predictive modeling indicates the potential to surpass -50 dB. The experimental results align closely with model predictions for both single-layer and bilayer systems, underscoring their reliability and effectiveness.

Supplementary Table 3. Genetic variant detected in the custom gene panel through whole exome sequencing.

Supplementary Table 4. Preclinical model recommendation

PURPOSE:Pancreatic ductal adenocarcinoma (PDAC) has limited treatment options. We compared the efficacy of comprehensive precision medicine against that of the conventional treatment in PDAC. PATIENTS AND METHODS:We report a phase III trial of advanced PDAC in which patients were randomized (1:2) to a conventional treatment treated at physician's discretion (arm A) or to precision medicine (arm B). Subjects randomized to arm B underwent a tumor biopsy for whole-exome sequencing and to generate avatar mouse models and patient-derived organoids for phenotypic drug screening, with final treatment recommended by the molecular tumor board. The primary objective was median overall survival (OS). RESULTS:A total of 137 patients were enrolled with 125 randomized, 44 to arm A and 81 to arm B. Whole-exome sequencing was performed in 80.3% (65/81) patients of arm B, with potentially actionable mutations detected in 21.5% (14/65). Experimental models were generated in 16/81 patients (19.8%). Second-line treatment was administered to 39 patients in the experimental arm, but only four (10.2%) received personalized treatment, whereas 35 could not receive matched therapy because of rapid clinical deterioration, delays in obtaining study results, or the absence of actionable targets. The median OS was 8.7 and 8.6 months (P = 0.849) and the median progression-free survival was 3.8 and 4.3 months (P = 0.563) for the conventional and experimental arms, respectively. Notably, the four patients who received personalized treatment had a median OS of 19.3 months. CONCLUSIONS:Personalized medicine was challenging to implement in most patients with PDAC, limiting the interpretation of intention-to-treat analysis. Survival was improved in the subset of patients who did receive matched therapy.

Supplementary Table 5. Complete Efficacy Data

Supplementary Table 1. Custom virtual gene panel included in the whole exome sequencing analysis

Thrombotic thrombocytopenic purpura (TTP) is a low prevalence disease characterized by severe deficiency of the enzyme ADAMTS13, leading to the development of thrombotic microangiopathy (TMA) and often resulting in severe organ disfunction. TTP is an extremely serious condition and, therefore, timely and appropriate treatment is critical to prevent life-threatening complications.Over the past 25 years, significant advances in the understanding of the pathophysiology of immune TTP have led to the development of readily available techniques for measuring ADAMTS13 levels, as well as new drugs that are particularly effective in the acute phase and in preventing relapses. These developments have improved the course of the disease.Given the complexity of the disease and its various clinical and laboratory manifestations, early diagnosis and treatment can be challenging.To address this challenge, a group of experienced professionals from the Catalan TTP group have developed this consensus statement to standardize terminology, diagnosis, treatment and follow up for immune TTP, based on currently available scientific evidence in the field. This guidance document aims to provide healthcare professionals with a comprehensive tool to make more accurate and timely diagnosis of TTP and improve patient outcomes.

Introduction: Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder that significantly affects patient’s quality of life. It is characterized by a complex interplay of physical symptoms and psychological stress, with notable impact on daily function. Cognitive Behavioral Therapy (CBT) has emerged as a promising intervention, targeting the psychological aspects of IBS to manage symptoms and improve life quality. Recognizing its potential and effectiveness as a treatment modality, considering the varied presentations of IBS across different populations. Objective: To evaluate the effectiveness of CBT in the management of IBS symptoms among adults, focusing on the reduction of symptom severity, improvement in quality of life, and decrease in associated psychological distress. Methods: This Scoping Review adopted an exhaustive search strategy across both published and unpublished literature. It began with an initial focus on databases such as PubMed, followed by a broader search across EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, LiLACS (BVS), PsycArticles (PsycNet), and ProQuest. Results: All 21 selected studies demonstrated that CBT had a positive impact on reducing abdominal pain and frequency in patients with IBS. Additionally, four studies directly assessed quality of life, showing significant improvements in this aspect. Conclusion: The reviewed literature highlights the significant role of CBT in IBS. CBT has been shown to improve gastrointestinal symptoms, reduce psychological distress and improve quality of life. It enhances self-efficacy and coping mechanisms by addressing cognitive distortions. Studies confirm that CBT leads to better clinical outcomes compared to educational support, with neurobiological findings showing reduced limbic activity, linked to decreased anxiety and symptoms. However, access to CBT remains limited, underscoring the need to address these barriers in standard IBS care.

