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2. Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context

Author

Gemini Team, Georgiev, Petko, Lei, Ving Ian, Burnell, Ryan, Bai, Libin, Gulati, Anmol, Tanzer, Garrett, Vincent, Damien, Pan, Zhufeng, Wang, Shibo, Mariooryad, Soroosh, Ding, Yifan, Geng, Xinyang, Alcober, Fred, Frostig, Roy, Omernick, Mark, Walker, Lexi, Paduraru, Cosmin, Sorokin, Christina, Tacchetti, Andrea, Gaffney, Colin, Daruki, Samira, Sercinoglu, Olcan, Gleicher, Zach, Love, Juliette, Voigtlaender, Paul, Jain, Rohan, Surita, Gabriela, Mohamed, Kareem, Blevins, Rory, Ahn, Junwhan, Zhu, Tao, Kawintiranon, Kornraphop, Firat, Orhan, Gu, Yiming, Zhang, Yujing, Rahtz, Matthew, Faruqui, Manaal, Clay, Natalie, Gilmer, Justin, Co-Reyes, JD, Penchev, Ivo, Zhu, Rui, Morioka, Nobuyuki, Hui, Kevin, Haridasan, Krishna, Campos, Victor, Mahdieh, Mahdis, Guo, Mandy, Hassan, Samer, Kilgour, Kevin, Vezer, Arpi, Cheng, Heng-Tze, de Liedekerke, Raoul, Goyal, Siddharth, Barham, Paul, Strouse, DJ, Noury, Seb, Adler, Jonas, Sundararajan, Mukund, Vikram, Sharad, Lepikhin, Dmitry, Paganini, Michela, Garcia, Xavier, Yang, Fan, Valter, Dasha, Trebacz, Maja, Vodrahalli, Kiran, Asawaroengchai, Chulayuth, Ring, Roman, Kalb, Norbert, Soares, Livio Baldini, Brahma, Siddhartha, Steiner, David, Yu, Tianhe, Mentzer, Fabian, He, Antoine, Gonzalez, Lucas, Xu, Bibo, Kaufman, Raphael Lopez, Shafey, Laurent El, Oh, Junhyuk, Hennigan, Tom, Driessche, George van den, Odoom, Seth, Lucic, Mario, Roelofs, Becca, Lall, Sid, Marathe, Amit, Chan, Betty, Ontanon, Santiago, He, Luheng, Teplyashin, Denis, Lai, Jonathan, Crone, Phil, Damoc, Bogdan, Ho, Lewis, Riedel, Sebastian, Lenc, Karel, Yeh, Chih-Kuan, Chowdhery, Aakanksha, Xu, Yang, Kazemi, Mehran, Amid, Ehsan, Petrushkina, Anastasia, Swersky, Kevin, Khodaei, Ali, Chen, Gowoon, Larkin, Chris, Pinto, Mario, Yan, Geng, Badia, Adria Puigdomenech, Patil, Piyush, Hansen, Steven, Orr, Dave, Arnold, Sebastien M. R., Grimstad, Jordan, Dai, Andrew, Douglas, Sholto, Sinha, Rishika, Yadav, Vikas, Chen, Xi, Gribovskaya, Elena, Austin, Jacob, Zhao, Jeffrey, Patel, Kaushal, Komarek, Paul, Austin, Sophia, Borgeaud, Sebastian, Friso, Linda, Goyal, Abhimanyu, Caine, Ben, Cao, Kris, Chung, Da-Woon, Lamm, Matthew, Barth-Maron, Gabe, Kagohara, Thais, Olszewska, Kate, Chen, Mia, Shivakumar, Kaushik, Agarwal, Rishabh, Godhia, Harshal, Rajwar, Ravi, Snaider, Javier, Dotiwalla, Xerxes, Liu, Yuan, Barua, Aditya, Ungureanu, Victor, Zhang, Yuan, Batsaikhan, Bat-Orgil, Wirth, Mateo, Qin, James, Danihelka, Ivo, Doshi, Tulsee, Chadwick, Martin, Chen, Jilin, Jain, Sanil, Le, Quoc, Kar, Arjun, Gurumurthy, Madhu, Li, Cheng, Sang, Ruoxin, Liu, Fangyu, Lamprou, Lampros, Munoz, Rich, Lintz, Nathan, Mehta, Harsh, Howard, Heidi, Reynolds, Malcolm, Aroyo, Lora, Wang, Quan, Blanco, Lorenzo, Cassirer, Albin, Griffith, Jordan, Das, Dipanjan, Lee, Stephan, Sygnowski, Jakub, Fisher, Zach, Besley, James, Powell, Richard, Ahmed, Zafarali, Paulus, Dominik, Reitter, David, Borsos, Zalan, Joshi, Rishabh, Pope, Aedan, Hand, Steven, Selo, Vittorio, Jain, Vihan, Sethi, Nikhil, Goel, Megha, Makino, Takaki, May, Rhys, Yang, Zhen, Schalkwyk, Johan, Butterfield, Christina, Hauth, Anja, Goldin, Alex, Hawkins, Will, Senter, Evan, Brin, Sergey, Woodman, Oliver, Ritter, Marvin, Noland, Eric, Giang, Minh, Bolina, Vijay, Lee, Lisa, Blyth, Tim, Mackinnon, Ian, Reid, Machel, Sarvana, Obaid, Silver, David, Chen, Alexander, Wang, Lily, Maggiore, Loren, Chang, Oscar, Attaluri, Nithya, Thornton, Gregory, Chiu, Chung-Cheng, Bunyan, Oskar, Levine, Nir, Chung, Timothy, Eltyshev, Evgenii, Si, Xiance, Lillicrap, Timothy, Brady, Demetra, Aggarwal, Vaibhav, Wu, Boxi, Xu, Yuanzhong, McIlroy, Ross, Badola, Kartikeya, Sandhu, Paramjit, Moreira, Erica, Stokowiec, Wojciech, Hemsley, Ross, Li, Dong, Tudor, Alex, Shyam, Pranav, Rahimtoroghi, Elahe, Haykal, Salem, Sprechmann, Pablo, Zhou, Xiang, Mincu, Diana, Li, Yujia, Addanki, Ravi, Krishna, Kalpesh, Wu, Xiao, Frechette, Alexandre, Eyal, Matan, Dafoe, Allan, Lacey, Dave, Whang, Jay, Avrahami, Thi, Zhang, Ye, Taropa, Emanuel, Lin, Hanzhao, Toyama, Daniel, Rutherford, Eliza, Sano, Motoki, Choe, HyunJeong, Tomala, Alex, Safranek-Shrader, Chalence, Kassner, Nora, Pajarskas, Mantas, Harvey, Matt, Sechrist, Sean, Fortunato, Meire, Lyu, Christina, Elsayed, Gamaleldin, Kuang, Chenkai, Lottes, James, Chu, Eric, Jia, Chao, Chen, Chih-Wei, Humphreys, Peter, Baumli, Kate, Tao, Connie, Samuel, Rajkumar, Santos, Cicero Nogueira dos, Andreassen, Anders, Rakićević, Nemanja, Grewe, Dominik, Kumar, Aviral, Winkler, Stephanie, Caton, Jonathan, Brock, Andrew, Dalmia, Sid, Sheahan, Hannah, Barr, Iain, Miao, Yingjie, Natsev, Paul, Devlin, Jacob, Behbahani, Feryal, Prost, Flavien, Sun, Yanhua, Myaskovsky, Artiom, Pillai, Thanumalayan Sankaranarayana, Hurt, Dan, Lazaridou, Angeliki, Xiong, Xi, Zheng, Ce, Pardo, Fabio, Li, Xiaowei, Horgan, Dan, Stanton, Joe, Ambar, Moran, Xia, Fei, Lince, Alejandro, Wang, Mingqiu, Mustafa, Basil, Webson, Albert, Lee, Hyo, Anil, Rohan, Wicke, Martin, Dozat, Timothy, Sinha, Abhishek, Piqueras, Enrique, Dabir, Elahe, Upadhyay, Shyam, Boral, Anudhyan, Hendricks, Lisa Anne, Fry, Corey, Djolonga, Josip, Su, Yi, Walker, Jake, Labanowski, Jane, Huang, Ronny, Misra, Vedant, Chen, Jeremy, Skerry-Ryan, RJ, Singh, Avi, Rijhwani, Shruti, Yu, Dian, Castro-Ros, Alex, Changpinyo, Beer, Datta, Romina, Bagri, Sumit, Hrafnkelsson, Arnar Mar, Maggioni, Marcello, Zheng, Daniel, Sulsky, Yury, Hou, Shaobo, Paine, Tom Le, Yang, Antoine, Riesa, Jason, Rogozinska, Dominika, Marcus, Dror, Badawy, Dalia El, Zhang, Qiao, Wang, Luyu, Miller, Helen, Greer, Jeremy, Sjos, Lars Lowe, Nova, Azade, Zen, Heiga, Chaabouni, Rahma, Rosca, Mihaela, Jiang, Jiepu, Chen, Charlie, Liu, Ruibo, Sainath, Tara, Krikun, Maxim, Polozov, Alex, Lespiau, Jean-Baptiste, Newlan, Josh, Cankara, Zeyncep, Kwak, Soo, Xu, Yunhan, Chen, Phil, Coenen, Andy, Meyer, Clemens, Tsihlas, Katerina, Ma, Ada, Gottweis, Juraj, Xing, Jinwei, Gu, Chenjie, Miao, Jin, Frank, Christian, Cankara, Zeynep, Ganapathy, Sanjay, Dasgupta, Ishita, Hughes-Fitt, Steph, Chen, Heng, Reid, David, Rong, Keran, Fan, Hongmin, van Amersfoort, Joost, Zhuang, Vincent, Cohen, Aaron, Gu, Shixiang Shane, Mohananey, Anhad, Ilic, Anastasija, Tobin, Taylor, Wieting, John, Bortsova, Anna, Thacker, Phoebe, Wang, Emma, Caveness, Emily, Chiu, Justin, Sezener, Eren, Kaskasoli, Alex, Baker, Steven, Millican, Katie, Elhawaty, Mohamed, Aisopos, Kostas, Lebsack, Carl, Byrd, Nathan, Dai, Hanjun, Jia, Wenhao, Wiethoff, Matthew, Davoodi, Elnaz, Weston, Albert, Yagati, Lakshman, Ahuja, Arun, Gao, Isabel, Pundak, Golan, Zhang, Susan, Azzam, Michael, Sim, Khe Chai, Caelles, Sergi, Keeling, James, Sharma, Abhanshu, Swing, Andy, Li, YaGuang, Liu, Chenxi, Bostock, Carrie Grimes, Bansal, Yamini, Nado, Zachary, Anand, Ankesh, Lipschultz, Josh, Karmarkar, Abhijit, Proleev, Lev, Ittycheriah, Abe, Yeganeh, Soheil Hassas, Polovets, George, Faust, Aleksandra, Sun, Jiao, Rrustemi, Alban, Li, Pen, Shivanna, Rakesh, Liu, Jeremiah, Welty, Chris, Lebron, Federico, Baddepudi, Anirudh, Krause, Sebastian, Parisotto, Emilio, Soricut, Radu, Xu, Zheng, Bloxwich, Dawn, Johnson, Melvin, Neyshabur, Behnam, Mao-Jones, Justin, Wang, Renshen, Ramasesh, Vinay, Abbas, Zaheer, Guez, Arthur, Segal, Constant, Nguyen, Duc Dung, Svensson, James, Hou, Le, York, Sarah, Milan, Kieran, Bridgers, Sophie, Gworek, Wiktor, Tagliasacchi, Marco, Lee-Thorp, James, Chang, Michael, Guseynov, Alexey, Hartman, Ale Jakse, Kwong, Michael, Zhao, Ruizhe, Kashem, Sheleem, Cole, Elizabeth, Miech, Antoine, Tanburn, Richard, Phuong, Mary, Pavetic, Filip, Cevey, Sebastien, Comanescu, Ramona, Ives, Richard, Yang, Sherry, Du, Cosmo, Li, Bo, Zhang, Zizhao, Iinuma, Mariko, Hu, Clara Huiyi, Roy, Aurko, Bijwadia, Shaan, Zhu, Zhenkai, Martins, Danilo, Saputro, Rachel, Gergely, Anita, Zheng, Steven, Jia, Dawei, Antonoglou, Ioannis, Sadovsky, Adam, Gu, Shane, Bi, Yingying, Andreev, Alek, Samangooei, Sina, Khan, Mina, Kocisky, Tomas, Filos, Angelos, Kumar, Chintu, Bishop, Colton, Yu, Adams, Hodkinson, Sarah, Mittal, Sid, Shah, Premal, Moufarek, Alexandre, Cheng, Yong, Bloniarz, Adam, Lee, Jaehoon, Pejman, Pedram, Michel, Paul, Spencer, Stephen, Feinberg, Vladimir, Xiong, Xuehan, Savinov, Nikolay, Smith, Charlotte, Shakeri, Siamak, Tran, Dustin, Chesus, Mary, Bohnet, Bernd, Tucker, George, von Glehn, Tamara, Muir, Carrie, Mao, Yiran, Kazawa, Hideto, Slone, Ambrose, Soparkar, Kedar, Shrivastava, Disha, Cobon-Kerr, James, Sharman, Michael, Pavagadhi, Jay, Araya, Carlos, Misiunas, Karolis, Ghelani, Nimesh, Laskin, Michael, Barker, David, Li, Qiujia, Briukhov, Anton, Houlsby, Neil, Glaese, Mia, Lakshminarayanan, Balaji, Schucher, Nathan, Tang, Yunhao, Collins, Eli, Lim, Hyeontaek, Feng, Fangxiaoyu, Recasens, Adria, Lai, Guangda, Magni, Alberto, De Cao, Nicola, Siddhant, Aditya, Ashwood, Zoe, Orbay, Jordi, Dehghani, Mostafa, Brennan, Jenny, He, Yifan, Xu, 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Henryk, Viola, Fabio, Quitry, Felix de Chaumont, Lan, Charline Le, Hudson, Tom, Wang, Qingze, Fischer, Felix, Zheng, Ivy, White, Elspeth, Dragan, Anca, Alayrac, Jean-baptiste, Ni, Eric, Pritzel, Alexander, Iwanicki, Adam, Isard, Michael, Bulanova, Anna, Zilka, Lukas, Dyer, Ethan, Sachan, Devendra, Srinivasan, Srivatsan, Muckenhirn, Hannah, Cai, Honglong, Mandhane, Amol, Tariq, Mukarram, Rae, Jack W., Wang, Gary, Ayoub, Kareem, FitzGerald, Nicholas, Zhao, Yao, Han, Woohyun, Alberti, Chris, Garrette, Dan, Krishnakumar, Kashyap, Gimenez, Mai, Levskaya, Anselm, Sohn, Daniel, Matak, Josip, Iturrate, Inaki, Chang, Michael B., Xiang, Jackie, Cao, Yuan, Ranka, Nishant, Brown, Geoff, Hutter, Adrian, Mirrokni, Vahab, Chen, Nanxin, Yao, Kaisheng, Egyed, Zoltan, Galilee, Francois, Liechty, Tyler, Kallakuri, Praveen, Palmer, Evan, Ghemawat, Sanjay, Liu, Jasmine, Tao, David, Thornton, Chloe, Green, Tim, Jasarevic, Mimi, Lin, Sharon, Cotruta, Victor, Tan, Yi-Xuan, Fiedel, Noah, Yu, Hongkun, Chi, Ed, Neitz, Alexander, Heitkaemper, Jens, Sinha, Anu, Zhou, Denny, Sun, Yi, Kaed, Charbel, Hulse, Brice, Mishra, Swaroop, Georgaki, Maria, Kudugunta, Sneha, Farabet, Clement, Shafran, Izhak, Vlasic, Daniel, Tsitsulin, Anton, Ananthanarayanan, Rajagopal, Carin, Alen, Su, Guolong, Sun, Pei, V, Shashank, Carvajal, Gabriel, Broder, Josef, Comsa, Iulia, Repina, Alena, Wong, William, Chen, Warren Weilun, Hawkins, Peter, Filonov, Egor, Loher, Lucia, Hirnschall, Christoph, Wang, Weiyi, Ye, Jingchen, Burns, Andrea, Cate, Hardie, Wright, Diana Gage, Piccinini, Federico, Zhang, Lei, Lin, Chu-Cheng, Gog, Ionel, Kulizhskaya, Yana, Sreevatsa, Ashwin, Song, Shuang, Cobo, Luis C., Iyer, Anand, Tekur, Chetan, Garrido, Guillermo, Xiao, Zhuyun, Kemp, Rupert, Zheng, Huaixiu Steven, Li, Hui, Agarwal, Ananth, Ngani, Christel, Goshvadi, Kati, Santamaria-Fernandez, Rebeca, Fica, Wojciech, Chen, Xinyun, Gorgolewski, Chris, Sun, Sean, Garg, Roopal, Ye, Xinyu, Eslami, S. M. 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Lilly, Prendki, Jennifer, Wu, Marcus, Eccles, Tom, Liu, Tianqi, Kopparapu, Kavya, Beaufays, Francoise, Angermueller, Christof, Marzoca, Andreea, Sarcar, Shourya, Dib, Hilal, Stanway, Jeff, Perbet, Frank, Trdin, Nejc, Sterneck, Rachel, Khorlin, Andrey, Li, Dinghua, Wu, Xihui, Goenka, Sonam, Madras, David, Goldshtein, Sasha, Gierke, Willi, Zhou, Tong, Liu, Yaxin, Liang, Yannie, White, Anais, Li, Yunjie, Singh, Shreya, Bahargam, Sanaz, Epstein, Mark, Basu, Sujoy, Lao, Li, Ozturel, Adnan, Crous, Carl, Zhai, Alex, Lu, Han, Tung, Zora, Gaur, Neeraj, Walton, Alanna, Dixon, Lucas, Zhang, Ming, Globerson, Amir, Uy, Grant, Bolt, Andrew, Wiles, Olivia, Nasr, Milad, Shumailov, Ilia, Selvi, Marco, Piccinno, Francesco, Aguilar, Ricardo, McCarthy, Sara, Khalman, Misha, Shukla, Mrinal, Galic, Vlado, Carpenter, John, Villela, Kevin, Zhang, Haibin, Richardson, Harry, Martens, James, Bosnjak, Matko, Belle, Shreyas Rammohan, Seibert, Jeff, Alnahlawi, Mahmoud, McWilliams, Brian, Singh, Sankalp, Louis, Annie, Ding, Wen, Popovici, Dan, Simicich, Lenin, Knight, Laura, Mehta, Pulkit, Gupta, Nishesh, Shi, Chongyang, Fatehi, Saaber, Mitrovic, Jovana, Grills, Alex, Pagadora, Joseph, Petrova, Dessie, Eisenbud, Danielle, Zhang, Zhishuai, Yates, Damion, Mittal, Bhavishya, Tripuraneni, Nilesh, Assael, Yannis, Brovelli, Thomas, Jain, Prateek, Velimirovic, Mihajlo, Akbulut, Canfer, Mu, Jiaqi, Macherey, Wolfgang, Kumar, Ravin, Xu, Jun, Qureshi, Haroon, Comanici, Gheorghe, Wiesner, Jeremy, Gong, Zhitao, Ruddock, Anton, Bauer, Matthias, Felt, Nick, GP, Anirudh, Arnab, Anurag, Zelle, Dustin, Rothfuss, Jonas, Rosgen, Bill, Shenoy, Ashish, Seybold, Bryan, Li, Xinjian, Mudigonda, Jayaram, Erdogan, Goker, Xia, Jiawei, Simsa, Jiri, Michi, Andrea, Yao, Yi, Yew, Christopher, Kan, Steven, Caswell, Isaac, Radebaugh, Carey, Elisseeff, Andre, Valenzuela, Pedro, McKinney, Kay, Paterson, Kim, Cui, Albert, Latorre-Chimoto, Eri, Kim, Solomon, Zeng, William, Durden, Ken, Ponnapalli, Priya, Sosea, Tiberiu, Choquette-Choo, Christopher A., Manyika, James, Robenek, Brona, Vashisht, Harsha, Pereira, Sebastien, Lam, Hoi, Velic, Marko, Owusu-Afriyie, Denese, Lee, Katherine, Bolukbasi, Tolga, Parrish, Alicia, Lu, Shawn, Park, Jane, Venkatraman, Balaji, Talbert, Alice, Rosique, Lambert, Cheng, Yuchung, Sozanschi, Andrei, Paszke, Adam, Kumar, Praveen, Austin, Jessica, Li, Lu, Salama, Khalid, Kim, Wooyeol, Dukkipati, Nandita, Baryshnikov, Anthony, Kaplanis, Christos, Sheng, XiangHai, Chervonyi, Yuri, Unlu, Caglar, Casas, Diego de Las, Askham, Harry, Tunyasuvunakool, Kathryn, Gimeno, Felix, Poder, Siim, Kwak, Chester, Miecnikowski, Matt, Dimitriev, Alek, Parisi, Aaron, Liu, Dangyi, Tsai, Tomy, Shevlane, Toby, Kouridi, Christina, Garmon, Drew, Goedeckemeyer, Adrian, Brown, Adam R., Vijayakumar, Anitha, Elqursh, Ali, Jazayeri, Sadegh, Huang, Jin, Carthy, Sara Mc, Hoover, Jay, Kim, Lucy, Kumar, Sandeep, Chen, Wei, Biles, Courtney, Bingham, Garrett, Rosen, Evan, Wang, Lisa, Tan, Qijun, Engel, David, Pongetti, Francesco, de Cesare, Dario, Hwang, Dongseong, Yu, Lily, Pullman, Jennifer, Narayanan, Srini, Levin, Kyle, Gopal, Siddharth, Li, Megan, Aharoni, Asaf, Trinh, Trieu, Lo, Jessica, Casagrande, Norman, Vij, Roopali, Matthey, Loic, Ramadhana, Bramandia, Matthews, Austin, Carey, CJ, Johnson, Matthew, Goranova, Kremena, Shah, Rohin, Ashraf, Shereen, Dasgupta, Kingshuk, Larsen, Rasmus, Wang, Yicheng, Vuyyuru, Manish Reddy, Jiang, Chong, Ijazi, Joana, Osawa, Kazuki, Smith, Celine, Boppana, Ramya Sree, Bilal, Taylan, Koizumi, Yuma, Xu, Ying, Altun, Yasemin, Shabat, Nir, Bariach, Ben, Korchemniy, Alex, Choo, Kiam, Ronneberger, Olaf, Iwuanyanwu, Chimezie, Zhao, Shubin, Soergel, David, Hsieh, Cho-Jui, Cai, Irene, Iqbal, Shariq, Sundermeyer, Martin, Chen, Zhe, Bursztein, Elie, Malaviya, Chaitanya, Biadsy, Fadi, Shroff, Prakash, Dhillon, Inderjit, Latkar, Tejasi, Dyer, Chris, Forbes, Hannah, Nicosia, Massimo, Nikolaev, Vitaly, Greene, Somer, Georgiev, Marin, Wang, Pidong, Martin, Nina, Sedghi, Hanie, Zhang, John, Banzal, Praseem, Fritz, Doug, Rao, Vikram, Wang, Xuezhi, Zhang, Jiageng, Patraucean, Viorica, Du, Dayou, Mordatch, Igor, Jurin, Ivan, Liu, Lewis, Dubey, Ayush, Mohan, Abhi, Nowakowski, Janek, Ion, Vlad-Doru, Wei, Nan, Tojo, Reiko, Raad, Maria Abi, Hudson, Drew A., Keshava, Vaishakh, Agrawal, Shubham, Ramirez, Kevin, Wu, Zhichun, Nguyen, Hoang, Liu, Ji, Sewak, Madhavi, Petrini, Bryce, Choi, DongHyun, Philips, Ivan, Wang, Ziyue, Bica, Ioana, Garg, Ankush, Wilkiewicz, Jarek, Agrawal, Priyanka, Guo, Danhao, Xue, Emily, Shaik, Naseer, Leach, Andrew, Khan, Sadh MNM, Wiesinger, Julia, Jerome, Sammy, Chakladar, Abhishek, Wang, Alek Wenjiao, Ornduff, Tina, Abu, Folake, Ghaffarkhah, Alireza, Wainwright, Marcus, Cortes, Mario, Liu, Frederick, Maynez, Joshua, Terzis, Andreas, Samangouei, Pouya, Mansour, Riham, Kępa, Tomasz, Aubet, François-Xavier, Algymr, Anton, Banica, Dan, Weisz, Agoston, Orban, Andras, Senges, Alexandre, Andrejczuk, Ewa, Geller, Mark, Santo, Niccolo Dal, Anklin, Valentin, Merey, Majd Al, Baeuml, Martin, Strohman, Trevor, Bai, Junwen, Petrov, Slav, Wu, Yonghui, Hassabis, Demis, Kavukcuoglu, Koray, Dean, Jeffrey, and Vinyals, Oriol

