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Background Sacubitril/valsartan has been proved to reduce mortality in heart failure and reduced ejection fraction (EF) and is currently recommended as first-line therapy. However, effects in patients with a systemic right ventricle (sRV) have not been systematically investigated yet. Purpose We aimed to assess safety and efficacy of sacubitril/valsartan in patients with a sRV Methods From September 2020 to April 2021, all patients with congenitally corrected transposition of the great arteries (TGA) or TGA after Senning/Mustard repair attending our tertiary centre were prospectively enrolled. Inclusion criteria were: age ≥18 years, 3-months of optimal medical therapy including ACEi/ARB and sRV EF≤40%. Patients with univentricular physiology, systolic blood pressure (SBP) 5.5 mEq/L were excluded. SBP and blood samples were obtained at 1-month of treatment. Other clinical and echocardiographic variables were reassessed at 6 and 12-month follow-up and the medication was progressively up-titrated to the highest tolerated dose. Results Fifty-one patients (38±11 years, 60% male, 34% ccTGA) were included. Up to March 2022, 48 (92%) patients were reviewed after 6 months of therapy and 35 (68%) completed the first year of follow-up. Baseline patients' characteristics are summarized in Table 1. At 1 month, treatment did not impact on the serum potassium values (4.5±0.3 vs 4.4±0.3 mEq/L, p=0.9) and GFR (112±33 vs 112±31 ml/min, p=0.3), while SBP dropped significantly (119±13 vs 108±18 mmHg, p=0.003). Two patients ceased the treatment due to symptomatic hypotension during the first month. One patient developed a nephrotic syndrome at 4 months of follow-up, which was likely unrelated to the treatment. No other major adverse events were reported. One patient was lost to follow-up after 3 months. Despite no significant change in the NYHA class (p=0.9), the 6-minute walking distance increased significantly at 6-month (Table 2). Nt pro BNP values were significantly decreased at 6-month, and returned to baseline at 12-month. Improved sRV systolic function was demonstrated at 6 and 12-month by significant increase in fractional area change, RV global longitudinal strain and sRV EF measured with 3D echocardiography. Conclusions Our mid-term results showed that sacubitril/valsartan is well tolerated in patients with a sRV and leads to signficant improvement of sRV systolic function, supporting its use in this complex population. Funding Acknowledgement Type of funding sources: None.

Background According to current guidelines, the diagnosis of pulmonary hypertension (PH) relies on echocardiographic probability followed by right heart catheterization. How echocardiography predicts PH recently re-defined by a mean pulmonary artery pressure (mPAP) >20 mmHg instead of ≥25 mmHg and pulmonary vascular disease defined by a pulmonary vascular resistance (PVR) >3 or >2 Wood units has not been established. Methods A total of 278 patients referred for PH underwent a comprehensive echocardiography followed by a right heart catheterization. Fifteen patients (5.4%) were excluded because of insufficient quality echocardiography. Results With PH defined by a mPAP >20 mmHg, 23 patients had no PH, 146 had pre-capillary and 94 post-capillary PH. At univariate analysis, maximum velocity of tricuspid regurgitation (TRV) ≥2.9 and ≤3.4 m/s, left ventricle (LV) eccentricity index >1.1, right ventricle (RV) outflow tract (OT) notching or acceleration time 1 and PA diameter predicted PH, whereas inferior vena cava diameter and right atrial area did not. At multivariable analysis, only TRV ≥2.9 m/s independently predicted PH. Additional independent prediction of PVR >3 Wood units was offered by LV eccentricity index >1.1 and RVOT acceleration time 20 mmHg, mPAP ≥25 mmHg, mPAP >20 mmHg + PVR >2 Wood units and mPAP ≥25 mmHg + PVR >3 Wood units are illustrated in Figure 1A–D. Conclusions Echocardiography as recommended in current guidelines can be used to assess the probability of re-defined PH in a referral center. However, the added value of indirect signs is modest and sufficient quality echocardiographic signals may not be recovered in some patients. Funding Acknowledgement Type of funding sources: None.

Background Wolf-Parkinson-White Syndrome (WPW) has been associated with reduced local myocardium deformation during systole. According to guidelines, when the left ventricle (LV) dysfunction is present catheter ablation of the accessory pathway may be required, even in asymptomatic patients. Purpose The study aimed to assess the diagnostic value of non-invasive myocardial work in predicting subtle myocardial abnormalities in children with WPW. Methods Eighty pediatric patients (age 7.91±3.2 years) were included in the study: 20 cases with manifest WPW and 60 age- and sex-matched controls (CTR). Global myocardial work index (MWI) was measured as the area of the LV pressure-strain loops. From MWI, global Constructive Work (MCW), Wasted Work (MWW) and Work Efficiency (MWE) were estimated. In addition, standard echocardiographic parameters of LV function were evaluated. Results Patients characteristics are summarized in the table. Despite normal LV EF and GLS, children with WPW had worse MWI (WPW 1292.90±307.67 mmHg% vs CTR 1658.73±241.74 mmHg%, p=0.0000005), MCW (WPW 1844.15±267.96 mmHg% vs CTR 2104.90±237.85 mmHg%, p=0.00009), MWW (WPW 101.5 [85–148.25] mmHg% vs CTR 72 [54.75–109.25] mmHg%, p=0.004) and GWE (WPW 94 [91.75–95] mmHg% vs 96 [95–97] mmHg%, p=0.00012) (table). In the WPW group, MWE (r=−0.6, p=0.009) and MWW (r=0.6, p=0.01) was found to correlate with a prolonged QRS (figure). A multiple regression model was generated to identify the relation between abnormal myocardial work indices (worst interquartile range as dependent variable) and several independent variables. QRS was the best independent predictor of impaired myocardial work. In particular, a QRS>110 msec showed an 86% sensibility and 85% specificity for abnormal MWE (AUC of 0.85), and a 75% sensibility and 83% specificity for abnormal MWW (AUC of 0.83) (figure). Conclusion In children with WPW, myocardial work indices were found significantly reduced, even in presence of normal LV EF and GLS. Prolonged QRS independently predicted myocardial impairment. In pediatric patients with WPW, myocardial work may represent a sensitive measure of LV dysfunction and help in the decision-making. Funding Acknowledgement Type of funding sources: None.

