University of Limoges

Fe-based materials have received more and more interests in recent years as candidates to fabricate bioresorbable stents due to their appropriate mechanical properties and biocompatibility. However, the low degradation rate of Fe is a serious limitation for such application. To overcome this critical issue, many efforts have been devoted to accelerate the corrosion rate of Fe-based stents, through the structural and surface modification of Fe matrix. As stents are implantable devices, the released corrosion products (Fe 2+ ions) in vessels may alter the metabolism, by generating reactive oxygen species (ROS), which might in turn impact the biosafety of Fe-based stents. These considerations emphasize the importance of combining knowledge in both materials and biological science for the development of efficient and safe Fe-based stents, although there are still only limited numbers of reviews regarding this interdisciplinary field. This review aims to provide a concise overview of the main strategies developed so far to design Fe-based stents with accelerated degradation, highlighting the fundamental mechanisms of corrosion and the methods to study them as well as the reported approaches to accelerate the corrosion rates. These approaches will be divided into four main sections, focusing on (i) increased active surface areas, (ii) tailored microstructures, (iii) creation of galvanic reactions (by alloying, ion implantation or surface coating of noble metals) and (iv) decreased local pH induced by degradable surface organic layers. Recent advances in the evaluation of the in vitro biocompatibility of the final materials and ongoing in vivo tests are also provided.

In order to solve the low signal-to-noise ratio (SNR) problem of the differential coincidence imaging (DCI) system, a frequency-diverse metacavity Cassegrain antenna (FDMCA) that is able to generate low-correlated bunching radiation patterns is proposed in this paper. The FDMCA is designed according to the Cassegrain antenna form, which consists of a frequency-diverse half-spherical metacavity etched with back-projecting slot arrays and a parabolic reflector. In total 81 useful measurement modes with a bunching angle of 40 ° are obtained from 32 to 36 GHz. Firstly, frequency-diverse field distributions in the metacavity are obtained utilizing a high-dispersion metasurface. Back-projecting slot arrays etched on the metacavity would couple the energy from the metacavity and back-radiate to the reflector. When placing the phase center of the feed source at the reflector focal point, the reflected patterns would be focused. Then, the performance of the proposed FDMCA is evaluated. In total 81 radiation patterns with correlation coefficients under 0.3 are generated. Finally, imaging experiments using the proposed FDMCA are carried out and the target image is reconstructed successfully using the DCI method. Comparative experiments are also implemented under the same conditions using a non-bunching frequency-diverse metasurface antenna to verify the bunching advantage of the FDMCA. The design is validated by simulations and measurements.

Objective To determine the overall and procedure-specific incidence of surgical site infections (SSI) caused by Staphylococcus aureus (S. aureus) as well as risk factors for such across all surgical disciplines in Europe. Methods This is a retrospective cohort of patients with surgical procedures performed at 14 European centres in 2016, with a nested case–control analysis. S. aureus SSI were identified by a semi-automated crossmatching bacteriological and electronic health record data. Within each surgical procedure, cases and controls were matched using optimal propensity score matching. Results A total of 764 of 178 902 patients had S. aureus SSI (0.4%), with 86.0% of these caused by methicillin susceptible and 14% by resistant pathogens. Mean S. aureus SSI incidence was similar for all surgical specialties, while varying by procedure. Conclusions This large procedure-independent study of S. aureus SSI proves a low overall infection rate of 0.4% in this cohort. It provides proof of principle for a semi-automated approach to utilize big data in epidemiological studies of healthcare-associated infections. Trials registration The study was registered at clinicaltrials.gov under NCT03353532 (11/2017).