Subjects
Computer Science - Computation and Language, Computer Science - Artificial Intelligence
Abstract

In this report, we introduce the Gemini 1.5 family of models, representing the next generation of highly compute-efficient multimodal models capable of recalling and reasoning over fine-grained information from millions of tokens of context, including multiple long documents and hours of video and audio. The family includes two new models: (1) an updated Gemini 1.5 Pro, which exceeds the February version on the great majority of capabilities and benchmarks; (2) Gemini 1.5 Flash, a more lightweight variant designed for efficiency with minimal regression in quality. Gemini 1.5 models achieve near-perfect recall on long-context retrieval tasks across modalities, improve the state-of-the-art in long-document QA, long-video QA and long-context ASR, and match or surpass Gemini 1.0 Ultra's state-of-the-art performance across a broad set of benchmarks. Studying the limits of Gemini 1.5's long-context ability, we find continued improvement in next-token prediction and near-perfect retrieval (>99%) up to at least 10M tokens, a generational leap over existing models such as Claude 3.0 (200k) and GPT-4 Turbo (128k). Finally, we highlight real-world use cases, such as Gemini 1.5 collaborating with professionals on completing their tasks achieving 26 to 75% time savings across 10 different job categories, as well as surprising new capabilities of large language models at the frontier; when given a grammar manual for Kalamang, a language with fewer than 200 speakers worldwide, the model learns to translate English to Kalamang at a similar level to a person who learned from the same content.