Background Adults with congenital heart disease (ACHD) are a vulnerable population. Routine vaccination is the only strategy to prevent a life-threatening infection. However, concerns on the cardiac safety and efficacy of COVID-19 vaccines have been raised. Aim To assess safety and efficacy of available COVID-19 vaccines in ACHD patients. Methods Data on COVID-19 infection and vaccines including booster doses and any suspected or confirmed adverse events were prospectively collected for all ACHD patients attending our tertiary centre from the beginning of the vaccination campaign (March 2021). A group of 75 healthy volunteers, matched per age and sex, was included for comparison. Antispike IgG titre was routinely obtained at the ACHD clinic. Patients' attitude towards COVID-19 was explored with a questionnaire. Results As of February 2022, 498 ACHD patients (36.7±16 years, 54% male,69% with moderate-complex defects, 48% with advanced physiological stage) were enrolled. Four hundred and sixty-one (92%) were fully vaccinated: the type of vaccine was Pfizer-BioNTech for 399 (86%) patients, Moderna for 20 (4%) and AstraZeneca for 26 (6%), 9 received a mixed vaccine regimen (2%). Forty-two (9%) had a history of previous COVID-19 infection and therefore received only one dose. Two-hundred and sixty-nine (58%) patients received a booster dose. Adverse events were mainly mild and transient. One patient complaining of chest pain following administration of mRNA-based vaccination was diagnosed with acute pericarditis, which made full remission after appropriate therapy. Two patients reported a non-specific increment of inflammatory markers. No other severe adverse events were reported. Thirty-seven (7%) refused COVID-19 vaccination being scared of potential cardiac/extra-cardiac adverse events. Among those not-vaccinated, 9 (24%) had a history of previous mild COVID-19 infection. IgG titre was measured in 243 patients at 1915 [835–5934] BAU/ml, which was significantly higher compared to controls (1196 [827–2048] BAU/ml, p=0.002). Three ACHD patients contracted COVID-19 infection after the first dose, while 65 (14%) fully vaccinated patients tested positive for COVID-19, all with mild to moderate symptoms. COVID-19 symptoms duration was significantly longer in case of infection before vaccination (10 [2.7–15] vs 3 [1.2–7], p=0.03). One Fontan patient was tested positive for COVID-19 twice, before and after COVID-19 vaccination, requiring hospitalization in both cases. Four hundred and seven patients completed the questionnaire: 128 (31%) declared to be scared of potential cardiac effects of the vaccine and that the discussion with the ACHD cardiologist was crucial to decide to undergo COVID-19 vaccination. Conclusions Our data provide real-world evidence on COVID-19 vaccines safety and efficacy in ACHD patients. Patients' education from the ACHD team may play a key role in vaccine acceptance in this vulnerable population. Funding Acknowledgement Type of funding sources: None.

Introduction The maintenance of military surgeons’ operative skills is challenging. Different and specific training strategies have been implemented in this context; however, little has been evaluated with regard to their effectiveness. Cancer surgery is a part of military surgeons’ activities in their home hospitals. This study aimed to assess the role of oncological surgery in the improvement of military surgeons’ operative skills. Methods Between January and June 2019, the surgical activities of the departments of visceral, ear, nose, and throat, urological, and thoracic surgery were retrospectively reviewed and assessed in terms of the operative time (OT). All surgeons working at the Sainte Anne Military Teaching Hospital were sent a survey to rate on a 5-point scale the current surgical practices on their usefulness in improving surgical skills required for treating war injuries during deployment (primary endpoint) and to compare on a 10-point visual analog scale the influence of cancer surgery and specific training on surgical fluency (secondary endpoint). Results Over the study period, 2,571 hours of OT was analyzed. Oncological surgery represented 52.5% of the surgical activity and almost 1,350 hours of cumulative OT. Considering the primary endpoint, the mean rating allocated to cancer surgery was 4.53 ± 0.84, which was not statistically different than that allocated to trauma surgery (4.42 ± 1.02, P = 0.98) but higher than other surgery (2.47 ± 1.00, P Conclusion This study demonstrates the usefulness of cancer surgery in improving the operative skills of military surgeons.

Funding Acknowledgements Type of funding sources: None. Background Wolff-Parkinson-White Syndrome (WPW) has been associated with reduced local myocardium deformation during systole. Left ventricle (LV) dysfunction due to electrical dyssynchrony may require catheter ablation of the accessory pathway, even in asymptomatic patients. Purpose The study aimed to assess the diagnostic value of non-invasive myocardial work in predicting subtle myocardial abnormalities in patients with WPW. Methods Forty-four paediatric patients (age 8.2 ± 4.3 years) were included in the study: 12 cases with manifest WPW and 32 age-, sex- and arterial pressure- matched controls (CTR). LV ejection fraction (EF) and global longitudinal strain (GLS) were evaluated. Global myocardial work index (MWI) was measured as the area of the LV pressure-strain loops. From MWI, global Constructive Work (MCW), Wasted Work (MWW) and Work Efficiency (MWE) were estimated. Results Despite normal LV systolic function by standard echocardiographic parameters, patients with WPW had lower MWI (1233.5 ± 281.6 mmHg% in WPW vs 1624.0 ± 305.8 mmHg% in CTR, p = 0.0004), MCW (1833.4 ± 257.9 mmHg% in WPW vs 2069.0 ± 319.9 mmHg% in CTR, p= 0.03), MWW (187.6 ± 117.7 mmHg% in WPW vs 90.9 ± 58.9 mmHg% in CTR, p= 0.0008) and GWE (90.5 ± 4.8% in WPW vs 95.2 ± 2.2% in CTR, p= 0.00006). There were no significant differences in GLS and EF between patients with WPW and controls. Conclusion Myocardial work indices were found significantly reduced in patients with WPW, even in presence of normal LV EF and GLS. In patients with WPW, MWI may represent a sensitive measure of myocardial dysfunction and help in the decision-making for catheter ablation. Abstract Figure. Myocardial work in WPW Abstract Figure. Myocardial work in control patient