This study aimed to evaluate the nutritional status of elderly subjects in the general Guinean population and the associated factors. A general population, cross-sectional study was conducted among a representative sample from urban and rural areas. Socio-demographic clinical and anthropometric data were collected. Oral status was determined using the University of Nebraska Oral Status Scale. Visual acuity was assessed using the Monoyer scale. Statistical analysis of the data was carried out using the Shapiro-Wilk test, ANOVA, Kruskal-Wallis test and Chi-squared test. The standardized prevalence ratio (SPR) of the nutritional status was calculated for each region. Sample included 1,698 subjects with a mean BMI 22.6±4.3 kg/m2. A total of 50.3% had an impaired oral status and 20.3% had moderately to severely impaired visual acuity. The prevalence of undernutrition was 14.4% and obesity was 5.7%. Differences were found in the prevalence of the nutritional status between regions (p≤0.0001) with an SPR >1 for undernutrition in the Labé region (SPR 1.9, 95% CI =1.5-2.5) and for obesity in the Conakry and Kindia regions (SPR of 2.90, 95% CI =2.0-4.05 and 2.32, 95% CI =1.5-3.3, respectively). In Guinea, the prevalence of nutritional disorders was approximately 20%.

Purpose Ejaculatory dysfunction is the most common side effect of benign prostatic hyperplasia surgery. Modified techniques have emerged with the aim of preserving antegrade ejaculation without compromising obstruction relief. None are standardized or validated. The PARTURP study is a randomized study investigating partial versus complete prostate resection. We conducted an investigator consensus meeting to define the ideal surgical technique to achieve both correct obstruction relief with ejaculation preservation. Methods An expert consensus meeting involving all investigators of the PARTURP study took place to define a common technique using the nominal group methodology. The objectives were to define the areas to be resected and the areas to be preserved; to define the criteria for proper obstruction relief; to define the criteria for proper ejaculation preservation. Results All investigators (n = 15) attended the consensus meeting, and agreement between all the participants was obtained. The anatomical landmarks to be preserved are located around the verumontanum and along the posterior part of the prostatic urethra. These structures must be preserved up to 2 cm from the verumontanum. The participants agreed on the need to preserve the urethral mucosa in all the areas to be preserved and to reach the enucleation plane in the areas of resection. Conclusions Anatomical landmarks for ejaculation-sparing surgery have been defined by the investigators of the PARTURP randomized study. These landmarks will be used during the study, and the clinical outcomes of this ejaculation-sparing technique will be compared with complete resection with up to 3 years follow-up.

There is no consensus on definitions of educational or academic integrity, and their philosophical relationship with the notion of responsibility is complex. Here, we aim to i) disentangle these three notions. We lean on a philosophical framework of ethics and our method involves different kinds of reasoning and the modeling of complex thinking. We combine this frame with a three-level epistemic dimension to allow us ii) to model the psycho-epistemic (level 1), epistemological (level 2), and phenomenological (ground 0) ways in which subjects interact with their own norms and knowledge and with those of the surrounding institutions. Finally, iii) we also aim to propose concrete educational means by which to implement educational integrity. Our theoretical findings lead us i) to consider responsibility as a process that consists of establishing a dialogical relationship between one’s inner and outer worlds, which relies on an epistemic decentering. Based on this, we argue that education for responsibility founds a new, expanded definition of educational integrity. Moreover, ii) empirical evidence suggests that this model can be operationalized by psychological indicators such as critical and complex thinking, cognitive flexibility, contextual relativism, and decentering, all of which are skills that can be fostered in spite of simplifying thinking, dogmatism, naive epistemology (and dualism) and cognitive fusion, respectively. It points to iii) the benefits of an educational approach in which subjects are encouraged to practice different types of meditation and to feel free to break institutional rules. Therefore, promoting educational integrity may require methods that lie beyond the obvious choices. After discussing the scope and limitations of our results, we propose a new research agenda for educational integrity, which could ground a field of research broader than just academic integrity, but complementary to it.

