bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in cardiac adaptation to exercise in male and female athletes assessed by noninvasive techniques: a state-of-the-art review
Authors: Lasocka-Koriat Zofia , Lewicka-Potocka Zuzanna , Kaleta-Duss Anna , Siekierzycka Anna , Kalinowski Leszek , Lewicka Ewa , Dąbrowska-Kugacka Alicja
Published: February 2024

Athlete’s heart is generally regarded as a physiological adaptation to regular training, with specific morphological and functional alterations in the cardiovascular system. Development of the noninvasive imaging techniques over the past several years enabled better assessment of cardiac remodeling in athletes, which may eventually mimic certain pathological conditions with the potential for sudden cardiac death, or disease progression. The current literature provides a compelling overview of the available methods that target the interrelation of prolonged exercise with cardiac structure and function. However, this data stems from scientific studies that included mostly male athletes. Despite the growing participation of females in competitive sport meetings, little is known about the long-term cardiac effects of repetitive training in this population. There are several factors—biochemical, physiological and psychological, that determine sex-dependent cardiac response. Herein, the aim of this review was to compare cardiac adaptation to endurance exercise in male and female athletes with the use of electrocardiographic, echocardiographic, and biochemical examination, to determine the sex-specific phenotypes, and to improve the healthcare providers’ awareness of cardiac remodeling in athletes. Finally, we discuss the possible exercise-induced alternations that should arouse suspicion of pathology and be further evaluated.
Impact of coronary hyperemia on collateral flow correction of coronary microvascular resistance indices
Authors: Boerhout Coen K. M. , Veelen Anna van , Feenstra Rutger G. T. , de Jong Elize A. M. , Namba Hanae F. , Beijk Marcel A. M. , Henriques Jose P. , Piek Jan J. , van de Hoef Tim P.
Published: February 2024

The following are what is known: 1) wedge-pressure correction is often considered for the derivation of indices of minimal microvascular resistance, and 2) the Yong method for calculating wedge pressure-corrected index of microvascular resistance (IMR) without balloon inflation has never been validated in a Doppler-derived population and has not been tested under different physiological conditions. This study 1) adds validation for the Yong method for calculated wedge-pressure correction in a Doppler-derived study population and 2) shows significant influence of the physiological conditions on the derivation of coronary wedge pressure.
Sentinel Node Mapping in Ovarian Tumors: A Study Using Lymphoscintigraphy and SPECT/CT
Authors: Ataei Nakhaei Saeideh , Sadeghi Ramin , Mostafavi Sayyed Mostafa , Treglia Giorgio , Hassanzadeh Malihe , Esmaeilpour Maryam , Taheri Negar Sadat , Farazestanian Marjaneh
Published: February 2024

Purpose. Ovarian cancer in the early stage requires a complete surgical staging, including radical lymphadenectomy, implying subsequent risk of morbidity and complications. Sentinel lymph node (SLN) mapping is a procedure that attempts to reduce radical lymphadenectomy-related complications and morbidities. Our study evaluates the feasibility of SLN mapping in patients with ovarian tumors by the use of intraoperative Technetium-99m-Phytate (Tc-99m-Phytate) and postoperative lymphoscintigraphy using tomographic (single-photon emission computed tomography/computed tomography (SPECT/CT)) acquisition. Materials and Methods. Thirty-two patients with ovarian mass participated in this study. Intraoperative injection of the radiopharmaceutical was performed just after laparotomy and before the removal of tumor in utero-ovarian and suspensory ligaments of the ovary just beneath the peritoneum. Subsequently, pelvic and para-aortic lymphadenectomy was performed for malignant masses, and the presence of tumor in the lymph nodes was assessed through histopathological examination. Conversely, lymphadenectomy was not performed in patients with benign lesions or borderline ovarian tumors. Lymphoscintigraphy was performed within 24 hr using tomographic acquisition (SPECT/CT) of the abdomen and pelvis. Results. Final pathological examination showed 19 patients with benign pathology, 5 with borderline tumors, and 6 with malignant ovarian tumors. SPECT/CT identified SLNs in para-aortic-only areas in 6 (20%), pelvic/para-aortic areas in 14 (47%), and pelvic-only areas in 7 (23%) cases. Notably, additional unusual SLN locations were revealed in perirenal, intergluteal, and posterior to psoas muscle regions in three patients. We were not able to calculate the false negative rate due to the absence of patients with involved lymph nodes. Conclusion. SLN mapping using intraoperative injection of radiotracers is safe and feasible. Larger studies with more malignant cases are needed to better evaluate the sensitivity of this method for lymphatic staging of ovarian malignancies.
Trust in the Leader and Trust in the Organization in Healthcare: A Concept Analysis Based on a Systematic Review
Authors: Karikumpu Venla , Häggman-Laitila Arja , Romppanen Johanna , Kangasniemi Mari , Terkamo-Moisio Anja
Published: February 2024