We have read with great interest the article published previously by Peng et al (1) about the use of Optic Nerve Sheath Diameter (ONSD) to predict the occurrence of postdural puncture headache (PDPH). This condition remains hard to diagnose and may be very harmful for young patients in the obstetrical context. The authors should be warmly congratulated for their follow-up of a fair number of patients, which allows the identification of risk factor of PDPH. However, we believe that their results raise questions and we would like to underline 2 points. Firstly, the smallest values of ONSD observed by the authors at T1 and T2 are very low, with a mean value of 3.7 and 3.5 mm at T1 and T2, respectively. We believe that such low values of ONSD could be questioned because (i) the normal ONSD values assessed by computed tomography-scan 3 mm from the optic globe were: 4.94 ± 1.51/5.17 ± 1.34 mm for right/left ONSD, respectively (2); (ii) and in the context of obstetrical PDPH, the ceredrospinal fluid leakage is very acute and it would be surprising that the value of the ONSD decreased to approach the size of the optic nerve itself (3). Takeuchi et al (4) did find such low values of ONSD, but in patients with spontaneous intracranial hypotension, a condition evolving over months if not years, before being diagnosed. Secondly, we acknowledge that when we performed a similar study in 2011, we have not been able to identify criteria to predict the occurrence of PDPH, maybe because of the small size of our cohort (10 patients with PDPH) (5). But we identified a fact that may be of interest to the authors and that they should consider adding in their next project: the assessment of the success of the treatment. Indeed, we demonstrated that in the 9 patients with a successful epidural blood patch (EBP), the ONSD remains above 5 mm even 20 hours after the procedure contrary to one patient with a failed EBP in whom the ONSD decreased below 5 mm at 20 hours. By adding this simple measurement, the day after performing the EBP, we are able to identify patients who will need additional treatment. We think that this specific evaluation could interestingly be added to a next study and in the meantime should be used to the benefits of our patients.

The automation of railroad operations is a rapidly growing industry. In 2023, a new European standard for the automated Grade of Automation (GoA) 2 over European Train Control System (ETCS) driving is anticipated. Meanwhile, railway stakeholders are already planning their research initiatives for driverless and unattended autonomous driving systems. As a result, the industry is particularly active in research regarding perception technologies based on Computer Vision (CV) and Artificial Intelligence (AI), with outstanding results at the application level. However, executing high-performance and safety-critical applications on embedded systems and in real-time is a challenge. There are not many commercially available solutions, since High-Performance Computing (HPC) platforms are typically seen as being beyond the business of safety-critical systems. This work proposes a novel safety-critical and high-performance computing platform for CV- and AI-enhanced technology execution used for automatic accurate stopping and safe passenger transfer railway functionalities. The resulting computing platform is compatible with the majority of widely-used AI inference methodologies, AI model architectures, and AI model formats thanks to its design, which enables process separation, redundant execution, and HW acceleration in a transparent manner. The proposed technology increases the portability of railway applications into embedded systems, isolates crucial operations, and effectively and securely maintains system resources.

Background and Objectives: Autologous stem cell transplant (ASCT) is a widely used therapy for lymphoma patients and can nowadays be performed on an outpatient basis. This study aimed to describe transfusion support in lymphoma patients undergoing ASCT and identify increased or prolonged transfusion requirement predictors. Materials and Methods: A retrospective study of all consecutive lymphoma patients undergoing ASCT between 2010 and 2020. Results: Out of 226 patients, 145 (64%) received red blood cell (RBC) transfusions, whereas all 226 (100%) required platelet transfusion (PT). Transfusions between Day + 1 and +30 were higher in patients over 60 ( 2 [1-4] vs. 2 [0-2] RBC; p = 0.001 and 4 [2-8] vs. 3 [2-4] PT; p < 0.001); patients with pre-transplant anaemia ( 4 [2.5-6] vs. 2 [0-2] RBC; p < 0.001 and 5 [3-9] vs. 3 [ 2-4] PT; p = 0.001); pre-transplant thrombocytopenia (2 [1- 4] vs. 2 [0-2] RBC; p < 0.001 and 4 [3-8.5] vs. 2 [1-3] PT; p < 0.001) or CD34(+) cell dose <4 x 10(6)/kg (2 [0-4] vs. 2 [0-2] RBC; p = 0.024 and 4 [2-6] vs. 2 [ 1-3.5] PT; p < 0.001). RBC transfusion independence was reached later in patients receiving carmustine, cytarabine, etoposide and melphalan (BEAM) (hazard ratio [HR] 1.6; confidence interval [CI] 1.1-2.3) and those requiring RBC before infusion and/or with pre-transplant anaemia (HR 2.2; CI 1.4-3.4). Age above 60 (HR 1.4; CI 1.0-1.9), BEAM conditioning (HR 1.4; CI 1.0 - 2.0) and pre-transplant thrombocytopenia and/or requiring PT before infusion (HR 1.8; CI 1.4-2.5) entailed longer time until PT independence. Conclusion: These four factors (age >= 60 years; BEAM conditioning, CD34(+) dose <4 x 10(6)/kg and pre-transplant cytopenia and/or Day -10 to 0 transfusion) allowed dividing patients into three groups with significant differences between them regarding the time until transfusion independence.