Published
2024

5. Gemini: A Family of Highly Capable Multimodal Models

Author

Gemini Team, Anil, Rohan, Borgeaud, Sebastian, Alayrac, Jean-Baptiste, Yu, Jiahui, Soricut, Radu, Schalkwyk, Johan, Dai, Andrew M., Hauth, Anja, Millican, Katie, Silver, David, Johnson, Melvin, Antonoglou, Ioannis, Schrittwieser, Julian, Glaese, Amelia, Chen, Jilin, Pitler, Emily, Lillicrap, Timothy, Lazaridou, Angeliki, Firat, Orhan, Molloy, James, Isard, Michael, Barham, Paul R., Hennigan, Tom, Lee, Benjamin, Viola, Fabio, Reynolds, Malcolm, Xu, Yuanzhong, Doherty, Ryan, Collins, Eli, Meyer, Clemens, Rutherford, Eliza, Moreira, Erica, Ayoub, Kareem, Goel, Megha, Krawczyk, Jack, Du, Cosmo, Chi, Ed, Cheng, Heng-Tze, Ni, Eric, Shah, Purvi, Kane, Patrick, Chan, Betty, Faruqui, Manaal, Severyn, Aliaksei, Lin, Hanzhao, Li, YaGuang, Cheng, Yong, Ittycheriah, Abe, Mahdieh, Mahdis, Chen, Mia, Sun, Pei, Tran, Dustin, Bagri, Sumit, Lakshminarayanan, Balaji, Liu, Jeremiah, Orban, Andras, Güra, Fabian, Zhou, Hao, Song, Xinying, Boffy, Aurelien, Ganapathy, Harish, Zheng, Steven, Choe, HyunJeong, Weisz, Ágoston, Zhu, Tao, Lu, Yifeng, Gopal, Siddharth, Kahn, Jarrod, Kula, Maciej, Pitman, Jeff, Shah, Rushin, Taropa, Emanuel, Merey, Majd Al, Baeuml, Martin, Chen, Zhifeng, Shafey, Laurent El, Zhang, Yujing, Sercinoglu, Olcan, Tucker, George, Piqueras, Enrique, Krikun, Maxim, Barr, Iain, Savinov, Nikolay, Danihelka, Ivo, Roelofs, Becca, White, Anaïs, Andreassen, Anders, von Glehn, Tamara, Yagati, Lakshman, Kazemi, Mehran, Gonzalez, Lucas, Khalman, Misha, Sygnowski, Jakub, Frechette, Alexandre, Smith, Charlotte, Culp, Laura, Proleev, Lev, Luan, Yi, Chen, Xi, Lottes, James, Schucher, Nathan, Lebron, Federico, Rrustemi, Alban, Clay, Natalie, Crone, Phil, Kocisky, Tomas, Zhao, Jeffrey, Perz, Bartek, Yu, Dian, Howard, Heidi, Bloniarz, Adam, Rae, Jack W., Lu, Han, Sifre, Laurent, Maggioni, Marcello, Alcober, Fred, Garrette, Dan, Barnes, Megan, Thakoor, Shantanu, Austin, Jacob, Barth-Maron, Gabriel, Wong, William, Joshi, Rishabh, Chaabouni, Rahma, Fatiha, Deeni, Ahuja, Arun, Tomar, Gaurav Singh, Senter, Evan, Chadwick, Martin, Kornakov, Ilya, Attaluri, Nithya, Iturrate, Iñaki, Liu, Ruibo, Li, Yunxuan, Cogan, Sarah, Chen, Jeremy, Jia, Chao, Gu, Chenjie, Zhang, Qiao, Grimstad, Jordan, Hartman, Ale Jakse, Garcia, Xavier, Pillai, Thanumalayan Sankaranarayana, Devlin, Jacob, Laskin, Michael, Casas, Diego de Las, Valter, Dasha, Tao, Connie, Blanco, Lorenzo, Badia, Adrià Puigdomènech, Reitter, David, Chen, Mianna, Brennan, Jenny, Rivera, Clara, Brin, Sergey, Iqbal, Shariq, Surita, Gabriela, Labanowski, Jane, Rao, Abhi, Winkler, Stephanie, Parisotto, Emilio, Gu, Yiming, Olszewska, Kate, Addanki, Ravi, Miech, Antoine, Louis, Annie, Teplyashin, Denis, Brown, Geoff, Catt, Elliot, Balaguer, Jan, Xiang, Jackie, Wang, Pidong, Ashwood, Zoe, Briukhov, Anton, Webson, Albert, Ganapathy, Sanjay, Sanghavi, Smit, Kannan, Ajay, Chang, Ming-Wei, Stjerngren, Axel, Djolonga, Josip, Sun, Yuting, Bapna, Ankur, Aitchison, Matthew, Pejman, Pedram, Michalewski, Henryk, Yu, Tianhe, Wang, Cindy, Love, Juliette, Ahn, Junwhan, Bloxwich, Dawn, Han, Kehang, Humphreys, Peter, Sellam, Thibault, Bradbury, James, Godbole, Varun, Samangooei, Sina, Damoc, Bogdan, Kaskasoli, Alex, Arnold, Sébastien M. R., Vasudevan, Vijay, Agrawal, Shubham, Riesa, Jason, Lepikhin, Dmitry, Tanburn, Richard, Srinivasan, Srivatsan, Lim, Hyeontaek, Hodkinson, Sarah, Shyam, Pranav, Ferret, Johan, Hand, Steven, Garg, Ankush, Paine, Tom Le, Li, Jian, Li, Yujia, Giang, Minh, Neitz, Alexander, Abbas, Zaheer, York, Sarah, Reid, Machel, Cole, Elizabeth, Chowdhery, Aakanksha, Das, Dipanjan, Rogozińska, Dominika, Nikolaev, Vitaliy, Sprechmann, Pablo, Nado, Zachary, Zilka, Lukas, Prost, Flavien, He, Luheng, Monteiro, Marianne, Mishra, Gaurav, Welty, Chris, Newlan, Josh, Jia, Dawei, Allamanis, Miltiadis, Hu, Clara Huiyi, de Liedekerke, Raoul, Gilmer, Justin, Saroufim, Carl, Rijhwani, Shruti, Hou, Shaobo, Shrivastava, Disha, Baddepudi, Anirudh, Goldin, Alex, Ozturel, Adnan, Cassirer, Albin, Xu, Yunhan, Sohn, Daniel, Sachan, Devendra, Amplayo, Reinald Kim, Swanson, Craig, Petrova, Dessie, Narayan, Shashi, Guez, Arthur, Brahma, Siddhartha, Landon, Jessica, Patel, Miteyan, Zhao, Ruizhe, Villela, Kevin, Wang, Luyu, Jia, Wenhao, Rahtz, Matthew, Giménez, Mai, Yeung, Legg, Keeling, James, Georgiev, Petko, Mincu, Diana, Wu, Boxi, Haykal, Salem, Saputro, Rachel, Vodrahalli, Kiran, Qin, James, Cankara, Zeynep, Sharma, Abhanshu, Fernando, Nick, Hawkins, Will, Neyshabur, Behnam, Kim, Solomon, Hutter, Adrian, Agrawal, Priyanka, Castro-Ros, Alex, Driessche, George van den, Wang, Tao, Yang, Fan, Chang, Shuo-yiin, Komarek, Paul, McIlroy, Ross, Lučić, Mario, Zhang, Guodong, Farhan, Wael, Sharman, Michael, Natsev, Paul, Michel, Paul, Bansal, Yamini, Qiao, Siyuan, Cao, Kris, Shakeri, Siamak, Butterfield, Christina, Chung, Justin, Rubenstein, Paul Kishan, Agrawal, Shivani, Mensch, Arthur, Soparkar, Kedar, Lenc, Karel, Chung, Timothy, Pope, Aedan, Maggiore, Loren, Kay, Jackie, Jhakra, Priya, Wang, Shibo, Maynez, Joshua, Phuong, Mary, Tobin, Taylor, Tacchetti, Andrea, Trebacz, Maja, Robinson, Kevin, Katariya, Yash, Riedel, Sebastian, Bailey, Paige, Xiao, Kefan, Ghelani, Nimesh, Aroyo, Lora, Slone, Ambrose, Houlsby, Neil, Xiong, Xuehan, Yang, Zhen, Gribovskaya, Elena, Adler, Jonas, Wirth, Mateo, Lee, Lisa, Li, Music, Kagohara, Thais, Pavagadhi, Jay, Bridgers, Sophie, Bortsova, Anna, Ghemawat, Sanjay, Ahmed, Zafarali, Liu, Tianqi, Powell, Richard, Bolina, Vijay, Iinuma, Mariko, Zablotskaia, Polina, Besley, James, Chung, Da-Woon, Dozat, Timothy, Comanescu, Ramona, Si, Xiance, Greer, Jeremy, Su, Guolong, Polacek, Martin, Kaufman, Raphaël Lopez, Tokumine, Simon, Hu, Hexiang, Buchatskaya, Elena, Miao, Yingjie, Elhawaty, Mohamed, Siddhant, Aditya, Tomasev, Nenad, Xing, Jinwei, Greer, Christina, Miller, Helen, Ashraf, Shereen, Roy, Aurko, Zhang, Zizhao, Ma, Ada, Filos, Angelos, Besta, Milos, Blevins, Rory, Klimenko, Ted, Yeh, Chih-Kuan, Changpinyo, Soravit, Mu, Jiaqi, Chang, Oscar, Pajarskas, Mantas, Muir, Carrie, Cohen, Vered, Lan, Charline Le, Haridasan, Krishna, Marathe, Amit, Hansen, Steven, Douglas, Sholto, Samuel, Rajkumar, Wang, Mingqiu, Austin, Sophia, Lan, Chang, Jiang, Jiepu, Chiu, Justin, Lorenzo, Jaime Alonso, Sjösund, Lars Lowe, Cevey, Sébastien, Gleicher, Zach, Avrahami, Thi, Boral, Anudhyan, Srinivasan, Hansa, Selo, Vittorio, May, Rhys, Aisopos, Konstantinos, Hussenot, Léonard, Soares, Livio Baldini, Baumli, Kate, Chang, Michael B., Recasens, Adrià, Caine, Ben, Pritzel, Alexander, Pavetic, Filip, Pardo, Fabio, Gergely, Anita, Frye, Justin, Ramasesh, Vinay, Horgan, Dan, Badola, Kartikeya, Kassner, Nora, Roy, Subhrajit, Dyer, Ethan, Campos, Víctor Campos, Tomala, Alex, Tang, Yunhao, Badawy, Dalia El, White, Elspeth, Mustafa, Basil, Lang, Oran, Jindal, Abhishek, Vikram, Sharad, Gong, Zhitao, Caelles, Sergi, Hemsley, Ross, Thornton, Gregory, Feng, Fangxiaoyu, Stokowiec, Wojciech, Zheng, Ce, Thacker, Phoebe, Ünlü, Çağlar, Zhang, Zhishuai, Saleh, Mohammad, Svensson, James, Bileschi, Max, Patil, Piyush, Anand, Ankesh, Ring, Roman, Tsihlas, Katerina, Vezer, Arpi, Selvi, Marco, Shevlane, Toby, Rodriguez, Mikel, Kwiatkowski, Tom, Daruki, Samira, Rong, Keran, Dafoe, Allan, FitzGerald, Nicholas, Gu-Lemberg, Keren, Khan, Mina, Hendricks, Lisa Anne, Pellat, Marie, Feinberg, Vladimir, Cobon-Kerr, James, Sainath, Tara, Rauh, Maribeth, Hashemi, Sayed Hadi, Ives, Richard, Hasson, Yana, Noland, Eric, Cao, Yuan, Byrd, Nathan, Hou, Le, Wang, Qingze, Sottiaux, Thibault, Paganini, Michela, Lespiau, Jean-Baptiste, Moufarek, Alexandre, Hassan, Samer, Shivakumar, Kaushik, van Amersfoort, Joost, Mandhane, Amol, Joshi, Pratik, Goyal, Anirudh, Tung, Matthew, Brock, Andrew, Sheahan, Hannah, Misra, Vedant, Li, Cheng, Rakićević, Nemanja, Dehghani, Mostafa, Liu, Fangyu, Mittal, Sid, Oh, Junhyuk, Noury, Seb, Sezener, Eren, Huot, Fantine, Lamm, Matthew, De Cao, Nicola, Chen, Charlie, Mudgal, Sidharth, Stella, Romina, Brooks, Kevin, Vasudevan, Gautam, Liu, Chenxi, Chain, Mainak, Melinkeri, Nivedita, Cohen, Aaron, Wang, Venus, Seymore, Kristie, Zubkov, Sergey, Goel, Rahul, Yue, Summer, Krishnakumaran, Sai, Albert, Brian, Hurley, Nate, Sano, Motoki, Mohananey, Anhad, Joughin, Jonah, Filonov, Egor, Kępa, Tomasz, Eldawy, Yomna, Lim, Jiawern, Rishi, Rahul, Badiezadegan, Shirin, Bos, Taylor, Chang, Jerry, Jain, Sanil, Padmanabhan, Sri Gayatri Sundara, Puttagunta, Subha, Krishna, Kalpesh, Baker, Leslie, Kalb, Norbert, Bedapudi, Vamsi, Kurzrok, Adam, Lei, Shuntong, Yu, Anthony, Litvin, Oren, Zhou, Xiang, Wu, Zhichun, Sobell, Sam, Siciliano, Andrea, Papir, Alan, Neale, Robby, Bragagnolo, Jonas, Toor, Tej, Chen, Tina, Anklin, Valentin, Wang, Feiran, Feng, Richie, Gholami, Milad, Ling, Kevin, Liu, Lijuan, Walter, Jules, Moghaddam, Hamid, Kishore, Arun, Adamek, Jakub, Mercado, Tyler, Mallinson, Jonathan, Wandekar, Siddhinita, Cagle, Stephen, Ofek, Eran, Garrido, Guillermo, Lombriser, Clemens, Mukha, Maksim, Sun, Botu, Mohammad, Hafeezul Rahman, Matak, Josip, Qian, Yadi, Peswani, Vikas, Janus, Pawel, Yuan, Quan, Schelin, Leif, David, Oana, Garg, Ankur, He, Yifan, Duzhyi, Oleksii, Älgmyr, Anton, Lottaz, Timothée, Li, Qi, Yadav, Vikas, Xu, Luyao, Chinien, Alex, Shivanna, Rakesh, Chuklin, Aleksandr, Li, Josie, Spadine, Carrie, Wolfe, Travis, Mohamed, Kareem, Das, Subhabrata, Dai, Zihang, He, Kyle, von Dincklage, Daniel, Upadhyay, Shyam, Maurya, Akanksha, Chi, Luyan, Krause, Sebastian, Salama, Khalid, Rabinovitch, Pam G, M, Pavan Kumar Reddy, Selvan, Aarush, Dektiarev, Mikhail, Ghiasi, Golnaz, Guven, Erdem, Gupta, Himanshu, Liu, Boyi, Sharma, Deepak, Shtacher, Idan Heimlich, Paul, Shachi, Akerlund, Oscar, Aubet, François-Xavier, Huang, Terry, Zhu, Chen, Zhu, Eric, Teixeira, Elico, Fritze, Matthew, Bertolini, Francesco, Marinescu, Liana-Eleonora, Bölle, Martin, Paulus, Dominik, Gupta, Khyatti, Latkar, Tejasi, Chang, Max, Sanders, Jason, Wilson, Roopa, Wu, Xuewei, Tan, Yi-Xuan, Thiet, Lam Nguyen, Doshi, Tulsee, Lall, Sid, Mishra, Swaroop, Chen, Wanming, Luong, Thang, Benjamin, Seth, Lee, Jasmine, Andrejczuk, Ewa, Rabiej, Dominik, Ranjan, Vipul, Styrc, Krzysztof, Yin, Pengcheng, Simon, Jon, Harriott, Malcolm Rose, Bansal, Mudit, Robsky, Alexei, Bacon, Geoff, Greene, David, Mirylenka, Daniil, Zhou, Chen, Sarvana, Obaid, Goyal, Abhimanyu, Andermatt, Samuel, Siegler, Patrick, Horn, Ben, Israel, Assaf, Pongetti, Francesco, Chen, Chih-Wei "Louis", Selvatici, Marco, Silva, Pedro, Wang, Kathie, Tolins, Jackson, Guu, Kelvin, Yogev, Roey, Cai, Xiaochen, Agostini, Alessandro, Shah, Maulik, Nguyen, Hung, Donnaile, Noah