Orientation. Trust is the central part of leadership and organizational culture and can often go unnoticed until it decreases. There is a lack of a comprehensive concept analysis of trust in the healthcare setting. Research Purpose. The research aim was to gather, assess, and synthesize previous empirical evidence from the field of healthcare about the concepts of trust in the leader and trust in the organization. Motivation for the Study. To create a comprehensive and generic concept analysis of trust in the leader and organization for the healthcare sector based on recent empirical studies. Research Design and Method. A concept analysis, which followed the method presented by Walker and Avant, was conducted as a systematic review that adhered to the PRISMA guidelines. A total of eight databases were searched for relevant literature and 42 articles were included. Main Findings. The definitions of trust in the leader and the organization were based on emotion and cognition. Trust in the leader emerged as a core feature of collaborative leader-employee relationships, whereas trust in the organization was a key construct of organizational functioning. Trust in the leader and the organization contributed to commitment, increased work production, enhanced collaboration, and improved workplace well-being. Defense mechanisms were identified as a new contrary concept, while justice was found to be a related concept. Contribution. Both trust in the leader and trust in the organization positively impact an organization, nurse leaders, and employees. Deeper knowledge of trust and its attributes will be critical to the operationalization and estimation of levels of trust in healthcare organizations. Managerial Implications. Trust in the leader and the organization can significantly influence the attractiveness of an organization, retention of personnel, productivity, and work-related well-being. Thus, this aspect should be measured and developed systematically while acknowledging the antecedents of trust building.
Improved Innate Immune Function in Patients with Chronic Lymphocytic Leukemia Treated with Targeted Therapy in Clinical Trials
Authors: Svanberg Teglgaard Rebecca , Marquart Hanne Vibeke , Hartling Hans Jakob , Bay Jakob Thaning , da Cunha-Bang Caspar , Brieghel Christian , Faitová Tereza , Enggaard Lisbeth , Kater Arnon P. , Levin Mark-David , Kersting Sabina , Ostrowski Sisse Rye , Niemann Carsten U.
Published: February 2024

Purpose:

Patients with chronic lymphocytic leukemia (CLL) have increased risk of severe infections. Although adaptive immune dysfunction is well described, clinical tools for identifying patients at risk are lacking, warranting investigation of additional immune components. In contrast to chemotherapy, targeted agents could spare or even improve innate immune function. Therefore, we investigated innate immune phenotypes and function in patients with CLL before and during targeted treatment.

Experimental Design:

Baseline and consecutive blood samples were collected from patients with CLL treated with acalabrutinib (n = 17) or ibrutinib+venetoclax (n = 18) in clinical trials. Innate immune function was assessed by TruCulture, a whole-blood ligand-stimulation assay quantifying cytokine release in response to standardized stimuli. Innate immune phenotypes were characterized by flow cytometry. As a proxy for infections, we mapped antimicrobial use before and during treatment.

Results:

At baseline, patients with CLL displayed impaired stimulated cytokine responses to the endotoxin lipopolysaccharide (LPS) along with deactivated monocytes, enrichment of myeloid-derived suppressor cells and metamyelocytes, and elevated (unstimulated) proinflammatory cytokines. Two/three cycles of acalabrutinib or ibrutinib normalized LPS-stimulated responses, in parallel with decreased duration of infections. Innate immune profiles and elevated proinflammatory cytokines further normalized during longer-term acalabrutinib or ibrutinib+venetoclax, paralleled by decreased infection frequency.