Neural networks (NN) for image processing in embedded systems expose two conflicting requirements: increasing computing power needs as models become more complex and constrained resource budget. In order to alleviate this problems, model compression based on quantization and pruning techniques are common. Derived models then need to fit on reconfigurable systems such as FPGAs for the embedded system to work properly. In this paper, we present HLSinf, an open source framework for the development of custom NN accelerators for FPGAs which provides efficient support to quantized and pruned NN models. With HLSinf, significant inference speedups can be obtained for typical medical image-based applications. In particular, we obtain up to 90x speedup factor when we combine quantization/pruning with the flexibility of HLSinf compared to CPU.

Cryopreservation was recommended to ensure continuity in allogeneic hematopoietic progenitor cells (HPC) transplantation during the COVID-19 pandemic. Several groups have shown no impact on clinical outcomes for patients who underwent HPC transplantation with cryopreserved products during the first months of this pandemic. However, concerns about quality control attributes after cryopreservation have been raised. We investigated, in 155 allogeneic peripheral blood cryopreserved HPC, leukocytapheresis characteristics influencing viable CD34+ and CD3+ cells, and CFU-GM recoveries after thawing. Collection characteristics such as volume, nucleated cells (NC)/mL and hematocrit correlated with viable CD34+ and CD3+ cells recoveries after thawing in univariate analysis but only CD3+ cells remained statistically significant in multivariate analysis (r2 = 0.376; P = < 0.001). Additionally, transit time also showed correlation with viable CD34+ (r2 = 0.186), CD3+ (r2 = 0.376) and CFU-GM recoveries (r2 = 0.212) in multivariate analysis. Thus, diluting leukocytapheresis below 200 × 106 NC/mL, avoiding red cells contamination above 2%, cryopreserving below 250 × 106 NC/mL and minimizing transit time below 36 h, prevented poor viable CD34+ and CD3+ cells, and CFU-GM recoveries. In summary, optimizing leukocytapheresis practices and minimizing transportation time may better preserve the quality attributes of HPC when cryopreservation is indicated.

The goal of the H2020 SELENE project is the development of a flexible computing platform for autonomous applications that includes built-in hardware support for safety. The SELENE computing platform is an open-source RISC-V heterogeneous multicore system-on-chip (SoC) that includes 6 NOEL-V RISC-V cores and artificial intelligence accelerators. In this paper, we describe the approach followed in the SELENE project to accelerate neural network inference processes. Our intermediate results show that both the FPGA and ASIC accelerators provide real-time inference performance for the analyzed network models at a reasonable implementation cost.

BACKGROUND AIMS:To describe and analyze whether a hub-and-spoke organizational model could efficiently provide access to chimeric antigen receptor (CAR) T-cell therapy within a network of academic hospitals and address the growing demands of this complex and specialized activity. METHODS:The authors performed a retrospective evaluation of activity within the Catalan Blood and Tissue Bank network, which was established for hematopoietic stem cell transplantation to serve six CAR T-cell programs in academic hospitals of the Catalan Health Service. Procedures at six hospitals were followed from 2016 to 2021. Collection shipments of starting materials, CAR T-cell returns for storage and infusions for either clinical trials or commercial use were evaluated. RESULTS:A total of 348 leukocytapheresis procedures were performed, 39% of which were delivered fresh and 61% of which were cryopreserved. The network was linked to seven advanced therapy medicinal product manufacturers. After production, 313 CAR T-cell products were shipped back to the central cryogenic medicine warehouse located in the hub. Of the units received, 90% were eventually administered to patients. A total of 281 patients were treated during this period, 45% in clinical trials and the rest with commercially available CAR T-cell therapies. CONCLUSIONS:A hub-and-spoke organizational model based on an existing hematopoietic stem cell transplantation program is efficient in incorporating CAR T-cell therapy into a public health hospital network. Rapid access and support of growing activity enabled 281 patients to receive CAR T cells during the study period.

Cryopreservation was recommended to ensure continuity of unrelated donor (UD) hematopoietic stem cell transplantation (HSCT) during COVID-19 pandemic. However, its impact on clinical outcomes and feasibility was not well known. We compared 32 patients who underwent UD HSCT using cryopreserved peripheral blood stem cells (PBSC) during the COVID-19 pandemic with 32 patients who underwent UD HSCT using fresh PBSC in the previous period. Median neutrophil engraftment was 17.5 and 17.0 days with cryopreserved and fresh grafts, respectively. Non-significant delays were found in platelet recovery days (25.5 versus 19.0; P = 0.192) and full donor chimerism days (35.0 and 31.5; P = 0.872) using cryopreserved PBSC. The rate of acute graft-versus-host disease at 100 days was 41% (95% CI [21–55%]) in cryopreserved group versus 31% (95% CI [13–46%]) in fresh group (P = 0.380). One-hundred days progression-relapse free survival and overall survival did not differ significantly. During COVID-19 pandemic, six frozen UD donations were not transfused and logistical and clinical issues regarding cryopreservation procedure, packaging, and transporting appeared. In summary, UD HSCT with cryopreserved PBSC was safe during this challenging time. More efforts are needed to ensure that all frozen grafts are transplanted and cryopreservation requirements are harmonized.