Ó, Pereira, Sébastien, Friso, Linda, Stambler, Adam, Kuang, Chenkai, Romanikhin, Yan, Geller, Mark, Yan, ZJ, Jang, Kane, Lee, Cheng-Chun, Fica, Wojciech, Malmi, Eric, Tan, Qijun, Banica, Dan, Balle, Daniel, Pham, Ryan, Huang, Yanping, Avram, Diana, Shi, Hongzhi, Singh, Jasjot, Hidey, Chris, Ahuja, Niharika, Saxena, Pranab, Dooley, Dan, Potharaju, Srividya Pranavi, O'Neill, Eileen, Gokulchandran, Anand, Foley, Ryan, Zhao, Kai, Dusenberry, Mike, Liu, Yuan, Mehta, Pulkit, Kotikalapudi, Ragha, Safranek-Shrader, Chalence, Goodman, Andrew, Kessinger, Joshua, Globen, Eran, Kolhar, Prateek, Gorgolewski, Chris, Ibrahim, Ali, Song, Yang, Eichenbaum, Ali, Brovelli, Thomas, Potluri, Sahitya, Lahoti, Preethi, Baetu, Cip, Ghorbani, Ali, Chen, Charles, Crawford, Andy, Pal, Shalini, Sridhar, Mukund, Gurita, Petru, Mujika, Asier, Petrovski, Igor, Cedoz, Pierre-Louis, Li, Chenmei, Chen, Shiyuan, Santo, Niccolò Dal, Goyal, Siddharth, Punjabi, Jitesh, Kappaganthu, Karthik, Kwak, Chester, LV, Pallavi, Velury, Sarmishta, Choudhury, Himadri, Hall, Jamie, Shah, Premal, Figueira, Ricardo, Thomas, Matt, Lu, Minjie, Zhou, Ting, Kumar, Chintu, Jurdi, Thomas, Chikkerur, Sharat, Ma, Yenai, Yu, Adams, Kwak, Soo, Ähdel, Victor, Rajayogam, Sujeevan, Choma, Travis, Liu, Fei, Barua, Aditya, Ji, Colin, Park, Ji Ho, Hellendoorn, Vincent, Bailey, Alex, Bilal, Taylan, Zhou, Huanjie, Khatir, Mehrdad, Sutton, Charles, Rzadkowski, Wojciech, Macintosh, Fiona, Shagin, Konstantin, Medina, Paul, Liang, Chen, Zhou, Jinjing, Shah, Pararth, Bi, Yingying, Dankovics, Attila, Banga, Shipra, Lehmann, Sabine, Bredesen, Marissa, Lin, Zifan, Hoffmann, John Eric, Lai, Jonathan, Chung, Raynald, Yang, Kai, Balani, Nihal, Bražinskas, Arthur, Sozanschi, Andrei, Hayes, Matthew, Alcalde, Héctor Fernández, Makarov, Peter, Chen, Will, Stella, Antonio, Snijders, Liselotte, Mandl, Michael, Kärrman, Ante, Nowak, Paweł, Wu, Xinyi, Dyck, Alex, Vaidyanathan, Krishnan, R, Raghavender, Mallet, Jessica, Rudominer, Mitch, Johnston, Eric, Mittal, Sushil, Udathu, Akhil, Christensen, Janara, Verma, Vishal, Irving, Zach, Santucci, Andreas, Elsayed, Gamaleldin, Davoodi, Elnaz, Georgiev, Marin, Tenney, Ian, Hua, Nan, Cideron, Geoffrey, Leurent, Edouard, Alnahlawi, Mahmoud, Georgescu, Ionut, Wei, Nan, Zheng, Ivy, Scandinaro, Dylan, Jiang, Heinrich, Snoek, Jasper, Sundararajan, Mukund, Wang, Xuezhi, Ontiveros, Zack, Karo, Itay, Cole, Jeremy, Rajashekhar, Vinu, Tumeh, Lara, Ben-David, Eyal, Jain, Rishub, Uesato, Jonathan, Datta, Romina, Bunyan, Oskar, Wu, Shimu, Zhang, John, Stanczyk, Piotr, Zhang, Ye, Steiner, David, Naskar, Subhajit, Azzam, Michael, Johnson, Matthew, Paszke, Adam, Chiu, Chung-Cheng, Elias, Jaume Sanchez, Mohiuddin, Afroz, Muhammad, Faizan, Miao, Jin, Lee, Andrew, Vieillard, Nino, Park, Jane, Zhang, Jiageng, Stanway, Jeff, Garmon, Drew, Karmarkar, Abhijit, Dong, Zhe, Lee, Jong, Kumar, Aviral, Zhou, Luowei, Evens, Jonathan, Isaac, William, Irving, Geoffrey, Loper, Edward, Fink, Michael, Arkatkar, Isha, Chen, Nanxin, Shafran, Izhak, Petrychenko, Ivan, Chen, Zhe, Jia, Johnson, Levskaya, Anselm, Zhu, Zhenkai, Grabowski, Peter, Mao, Yu, Magni, Alberto, Yao, Kaisheng, Snaider, Javier, Casagrande, Norman, Palmer, Evan, Suganthan, Paul, Castaño, Alfonso, Giannoumis, Irene, Kim, Wooyeol, Rybiński, Mikołaj, Sreevatsa, Ashwin, Prendki, Jennifer, Soergel, David, Goedeckemeyer, Adrian, Gierke, Willi, Jafari, Mohsen, Gaba, Meenu, Wiesner, Jeremy, Wright, Diana Gage, Wei, Yawen, Vashisht, Harsha, Kulizhskaya, Yana, Hoover, Jay, Le, Maigo, Li, Lu, Iwuanyanwu, Chimezie, Liu, Lu, Ramirez, Kevin, Khorlin, Andrey, Cui, Albert, LIN, Tian, Wu, Marcus, Aguilar, Ricardo, Pallo, Keith, Chakladar, Abhishek, Perng, Ginger, Abellan, Elena Allica, Zhang, Mingyang, Dasgupta, Ishita, Kushman, Nate, Penchev, Ivo, Repina, Alena, Wu, Xihui, van der Weide, Tom, Ponnapalli, Priya, Kaplan, Caroline, Simsa, Jiri, Li, Shuangfeng, Dousse, Olivier, Piper, Jeff, Ie, Nathan, Pasumarthi, Rama, Lintz, Nathan, Vijayakumar, Anitha, Andor, Daniel, Valenzuela, Pedro, Lui, Minnie, Paduraru, Cosmin, Peng, Daiyi, Lee, Katherine, Zhang, Shuyuan, Greene, Somer, Nguyen, Duc Dung, Kurylowicz, Paula, Hardin, Cassidy, Dixon, Lucas, Janzer, Lili, Choo, Kiam, Feng, Ziqiang, Zhang, Biao, Singhal, Achintya, Du, Dayou, McKinnon, Dan, Antropova, Natasha, Bolukbasi, Tolga, Keller, Orgad, Reid, David, Finchelstein, Daniel, Raad, Maria Abi, Crocker, Remi, Hawkins, Peter, Dadashi, Robert, Gaffney, Colin, Franko, Ken, Bulanova, Anna, Leblond, Rémi, Chung, Shirley, Askham, Harry, Cobo, Luis C., Xu, Kelvin, Fischer, Felix, Xu, Jun, Sorokin, Christina, Alberti, Chris, Lin, Chu-Cheng, Evans, Colin, Dimitriev, Alek, Forbes, Hannah, Banarse, Dylan, Tung, Zora, Omernick, Mark, Bishop, Colton, Sterneck, Rachel, Jain, Rohan, Xia, Jiawei, Amid, Ehsan, Piccinno, Francesco, Wang, Xingyu, Banzal, Praseem, Mankowitz, Daniel J., Polozov, Alex, Krakovna, Victoria, Brown, Sasha, Bateni, MohammadHossein, Duan, Dennis, Firoiu, Vlad, Thotakuri, Meghana, Natan, Tom, Geist, Matthieu, Girgin, Ser tan, Li, Hui, Ye, Jiayu, Roval, Ofir, Tojo, Reiko, Kwong, Michael, Lee-Thorp, James, Yew, Christopher, Sinopalnikov, Danila, Ramos, Sabela, Mellor, John, Sharma, Abhishek, Wu, Kathy, Miller, David, Sonnerat, Nicolas, Vnukov, Denis, Greig, Rory, Beattie, Jennifer, Caveness, Emily, Bai, Libin, Eisenschlos, Julian, Korchemniy, Alex, Tsai, Tomy, Jasarevic, Mimi, Kong, Weize, Dao, Phuong, Zheng, Zeyu, Liu, Frederick, Zhu, Rui, Teh, Tian Huey, Sanmiya, Jason, Gladchenko, Evgeny, Trdin, Nejc, Toyama, Daniel, Rosen, Evan, Tavakkol, Sasan, Xue, Linting, Elkind, Chen, Woodman, Oliver, Carpenter, John, Papamakarios, George, Kemp, Rupert, Kafle, Sushant, Grunina, Tanya, Sinha, Rishika, Talbert, Alice, Wu, Diane, Owusu-Afriyie, Denese, Thornton, Chloe, Pont-Tuset, Jordi, Narayana, Pradyumna, Li, Jing, Fatehi, Saaber, Wieting, John, Ajmeri, Omar, Uria, Benigno, Ko, Yeongil, Knight, Laura, Héliou, Amélie, Niu, Ning, Gu, Shane, Pang, Chenxi, Li, Yeqing, Levine, Nir, Stolovich, Ariel, Santamaria-Fernandez, Rebeca, Goenka, Sonam, Yustalim, Wenny, Strudel, Robin, Elqursh, Ali, Deck, Charlie, Lee, Hyo, Li, Zonglin, Levin, Kyle, Hoffmann, Raphael, Holtmann-Rice, Dan, Bachem, Olivier, Arora, Sho, Koh, Christy, Yeganeh, Soheil Hassas, Põder, Siim, Tariq, Mukarram, Sun, Yanhua, Ionita, Lucian, Seyedhosseini, Mojtaba, Tafti, Pouya, Liu, Zhiyu, Gulati, Anmol, Liu, Jasmine, Ye, Xinyu, Chrzaszcz, Bart, Wang, Lily, Sethi, Nikhil, Li, Tianrun, Brown, Ben, Singh, Shreya, Fan, Wei, Parisi, Aaron, Stanton, Joe, Koverkathu, Vinod, Choquette-Choo, Christopher A., Li, Yunjie, Lu, TJ, Shroff, Prakash, Varadarajan, Mani, Bahargam, Sanaz, Willoughby, Rob, Gaddy, David, Desjardins, Guillaume, Cornero, Marco, Robenek, Brona, Mittal, Bhavishya, Albrecht, Ben, Shenoy, Ashish, Moiseev, Fedor, Jacobsson, Henrik, Ghaffarkhah, Alireza, Rivière, Morgane, Walton, Alanna, Crepy, Clément, Parrish, Alicia, Zhou, Zongwei, Farabet, Clement, Radebaugh, Carey, Srinivasan, Praveen, van der Salm, Claudia, Fidjeland, Andreas, Scellato, Salvatore, Latorre-Chimoto, Eri, Klimczak-Plucińska, Hanna, Bridson, David, de Cesare, Dario, Hudson, Tom, Mendolicchio, Piermaria, Walker, Lexi, Morris, Alex, Mauger, Matthew, Guseynov, Alexey, Reid, Alison, Odoom, Seth, Loher, Lucia, Cotruta, Victor, Yenugula, Madhavi, Grewe, Dominik, Petrushkina, Anastasia, Duerig, Tom, Sanchez, Antonio, Yadlowsky, Steve, Shen, Amy, Globerson, Amir, Webb, Lynette, Dua, Sahil, Li, Dong, Bhupatiraju, Surya, Hurt, Dan, Qureshi, Haroon, Agarwal, Ananth, Shani, Tomer, Eyal, Matan, Khare, Anuj, Belle, Shreyas Rammohan, Wang, Lei, Tekur, Chetan, Kale, Mihir Sanjay, Wei, Jinliang, Sang, Ruoxin, Saeta, Brennan, Liechty, Tyler, Sun, Yi, Zhao, Yao, Lee, Stephan, Nayak, Pandu, Fritz, Doug, Vuyyuru, Manish Reddy, Aslanides, John, Vyas, Nidhi, Wicke, Martin, Ma, Xiao, Eltyshev, Evgenii, Martin, Nina, Cate, Hardie, Manyika, James, Amiri, Keyvan, Kim, Yelin, Xiong, Xi, Kang, Kai, Luisier, Florian, Tripuraneni, Nilesh, Madras, David, Guo, Mandy, Waters, Austin, Wang, Oliver, Ainslie, Joshua, Baldridge, Jason, Zhang, Han, Pruthi, Garima, Bauer, Jakob, Yang, Feng, Mansour, Riham, Gelman, Jason, Xu, Yang, Polovets, George, Liu, Ji, Cai, Honglong, Chen, Warren, Sheng, XiangHai, Xue, Emily, Ozair, Sherjil, Angermueller, Christof, Li, Xiaowei, Sinha, Anoop, Wang, Weiren, Wiesinger, Julia, Koukoumidis, Emmanouil, Tian, Yuan, Iyer, Anand, Gurumurthy, Madhu, Goldenson, Mark, Shah, Parashar, Blake, MK, Yu, Hongkun, Urbanowicz, Anthony, Palomaki, Jennimaria, Fernando, Chrisantha, Durden, Ken, Mehta, Harsh, Momchev, Nikola, Rahimtoroghi, Elahe, Georgaki, Maria, Raul, Amit, Ruder, Sebastian, Redshaw, Morgan, Lee, Jinhyuk, Zhou, Denny, Jalan, Komal, Li, Dinghua, Hechtman, Blake, Schuh, Parker, Nasr, Milad, Milan, Kieran, Mikulik, Vladimir, Franco, Juliana, Green, Tim, Nguyen, Nam, Kelley, Joe, Mahendru, Aroma, Hu, Andrea, Howland, Joshua, Vargas, Ben, Hui, Jeffrey, Bansal, Kshitij, Rao, Vikram, Ghiya, Rakesh, Wang, Emma, Ye, Ke, Sarr, Jean Michel, Preston, Melanie Moranski, Elish, Madeleine, Li, Steve, Kaku, Aakash, Gupta, Jigar, Pasupat, Ice, Juan, Da-Cheng, Someswar, Milan, M., Tejvi, Chen, Xinyun, Amini, Aida, Fabrikant, Alex, Chu, Eric, Dong, Xuanyi, Muthal, Amruta, Buthpitiya, Senaka, Jauhari, Sarthak, Khandelwal, Urvashi, Hitron, Ayal, Ren, Jie, Rinaldi, Larissa, Drath, Shahar, Dabush, Avigail, Jiang, Nan-Jiang, Godhia, Harshal, Sachs, Uli, Chen, Anthony, Fan, Yicheng, Taitelbaum, Hagai, Noga, Hila, Dai, Zhuyun, Wang, James, Hamer, Jenny, Ferng, Chun-Sung, Elkind, Chenel, Atias, Aviel, Lee, Paulina, Listík, Vít, Carlen, Mathias, van de Kerkhof, Jan, Pikus, Marcin, Zaher, Krunoslav, Müller, Paul, Zykova, Sasha, Stefanec, Richard, Gatsko, Vitaly, Hirnschall, Christoph, Sethi, Ashwin, Xu, Xingyu Federico, Ahuja, Chetan, Tsai, Beth, Stefanoiu, Anca, Feng, Bo, Dhandhania, Keshav, Katyal, Manish, Gupta, Akshay, Parulekar, Atharva, Pitta, Divya, Zhao, Jing, Bhatia, Vivaan, Bhavnani, Yashodha, Alhadlaq, Omar, Li, Xiaolin, Danenberg, Peter, Tu, Dennis, Pine, Alex, Filippova, Vera, Ghosh, Abhipso, Limonchik, Ben, Urala, Bhargava, Lanka, Chaitanya Krishna, Clive, Derik, Li, Edward, Wu, Hao, Hongtongsak, Kevin, Li, Ianna, Thakkar, Kalind, Omarov, Kuanysh, Majmundar, Kushal, Alverson, Michael, Kucharski, Michael, Patel, Mohak, Jain, Mudit, Zabelin, Maksim, Pelagatti, Paolo, Kohli, Rohan, Kumar, Saurabh, Kim, Joseph, Sankar, Swetha, Shah, Vineet, Ramachandruni, Lakshmi, Zeng, Xiangkai, Bariach, Ben, Weidinger, Laura, Vu, Tu, Andreev, Alek, He, Antoine, Hui, Kevin, Kashem, Sheleem, Subramanya, Amar, Hsiao, Sissie, Hassabis, Demis, Kavukcuoglu, Koray, Sadovsky, Adam, Le, Quoc, Strohman, Trevor, Wu, Yonghui, Petrov, Slav, Dean, Jeffrey, and Vinyals, Oriol