Funding Acknowledgements Type of funding sources: None. Background Adults with coarctation of the aorta (CoA) may present residual aortic obstruction and develop arterial vasculopathy and subclinical left ventricular (LV) dysfunction. Myocardial work (MW) is a novel non-invasive index of myocardial efficiency calculated from echocardiographic LV pressure-strain loops, which yields incremental information over ejection fraction and global longitudinal strain. (GLS) Purpose Aim of the present study is to analyze LVMW in a cohort of adult patients with operated aortic CoA Methods CoA patients aged > 18 years who underwent transthoracic echocardiography between September 2020 and July 2021 at our tertiary centre were included. Exclusion criteria were significant recoarctation, impaired LVEF, significant valvular disease and suboptimal image quality. A group of healthy individuals with no cardiac abnormalities. GLS and peak strain dispersion(PSD) were measured. MW indices were calculated using the blood pressure measured in the right arm at the time of the exam. Results Sixty patients (26[22-33]years, 66%male) were included. Data on previous medical history, clinical status at last assessment and Coa-related echocardiographic findings are showed in table 1. No significant differences in traditional parameters of LV systolic and diastolic function were found between groups (EF 60[57-64] vs 57[53-61],p = 0.6), however Coa patients had higher LVmass (84[75-97] vs 68[56-75]g). GLS and MW indices in the study population and in the control group are reported in table 2. Coa group showed lower GLS values and higher PSD (p 0.0001). Conclusion MW indices assessment is feasible in Coa patients may provide a more comprehensive understanding of the overall myocardial mechanics and performance. In particular, MW demonstrated impaired LV efficiency, which was strongly related to increased mechanical dispersion in Coa patients. Abstract Figure. Abstract Figure.

Pulmonary arterial hypertension (PAH) is a heart failure syndrome characterized by right ventricular (RV) to pulmonary circulation uncoupling, counteracted by the sympathetic nervous system activation leading to β

This work explores the preparation of graphene-related materials (GRMs) grown on stainless steel foams via catalytic decomposition of methane (CDM). The main active phases for the reaction are the Fe nanoparticles segregated from the stainless-steel after the activation stage of the foam. The effect of the feed composition and reaction temperature has been studied in order to maximize the productivity, stability and selectivity to GRMs. The maximum productivity attained was 0.116 gC/gfoam h operating at 950 °C with a feed ratio of CH4/H2 = 3 (42.9 %CH4:14.3 %H2). The carbonaceous nanomaterials (CNMs) obtained were characterized by X-Ray diffraction, Raman spectroscopy and by transmission and scanning electron microscopy. The parameters of the kinetic model developed are directly related to the relevant stages of the process, including carburization, diffusion-precipitation and deactivation-regeneration. The balance among these sequential stages determines the overall performance of the activated foam. In conditions of rapid carburization of the Fe NPs (pCH4 > 14 %), the productivity to CNMs is favoured, avoiding an initial deactivation of the active sites by fouling with amorphous carbon. After a rapid carburization, the selectivity to the different CNMs is governed by the ratio CH4/H2, and mainly by the temperature. Thus, the formation of GRMs, mainly Few Layer Graphene (FLG) and even graphene, is favoured at temperatures above 900 °C. At lower temperatures, carbon nanotubes are formed., The authors acknowledge financial support from MICINN (Madrid, Spain) FEDER, Project ENE2017-82451-C3. P. Tarifa acknowledges the grant of MICINN (Ref.: BES-2014-069010).

Background Transthoracic echocardiogram is the most important non-invasive screening tool for pulmonary hypertension (PH), but right heart catheterization (RHC) remains mandatory to establish the diagnosis. According to the current guidelines, the echocardiographic probability of PH is based on the combination of direct and indirect signs. In the 6th World Symposium on Pulmonary Hypertension, PH has been defined as mean pulmonary artery pressure (mPAP) >20 mmHg, and pulmonary vascular resistance (PVR) ≥3 WU. Aim To validate the echocardiographic direct and indirect signs of PH suggested by the guidelines in view of the new definition of PH in patients who underwent echocardiography and RHC. Methods All consecutive patients referred between January 2018 and December 2019 to undergo RHC for suspected PH were prospectively enrolled in the study. Echocardiography was performed within one hour from indicated RHC. Results Overall, 263 patients were enrolled: 33 (13%) had normal pulmonary pressures, and 230 (87%) had PH. Among the 230 patients with PH, 136 (59%) had pre-capillary and 94 (41%) had post-capillary PH. All underwent echocardiography within one hour from RHC. At univariable logistic regression test, tricuspid regurgitant jet (TRJ) >2.9 m/sec [OR 8.32 (3.15–26.37, p1.1 [OR 5.57 (2.44–14.41, p25 mm [OR 4.74 (2.01–13.09, p=0.001)], right-to-left ventricle basal diameter >1 [OR 4.54 (1.83–13.74, p=0.003)], and early diastolic pulmonary regurgitation velocity >2.2 m/sec [OR 3.14 (1.07–13.46, p=0.067)], predicted PH, whereas dilated inferior vena cava and right atrial area did not. At multivariable analysis, only TRJ >2.9 m/sec [OR 7.95 (2.78–27.07, p1.1 [OR 4.89 (1.75–15.35, p=0.004)] showed a positive correlation to PH. The best area under the curve (AUC, 0.86) for predicting PH was obtained with TVR >2.9 m/sec + 2 indirect signs (sensitivity 0.77, specificity 0.94). Non-invasive estimate of mPAP showed a good correlation to invasive measurement (regression coefficient β 16.8±0.7, p Conclusions Echocardiographic direct and indirect signs of PH as suggested by the current guidelines should be used to assess the probability of PH being present. Echocardiographic measurements have high accuracy (low bias) and moderate precision (acceptable limits of agreement) The best area under the curve for predicting PH according to the new definition (mPAP >20 mmHg and PVR ≥3 WU) can be obtained with TVR >2.9 m/sec + 2 indirect signs. Funding Acknowledgement Type of funding sources: None. Figure 1