Ischemia-reperfusion injury (IRI) induces several perturbations that alter immediate kidney graft function after transplantation and may affect long-term graft outcomes. Given the IRI-dependent metabolic disturbances previously reported, we hypothesized that proximal transporters handling endo/exogenous substrates may be victims of such lesions. This study aimed to determine the impact of hypoxia/reoxygenation on the human proximal transport system through two semi-targeted omics analyses. Human proximal tubular cells were cultured in hypoxia (6 or 24 h), each followed by 2, 24 or 48-h reoxygenation. We investigated the transcriptomic modulation of transporters. Using semi-targeted LC–MS/MS profiling, we characterized the extra/intracellular metabolome. Statistical modelling was used to identify significant metabolic variations. The expression profile of transporters was impacted during hypoxia (y + LAT1 and OCTN2), reoxygenation (MRP2, PEPT1/2, rBAT, and OATP4C1), or in both conditions (P-gp and GLUT1). The P-gp and GLUT1 transcripts increased (FC (fold change) = 2.93 and 4.11, respectively) after 2-h reoxygenation preceded by 24-h hypoxia. We observed a downregulation (FC = 0.42) of y+LAT1 after 24-h hypoxia, and of PEPT2 after 24-h hypoxia followed by 2-h reoxygenation (FC = 0.40). Metabolomics showed that hypoxia altered the energetic pathways. However, intracellular metabolic homeostasis and cellular exchanges were promptly restored after reoxygenation. This study provides insight into the transcriptomic response of the tubular transporters to hypoxia/reoxygenation. No correlation was found between the expression of transporters and the metabolic variations observed. Given the complexity of studying the global tubular transport systems, we propose that further studies focus on targeted transporters.

Importance The utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested. Objectives To assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age >60 years) with dementia and the moderating factors of age, sex, and racial group. Data Source and Study Selection Longitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included. Participants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries (US, Brazil, Australia, China, Korea, Singapore, Central African Republic, Republic of Congo, Nigeria, Germany, Spain, Italy, France, Sweden, and Greece). Data Extraction and Synthesis Participants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. Baseline systolic BP (SBP) and diastolic BP (DBP) were treated as continuous variables. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analyses of Individual Participant Data reporting guidelines. Main Outcomes and Measures The key outcome was all-cause dementia. Mixed-effects Cox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. The association between dementia and baseline BP was modeled using nonlinear natural splines. The main analysis was a partially adjusted Cox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. Sensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group. Results The analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean (SD) age of 72.5 (7.5) years and a mean (SD) follow-up of 4.3 (4.3) years. In the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [HR], 1.42; 95% CI 1.15-1.76; P = .001) and 26% increased risk compared with individuals with treated hypertension (HR, 1.26; 95% CI, 1.03-1.53; P = .02). Individuals with treated hypertension had no significant increased dementia risk compared with healthy controls (HR, 1.13; 95% CI, 0.99-1.28; P = .07). The association of antihypertensive use or hypertension status with dementia did not vary with baseline BP. There was no significant association of baseline SBP or DBP with dementia risk in any of the analyses. There were no significant interactions with age, sex, or racial group for any of the analyses. Conclusions and Relevance This individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive use was associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. Individuals with treated hypertension had no increased risk of dementia compared with healthy controls.