Subjects
Computer Science - Computation and Language, Computer Science - Artificial Intelligence, Computer Science - Computer Vision and Pattern Recognition
Abstract

This report introduces a new family of multimodal models, Gemini, that exhibit remarkable capabilities across image, audio, video, and text understanding. The Gemini family consists of Ultra, Pro, and Nano sizes, suitable for applications ranging from complex reasoning tasks to on-device memory-constrained use-cases. Evaluation on a broad range of benchmarks shows that our most-capable Gemini Ultra model advances the state of the art in 30 of 32 of these benchmarks - notably being the first model to achieve human-expert performance on the well-studied exam benchmark MMLU, and improving the state of the art in every one of the 20 multimodal benchmarks we examined. We believe that the new capabilities of the Gemini family in cross-modal reasoning and language understanding will enable a wide variety of use cases. We discuss our approach toward post-training and deploying Gemini models responsibly to users through services including Gemini, Gemini Advanced, Google AI Studio, and Cloud Vertex AI.

Published
2023

10. The epidemiology of gram-negative bacteremia in Lebanon: a study in four hospitals

Author

Janane Nasr, Hilal Abdessamad, Johnathan Mina, Tony Haykal, Yasser Jamil, Emma Abboud, Ahmad Mahdi, Rana Asmar, Rawad Abi Assaad, Dana Alameddine, Alaa Bourji, Mahmoud Mahdi, Razan Abdulaal, Serge Tomassian, Hanane El Ahmadieh, Wael Azzam, Jacques E. Mokhbat, Rima Moghnieh, Alfonso J. Rodriguez-Morales, and Rola Husni

Subjects
Gram-negative, Bacteremia, Multicentric, Mortality, Lebanon, Therapeutics. Pharmacology, RM1-950, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

Abstract Introduction Gram-negative bacteremia is a life-threatening infection with high morbidity and mortality. Its incidence is rising worldwide, and treatment has become more challenging due to emerging bacterial resistance. Little data is available on the burden and outcome of such infections in Lebanon. Methods We conducted this retrospective study in four Lebanese hospitals. Data on medical conditions and demographics of 2400 patients diagnosed with a bloodstream infection based on a positive blood culture were collected between January 2014 and December 2020. Results Most bacteremias were caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, with the more resistant organisms being hospital-acquired. Third-generation cephalosporin and quinolone resistance was steady throughout the study, but carbapenem resistance increased. Mortality with such infections is high, but carbapenem resistance or infection with Pseudomonas or Acinetobacter species were significant risk factors for poor outcomes. Conclusion This is the first multi-center study from Lebanon on gram-negative bacteremia, resistance patterns, and factors associated with a poor outcome. More surveillance is needed to provide data to guide empirical treatment for bacteremia in Lebanon.

Published
2024
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11. Association Between Conduit Type and Outcomes After Open Repair of Popliteal Artery Aneurysms

Author

Naazie, Isaac N, Willie-Permor, Daniel, Haykal, Tony, Harris, Linda M, Hughes, Kakra, and Malas, Mahmoud B

Subjects
Clinical Research, Rehabilitation, Cardiovascular, Amputation free survival, Bypass conduit, Popliteal artery aneurysm, Clinical Sciences, Surgery
Abstract

IntroductionPrior studies have demonstrated acceptable midterm outcomes with prosthetic conduits for above-knee bypass for occlusive disease in patients with inadequate segment great saphenous vein (GSV). In this study we aimed to investigate whether this holds true for open repair of popliteal artery aneurysms (PAA).MethodsWe queried the Vascular Quality Initiative data for patients who underwent open PAA repair (OPAR). We divided the cohort into three groups based on the conduit used: GSV, other autologous veins, or prosthetic graft. Study outcomes included primary patency, freedom from major amputation, amputation-free survival, and overall survival at 1 y. Kaplan-Meier survival estimates, log-rank tests and multivariable Cox regression were used to compare outcomes between study groups.ResultsA total of 4016 patients underwent bypass for PAA from January 2010 to October 2021. The three cohorts were significantly different in many demographic and clinical characteristics. The adjusted odds of postoperative amputation among symptomatic patients were 3-fold higher for prosthetic conduits compared to the GSV (odds ratio, 3.20; 95% CI, 1.72-5.92; P

Published
2023

12. Creating Realistic Anterior Segment Optical Coherence Tomography Images using Generative Adversarial Networks

Author

Assaf, Jad F., Mrad, Anthony Abou, Reinstein, Dan Z., Amescua, Guillermo, Zakka, Cyril, Archer, Timothy, Yammine, Jeffrey, Lamah, Elsa, Haykal, Michèle, and Awwad, Shady T.

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition, 68T45, I.2.10
Abstract

This paper presents the development and validation of a Generative Adversarial Network (GAN) purposed to create high-resolution, realistic Anterior Segment Optical Coherence Tomography (AS-OCT) images. We trained the Style and WAvelet based GAN (SWAGAN) on 142,628 AS-OCT B-scans. Three experienced refractive surgeons performed a blinded assessment to evaluate the realism of the generated images; their results were not significantly better than chance in distinguishing between real and synthetic images, thus demonstrating a high degree of image realism. To gauge their suitability for machine learning tasks, a convolutional neural network (CNN) classifier was trained with a dataset containing both real and GAN-generated images. The CNN demonstrated an accuracy rate of 78% trained on real images alone, but this accuracy rose to 100% when training included the generated images. This underscores the utility of synthetic images for machine learning applications. We further improved the resolution of the generated images by up-sampling them twice (2x) using an Enhanced Super Resolution GAN (ESRGAN), which outperformed traditional up-sampling techniques. In conclusion, GANs can effectively generate high-definition, realistic AS-OCT images, proving highly beneficial for machine learning and image analysis tasks., Comment: British Journal of Ophthalmology, published online May 2, 2024

Published
2023
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13. Skin and Digital–The 2024 Narrative

Author

Dominique du Crest, MBE, Monisha Madhumita, MD, Wendemagegn Enbiale, MD, MPH, PhD, Alexander Zink, MD, MPH, PhD, Art Papier, MD, Gaone Matewa, BBA, Harvey Castro, MD, MBA, Hector Perandones, MD, Josef De Guzman, OD-OPS, Misha Rosenbach, MD, Tu-Anh Duong, MD, PhD, Yu-Chuan Jack Li, MD, PhD, Hugues Cartier, MD, Benjamin Ascher, MD, Sebastien Garson, MD, Alessandra Haddad, MD, PhD, Daniel Z. Liu, MD, Diala Haykal, MD, Jane Yoo, MD, MPP, Nav Paul, MBBS, MRCP, Tracy Cohen Sayag, Mfin, Merete Hædersdal, MD, PhD, DMSc, Esther Freeman, MD, PhD, and Lilit Garibyan, MD, PhD

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

The global burden of skin diseases affects over 3 billion individuals, posing important public health challenges worldwide, with profound impacts in both high-income and low-income and middle-income countries. These challenges are exacerbated by widespread disparities in access to dermatologic care and the prevalence of misinformation. This article, derived from the Skin and Digital Summit at the International Master Course on Aging Science critically evaluates how digital technologies such as artificial intelligence, teledermatology, and large language models can bridge these access gaps. It explores practical applications and case studies demonstrating the impact of these technologies in various settings, with a particular focus on adapting solutions to meet the diverse needs of low-income and middle-income countries. In addition, the narrative highlights the ongoing conversation within the dermatologic community about the role of digital advances in health care, emphasizing that this discussion is dynamic and the one that is continuously evolving. Dermatologists play an essential role in this transition, integrating digital tools into mainstream care to complement a patient-centered, culturally sensitive approach. The article advocates for a globally coordinated digital response that not only addresses current disparities in skin health care but also promotes equitable access to digital health resources, making dermatologic care more representative of all skin types and accessible worldwide.

Published
2024
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14. Two Decades of Advances and Limitations in Organ Recellularization

Author

Alina Stoian, Aisha Adil, Felor Biniazan, and Siba Haykal

Subjects
decellularization, recellularization, organ recellularization, extracellular matrix, Biology (General), QH301-705.5
Abstract

The recellularization of tissues after decellularization is a relatively new technology in the field of tissue engineering (TE). Decellularization involves removing cells from a tissue or organ, leaving only the extracellular matrix (ECM). This can then be recellularized with new cells to create functional tissues or organs. The first significant mention of recellularization in decellularized tissues can be traced to research conducted in the early 2000s. One of the landmark studies in this field was published in 2008 by Ott, where researchers demonstrated the recellularization of a decellularized rat heart with cardiac cells, resulting in a functional organ capable of contraction. Since then, other important studies have been published. These studies paved the way for the widespread application of recellularization in TE, demonstrating the potential of decellularized ECM to serve as a scaffold for regenerating functional tissues. Thus, although the concept of recellularization was initially explored in previous decades, these studies from the 2000s marked a major turning point in the development and practical application of the technology for the recellularization of decellularized tissues. The article reviews the historical advances and limitations in organ recellularization in TE over the last two decades.

Published
2024
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15. Safety and Activity of Immune Checkpoint Inhibitors in People Living With HIV and Cancer: A Real-World Report From the Cancer Therapy Using Checkpoint Inhibitors in People Living With HIV-International (CATCH-IT) Consortium.

Author

El Zarif, Talal, Nassar, Amin, Adib, Elio, Fitzgerald, Bailey, Huang, Jiaming, Mouhieddine, Tarek, Rubinstein, Paul, Nonato, Taylor, McKay, Rana, Li, Mingjia, Mittra, Arjun, Owen, Dwight, Baiocchi, Robert, Lorentsen, Michael, Dittus, Christopher, Dizman, Nazli, Falohun, Adewunmi, Abdel-Wahab, Noha, Diab, Adi, Bankapur, Anand, Reed, Alexandra, Kim, Chul, Arora, Aakriti, Shah, Neil, El-Am, Edward, Kozaily, Elie, Abdallah, Wassim, Al-Hader, Ahmad, Abu Ghazal, Batool, Saeed, Anwaar, Drolen, Claire, Lechner, Melissa, Drakaki, Alexandra, Baena, Javier, Nebhan, Caroline, Haykal, Tarek, Morse, Michael, Cortellini, Alessio, Pinato, David, Dalla Pria, Alessia, Hall, Evan, Bakalov, Veli, Bahary, Nathan, Rajkumar, Aarthi, Mangla, Ankit, Shah, Vishal, Singh, Parminder, Aboubakar Nana, Frank, Lopetegui-Lia, Nerea, Dima, Danai, Dobbs, Ryan, Funchain, Pauline, Saleem, Rabia, Woodford, Rachel, Long, Georgina, Menzies, Alexander, Genova, Carlo, Barletta, Giulia, Puri, Sonam, Florou, Vaia, Idossa, Dame, Saponara, Maristella, Queirolo, Paola, Lamberti, Giuseppe, Addeo, Alfredo, Bersanelli, Melissa, Freeman, Dory, Xie, Wanling, Reid, Erin, Chiao, Elizabeth, Sharon, Elad, Johnson, Douglas, Ramaswami, Ramya, Bower, Mark, Emu, Brinda, Marron, Thomas, Choueiri, Toni, Baden, Lindsey, Lurain, Kathryn, Sonpavde, Guru, and Naqash, Abdul