Conclusions:

Innate immune impairment and infection susceptibility in patients with CLL were restored in parallel during targeted therapy. Thus, targeted treatment may reduce the risk of infections in CLL, as currently under investigation in the PreVent-ACaLL phase 2 trial of acalabrutinib+venetoclax for high-risk CLL (NCT03868722).
Belzutifan for von Hippel–Lindau Disease: Pancreatic Lesion Population of the Phase 2 LITESPARK-004 Study
Authors: Else Tobias , Jonasch Eric , Iliopoulos Othon , Beckermann Kathryn E. , Narayan Vivek , Maughan Benjamin L. , Oudard Stephane , Maranchie Jodi K. , Iversen Ane B. , Goldberg Cynthia M. , Fu Wei , Perini Rodolfo F. , Liu Yanfang , Linehan W. Marston , Srinivasan Ramaprasad
Published: February 2024

Purpose:

Primary analysis of the ongoing, single-arm, phase 2 LITESPARK-004 study (NCT03401788) showed clinically meaningful antitumor activity in von Hippel–Lindau (VHL) disease–associated renal cell carcinoma (RCC) and other neoplasms with belzutifan treatment. We describe results of belzutifan treatment for VHL disease–associated pancreatic lesions [pancreatic neuroendocrine tumors (pNET) and serous cystadenomas].

Patients and Methods:

Adults with VHL diagnosis based on germline VHL alteration, ≥1 measurable RCC tumor, no renal tumor >3 cm or other VHL neoplasm requiring immediate surgery, Eastern Cooperative Oncology Group performance status of 0 or 1, and no prior systemic anticancer treatment received belzutifan 120 mg once daily. End points included objective response rate (ORR), duration of response (DOR), progression-free survival (PFS), and linear growth rate (LGR) in all pancreatic lesions and pNETs per RECIST version 1.1 by independent review committee, and safety.

Results:

All 61 enrolled patients (100%) had ≥1 pancreatic lesion and 22 (36%) had ≥1 pNET measurable at baseline. Median follow-up was 37.8 months (range, 36.1–46.1). ORR was 84% [51/61; 17 complete responses (CR)] in pancreatic lesions and 91% (20/22; 7 CRs) in pNETs. Median DOR and median PFS were not reached in pancreatic lesions or pNETs. After starting treatment, median LGR for pNETs was –4.2 mm per year (range, –7.9 to –0.8). Eleven patients (18%) had ≥1 grade 3 treatment-related adverse event (AE). No grade 4 or 5 treatment-related AEs occurred.

Conclusions:

Belzutifan continued to show robust activity and manageable safety in VHL disease–associated pNETs.
Mesothelin CAR T Cells Secreting Anti-FAP/Anti-CD3 Molecules Efficiently Target Pancreatic Adenocarcinoma and its Stroma
Authors: Wehrli Marc , Guinn Samantha , Birocchi Filippo , Kuo Adam , Sun Yi , Larson Rebecca C. , Almazan Antonio J. , Scarfò Irene , Bouffard Amanda A. , Bailey Stefanie R. , Anekal Praju Vikas , Montero Llopis Paula , Nieman Linda T. , Song Yuhui , Xu Katherine H. , Berger Trisha R. , Kann Michael C. , Leick Mark B. , Silva Harrison , Salas-Benito Diego , Kienka Tamina , Grauwet Korneel , Armstrong Todd D. , Zhang Rui , Zhu Qingfeng , Fu Juan , Schmidts Andrea , Korell Felix , Jan Max , Choi Bryan D. , Liss Andrew S. , Boland Genevieve M. , Ting David T. , Burkhart Richard A. , Jenkins Russell W. , Zheng Lei , Jaffee Elizabeth M. , Zimmerman Jacquelyn W. , Maus Marcela V.
Published: February 2024

Purpose:

Targeting solid tumors with chimeric antigen receptor (CAR) T cells remains challenging due to heterogenous target antigen expression, antigen escape, and the immunosuppressive tumor microenvironment (TME). Pancreatic cancer is characterized by a thick stroma generated by cancer-associated fibroblasts (CAF), which may contribute to the limited efficacy of mesothelin-directed CAR T cells in early-phase clinical trials. To provide a more favorable TME for CAR T cells to target pancreatic ductal adenocarcinoma (PDAC), we generated T cells with an antimesothelin CAR and a secreted T-cell–engaging molecule (TEAM) that targets CAF through fibroblast activation protein (FAP) and engages T cells through CD3 (termed mesoFAP CAR-TEAM cells).

Experimental Design:

Using a suite of in vitro, in vivo, and ex vivo patient-derived models containing cancer cells and CAF, we examined the ability of mesoFAP CAR-TEAM cells to target PDAC cells and CAF within the TME. We developed and used patient-derived ex vivo models, including patient-derived organoids with patient-matched CAF and patient-derived organotypic tumor spheroids.