Background Adults with congenital heart disease (ACHD) are frequently affected by thyroid diseases (TD). However, the clinical relevance of TD in ACHD remains unknown. Purpose We aimed to describe the prevalence of TD in the ACHD population and to ascertain whether TD are associated with worse outcome. Methods Clinical data on all consecutive patients aged >18 years attending our ACHD unit for a day-case between 2014 and 2019 were retrospectively collected. For statistical analysis, a composite endpoint was created combining the following events at follow-up: hospitalization for heart failure, new-onset tachyarrhythmic or bradyarrhythmic events and death. Results Four hundred ninety-five ACHD patients with a median age of 32.2 [24.5–45.6] years (46% male) were included. There was an overall prevalence of patients with moderate or complex lesions (414=84%). Compared to the group with no history of TD, patients in the TD were older, (41.9 [29.7–53.5] vs 30.2 [24.3–39] years; p Median follow-up was 9.4 [4.5–13.1] years. Patients with TD had a higher unadjusted mortality rate, with a trend towards statistical significance (p=0.07). Sixty-four (42%) patients in the TD group and 43 (12.5%) met our composite endpoint, leading to a 10-year survival free from events of 53.7% Vs 86.5%, respectively (p Conclusion TD is a strong predictor of adverse outcome in the ACHD population after exclusion of potential confounding factors, being related to a fourfold increased risk of events at follow-up. Funding Acknowledgement Type of funding sources: None. Figure 1Table 1

Background Careful, step-wise assessment is required in all patients with an atrial septal defect (ASD) to exclude pre-existing pulmonary vascular disease or left ventricular disease. Fluid challenge test (FCT) and balloon occlusion testing (BOT) may unmask left ventricular disease and challenge the pulmonary circulation, but their complementary role in the evaluation of patients with “operable” ASD is not well established. Aim To evaluate the haemodynamic changes of the pulmonary circulation by FCT and BOT in ASD patients undergoing percutaneous closure according to the current guidelines. Methods Consecutive patients selected for percutaneous ASD closure underwent invasive hemodynamic assessment at baseline and after BOT, FCT and both. Results Fifty patients (mean age 47.3±11.7 years, 72% female) were included. All patients had a pulmonary-to-systemic flow ratio (QP/QS) ≥1.5, pulmonary vascular resistance (PVR) FCT caused a marked increase in pulmonary blood flow of almost 2 liters (p0.1). No difference was observed in the PAWP response to FCT, BOT or both between groups; no patients reached a PAWP ≥18 mmHg following FCT or BOT alone, but 4 (8%) patients did following the addition of FCT to BOT. No acute clinical adverse events were experienced by any patients. Conclusions None of the reported ASD patients presented with FCT criteria of post-capillary PH (that is a PAWP >18 mmHg). Even small rises in PVR may have significant implications on cardiovascular haemodynamics. In fact, patients with PVR Funding Acknowledgement Type of funding sources: None. Figure 1

International audience; In this study, lead metasilicate glasses (PbSiO3) were densified at different maximum pressures in a diamond anvil cell (DAC) at room temperature. The densified glass samples were investigated ex-situ by Raman spectroscopy to probe their pressure-induced plastic deformation limit and permanent structural modifications on the Q(n) distribution. With a high Pb content, this glass exhibits a low elastic limit at similar to 4 GPa, which is linked to an initial compact structure. Spectral curve fitting of the high-frequency region of the Raman spectra, consisting of symmetric Si-O stretching modes, exhibit subtle Q(n) population modifications with maximum pressure. This reveals silica network depolymerization where the proportion of non-bridging oxygens (NBO) increases at the expense of bridging oxygens (BO). Possible densification mechanisms are discussed in contrast to those known in other silicate glasses.

International audience; BACKGROUND: The management of older cancer patients has been highly challenging for clinicians in a health-care system operating at maximum capacity during the COVID-19 pandemic. PATIENTS AND METHODS: We analyzed data from 9 different institutions. The primary endpoint was to assess the prevalence of adapted patient care during the pandemic for elderly cancer patients. The secondary endpoint was to assess the incidence of hospitalization and mortality due to COVID-19. All patients were older than 65years of age. RESULTS: We analyzed data from 332 outpatients’ case files between 9th of March and 30th of April 2020. The median age was 75years (range: 65-101) and 53% were male. Because of the COVID-19 pandemic, more than half of the outpatients received modified patient care, defined as postponement or cancellation of surgery, irradiation scheme adapted, systemic treatment or the use of telemedicine. Among patients with localized cancer, 60% had a change in management strategy due to the pandemic. Changes in management strategy were made for 53% of patients at the metastatic stage. GCSF was used , in 83% of patients, increasing considerably in the context of the pandemic. Sixty-nine percent of physicians used telemedicine. In the final analysis, only one patient was hospitalized for COVID-19 infection. No deaths due to COVID-19 were reported in elderly cancer patients during this time period. CONCLUSION: Our study is the first to assess modification of patient care in elderly cancer outpatients during an epidemic. With this unprecedented crisis, our objective is to protect our patients from infection via protective barrier measures and social distancing, but also to guarantee the continuity of cancer care without overexposing this fragile population. Physicians were able to adapt their practice and used new forms of management, like telemedicine.