Subjects
Male, Humans, Middle Aged, Female, Carcinoma, Hepatocellular, Immune Checkpoint Inhibitors, Retrospective Studies, Squamous Cell Carcinoma of Head and Neck, Liver Neoplasms, Carcinoma, Non-Small-Cell Lung, Lung Neoplasms, Head and Neck Neoplasms, HIV Infections
Abstract

PURPOSE: Compared with people living without HIV (PWOH), people living with HIV (PWH) and cancer have traditionally been excluded from immune checkpoint inhibitor (ICI) trials. Furthermore, there is a paucity of real-world data on the use of ICIs in PWH and cancer. METHODS: This retrospective study included PWH treated with anti-PD-1- or anti-PD-L1-based therapies for advanced cancers. Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS). Objective response rates (ORRs) were measured per RECIST 1.1 or other tumor-specific criteria, whenever feasible. Restricted mean survival time (RMST) was used to compare OS and PFS between matched PWH and PWOH with metastatic NSCLC (mNSCLC). RESULTS: Among 390 PWH, median age was 58 years, 85% (n = 331) were males, 36% (n = 138) were Black; 70% (n = 274) received anti-PD-1/anti-PD-L1 monotherapy. Most common cancers were NSCLC (28%, n = 111), hepatocellular carcinoma ([HCC]; 11%, n = 44), and head and neck squamous cell carcinoma (HNSCC; 10%, n = 39). Seventy percent (152/216) had CD4+ T cell counts ≥200 cells/µL, and 94% (179/190) had HIV viral load

Published
2023

16. Critical Assessment of Fellowship Director Gender and Ethnic Diversity across the Five Major Plastic Surgery Fellowships

Author

Sam Boroumand, BS, Sasha Stogniy, BS, Beatrice Katsnelson, BS, Omar Allam, MD, Aliyar Zahedi Vafa, BS, Janessa Sullivan, MD, Bohdan Pomahac, MD, Siba Haykal, MD, PhD, and Paris D. Butler, MD, MPH

Subjects
Surgery, RD1-811
Abstract

Background:. Subspecialty fellowship directors are essential to the selection and mentorship of trainees. The purpose of this study is to evaluate the gender and racial/ethnic diversity of fellowship directors across fellowship programs in plastic and reconstructive surgery (PRS). Methods:. In December 2023, listings of fellowship programs/directors were surveyed from respective professional society websites across the 5 primary PRS fellowships: hand (American Society for Surgery of the Hand), craniofacial (American Society of Craniofacial Surgeons), microsurgery (American Society for Reconstructive Microsurgery), aesthetic (The Aesthetic Society), and burn (American Burn Association). Fellowship director demographics from each program were researched and identified. Results:. In total, 248 fellowship directors were identified: 94 hand, 34 craniofacial, 62 microsurgery, 38 aesthetic, and 20 burn. There was a significantly greater percentage of male versus female directors across all fellowships (87.5% versus 12.5%; P < 0.01). Men were noted to have a significantly higher average h-index score (20.4 versus 15.0; P = 0.045) but constituted a lower proportion of assistant professorships (32.3% versus 12.9%; P < 0.01). Relative to directors from racial/ethnic minority backgrounds, White directors constituted a significantly greater percentage of fellowship directors (72.9% versus 27.1%; P < 0.01) and had a greater number of years passed since completing their most recent training (21.7 versus 17.1; P = 0.030). Conclusions:. Across PRS fellowship programs, women and racial/ethnic minorities are disproportionately underrepresented in leadership. Targeted initiatives to promote diversity in PRS fellowship directors should be considered as medicine works toward a surgical workforce more reflective of the patient population.

Published
2024
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18. The impact of religiosity and financial literacy on financial management behavior and well-being among Indonesian Muslims

Author

Haykal Rafif Wijaya, Sri Rahayu Hijrah Hati, Irwan Adi Ekaputra, and Salina Kassim

Subjects
History of scholarship and learning. The humanities, AZ20-999, Social Sciences
Abstract

Abstract This study examines the effects of religiosity and Islamic financial literacy on Muslims’ financial behavior and well-being. Additionally, it investigates the impact of sociodemographic variables on the centrality of religiosity, financial literacy, financial management behavior, and the well-being of Muslim consumers. This research integrates perspectives from Rational Choice Theory, the Rational Choice Theory of Religion, and Behavioral Finance to illuminate the mechanisms behind these relationships. Data were collected through a non-probability sampling method from 1141 Muslim individuals aged between 18 and 65 living in Indonesia. The results indicate that the centrality of religion in the lives of Muslim consumers and Islamic financial literacy significantly affects their financial management behavior and financial well-being. However, the empirical evidence suggests a more substantial effect of Islamic financial literacy than religiosity on both dependent variables.

Published
2024
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19. Multiple lower urinary tract calculi induced by foreign bodies insertion: A case report

Author

Haykal Hermatyar Fatahajjad, MD, Ricky Agave Ompusunggu, MD, Tetuka Bagus Laksita, MD, and Mohammad Ayodhia Soebadi, MD,PhD

Subjects
Lower urinary tract, Foreign body, Obstructive nephropathy, Endoscopy, Psychiatric disorder, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Lower urinary tract foreign bodies are often reported but the underlying causes remain intriguing, ranging from unconventional practices to medical interventions. This condition predominantly affects young males and presentations are varied from asymptomatic, lower urinary tract symptoms to acute obstructive renal failure. We report a case of a 48-year-old male presented with lower urinary tract symptoms and obstructive renal failure. Imaging revealed multiple foreign bodies in the pelvic cavity, suggestive of vesical, and urethral lithiasis. Urethrocystoscopy removed an 8-cm needle with rubber band and a 10-cm encrusted cable, forming a urethral stone. Vesicolithotomy removed a 5 × 3 cm bladder stone with a SIM card inserter as its core. The patient's condition improved after surgery. Notably, the patient's history prompted a psychiatric evaluation, leading to the diagnosis of and treatment for an adjustment disorder. While endourology procedure is effective in most cases, some cases necessitate open surgery. Identification and treatment of underlying psychiatric disorders is needed to for long term care.

Published
2024
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20. Gambaran Tingkat Kecemasan Pasien Bedah Anak pada Persiapan Perioperatif di Rumah Sakit Daerah dr. Soebandi Jember

Author

Supangat Supangat, Elly Nurus Sakinah, Muhammad Yuda Nugraha, Achmad Haykal Baswedan, and Prisma Atha Haritsah

Subjects
bedah anak, kecemasan, perioperatif, Anesthesiology, RD78.3-87.3
Abstract

Pasien yang akan menjalani tindakan pembedahan umumnya akan mengalami cemas, khususnya pasien anak. Kecemasan yang dirasakan dapat berhubungan dengan prosedur pembedahan maupun anestesi yang akan dilakukan. Kecemasan yang terjadi akan berdampak pada proses penyembuhan luka pascaoperasi. Beberapa penelitian menemukan bahwa jenis kelamin, tingkat pendidikan, dan pengalaman operasi dapat memengaruhi tingkat kecemasan pasien. Penelitian ini bertujuan menganalisis gambaran tingkat kecemasan pasien yang akan mengalami prosedur pembedahan dan dikaitkan dengan usia pasien. Desain penelitian ini merupakan penelitian cross-sectional pada bulan September–Oktober 2022 di RSD dr. Soebandi Jember pada pasien anak berusia 1–18 tahun yang akan menjalani operasi. Instrumen pada penelitian ini menggunakan kuesioner Modified Yale Preoperative Anxiety Scale sebagai alat ukur tingkat kecemasan pasien. Selanjutnya, tingkat kecemasan dianalisis berdasarkan data demografi pasien. Pada penelitian ini didapatkan data responden sebanyak 48 pasien. Hasil penelitian terdapat 48% pasien mengalami kecemasan. Tingkat kecemasan pasien ini berhubungan dengan usia (p=0,000). Sebagian besar pasien yang mengalami kecemasan usia kurang dari 10 tahun. Simpulan, tingkat kecemasan berhubungan dengan usia terutama usia

Published
2024
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21. Extraction of Essential Oil from Moringa Oleifera Leaves Using Steam Distillation and Soxhlet Extraction Method

Author

Muhammad Husin Haykal, Naufal Nafis Trisnawan, Annas Wiguno, and Kuswandi Kuswandi

Subjects
essential oil, moringa leaves, soxhlet extraction, steam distillation, yield, Chemistry, QD1-999
Abstract

Essential oil is one of Indonesia's agro-industrial export commodities, one of which is essential oil from Moringa oleifera leaves. This study aims to study the results of the yield and analyze the essential oil content of Moringa oleifera leaves using the steam distillation method and Soxhlet extraction using ethanol and isopropyl alcohol as a solvent. The fresh feed was either directly extracted or pre-treated using an oven and then followed by several stages of extraction. The pre-treatment of fresh feed was carried out in the oven at 70°C for 1 hour. Atmospheric steam distillation was carried out at 100°C for 6 hours using 500 ml of distilled water. In the case of soxhlet extraction, the temperature was set at the boiling point of the solvent for 6 hours. Once soxhlet extraction was complete, the essential oil was separated from the solvent by distillation. After various extraction processes, the essential oils were analyzed for their compound content using GC-MS. Based on the results of the study, the highest yield of 29.04% was obtained from the treated feed using two stages of soxhlet extraction variable with ethanol as solvent.

Published
2024
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23. Experimental investigation on the effects of zinc oxide and goethite as additives in a diesel engine fueled by pure palm oil

Author

Rico Aditia Prahmana, Prihadi Setyo Darmanto, Firman Bagja Juangsa, Iman Kartolaksono Reksowardojo, Tirto Prakoso, Jooned Hendrarsakti, Zido Yuwazama, Azaria Haykal Ahmad, Teuku Meurah Indra Riayatsyah, Achmad Gus Fahmi, Arridina Susan Silitonga, and Samsu Dlukha Nurcholik

Subjects
Pure palm oil, Zinc oxide, Goethite, Engine performance, Engineering (General). Civil engineering (General), TA1-2040
Abstract

Recent studies have shown the potential of zinc oxide as an additive in diesel engines because of its favorable properties. Goethite, as a metal additive, exhibits good thermodynamic stability and acts as a catalyst carrier to reduce environmental pollution. Incorporating zinc oxide microparticles and goethite nanoparticles into pure palm oil (PPaO) has great potential to improve the fuel properties. Therefore, in this study, the effects of adding zinc oxide microparticles and goethite nanoparticles into PPaO on the engine performance, spray characteristics, and smoke opacity of a diesel engine were investigated. A high-speed camera was used for the spray experiments. The results showed that the use of PPaO significantly increased the smoke opacity by ∼127.89 % compared with diesel fuel (DF). However, the use of PPaO with zinc oxide microparticles (PPaOZnO) and PPaO with goethite nanoparticles (PPaOGOE) significantly reduced the smoke opacity. The reduction in smoke opacity was most pronounced for the PPaOGOE fuel blend, with a value of 60 %, relative to the smoke opacity for DF. The PPaOZnO fuel blend significantly increased the specific fuel consumption by 37.1 %, with an average increase of ∼24.21 %, compared with DF at an engine load of 40 %. Moreover, the use of PPaOZnO and PPaOGOE fuel blends improved spray penetration 2 times compared to PPaO, although the relative viscosity and spray angle were similar to those for PPaO. These findings suggest that zinc oxide and goethite have great potential as additives for PPaO fuel, thereby enhancing the efficiency and performance of diesel engines.

Published
2024
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24. The influence of acetylene black microparticles as a fuel additive in pure palm oil and its performance characteristic on diesel engine

Author

Rico Aditia Prahmana, Prihadi Setyo Darmanto, Firman Bagja Juangsa, Iman Kartolaksono Reksowardojo, Tirto Prakoso, Jooned Hendarsakti, Muhamad Allan Serunting, Zido Yuwazama, and Azaria Haykal Ahmad

Subjects
Pure palm oil, Acetylene black, Diesel engine, Diesel engine performance, Technology
Abstract

Fuel additives are recognized for their potential to make diesel engines cleaner and more efficient. However, the use of Pure Palm Oil (PPaO) as a fuel faces challenges due to its inherent combustion inefficiencies. This study explores how Acetylene Black (AB), as an additive, affects the combustion performance and spray characteristics of a diesel engine. Observations of spray phenomena were conducted using a High-Speed Camera Phantom C110. The addition of AB to PPaO resulted in an increase in engine power and torque by 11.43 % at a 60 % load, averaging a 2.97 % improvement over diesel fuel (DF). PPaO demonstrated the most significant improvement in Specific Fuel Consumption (SFC) by 17.2 % at a 40 % load, averaging an 8.2 % increase. For PPaO with AB (PPaOAB), the greatest enhancement in SFC occurred at a 10 % load, showing a 9.2 % improvement over DF, with an average increase of 2.1 %. The study also found that thermal efficiency was optimally enhanced with PPaOAB at a 20 % load, achieving a remarkable 17.7 % improvement compared to DF. Notably, the inclusion of PPaOAB significantly reduced the thickness of carbon deposits on the pistons and cylinder head by 51.8 % and 3.9 %, respectively, and improved spray angle and penetration compared to PPaO. These findings suggest that AB could be a promising additive for PPaO, sparking further research interest in the application of AB in other fuels.

Published
2024
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25. The Role of Negative Pressure Wound Therapy in Temporizing Traumatic Wounds before Lower Limb Soft Tissue Reconstruction: A Systematic Review

Author

Natasha Barone, MDCM, MSc, Natalia Ziolkowski, MD, PhD, and Siba Haykal, MD, PhD, FRCSC, FACS

Subjects
Surgery, RD1-811
Abstract

Background:. In practice, there is often a delay from initial debridement and temporary fixation to definitive soft tissue coverage of traumatic leg wounds. Without clear evidence, conservative negative pressure wound therapy (NPWT) is increasingly used to temporize these wounds. This systematic review summarizes and synthesizes the literature on using NPWT to temporize traumatic leg wounds before surgery in adult surgical patients. Methods:. A comprehensive search of Medline, Embase, and Cochrane Library was performed from inception until July 2022, inclusively. Two independent reviewers performed screening, data extraction, and risk of bias assessment. Primary English studies, including adult patients (≥16 years old) with a fracture below the knee up to and including the ankle that received NPWT to temporize wounds before definitive soft tissue reconstruction with a flap and/or graft, were included. Results:. Thirty-four studies, including 804 patients who received NPWT, were included. The partial/total flap loss rate was 6.95% (n = 9 studies), the infection rate was 19.5% (n = 25 studies), the nonunion rate was 18% (n = 15 studies), the delayed union rate was 9.31% (n = 3 studies), and the amputation rate was 15.4% (n = 6 studies). The mean late stay was 43.1 days (n = 9 studies), and the follow-up length was 23.7 months (n = 9 studies). The mean time to wound healing was 5.63 months (n = 2 studies), and the time to soft tissue coverage was 40.8 days (n = 12 studies). The mean time to achieve bone union was 7.26 months (n = 6 studies). Conclusion:. NPWT can be used to temporize traumatic wounds while awaiting soft tissue reconstruction.