Results:

We demonstrated specific and significant binding of the TEAM to its respective antigens (CD3 and FAP) when released from mesothelin-targeting CAR T cells, leading to T-cell activation and cytotoxicity of the target cell. MesoFAP CAR-TEAM cells were superior in eliminating PDAC and CAF compared with T cells engineered to target either antigen alone in our ex vivo patient-derived models and in mouse models of PDAC with primary or metastatic liver tumors.

Conclusions:

CAR-TEAM cells enable modification of tumor stroma, leading to increased elimination of PDAC tumors. This approach represents a promising treatment option for pancreatic cancer.
Differences in Serum miRNA Profiles by Race, Ethnicity, and Socioeconomic Status: Implications for Developing an Equitable Ovarian Cancer Screening Test
Authors: Alimena Stephanie , Stephenson Briana Joy K. , Webber James W. , Wollborn Laura , Sussman Chad B. , Packard Daniel George , Williams Marta , Comrie Cameron Elizabeth , Wang Joyce Y. , Markert Tahireh , Spiegel Julia , Rodriguez Carmen B. , Lightfoot Maya , Graye Amia , O'Connor Sean , Elias Kevin M.
Published: February 2024

Serum miRNAs are promising biomarkers for several clinical conditions, including ovarian cancer. To inform equitable implementation of these tests, we investigated the effects of race, ethnicity, and socioeconomic status on serum miRNA profiles. Serum samples from a large institutional biobank were analyzed using a custom panel of 179 miRNA species highly expressed in human serum, measured using the Abcam Fireplex assay via flow cytometry. Data were log-transformed prior to analysis. Differences in miRNA by race and ethnicity were assessed using logistic regression. Pairwise t tests analyzed racial and ethnic differences among eight miRNAs previously associated with ovarian cancer risk. Pearson correlations determined the relationship between mean miRNA expression and the social deprivation index (SDI) for Massachusetts residents. Of 1,586 patients (76.9% white, non-Hispanic), compared with white, non-Hispanic patients, those from other racial and ethnic groups were younger (41.9 years ± 13.2 vs. 51.3 ± 15.1, P < 0.01) and had fewer comorbidities (3.5 comorbidities ± 2.7 vs. 4.6 ± 2.8, P < 0.01). On logistic regression, miRNAs predicted race and ethnicity at an AUC of 0.69 (95% confidence interval, 0.66–0.72), which remained consistent when stratified by most comorbidities. Among eight miRNAs previously associated with ovarian cancer risk, seven significantly varied by race and ethnicity (all P < 0.01). There were no significant differences in SDI for any of these eight miRNAs. miRNA expression is significantly influenced by race and ethnicity, which remained consistent after controlling for confounders. Understanding baseline differences in biomarker test characteristics prior to clinical implementation is essential to ensure instruments perform comparably across diverse populations.

Prevention Relevance:

This study aimed to understand factors affecting miRNA expression, to ensure we create equitable screening tests for ovarian cancer that perform well in diverse populations. The goal is to ensure that we are detecting ovarian cancer cases earlier (secondary prevention) in women of all races, ethnic backgrounds, and socioeconomic means.
The NUTRIENT Trial (NUTRitional Intervention among myEloproliferative Neoplasms): Results from a Randomized Phase I Pilot Study for Feasibility and Adherence
Authors: Mendez Luque Laura F. , Avelar-Barragan Julio , Nguyen Hellen , Nguyen Jenny , Soyfer Eli M. , Liu Jiarui , Chen Jane H. , Mehrotra Nitya , Huang Xin , Kosiorek Heidi E. , Dueck Amylou , Himstead Alexander , Heide Elena , Lem Melinda , El Alaoui Kenza , Mas Eduard , Scherber Robyn M. , Mesa Ruben A. , Whiteson Katrine L. , Odegaard Andrew , Fleischman Angela G.
Published: February 2024

Purpose:

Chronic inflammation is integral to myeloproliferative neoplasm (MPN) pathogenesis. JAK inhibitors reduce cytokine levels, but not without significant side effects. Nutrition is a low-risk approach to reduce inflammation and ameliorate symptoms in MPN. We performed a randomized, parallel-arm study to determine the feasibility of an education-focused Mediterranean diet intervention among patients with MPN.

Experimental Design:

We randomly assigned patients with MPN to either a Mediterranean diet or standard U.S. Dietary Guidelines for Americans (USDA). Groups received equal but separate education with registered dietician counseling and written dietary resources. Patients were prospectively followed for feasibility, adherence, and symptom burden assessments. Biological samples were collected at four timepoints during the 15-week study to explore changes in inflammatory biomarkers and gut microbiome.