A double ampC (AmpCG183D) and ampD (AmpDH157Y) genes mutations have been identified by whole genome sequencing in a Pseudomonas aeruginosa (PaS) that became resistant (PaR) in a patient treated by ceftolozane/tazobactam (C/T). To precisely characterize the respective contributions of these mutations on the decreased susceptibility to C/T and on the parallel increased susceptibility to imipenem (IMI), mutants were generated by homologous recombination in PAO1 reference strain (PAO1- AmpCG183D, PAO1-AmpDH157Y, PAO1-AmpCG183D/AmpDH157Y) and in PaR (PaR-AmpCPaS/AmpDPaS). Sequential time-kill curve experiments were conducted on all strains and analyzed by semi-mechanistic PKPD modeling. A PKPD model with adaptation successfully described the data, allowing discrimination between initial and time-related (adaptive resistance) effects of mutations. With PAO1 and mutant-derived strains, initial EC50 values increased by 1.4, 4.1, and 29-fold after AmpCG183D , AmpDH157Y and AmpCG183D/AmpDH157Y mutations, respectively. EC50 values were increased by 320, 12.4, and 55-fold at the end of the 2 nd experiment. EC50 of PAO1-AmpCG183D/AmpDH157Y was higher than that of single mutants at any time of the experiments. Within the PaR clinical background, reversal of AmpCG183D, and AmpDH157Y mutations led to an important decrease of EC50 value, from 80.5 mg/L to 6.77 mg/L for PaR and PaR-AmpCPaS/AmpDPaS, respectively. The effect of mutations on IMI susceptibility mainly showed that the AmpCG183D mutation prevented the emergence of adaptive resistance. The model successfully described the separate and combined effect of AmpCG183D and AmpDH157Y mutations against C/T and IMI, allowing discrimination and quantification of the initial and time-related effects of mutations. This method could be reproduced in clinical strains to decipher complex resistance mechanisms.

Soil contamination linked to abandoned lead–zinc mining wastes represents a serious environmental hazard of worldwide concern, raising the need for cost-effective tools to spatialize the contaminated area and assess the risks. In worldwide industrial environments, positive correlation between magnetic susceptibility and heavy metal soil contamination is often reported and used for fast preliminary site assessments. In this study, we report monitoring of an olive grove, situated below one of the abandoned tailings dump of the former Jebel Ressas Pb–Zn mining site (Tunisia), with three different commercial susceptibilimeters (Terraplus KT10, Bartington MS2D and Geonics EM38 induction device). Integration depths of above-mentioned susceptibilimeters vary from 3 to 150 cm. Similar broad-scale magnetic susceptibility maps for the three devices emphasize the effect of topography and runoff transfer as the main mechanisms for tailings material dispersion. Very low susceptibilities (~ 10 × 10–5 SI) characterize the contaminants magnetic signal, while uncontaminated soils susceptibilities are one order of magnitude higher (100–150 × 10–5 SI). This unique case of reverse correlation between magnetic susceptibilities and contamination (Pb, Zn, Cd) trace efficiently the degree of contamination and is substantiated by further mineralogical and magnetic properties analyses showing the predominance of iron amorphous oxyhydroxides in the dump, while (titano)maghemite is the main natural magnetic carriers in the uncontaminated soils in this specific carbonated context. The Geonics EM 38, with a proper calibration procedure, reveals a performant tool increasing the depth of investigation and when combined with shallower susceptibilimeter, opens perspectives for qualitative 3D spatialization of metallic contamination.

To achieve low probability of intercept (LPI) in radar networks for multiple target detection, it is necessary to find the optimal assignment of distributed radars to targets. The multi-radar to multi-target assignment (MRMTA) problem aims to find the best radar combination, but its brute-force (BF)-based approach over all possible sensor combinations has exponential complexity, making it challenging to implement in networks with a large number of radars or targets. This limits the implementation of the BF approach in networks that prioritize low latency and complexity. To address this challenge, we propose a supervised machine-learning (ML)-based solution for the MRMTA problem. Our proposed implementation scheme performs the training procedure offline, leading to a significant reduction in assignment complexity and processing latency. We conducted extensive numerical simulations to design an ML structure with high accuracy, convergence speed, and scalability. Simulation results demonstrate the efficiency and effectiveness of our proposed ML-based MRMTA solution, which achieves near-optimal LPI performance with considerably lower computation time than benchmark schemes. Our proposed solution has the potential to optimize the assignment of distributed radars to targets in LPI radar networks and improve the performance of complex networks with low latency and complexity requirements.