Published
2024
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26. Modified STEMI protocol for PPCI during COVID-19 Pandemic: Does it prolong Door-To-Balloon performance?

Author

astri yuniarsih putranto, Teuku Muhammad Haykal Putra, and Wahyu Aditya Soedarsono

Subjects
ST-Segment Elevation Myocardial Infarction, door-to-balloon time, COVID-19 pandemic, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background COVID-19 became a main health problem and causes heavy impact, especially for healthcare system. Managing ST-Segment Elevation Myocardial Infarction (STEMI) patients before COVID-19 pandemic was already challenging enough for Healthcare Professionals (HCP) to pursue time-sensitive treatment. After COVID-19 pandemic, the time-sensitive treatment of pursuing door-to-balloon (DTB) time put a lot more burden to HCP. In this study, We sought to analyze how a change in protocol of PPCI in STEMI patients before and during the pandemic influence the performance of DTB in the hospital. Methods This is a single-centered retrospective observational study among STEMI patients which was treated by PPCI. Secondary data from the medical record were collected consecutively from April 2018 to January 2022 (46 months). We compared DTB performances before and during the pandemic. Result During 46 months period, the total population of this research was 880 patients. There were total 358 patients underwent PPCI before the pandemic and 522 patients after the pandemic. Modified protocol with the addition step to prevent the spread of COVID-19 had been implemented since April 2020. DTB increased significantly during the pandemic (90 (70-124) minutes vs 97 (76-135) minutes, p 0.002). The proportion of the patients who achieved DTB under 90 min was also significantly decreasing (56.4% vs 47.9%, p 0.0013). Conclusion It is necessary for PPCI center to modify PPCI workflow during the pandemic. A decent workflow should consider practicality and simplicity without compromising HCP and patient safety. Implementing modified PPCI workflow during the pandemic significantly increased DTB time but it is still within the limit of being reasonable and acceptable for the benefit of the patients.

Published
2024
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27. Utility of Ischemic Signs from Initial ECG in Detecting Culprit Vessels in NSTE-ACS Patients

Author

Michael Asby Wijaya, Teuku Muhammad Haykal Putra, and Wishnu Aditya Widodo

Subjects
Culprit Lesion, ECG, NSTEMI, UAP, PCI, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

ABSTRACT Background: Non-ST-Elevation ACS (NSTE-ACS) is a part of ACS which require some special attentions. Multivessel coronary disease (MVD) is common in patients with NSTE-ACS and associated with difficulties in determining the main target of revascularization. ECG is the first-line diagnostic tool in the assessment of patients with suspected ACS. However, the utility of the ECG in localizing coronary culprit lesions in NSTE-ACS is not well established. This study was conducted to evaluate whether the pattern of the ischemic signs in ECG can be used to identify the coronary culprit vessel in patients with NSTE-ACS. Methods: This is a single-centered cross-sectional study using secondary data. The data of all 101 patients with NSTE-ACS who were planned for revascularization procedure between January 2021 and December 2021 were collected from medical record. ECG with ischemic signs were classified to three locations of suspected coronary vessel with culprit lesions and it will be compared to its corresponding angiographic data. The accuracy data will be presented including both sensitivity and specificity. Results: This study involved 75 men (74.3%) and 26 women (25.7%) with mean age 61.2±9.1 years old. There were 72 patients presented with ischemic signs form ECG with identifiable culprit vessel to be suspected. The sensitivity and specificity of ischemic signs ECG in localizing culprit vessels from angiography were 37.0% and 85.5% in LAD distribution, 38.1% and 81.3% in LCX distribution, and 41.1% and 85.1% in RCA distribution, respectively. Conclusion: Overall ischemic signs in ECG gave impression of modest accuracy with conspicuous key points that ECG distribution have high specificity in detecting culprit vessels but with low sensitivity. Thus, ischemic signs from initial ECG can be used to detect culprit vessels in NSTE-ACS patients. Keyword: Culprit Lesion, ECG, NSTEMI, UAP, PCI

Published
2024
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28. Bioengineering of vascularized porcine flaps using perfusion-recellularization

Author

Michael S. Xu, Andrew D’Elia, Nina Hadzimustafic, Aisha Adil, Golnaz Karoubi, Thomas K. Waddell, and Siba Haykal

Subjects
Medicine, Science
Abstract

Abstract Large volume soft tissue defects greatly impact patient quality of life and function while suitable repair options remain a challenge in reconstructive surgery. Engineered flaps could represent a clinically translatable option that may circumvent issues related to donor site morbidity and tissue availability. Herein, we describe the regeneration of vascularized porcine flaps, specifically of the omentum and tensor fascia lata (TFL) flaps, using a tissue engineering perfusion-decellularization and recellularization approach. Flaps were decellularized using a low concentration sodium dodecyl sulfate (SDS) detergent perfusion to generate an acellular scaffold with retained extracellular matrix (ECM) components while removing underlying cellular and nuclear contents. A perfusion-recellularization strategy allowed for seeding of acellular flaps with a co-culture of human umbilical vein endothelial cell (HUVEC) and mesenchymal stromal cells (MSC) onto the decellularized omentum and TFL flaps. Our recellularization technique demonstrated evidence of intravascular cell attachment, as well as markers of endothelial and mesenchymal phenotype. Altogether, our findings support the potential of using bioengineered porcine flaps as a novel, clinically-translatable strategy for future application in reconstructive surgery.

Published
2024
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29. Mesenchymal cells support the early retention of primary alveolar type 2 cells on acellular mouse lung scaffolds

Author

Daisuke Taniguchi, Mohammadali Ahmadipour, Anthony L. Eiliazadeh, Pascal Duchesneau, Takeshi Nagayasu, Siba Haykal, Golnaz Karoubi, and Thomas K. Waddell

Subjects
Alveolar type 2 cells, Bone marrow-derived mesenchymal cells, Decellularized lung scaffold, Recellularization, Lung regeneration, Medicine (General), R5-920, Cytology, QH573-671
Abstract

Objectives: Tissue engineering approaches via repopulation of acellular biological grafts provide an exciting opportunity to generate lung grafts for transplantation. Alveolar type 2 (AT2) cells are a promising cell source for re-epithelialization. There are however inherent limitations with respect to their survival and growth, thus impeding their usability for tissue engineering applications. This study investigates the use of mesenchymal stromal cells to support primary AT2 cells for recellularization of mouse lung scaffolds. Methods: AT2 cells and bone marrow-derived mesenchymal cells (BMC) were co-delivered to decellularized mouse lung scaffolds. Recellularized lungs were evaluated for cell surface coverage, viability, and differentiation at 1 and 4 days after cell seeding. Recellularization was evaluated via histological analysis and immunofluorescence. Results: Simultaneous delivery of AT2 and BMC into acellular lung scaffolds resulted in enhanced cell surface coverage and reduced AT2 cell apoptosis in the recellularized scaffolds at Day 1 but not Day 4. AT2 cell number decreased after 4 days in both of AT2 only and codelivery groups suggesting limited expansion potential in the scaffold. After retention in the scaffold, AT2 cells differentiated into Aqp5-expressing cells. Conclusions: Our results indicate that BMC support AT2 cell survival during the initial attachment and engraftment phase of recellularization. While our findings suggest only a short-term beneficial effect of BMC, our study demonstrates that AT2 cells can be delivered and retained in acellular lung scaffolds; thus with preconditioning and supporting cells, may be used for re-epithelialization. Selection and characterization of appropriate cell sources for use in recellularization, will be critical for ultimate clinical application.

Published
2024
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30. Development of MATLAB GUI-Based Mathematics Learning Media with ADDIE Model to Enhance Students' Mathematical Connection Ability

Author

Fikri Haykal Kusuma Putra, Marhan Taufik, and Minatun Nadlifah

Subjects
Special aspects of education, LC8-6691, Mathematics, QA1-939
Abstract

Research was conducted to develop learning media using Matlab GUI to enhance students' connection abilities. The aim was to create media containing valid, practical, and effective arithmetic and geometric sequences and series to support mathematical understanding. The study involved 10 randomly selected eleventh-grade students. Data was collected from validation results, tests, and student questionnaires. The research followed the ADDIE model in five stages: analysis, design, development, implementation, and evaluation. Media validation test results showed 86.5% validity, while student use scored 85.67% for practicality. Effectiveness testing revealed an average student score of 85.84%, demonstrating high effectiveness. These findings indicate that the Matlab GUI-based learning media successfully meet valid, effective, and practical criteria for enhancing students' mathematical connection abilities.

Published
2024
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31. Imaging topological defects in a non-collinear antiferromagnet

Author

Finco, Aurore, Haykal, Angela, Fusil, Stéphane, Kumar, Pawan, Dufour, Pauline, Forget, Anne, Colson, Dorothée, Chauleau, Jean-Yves, Viret, Michel, Jaouen, Nicolas, Garcia, Vincent, and Jacques, Vincent

Subjects
Condensed Matter - Mesoscale and Nanoscale Physics, Physics - Applied Physics
Abstract

We report on the formation of topological defects emerging from the cycloidal antiferromagnetic order at the surface of bulk BiFeO$_3$ crystals. Combining reciprocal and real-space magnetic imaging techniques, we first observe, in a single ferroelectric domain, the coexistence of antiferromagnetic domains in which the antiferromagnetic cycloid propagates along different wavevectors. We then show that the direction of these wavevectors is not strictly locked to the preferred crystallographic axes as continuous rotations bridge different wavevectors. At the junctions between the magnetic domains, we observe topological line defects identical to those found in a broad variety of lamellar physical systems with rotational symmetries. Our work establishes the presence of these magnetic objects at room temperature in the multiferroic antiferromagnet BiFeO$_3$, offering new possibilities for their use in spintronics., Comment: 7 pages, 4 figures, supplemental material as ancillary file

Published
2022
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32. Decoherence of V$_{\rm B}^{-}$ spin defects in monoisotopic hexagonal boron nitride

Author

Haykal, A., Tanos, R., Minotto, N., Durand, A., Fabre, F., Li, J., Edgar, J. H., Ivady, V., Gali, A., Michel, T., Dréau, A., Gil, B., Cassabois, G., and Jacques, V.

Subjects
Condensed Matter - Materials Science, Quantum Physics
Abstract

Spin defects in hexagonal boron nitride (hBN) are promising quantum systems for the design of flexible two-dimensional quantum sensing platforms. Here we rely on hBN crystals isotopically enriched with either $^{10}$B or $^{11}$B to investigate the isotope-dependent properties of a spin defect featuring a broadband photoluminescence signal in the near infrared. By analyzing the hyperfine structure of the spin defect while changing the boron isotope, we first unambiguously confirm that it corresponds to the negatively-charged boron-vacancy center (${\rm V}_{\rm B}^-$). We then show that its spin coherence properties are slightly improved in $^{10}$B-enriched samples. This is supported by numerical simulations employing cluster correlation expansion methods, which reveal the importance of the hyperfine Fermi contact term for calculating the coherence time of point defects in hBN. Using cross-relaxation spectroscopy, we finally identify dark electron spin impurities as an additional source of decoherence. This work provides new insights into the properties of ${\rm V}_{\rm B}^-$ spin defects, which are valuable for the future development of hBN-based quantum sensing foils., Comment: 8 pages, 5 figures

Published
2021
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35. Real-World Multicenter Study of PD-1 Blockade in HIV-Associated Classical Hodgkin Lymphoma Across the United States

Author

Lurain, Kathryn, Zarif, Talal El, Ramaswami, Ramya, Nassar, Amin H., Adib, Elio, Abdel-Wahab, Noha, Chintapally, Nikita, Drolen, Claire E., Feldman, Tatyana, Haykal, Tarek, Nebhan, Caroline A., Thiruvengadam, Swetha Kambhampati, Li, Mingjia, Mittra, Arjun, Lorentsen, Michael, Kim, Chul, Drakaki, Alexandra, Morse, Michael, Johnson, Douglas B., Mangla, Ankit, Dittus, Christopher, Ravi, Praful, Baiocchi, Robert A., Chiao, Elizabeth Y., Rubinstein, Paul G., Yellapragada, Sarvari V., LaCasce, Ann S., Sonpavde, Guru P., Naqash, Abdul Rafeh, and Herrera, Alex F.

Published
2024
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36. Immediate DIEP Breast Reconstruction in a Trans Woman with Breast Cancer

Author

Emma C. Avery, MD, Natasha Barone, MDCM, MSc, and Siba Haykal, MD, PhD, FRCSC, FACS

Subjects
Surgery, RD1-811
Abstract

Summary:. Breast cancer is a leading cause of cancer among cisgender women worldwide, with an incidence that continues to rise. Breast reconstruction is increasingly recognized as an integral part of breast cancer management. In tandem, the population of trans women is also increasing. However, few studies have focused on the management of breast cancer in this population, given that estrogen therapy has the potential to increase the risk of breast cancer. We present the case of a 51-year-old trans woman diagnosed with right breast cancer following a 32-year history of estrogen therapy. She presented to our clinic for consultation and immediate breast reconstruction. She opted for bilateral skin-sparing mastectomies, sentinel lymph node biopsies, and immediate breast reconstruction using deep inferior epigastric perforator free flaps. There were no postoperative flap complications. Final pathology revealed invasive mucinous carcinoma, devoid of lymph node involvement. The patient was satisfied with her reconstruction and is currently planning for nipple reconstruction. To the authors’ knowledge, this is the first reported case in the literature of bilateral deep inferior epigastric perforator free flap reconstruction in the trans female population after breast cancer diagnosis. This case underscores the need for a holistic treatment approach and heightened vigilance among trans women on estrogen therapy. It also highlights that breast reconstruction should be considered and offered to this patient population.