Results:

The Mediterranean diet was as easy to follow for patients with MPN as the standard USDA diet. Approximately 80% of the patients in the Mediterranean diet group achieved a Mediterranean Diet Adherence Score of ≥8 throughout the entire active intervention period, whereas less than 50% of the USDA group achieved a score of ≥8 at any timepoint. Improvement in symptom burden was observed in both diet groups. No significant changes were observed in inflammatory cytokines. The diversity and composition of the gut microbiome remained stable throughout the duration of the intervention.

Conclusions:

With dietician counseling and written education, patients with MPN can adhere to a Mediterranean eating pattern. Diet interventions may be further developed as a component of MPN care, and potentially incorporated into the management of other hematologic conditions.

Significance:

Diet is a central tenant of management of chronic conditions characterized by subclinical inflammation, such as cardiovascular disease, but has not entered the treatment algorithm for clonal hematologic disorders. Here, we establish that a Mediterranean diet intervention is feasible in the MPN patient population and can improve symptom burden. These findings warrant large dietary interventions in patients with hematologic disorders to test the impact of diet on clinical outcomes.
Single-Cell CD4 and CD8 T-Cell Secretome Profiling Reveals Temporal and Niche Differences in Acute Myeloid Leukemia Following Immune Checkpoint Blockade Therapy
Authors: Root Jessica L. , Desai Poonam N. , Ly Christopher , Wang Bofei , Jelloul Fatima Zahra , Zhou Jing , Mackay Sean , Alfayez Mansour , Matthews Jairo , Pierce Sherry , Reville Patrick K. , Daver Naval , Abbas Hussein A.
Published: February 2024

Acute myeloid leukemia (AML) is a heterogeneous malignancy of the blood primarily treated with intensive chemotherapy. The allogeneic T-cell antileukemic activity via donor lymphocyte infusions and stem cell transplantation suggests a potential role for checkpoint blockade therapy in AML. While clinical trials employing these treatments have fallen short of expected results, a deeper exploration into the functional states of T cells in AML could bridge this knowledge gap. In this study, we analyzed the polyfunctional activity of T cells in a cohort of patients with relapsed/refractory (RelRef) AML treated on the clinical trial (ClinicalTrials.gov identifier: NCT02397720) of combination therapy using azacitidine and nivolumab (Aza/Nivo). We utilized the single-cell polyfunctional multiplexed immune assay IsoPlexis to evaluate the CD4 and CD8 T cells in peripheral blood and bone marrow samples collected before and after immunotherapy. This revealed at a pseudobulk level that the CD4 T cells exhibited higher functional activity post-immunotherapy (post-IO), suggesting that CD4-directed therapies may play a role in RelRef AML. Additional single-cell analysis revealed significant differences in baseline polyfunctionality in bone marrows of responders as compared with nonresponders for both CD4 and CD8 T cells. Overall, this study highlights the impact of polyfunctional assessment in understanding CD4 and CD8 dynamics in contexts of therapy in AML.

Significance:

We found T-cell polyfunctionality differs between local and systemic microenvironments. Enhanced variability in proteomic profiles of bone marrow CD4 T cells post-IO suggests their pivotal role in AML treatment response. Single-cell analysis identified novel CD4 and CD8 T-cell functional groups linked to immunotherapy response within the bone marrow.
Objective Responses in Metastatic Pleomorphic Rhabdomyosarcoma Treated with Combination of Doxorubicin and Pembrolizumab: A Case Series
Authors: Kournoutas Ioannis , Monga Varun , Davick Jonathan , Rieth John
Published: February 2024

Introduction: Pleomorphic rhabdomyosarcoma is a rare subtype of rhabdomyosarcoma, a soft tissue sarcoma with skeletal muscle differentiation. Although rhabdomyosarcoma is typically seen in the pediatric population, the pleomorphic variant most frequently presents in adulthood and is characteristically aggressive with no currently established treatment regimen in the setting of metastatic disease. There has been growing interest in the application of immune checkpoint inhibitors alongside conventional chemotherapeutic agents in the treatment of pleomorphic rhabdomyosarcoma. Case Presentation: In the present case series, we report 2 patients with metastatic pleomorphic rhabdomyosarcoma treated with combination doxorubicin and pembrolizumab who had confirmed objective responses. Of note, these 2 patients had variable PD-L1 status – negative and low positive. Duration of treatment response was notable at 14 months and 9 months, respectively, with the first patient remaining on maintenance pembrolizumab therapy and the second patient subsequently achieving complete response with third-line trabectedin. Both patients are currently undergoing routine interval imaging with no evidence of disease at this time. Conclusion: This report highlights and discusses the potential role of PD-1 blockade in the treatment of pleomorphic rhabdomyosarcoma and also discusses burgeoning immunological data that may explain the clinical responses seen in these 2 cases.
Folate Receptor Beta Signaling in the Regulation of Macrophage Antimicrobial Immune Response: A Scoping Review
Authors: Branco Anna C.C. Castelo , Rogers Lisa M. , Aronoff David M.
Published: February 2024