Background The International Agency for Research on Cancer evaluated formaldehyde (F) as carcinogenic for human in association with Nasopharyngeal Cancer (NPC). Occupational exposure to F occurs in many industrial sectors also in those non-traditional. For example in Tuscany F was detected in a bakery where a NPC case had ever worked. Methods In this study a) A case control approach (OCCAM) was used for monitoring occupational risks based on current information sources. Three Italian Regional Operating Centres, collected NPC cases from cancer registries and/or hospital discharge records. Controls were randomly sampled from the regional health service population data. Occupational histories were available through record linkage with the social security pension database (INPS). Study results were reported by industrial sectors, area and gender. b) A specific study on F exposure was conducted in bakeries and pastry industry carrying out measurements to determine the concentration of F in specific tasks and positions. Results 717 cases linked with INPS database. Increased ORs for several industrial sectors such as iron and steel, wood and plastic were observed. In two regions also health and veterinary services and hairdressers were at increased risk, but based on few cases of exposed workers. In the non traditional sector of bakeries and pastry industries, where workplaces were monitored, high levels of F in personal air samplings were found, in particular in processes that involve a strong leavening. Conclusions Many productive sectors, in which F exposure could occurred, were observed to be at higher risk. The measurements performed in the non traditional sector monitored, confirmed the F exposure in some phases of the work process. With this study we contributed to increased knowledge on the risk of NPC within the monitoring system of occupational risks, and to deepen exposure to F in a non traditional productive sector such as bakeries and pastry industries. Key messages The epidemiological method used (OCCAM) in this study provides further information on the role of occupational exposure in the development of nasopharyngeal cancer. The measurements performed in the bakeries and pastry industries provide new additional information on the exposure to formaldehyde in some work process phases of a non-traditional productive sector.

Background: The cancer population seems to be more susceptible to COVID-19 infection and have worse outcomes Front of this pandemic, we had to adapt our patient care to protect our patients without compromising their prognosis related to their cancer The national PRATICOVID study aims to describe the modification of the medical and surgical patient care for this population, according to the recommendations in this context of pandemic, within our hospitals which are strongly mobilized Methods: We analyzed data from 9 different institutions, 3 Military Hospitals, 4 Academics Hospital, 2 Private Hospital, from oncologists, surgeons, radiotherapists The primary endpoint was to assess the prevalence of adapted patient care during pandemic The secondary endpoints were to describe the point of view of clinicians and patients during and after the pandemic Results: We analyzed 435 medical care between 9th of March and 30th of April The median age was 69 years (range, 24-99), 54% was male 167 patients (38 4%) were newly diagnosed and only 4% were included in a clinical trial Because of COVID-19 pandemic, 47 6% of the outpatients had modified patient care The main primary tumor site was breast cancer (22 7%) at a metastatic stage 24 6% have postponed surgery, or not receive perioperative chemotherapy, 18 4% received hypofractioned schedule and 57% had an adaptive systemic protocol (stopped, oral protocol, spacing between cures) 70% of physicians are used telemedicine During this period, 67% of the physicians were relaxed to taking care of their patients 57% of the patients have seen to be relaxed or low worried about the pandemic However, 71% are worried after the lockdown, because of future patient care, stage at diagnosis, access to clinical trial, our abilities to receive in the same time all the patients Conclusions: PRATICOVID study is the first to assess modification of patients cares during an epidemic in cancer outpatients Faces with this unprecedented crisis, physicians were able to adapt their practice in order to protect their patients against the virus and while ensuring the course of patient care But physicians are worried after de lockdown because of the care pathway’s issues Clinical trial identification: CNIL;reference number: 2217722v0 Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest

A diverse group of adolescents (N = 41) from a large city in the Midwestern United States participated in focus groups about misogynistic and homophobic language. Our qualitative analysis yielded two major themes. First, participants discussed this language as a way to regulate peers' conformity to norms related to gender and sexuality. Second, participants spoke about the importance of the relationship between individuals using this language in determining different intentions. Understanding young people's perceptions of these types of interactions and the intentions behind them will allow us to more effectively reduce young peoples' use of misogynistic and homophobic language in schools.

Resume Introduction Le deficit acquis en facteur X (FX) est dans la majorite des cas associe a l’amylose AL. Le deficit non amyloide acquis en FX (DNAA-FX), d’etiologie variee, n’a ete qu’exceptionnellement rapporte dans la litterature. Observation Nous rapportons ici le premier cas de DNAA-FX satellite d’une leucemie lymphoide chronique atypique diagnostique chez un patient de 66 ans, lors de la survenue d’hematomes spontanes. Apres echec de deux cures d’immunoglobulines polyvalentes, un traitement specifique de l’hemopathie a permis la resolution des symptomes et la disparition de l’hypocoagulabilite. Conclusion Le DNAA-FX doit etre evoque en cas de manifestations hemorragiques ou d’anomalies de la crase sanguine au cours d’une hemopathie lymphoide de bas grade. La survenue d’un DNAA-FX peut alors etre consideree comme une indication de mise en traitement de l’hemopathie afin de prevenir des complications hemorragiques potentiellement fatales.

One hundred and fifty-six adolescents, drawn from a high school in a Midwestern suburb, provided judgments of a hypothetical incident of homophobic harassment with either a male or female victim. Participants also completed a revised version of the Macho Scale, measuring their endorsement of gender stereotypes (α = .75). Without the interaction term, victim gender was not predictive of judgments of the harassment, however, endorsement of gender stereotypes decreased the odds of believing the behavior was completely wrong (χ2 (1) = 9.18, p = .00). Once added, the interaction term was the only significant variable in the model, demonstrating that endorsement of gender stereotypes has an effect on judgments of homophobic harassment of male victims, but not female victims (χ2 (1) = 4.78, p = .03). As more schools invest resources in anti-harassment initiatives, our findings suggest that discussion of gender and gender stereotypes is essential.