Background: The Alberta Stroke Program Early CT scan Score (ASPECTS) is a reliable imaging biomarker of infarct extent on admission but the value of 24-hour ASPECTS evolution in day-to-day practice is not well studied, especially after successful reperfusion. We aimed to assess the association between ASPECTS evolution after successful reperfusion with functional and safety outcomes, as well as to identify the predictors of ASPECTS evolution. Methods: We used data from an ongoing prospective multicenter registry. Stroke patients with anterior circulation large vessel occlusion treated with endovascular therapy (EVT) and achieved successful reperfusion (modified thrombolysis in cerebral ischemia (mTICI) 2b-3) were included. ASPECTS evolution was defined as one or more point decrease in ASPECTS at 24 hours. Results: A total of 2366 patients were enrolled. In a fully adjusted model, ASPECTS evolution was associated with lower odds of favorable outcome (modified Rankin Scale (mRS) score 0-2) at 90 days (adjusted odds ratio (aOR) = 0.46; 95% confidence interval (CI) = 0.37-0.57). In addition, ASPECTS evolution was a predictor of excellent outcome (90-day mRS 0-1) (aOR = 0.52; 95% CI = 0.49-0.57), early neurological improvement (aOR = 0.42; 95% CI = 0.35-0.51), and parenchymal hemorrhage (aOR = 2.64; 95% CI, 2.03-3.44). Stroke severity, admission ASPECTS, total number of passes, complete reperfusion (mTICI 3 vs. mTICI 2b-2c) and good collaterals emerged as predictors of ASPECTS evolution. Conclusion: ASPECTS evolution is a strong predictor of functional and safety outcomes after successful endovascular therapy. Higher number of EVT attempts and incomplete reperfusion are associated with ASPECTS evolution at day 1.

Prostate cancer is the second most common cancer for men and a major health issue. Despite treatments, a lot of side effects are observed. Photodynamic therapy is a non-invasive method that uses photosensitizers and light to induce cell death through the intramolecular generation of reactive oxygen species, having almost no side effects. However, some of the PSs used in PDT show inherent low solubility in biological media, and accordingly, functionalization or vectorization is needed to ensure internalization. To this end, we have used arene–ruthenium cages in order to deliver PSs to cancer cells. These metalla-assemblies can host PSs inside their cavity or be constructed with PS building blocks. In this study, we wanted to determine if the addition of metals (Mg, Co, Zn) in the center of these PSs plays a role. Our results show that most of the compounds induce cytotoxic effects on DU 145 and PC-3 human prostate cancer cells. Localization by fluorescence confirms the internalization of the assemblies in the cytoplasm. An analysis of apoptotic processes shows a cleavage of pro-caspase-3 and poly-ADP-ribose polymerase, thus leading to a strong induction of DNA fragmentation. Finally, the presence of metals in the PS decreases PDT’s effect and can even annihilate it.

We present the characterization of the dielectric permittivity and loss tangent of germanium telluride (GeTe) and germanium antimonium telluride Ge $_{2}$ Sb $_{2}$ Te $_{5}$ (GST) phase change thin films (less than 1 $\mu $ m thicknesses) in the millimeter-wave (mmW) domain. The dielectric permittivities in the amorphous (insulator) state of GeTe and GST were measured using two independent differential methods: a wide bandwidth characterization based on the measurement of the propagation constant of a coplanar waveguide (CPW) and a single frequency characterization based on the measurement of the resonant frequency of a planar resonator. This differential approach allows addressing the challenges linked to thin-film dielectric characteristics estimation at mmWs without the need of an absolute knowledge of other parameters of the measurement circuit like the conductivity and the thickness of the metals as well as the permittivity and losses of the substrate. The extracted mean values range between 20 and 22 for the GeTe and 30 and 34 for the GST. These values are rather constant over the frequency range from 10 to 60 GHz. Additionally, the loss tangent at 30 GHz of both compositions was extracted giving values of 3.4 $\times$ 10 $^{-2}$ and 3.2 $\times$ 10 $^{-1}$ for the GeTe and GST, respectively. These values are among the first reported ones regarding the electromagnetic (EM) properties of GeTe and GST in this frequency band.

Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive and incurable neurodegenerative disease. While pharmacotherapy options remain limited, the Food and Drug Administration (FDA) approved intravenous (IV) and oral edaravone for the treatment of ALS in 2017 and 2022, respectively. With the addition of oral edaravone, patients with ALS may exclusively use oral medications. Areas covered: The authors performed a review of the published literature using the United States (US) National Library of Medicine's PubMed.gov resource to describe the pharmacokinetics, pharmacodynamics, safety, and efficacy of oral edaravone, as well as pertinent completed and ongoing clinical trials, including the oral edaravone clinical trial development program. The clinical profile of oral edaravone is also discussed. Expert opinion: Edaravone has been shown to slow the rate of motor function deterioration experienced by patients with ALS. As the oral formulation has been approved, patients with ALS may use it alone or in combination with other approved therapeutics. Additional clinical trials and real-world evidence are ongoing to gain further understanding of the clinical profile of oral edaravone.

The present research study analyzes the consequences of the incorporation of rare earth ions on the pyroelectric, ferroelectric and piezoelectric, and luminescence properties of Ba0.85Ca0.12RE0.03Ti0.90Zr0.04Nb0.042O3 (BCRETZN) (where RE = Ce or Pr) ceramic composites synthesized by means of a solid-state process. Rietveld refinement of X-ray diffraction data and Raman spectra analysis confirmed the presence of tetragonal symmetry (P4mm) at room temperature. Two different exciting laser wavelengths have been employed to illuminate the RE³⁺ emission phenomenon. The involvement of the luminescence behavior in the “abnormal” Raman spectra was registered at 785 nm. The measurements as a function of the temperature of pyroelectric properties, ferroelectric cycles, strain-field cycles, and dielectric properties confirmed the occurrence the tetragonal-to-cubic (T–C) and orthorhombic-to-tetragonal (O–T) phase transition sequence. Compared to pure BaTiO3, the incorporation of RE-ions lowers the phase transition temperatures. The BCPrTZN compound leads to a larger decrease in O–T and T–C phase transition temperatures than the BCCeTZN compound. The presence of Ce³⁺ and Pr³⁺ ions inside these perovskite ceramics is likely to have significant technological applications in future multifunctional devices.

Accurate estimation of transportation flow is a challenging task in Intelligent Transportation Systems (ITS). Transporting data with dynamic spatial-temporal dependencies elevates transportation flow forecasting to a significant issue for operational planning, managing passenger flow, and arranging for individual travel in a smart city. The task is challenging due to the composite spatial dependency on transportation networks and the non-linear temporal dynamics with mobility conditions changing over time. To address these challenges, we propose a Spatial-Temporal Graph Convolutional Recurrent Network (ST-GCRN) that learns from both the spatial stations network data and time series of historical mobility changes in order to estimate transportation flow at a future time. The model is based on Graph Convolutional Networks (GCN) and Long Short-Term Memory (LSTM) in order to further improve the accuracy of transportation flow estimation. Extensive experiments on two real-world datasets of transportation flow, New York bike-sharing system and Hangzhou metro system, prove the effectiveness of the proposed model. Compared to the current state-of-the-art baselines, it decreases the estimation error by 98% in the metro system and 63% in the bike-sharing system.

Background: Recurrence after Cytomegalovirus (CMV) infection in heart transplant recipients is difficult to predict, in spite of its high incidence. Secondary prophylaxis could reduce this burden; however, its duration remains unestablished. We evaluated the QuantiFERON®-CMV test to see if it could predict CMV recurrence and help optimize the duration of secondary prophylaxis. Methods: This observational retrospective single center study included all heart transplant recipients who developed CMV infection between 2019 and 2021, with the CD8+ T-cell-mediated CMV immunity QuantiFERON®-CMV test assessed at the time of (val)ganciclovir curative treatment completion. The main outcomes were CMV recurrence and duration of secondary prophylaxis. Secondary outcomes included immunosuppressive regimen, rejection, lymphocyte count, CMV viral load, infection type, and duration as possible confounding factors for recurrence. Results: Among the 15 patients included, five (33%) experienced recurrence, of whom three (60%) had a positive QuantiFERON®-CMV test. The duration of secondary prophylaxis was similar regardless of QF-CMV positivity. No confounding factor was significantly associated with CMV recurrence; however, it occurred in only 1/7 (14%) of the patients receiving an everolimus-containing immunosuppressive regimen. Conclusion: In the population of heart transplant recipients, most of whom received ATG-based induction, the QuantiFERON®-CMV assay may not accurately predict CMV recurrence and would have not helped refining the duration of secondary prophylaxis in our patients. Other cell-mediated immunity tests and strategies in this specific population, including everolimus-containing regimens, may help predict and manage CMV recurrence.