Published
2024
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37. Acute watery diarrhoea cases during cholera outbreak in Syria: a cohort study

Author

Amr Hamza, Ahmad Yamen Arnaout, Yaman Nerabani, Mohamad Nabhan Sawas, Tala Jouma Alhejazi, Mohamad Ali Farho, Khaled Arnaout, Hassan Alshaker, Baraa Shebli, Mostafa Helou, Bashir Badawi Mobaied, Mohamad Bassel Mouti, Fares Kady, Ziad Aljarad, Aalaa Mohammed nedal Al shalabi, Alaa Fawaz Dasouki, Abdulrhman Breij, Ahmad Ryyan Shheibar, Ahmed Alabdullah, Alaa Wais, Abd Alazeez Atli, Amira Fathi Breis, Bakri Roumu Jamal, Baraa Ahmad Abduljalil, Batoul Mohammed Mashhadi, Batoul Shyah, Bayan Zitani, Fatima Breim, Ghina Maarawi, Hala Jafa, Heba Haj Saleh, Hiba Bathish, Ibrahim AL mhawsh, Ibrahim Arnaout, Joud Khalili, Joud Markaby, Joudy Karh Damour, Lama Kanaa, Lana issa Kitan, Leen Jaber, Leen Tfnkjy, Leen Zoheir Amaraya, Maher Moaammar Zeno, Manar Haitham Nayef, Maram Ahmad Mobaid, Mawya Ghassan Alrawi, Maysoon Mohammad Jadid, Mohamad Amin Kreid, Mohamad Nour Martini, Mohamed Alkhalifa, Mohammed Al-mahdi Al-kurdi, Mona Abdulkader Haj Mahmoud, Mona Najib Barakat, Monzer Keblawy, Najlaa Mohammad Rabee Fjleh, Nour Mohammed raed Arab, Ola Hamdan, Ola Fateh Alkhallouf, Raneem Sattout, Rasha Yossef Al Ibrahim, Rasha Abdullah Al aouir, Rima Modabbes, Roua Arian, Saad Haykal, Sabah Faour, Salam Yones Al-wannous, Saleh Bourghol, Salma Alkurayem, Sana Ahmad Masoud, Sedra Mohammad Anas helou, Shahed Ammar Rihawi, shaimaa radwan, Sima Mohannad Sagheer, Toka Adna, Wael Najeb, Wafaa Jawesh, Wesam Hritani, Yahya Dordi, Yamama Alali, Yasmen Saber Toffaha, Zein A Alsayed-Ahmad, Rayan Badawi, Ghina Motaz Ghannam, Mahmoud Mohamad Mohamad Alhasan, Abdullah Mohammed Al-Nabbash, Ayah Kouli, Toula Bayaa, Osama Abd Alhaji, Ibrahim Al Tabbaa, Mary Alakkash, Shamma Alaa Aldeen Alothman, Fatima Abazid, Rima Saad Taleb, Bayan Rokia, Ahmad Saher Aljarad, Dimah Tarabelsi, Ahmad Fadel Karaze, Eman Abdulrahman Ibrahim, Hasan Hamsho, Ola Ramadan, Ola Alzalek, Noor Masri, Abdullah Ahmad Mohammad Mano, Wajeh Kurdi, Arij Assi, and Tasnim Zakaria Bathish

Subjects
Medicine
Abstract

Objectives The aim of this study is a descriptive presentation of cases of acute watery diarrhoea (AWD) that were presented to Aleppo University Hospital (AUH) during the recent cholera outbreak in Syria.Design Prospective, observational, cohort study.Setting and participants A total of 1061 patients with AWD were admitted to AUH during the timeframe of 20 September 2022 to 20 October 2022. The data collection was done through a structured questionnaire. This includes comprehensive clinical observation, laboratory analyses, therapeutic interventions and holistic case evaluations.Results The analysis has revealed notable insights: a predominant proportion of patients (58.6%) were residents from urban areas and 40.3% were residents from rural areas. Intriguingly, a diverse range of potential infection sources emerged from patient data within our hospital, including uncontrolled well water, vegetables and faecal-oral transmission through contaminated street/fast food. At discharge, most patients were in good health (79.7%), followed by moderate health (17.6%) and poor health (2.3%), with a minimal percentage dying before discharge (0.4%). The most common complications reported at admission and during hospitalisation included electrolyte imbalance (28.2%), followed by severe dehydration (16.3%). In the follow-up period, the majority of patients exhibited good health (81.0%). Older patients (>60 years) had poorer outcomes, with 8.4% having poor health and 4.2% death rate.Conclusions The study found results consistent with previous AWD outbreaks in developing countries like Yemen, Nigeria and Lebanon. Preventative measures like improving water sanitation and hygiene practices are essential to prevent future outbreaks and ease the strain on healthcare systems. Therefore, future studies must investigate the risk factors that increase the spread and the severity of the disease and investigate the best management method.

Published
2024
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39. Immune modulation in transplant medicine: a comprehensive review of cell therapy applications and future directions

Author

Leonard Knoedler, Jillian Dean, Fortunay Diatta, Noelle Thompson, Samuel Knoedler, Richmond Rhys, Khalil Sherwani, Tobias Ettl, Simon Mayer, Florian Falkner, Katja Kilian, Adriana C. Panayi, Jasper Iske, Ali-Farid Safi, Stefan G. Tullius, Siba Haykal, Bohdan Pomahac, and Martin Kauke-Navarro

Subjects
solid organ transplantation, SOT, vascularized composite allotransplantation, VCA, cellular therapies, Immunologic diseases. Allergy, RC581-607
Abstract

Balancing the immune response after solid organ transplantation (SOT) and vascularized composite allotransplantation (VCA) remains an ongoing clinical challenge. While immunosuppressants can effectively reduce acute rejection rates following transplant surgery, some patients still experience recurrent acute rejection episodes, which in turn may progress to chronic rejection. Furthermore, these immunosuppressive regimens are associated with an increased risk of malignancies and metabolic disorders. Despite significant advancements in the field, these IS related side effects persist as clinical hurdles, emphasizing the need for innovative therapeutic strategies to improve transplant survival and longevity. Cellular therapy, a novel therapeutic approach, has emerged as a potential pathway to promote immune tolerance while minimizing systemic side-effects of standard IS regiments. Various cell types, including chimeric antigen receptor T cells (CAR-T), mesenchymal stromal cells (MSCs), regulatory myeloid cells (RMCs) and regulatory T cells (Tregs), offer unique immunomodulatory properties that may help achieve improved outcomes in transplant patients. This review aims to elucidate the role of cellular therapies, particularly MSCs, T cells, Tregs, RMCs, macrophages, and dendritic cells in SOT and VCA. We explore the immunological features of each cell type, their capacity for immune regulation, and the prospective advantages and obstacles linked to their application in transplant patients. An in-depth outline of the current state of the technology may help SOT and VCA providers refine their perioperative treatment strategies while laying the foundation for further trials that investigate cellular therapeutics in transplantation surgery.

Published
2024
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40. Evaluation of a decellularized bronchial patch transplant in a porcine model

Author

Daisuke Taniguchi, Satoshi Kamata, Sara Rostami, Stephen Tuin, Alba Marin-Araujo, Kelly Guthrie, Thomas Petersen, Thomas K. Waddell, Golnaz Karoubi, Shaf Keshavjee, and Siba Haykal

Subjects
Medicine, Science
Abstract

Abstract Biological scaffolds for airway reconstruction are an important clinical need and have been extensively investigated experimentally and clinically, but without uniform success. In this study, we evaluated the use of a decellularized bronchus graft for airway reconstruction. Decellularized left bronchi were procured from decellularized porcine lungs and utilized as grafts for airway patch transplantation. A tracheal window was created and the decellularized bronchus was transplanted into the defect in a porcine model. Animals were euthanized at 7 days, 1 month, and 2 months post-operatively. Histological analysis, immunohistochemistry, scanning electron microscopy, and strength tests were conducted in order to evaluate epithelialization, inflammation, and physical strength of the graft. All pigs recovered from general anesthesia and survived without airway obstruction until the planned euthanasia timepoint. Histological and electron microscopy analyses revealed that the decellularized bronchus graft was well integrated with native tissue and covered by an epithelial layer at 1 month. Immunostaining of the decellularized bronchus graft was positive for CD31 and no difference was observed with immune markers (CD3, CD11b, myeloperoxidase) at two months. Although not significant, tensile strength was decreased after one month, but recovered by two months. Decellularized bronchial grafts show promising results for airway patch reconstruction in a porcine model. Revascularization and re-epithelialization were observed and the immunological reaction was comparable with the autografts. This approach is clinically relevant and could potentially be utilized for future applications for tracheal replacement.

Published
2023
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41. Thermodynamic analysis of ammonia co-firing for low-rank coal-fired power plant

Author

Azaria Haykal Ahmad, Prihadi Setyo Darmanto, and Firman Bagja Juangsa

Subjects
ammonia co-firing, coal-fired power plant, co2 emission, thermodynamics, Renewable energy sources, TJ807-830
Abstract

As one of the largest sources of CO2 emissions, the integration of non-carbon fuels in coal-fired power plants will significantly impact the global decarbonisation strategy. Hydrogen is a potential non-carbon fuel, and ammonia is a promising hydrogen carrier fuel. In this study, the effect of ammonia co-firing in a low-rank coal-fired power plant is thermodynamically modelled and evaluated in Aspen Plus V12.1. The integrated co-firing system is modelled in two different cases. The first case is made to maintain the combustion process, resulting in constant excess oxygen content in the flue gas. The second case is to minimise the fan modification in the power plant by maintaining the maximum air flow rate. The results show that increasing fraction of ammonia reduced CO2 and SOx emissions due to the decreasing coal fraction. NOx emission proportionally changes with the furnace temperature, which increases at constant excess oxygen case and decreases at constant airflow case. It was also shown that both cases’ boiler efficiency is relatively similar on the same ammonia fraction. The thermodynamic analysis provides an initial assessment of the implementation of ammonia co-firing in coal-fired power plants as an effort of decarbonisation in the energy sector.

Published
2023
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44. ZLN005, a PGC-1α Activator, Protects the Liver against Ischemia–Reperfusion Injury and the Progression of Hepatic Metastases

Author

Celine Tohme, Tony Haykal, Ruiqi Yang, Taylor J. Austin, Patricia Loughran, David A. Geller, Richard L. Simmons, Samer Tohme, and Hamza O. Yazdani

Subjects
ZLN005, mitochondria, ischemia, reperfusion injury, neoplasm metastasis, hepatocytes, Cytology, QH573-671
Abstract

Background: Exercise can promote sustainable protection against cold and warm liver ischemia–reperfusion injury (IRI) and tumor metastases. We have shown that this protection is by the induction of hepatic mitochondrial biogenesis pathway. In this study, we hypothesize that ZLN005, a PGC-1α activator, can be utilized as an alternative therapeutic strategy. Methods: Eight-week-old mice were pretreated with ZLN005 and subjected to liver warm IRI. To establish a liver metastatic model, MC38 cancer cells (1 × 106) were injected into the spleen, followed by splenectomy and liver IRI. Results: ZLN005-pretreated mice showed a significant decrease in IRI-induced tissue injury as measured by serum ALT/AST/LDH levels and tissue necrosis. ZLN005 pretreatment decreased ROS generation and cell apoptosis at the site of injury, with a significant decrease in serum pro-inflammatory cytokines, innate immune cells infiltration, and intrahepatic neutrophil extracellular trap (NET) formation. Moreover, mitochondrial mass was significantly upregulated in hepatocytes and maintained after IRI. This was confirmed in murine and human hepatocytes treated with ZLN005 in vitro under normoxic and hypoxic conditions. Additionally, ZLN005 preconditioning significantly attenuated tumor burden and increased the percentage of intratumoral cytotoxic T cells. Conclusions: Our study highlights the effective protection of ZLN005 pretreatment as a therapeutic alternative in terms of acute liver injury and tumor metastases.

Published
2024
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45. Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context.

Author

Machel Reid, Nikolay Savinov, Denis Teplyashin, Dmitry Lepikhin, Timothy P. Lillicrap, Jean-Baptiste Alayrac, Radu Soricut, Angeliki Lazaridou, Orhan Firat, Julian Schrittwieser, Ioannis Antonoglou, Rohan Anil, Sebastian Borgeaud, Andrew M. Dai, Katie Millican, Ethan Dyer, Mia Glaese, Thibault Sottiaux, Benjamin Lee, Fabio Viola, Malcolm Reynolds, Yuanzhong Xu, James Molloy, Jilin Chen, Michael Isard, Paul Barham 0001, Tom Hennigan, Ross McIlroy, Melvin Johnson, Johan Schalkwyk, Eli Collins, Eliza Rutherford, Erica Moreira, Kareem Ayoub, Megha Goel, Clemens Meyer, Gregory Thornton, Zhen Yang, Henryk Michalewski, Zaheer Abbas, Nathan Schucher, Ankesh Anand, Richard Ives, James Keeling, Karel Lenc, Salem Haykal, Siamak Shakeri, Pranav Shyam, Aakanksha Chowdhery, Roman Ring, Stephen Spencer, Eren Sezener, and et al.

Published
2024
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47. Incorporating TRIZ Methodology into Semi-structured Interviews for Innovative Insights

Author

Ben Moallem, Marwa, Houssin, Rémy, Coulibaly, Amadou, Ammar, Mohamed Haykal, Dhouib, Diala, Abdellatif, Mohamed, Rannenberg, Kai, Editor-in-Chief, Soares Barbosa, Luís, Editorial Board Member, Goedicke, Michael, Editorial Board Member, Tatnall, Arthur, Editorial Board Member, Neuhold, Erich J., Editorial Board Member, Stiller, Burkhard, Editorial Board Member, Stettner, Lukasz, Editorial Board Member, Pries-Heje, Jan, Editorial Board Member, Kreps, David, Editorial Board Member, Rettberg, Achim, Editorial Board Member, Furnell, Steven, Editorial Board Member, Mercier-Laurent, Eunika, Editorial Board Member, Winckler, Marco, Editorial Board Member, Malaka, Rainer, Editorial Board Member, Cavallucci, Denis, editor, Livotov, Pavel, editor, and Brad, Stelian, editor

Published
2023
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