Objectifs Depuis decembre 2019, nous devons faire face a la pandemie mondiale du COVID-19. Cela a entraine une adaptation des soins, notamment pour les patients atteints d’un cancer urologique. L’etude PRATICOVID vise a decrire la modification de la prise en charge medicale et chirurgicale des patients pour cette population, selon les recommandations dans ce contexte de pandemie, au sein de nos hopitaux fortement mobilises. Methodes Nous avons analyse les donnees de 9 institutions differentes : 3 hopitaux militaires, 4 hopitaux universitaires, 2 hopitaux prives. Nous avons considere les patients suivis par les oncologues, chirurgiens et radiotherapeutes. Au total, 435 patients ont ete inclus entre le 9 mars et le 30 avril 2020 dans l’etude PRATICOVID. Parmi eux 178 patients presentaient un cancer urologique. Le critere d’evaluation principal etait d’evaluer la prevalence des soins adaptes aux patients pendant la pandemie. Les criteres d’evaluation secondaires etaient de decrire le point de vue des cliniciens et des patients pendant et apres la pandemie. Resultats Cent quarante-cinq patients avec un cancer urologique ont ete retenus pour l’analyse finale. L’âge median etait de 71 ans (24–97), dont 90,3 % etaient des hommes. Parmi les patients, 62 (42,8 %) etaient nouvellement diagnostiques et seuls 10 etaient inclus dans un essai clinique. En raison de la pandemie de COVID19, 46,2 % des patients ambulatoires avaient modifie les soins aux patients. Le cancer de la prostate representait 50,7 % des cancers urologiques avec une modification de prise en charge. La chirurgie ne concernait que 11 % des patients inclus contre 56,6 % pour les traitements systemiques. Parmi les patients, 31,7 % ont beneficies exclusivement d’une teleconsultation. Parmi les medecins, 67 % etaient detendus et 57 % des patients se sont dits detendus ou peu inquiets par rapport a la pandemie. Parmi les patients, 71 % sont inquiets pour l’evolution de leur maladie. Conclusion L’etude PRATICOVID est la premiere a evaluer la modification des soins lors d’une epidemie des patients cancereux. Le suivi a long terme de ces patients est necessaire pour mesurer l’impact en termes de survie globale, specifique et sans progression.

In this work, we present the results of production of carbonaceous nanomaterials by decomposition of methane on a catalyst of Ni supported on a Biomorphic Carbon. The catalyst was prepared by thermal decomposition in a reductive atmosphere of vine shoots previously impregnated with the Ni precursor. In order to optimize the reaction productivity and selectivity, the effect of the main operational conditions (reaction temperature and feed composition) has been studied in a thermobalance. The main textural properties, BET area of 63 m2/g and 56% of microporosity, of the catalyst synthesized indicates that these materials are suitable for gas-phase reactions even in harsh conditions. Thus, the catalyst has proved to be active in the synthesis of carbon nanofibers and graphene related materials at elevated temperatures. The productivity, type, and quality of the carbonaceous nanomaterials obtained are deeply dependent on the operating conditions during the reaction. As an important fact, is has been obtained that the reaction temperature strongly affects the type of the nanomaterial produced. Thus, it is produced CNFs of bamboo type at temperatures until 850°C. Above this critical temperature, it is mainly obtained nanolayers of graphitic nature. The characterization results indicate that the highest quality graphenic materials were obtained operating at 950°C with 14.3% of CH4 and 14.3% of H2. The kinetic model used to analyze the experimental data is based on the more relevant stages of the mechanism of reaction., We acknowledge financial support from MINECO (Madrid, Spain) FEDER, Projects ENE2017-82451-C3 y ENE2013-47880-C3.

Determination of the optimal operating conditions for large-scale production of carbonaceous nanomaterials (CNTs), mainly carbon nanotubes (CNTs) but also graphene-related materials (GRMs), remains as a major industrial and scientific challenge. For this purpose, our group is conducting an extensive study to evaluate the effect of the reaction conditions and catalyst compositions on the productivity and selectivity to different carbonaceous nanomaterials. In the case of Co-based catalysts, we have found that the promotion with Cu or Mn has a dramatic effect on the type of carbon nanomaterials synthesized. Thus, the presence of Cu promotes the growth of CNTs, while Mn favors the formation of two-dimensional GRMs. In this context, we present here a comprehensive study of the CNTs growth via catalytic decomposition of methane using a Co-Cu/cellulose derived carbon catalyst. The influence of the reaction temperature (650–950 °C) and feed composition (7.1%–42.9% of CH4 and H2) on the yield and CNTs quality was evaluated. A transition in the characteristics of the carbonaceous nanomaterial growth was observed at about 800 °C. Below this temperature, the reaction was selective towards the formation of CNTs, while above 800 °C, the obtained nanomaterial exhibited a graphite-like morphology. In addition, the catalyst deactivation was quite low in the CNTs growth regime, attaining high productivity under 11 h of operation. The model used to study the kinetics of carbon formation allowed understanding the most influential variables in the growth process, revealing the existence of a transition temperature at which there is a change in the preferential path for the formation of CNTs or GRMs. After exploring a large set of reaction conditions, the best operating parameters for growing CNTs with high productivity (0.29 gC/gcat∙h) and quality (ID/IG = 1.10, I2D/IG = 0.13) were found at 750 °C under 28.6% CH4:14.3% H2:57.1% N2., The authors acknowledge financial support from the Ministry of Science and Innovation (Madrid, Spain), Projects ENE2017-82451-C3-1-R and ENE2017-82451-C3-2-R. W. Henao acknowledges the financial support from Fundación Carolina (Madrid, Spain) and the University of Zaragoza.

Some of the problems that occur during the operation of chemical reactors based of structured catalytic substrates, as monoliths, foams, membranes, cloths, fibres and other systems, are related to the preparation of long term stable coatings. Frequently, the deposition of the catalytic layer is carried out by washcoating, requiring this step a cautious attention, especially in the case of complex geometries, like of that of foams or cloths. In the case of the deposition of layers of carbonaceous materials (CNMs), an alternative route, avoiding the washcoating, it is their direct growth by catalytic decomposition light hydrocarbons (also called CCVD), over the surface of the metallic substrate. In this case, if the metallic substrate is of stainless steel, it already contains the catalytic active phases like Fe and Ni. In order to optimize the process of CNMs growth over structured metallic substrates, we are studying the effect of the main operational variables of the ethane decomposition reaction on stainless steel foams. In this contribution we present a study of the influence of the temperature of the activation (oxidation and reduction) stage on the type and morphology of the carbonaceous materials formed. The results obtained allow us to determine the optimal operating conditions to maximize the amount and the selectivity of the process to obtain a given type of CNM.