Background and aims Cardiovascular disease (CVD) impacts significantly health and social care systems as well as society through premature mortality and disability, with patients requiring care from relatives. Previous pan- European estimates of the economic burden of CVD are now outdated. This study aims to provide novel, up-to-date evidence on the economic burden across the 27 European Union (EU) countries in 2021. Methods Aggregate country-specific resource use data on morbidity, mortality, and health, social and informal care were obtained from international sources, such as the Statistical Office of the European Communities, enhanced by data from the European Society of Cardiology Atlas programme and patient-level data from the Survey of Health, Ageing and Retirement in Europe. Country-specific unit costs were used, with cost estimates reported on a per capita basis, after adjustment for price differentials. Results CVD is estimated to cost the EU €282 billion annually, with health and long-term care accounting for €155 billion (55%), equalling 11% of EU-health expenditure. Productivity losses accounted for 17% (€48 billion), whereas informal care costs were €79 billion (28%). CVD represented a cost of €630 per person, ranging from €381 in Cyprus to €903 in Germany. Coronary heart disease accounted for 27% (€77 billion) and cerebrovascular diseases for 27% (€76 billion) of CVD costs. Conclusions This study provides contemporary estimates of the wide-ranging impact of CVD on all aspects of the economy. The data help inform evidence-based policies to reduce the impact of CVD, promoting care access and better health outcomes and economic sustainability.

Double halide perovskites have received massive attention due to their low toxicity, tunable bandgap, structural flexibility, and stability as compared to conventional 3D lead halide perovskites. Particularly, newly discovered formamidinium germanium-antimony halide (FA4GeSbCl12) double perovskites offer an excellent bandgap (∼1.3 eV) for solar cell (SC) applications. Therefore, in this study, for the first time, we have simulated FTO/TiO2/FA4GeSbCl12/Cu2O/Au planar SCs using SCAPS-1D, showing a maximum power conversion efficiency of 22.5% with Jsc = 34.52 mA cm⁻², Voc = 0.76 V, and FF = 85.1%. The results show that the variation in valence and conduction band offsets (−0.4 to +0.2 eV and −0.4 to +0.57 eV) at the ETL/absorber and absorber/HTL interfaces dominate the SC performance. Also, different absorber defect densities (1 × 10¹⁴–1 × 10²⁰ cm⁻³) and thicknesses (200–3000 nm) effectively influence the PCE. Moreover, simulated impedance spectroscopy (IS) data (through SCAPS-1D) were fitted using equivalent electrical circuits to extract relevant parameters, including Rs, RHF, and RLF, allowing us to better discuss the physics of the device. The fitted IS results strongly revealed that enhanced SC performance is associated with higher recombination resistance and a larger recombination lifetime. Likewise, a slight variation in the Rs (0 to 2.5 Ω cm²) highly impacts the PCE (22.5% to 19.7%). Furthermore, a tandem cell is designed by combining the top cell of ethylenediammonium-FASnI3 perovskite with the FA4GeSbCl12 bottom cell using a filtered spectrum strategy, which opens the door for multi-junction SC applications. These findings firmly reveal that the appropriate energy level alignment at interfaces with suitable material properties is the key to boosting SC performance.