A novel hierarchically structured composite aimed as a stable catalyst for the heterogeneous Fenton-type (HFT) oxidation process was developed by using a cost-effective and versatile technique. Prussian Blue nanoparticles (PBNP) were dispersed onto aligned macroporous TiO

This paper reports the chemical identity and mechanism of action and formation of a cell growth inhibitory compound leached from some single-use Erlenmeyer polycarbonate shaker flasks under routine cell culture conditions. Single-use cell culture vessels have been increasingly used for the production of biopharmaceuticals; however, they often suffer from issues associated with leachables that may interfere with cell growth and protein stability. Here, high-performance liquid-chromatography preparations and cell proliferation assays led to identification of a compound from the water extracts of some polycarbonate flasks, which exhibited subline- and seeding density-dependent growth inhibition of CHO cells in suspension culture. Mass spectroscopy, nuclear magnetic resonance spectroscopy, and chemical synthesis confirmed that this compound is 3,5-dinitro-bisphenol A. Cell cycle analysis suggests that 3,5-dinitro-bisphenol A arrests CHO-S cells at the G1/Go phase. Dynamic mass redistribution assays showed tha...

This work presents the results obtained with novel Pd and Pd-Al catalysts supported on carbon, which have been prepared using a biomorphic mineralization technique. The catalyst synthesis procedure includes a stage of thermal decomposition under reductive atmosphere of cellulose previously impregnated with the metallic precursors. We have studied the influence of the temperature and time of decomposition, and of the Al precursor addition, on the textural and catalytic properties. The characterisation results indicate that the preparation method used leads to the formation of carbonaceous supports with a high microporosity (up to 97% micropore volume) and values of the BET surface up to 470 m/g while maintaining the original external structure. The use of low temperatures (ca. 600 °C) during the decomposition step allows the preparation of highly dispersed catalysts with narrow Pd particle size distributions. However, the thermal decomposition at elevated temperatures (ca. 800 °C) increases the Pd particle size due to the sintering of the metallic phase. This phenomenon is augmented with the decomposition time and is not affected by the presence of Al. Consequently, the catalytic activity of these materials in cyclohexene hydrogenation is strongly affected by the operational conditions used during the thermal decomposition step. Unexpectedly, the more sintered catalysts, i.e. those prepared at 800 °C, show the highest activity. According to the characterization results, this fact can be explained considering that the smaller Pd particles obtained after preparation at e.g. 600 °C are quite inactive because they are confined in the internal structure of the micropores of the support and/or embedded inside the carbon matrix. In contrast, after decomposition at 800 °C, the larger Pd particles formed are placed at the external surface of the catalyst, being accessible to the reactants. In addition, for the specific conditions under which the Pd is accessible, the presence of Al favours the cyclohexene conversion due to the enhancement of the adsorption on the Pd surface as a consequence of a charge transfer phenomenon. These results can serve as a guideline for the preparation of these catalysts based on raw lignocellulosic materials in order to maximize their catalytic performance., The authors acknowledge financial support from MINECO (Madrid, Spain)-FEDER, Projects CTQ2010-16132 and ENE2013-47880-C3-1-R.

This work addresses the preparation and application of the synthesis of graphene in Ni-Cu catalysts supported on carbonaceous materials. The catalysts have been prepared by a biomorphic mineralization technique which involves the thermal decomposition, under reductive atmosphere, of commercial cellulose previously impregnated with the metallic precursors. The characterization results indicate that the preparation method leads to the formation of carbonaceous supports with a moderate microporosity (ca. 33% pore volume) and adequate surface area (343 m2/g), maintaining the original external texture. The catalytic performance of these materials was previously tested in liquid phase reactions (Zampieri et al., 2007 [7]). In order to extend the use of these catalysts, in this work we present a study corresponding to a gas phase reaction: the synthesis of graphenic nanomaterials by catalytic decomposition of methane (CDM). The influence of the reaction temperature and of the feed composition (i.e.%CH4 and%H2) has been studied. The graphenic nanomaterials obtained after reaction were characterized by nitrogen adsorption-desorption isotherms, Raman spectroscopy and transmission electron microscopy (TEM). The results indicate that the carbonaceous nanomaterial with the highest quality is obtained operating at 950 °C and feeding 28.6% of CH4 and 14.3% of H2. The evolution of the carbon mass during the reaction time was analysed using a phenomenological kinetic model that takes into account the main stages involved during the formation of carbonaceous nanomaterials (NCMs). The results obtained from the kinetic model along with the characterization results enable the influence of the operating variables on each stage of the carbonaceous nanomaterial formation to be discerned.

The biomorphic mineralization technique is a powerful tool that allows to synthetize inorganic materials using as templates some structures of biological origin. This work presents kinetics results obtained during the liquid-phase hydrogenation of cyclohexene using a novel Pd–Al catalyst supported on biomorphic carbon. The catalysts have been prepared by a reactive method, using cellulose as carbonaceous precursor of the biomorphic support. The influence of the time and decomposition temperature (600–800 °C) of cellulose under hydrogen atmosphere has been studied. The characterization results indicate that the synthesis of these biomorphic materials produce solids with high microporosity. The metallic dispersion of the Pd nanoparticles is strongly dependent on the preparation conditions (i.e. heating rate, thermal decomposition temperature and time) of the carbonaceous precursor. The kinetic study has covered the effect of the hydrogen pressure and temperature, and was carried out using a real-time in situ Raman probe. The developed kinetic model considers the non-competitive adsorption between hydrogen and cyclohexene in two different types of Pd metallic sites. The model explains all the experimental results obtained, providing a rational explanation for the variation of the kinetic orders and apparent activation energy obtained using the empirical power-law model.

Resume Introduction Les manifestations neurologiques au cours de la maladie de Waldenstrom sont frequentes, principalement en lien avec une atteinte peripherique dysimmunitaire ou avec un syndrome d’hyperviscosite. Le syndrome de Bing et Neel correspond a l’infiltration du systeme nerveux central par le processus lymphoproliferatif. Cette entite extremement rare reste peu decrite dans la litterature. Observations Nous rapportons 4 observations de patients pour lesquels la survenue de troubles neurologiques centraux a conduit au diagnostic de syndrome de Bing et Neel. Ces quatre observations illustrent des presentations cliniques, des attitudes diagnostiques et therapeutiques ainsi que des evolutions differentes au cours de ce syndrome. Ces heterogeneites sont discutees dans le cadre d’une revue de la litterature. Conclusion Les manifestations cliniques polymorphes du syndrome de Bing et Neel peuvent simuler de nombreux diagnostics. Il convient toutefois de savoir l’evoquer. L’analyse du liquide cephalorachidien et de l’IRM peuvent permettre un diagnostic rapide ou orienter une biopsie. Des remissions prolongees sont possibles avec un traitement adapte.

This work is an advance on the development of structured catalytic reactors. Here, we present the results of the effect of the main operational variables (reaction temperature, % H2 and % C2H6) on the kinetics of carbonaceous nanomaterials (CNMs) formation by catalytic decomposition of ethane over stainless steel foams. Some of the main drawback problems that occur during the operation of chemical structured reactors are related to the preparation of long term stable coatings. The washcoating is the most used technique to deposit the catalytic layer over the substrate. The application of this procedure is quite complex in the case of geometries such as foams or cloths. In the case of the deposition of layers of carbonaceous nanomaterials, an alternative route, avoiding the washcoating, is their direct growth by catalytic decomposition of light hydrocarbons over the surface of the metallic substrate. In the case of structured steel foams, the substrate already contains the catalytic active phases for this reaction, like Fe and Ni, among of the minor components (Cr, Mn, Mo) that can act as promotors/stabilizers. The nanomaterials obtained after reaction were characterized by Raman spectroscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The characterization results indicate that there is a maximum, obtained at ca. 900 °C, 33.3 % of C2H6 and 1.7 % of H2, in the quality of the carbonaceous nanomaterials grown. Under these conditions, the CNMs consist mainly of few layer graphene (FLG) and graphite nanolayers (GNL) encapsulating the metallic nanoparticles. In addition, the kinetic results indicate the existence of another optimum, at ca. 800 °C, 33.3 % of C2H6 and 1.7 % of H2, in the productivity to the carbonaceous nanomaterials. The existence of these optimums is due to the driving force for the diffusion of the carbon atoms through the Fe-Ni nanoparticles (NPs) obtained at high temperatures (e. g. above 800 °C) caused by the competence between two opposite phenomena: the increase of the rate of carbon diffusion through the metallic nanoparticles of Fe-Ni and the deactivation of these nanoparticles. The deactivation is the consequence of the encapsulation and reconstruction of the nanoparticles during the formation of the several types of CNMs. The evolution of the carbon mass during the reaction time was analyzed using a phenomenological kinetic model that takes into account the main stages involved during the formation of carbonaceous nanomaterials: hydrocarbon decomposition, carburization, diffusion, precipitation and deactivation. The results obtained from the kinetic model, along with the characterization results, enable quantify the influence of the operating variables on each stage of the carbonaceous nanomaterial formation and therefore open the way to optimize the process.

Report sull'attività 4.5 svolta nell'ambito del progetto PON02_00451_3361909 "Utilizzo integrato di approcci tecnologici innovativi per migliorare la shelf-life e preservare le proprietà nutrizionali di prodotti agroalimentari" (SHELF-LIFE). (Prot. CNR-IPCB n° 0001364 del 15/06/2017)

La Presse Medicale - In Press.Proof corrected by the author Available online since vendredi 22 decembre 2017

Polyvinyl chloride (PVC) is a polymer widely used in medical field to produce equipments for blood transfusion, medical devices, etc. The replacement of di-2-ethyl hexyl phthalate (DEHP) from PVC processing, reducing or eliminating the health risk caused by its release into environment together with theachievementof antimicrobial properties are undoubtedly important for the development of new PVC products relevant for health care applications. In this study we used PVC plasticized with DEHP, di-isononyl phthalate (DINP) and tris-2-ethyhexyl trimellitate(TOTM) to test the influence of plasticizers on silver release from PVC silver composites. Polymer composites were prepared by mixing PVC pellets with a silver zeolite (SZ) in the amount of 10-20 wt%. The antibacterial activity of PVC SZ composites was tested on Escherichia coli and Staphylococcus epidermidisin culture broth, on agar plate and in sterile urine seeded with these strains for simulation purposes. The results indicate that the addition of large amount of SZ did not influence the processability and the formability of the composites as well as their thermal and mechanical properties, if compared to neat plasticized PVC. Composites showed antibacterial activity against S. epidermidis and E. coli in culture broth, direct inhibition on agar plate andin urine supplemented with bacteria. PVC-DEHP SZ composites exhibited a good antimicrobial activity at 10% wt of silver zeolite, while the best performance of composites of PVC plasticized with DINP and TOTM was at 20% wt of silver zeolite. In sterile urine, composites induced a significant reduction of viability of both strains already at 24 h, inhibiting E. coli growth up to 20 days, whereas their antimicrobial action against S. epidermidis vanished within 5 days. Data on silver release suggest that the different steric hindrance of plasticizers influence the migration and release of the antimicrobial agent from polymeric matrix to the environment.

La Presse Medicale - In Press.Proof corrected by the author Available online since mercredi 11 janvier 2017