Introduction: Folate, vitamin B9, is a water-soluble vitamin that is essential to cellular proliferation and division. In addition to the reduced folate carrier, eukaryotic cells take up folate through endocytosis mediated by one of two GPI-anchored folate receptors (FRs), FRα or FRβ. Two other isoforms of FR exist, FRγ and FRδ, neither of which support endocytic activities of FR signaling. FRβ is expressed primarily by monocytes and macrophages and highly expressed on activated macrophages. Macrophage expression of FRβ suggests a role for this receptor in modulating function of these immune sentinels, particularly as they engage in inflammatory processes. Despite several studies suggesting that folates can suppress inflammatory responses of macrophages to proinflammatory stimuli, there appears to be a lack of basic research examining the role of FRβ in modulating macrophage responses to microbial sensing. We therefore conducted a scoping review to assess evidence within the published literature addressing the question, “what is known about the extent to which FRβ regulates macrophage responses to sensing, and responding to, microorganisms?”. Methods: As a strategy for the study selection, we queried articles indexed in the research database PubMed and the search engine Google Scholar (up until August 12, 2023), including combinations of the research words: macrophage, folate receptor beta, FOLR2. Results: We identified 2 relevant articles out of 153 that are worth discussing here, none of which directly addressed our research question. Conclusion: There is an unmet need to better define the contribution of FRβ to regulating the macrophage response to microbes.
Current Perspectives on Type 3 Macular Neovascularization due to Age-Related Macular Degeneration
Authors: Clemens Christoph R. , Eter Nicole , Alten Florian
Published: February 2024

Background: The aim of this review was to systematically summarize the current knowledge on type 3 macular neovascularization (MNV3) in age-related macular degeneration (AMD). Summary: Recent histopathologic and multimodal imaging findings led to the consensus definition of the new term “type 3 macular neovascularization” in AMD. MNV3 originates in the deep vascular plexus as a neovascular process without connection with the retinal pigment epithelium in the initial stages. This type has numerous clinical and pathomorphologic features that separate it from the other two types of MNV in AMD. Besides, its frequency appears to be higher than previously thought. In optical coherence tomography (OCT), MNV3 can be classified into stages 1–3. Hyperreflective foci in the outer retina possibly represent a precursor lesion. In addition, MNV3 is characterized by a strong association with reticular pseudodrusen, a high rate of bilaterality, close associations with advanced age and arterial hypertension, decreased choroidal thickness, and decreased choriocapillaris flow signals. Data from latest anti-vascular endothelial growth factor studies in MNV3 suggest that the OCT biomarkers in intraretinal and subretinal fluids should be interpreted differently than in the other types. Additionally, data from MNV3 eyes should be analyzed separately, allowing optimal type-specific treatment strategies in the future. Key Messages: This review highlights the need for accurate characterization of neovascular AMD lesions and an MNV type-specific approach, particularly for MNV3.
Clinical Significance of Apela in Acute Cardiorenal Insuffiency of Chronic Heart Failure
Authors: Zong Yani , Wang Yajie , Hu Yuexin , Wang Zhi
Published: February 2024

Introduction: Apela has a wide range of biological effects on the cardiovascular system, but the changes and significance of endogenous Apela in patients with chronic heart failure (CHF) and acute deterioration of cardiac and renal function are unclear. Methods: A total of 69 patients with stable CHF combined with well-preserved renal function were enrolled and followed for 12 months. The effects of Apela on human renal glomerular endothelial cells (hRGEC), human glomerular mesangial cells (hMC), and human renal tubular epithelial cells (HK-2) were observed. Results: Serum Apela concentration was positively correlated with NYHA class (r = 0.711) and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration (r = 0.303) but negatively correlated with left ventricular ejection fraction (LVEF) (r = −0.374) and 6-min walk distance (r = −0.860) in patients with stable CHF. Twenty-one patients experiencing deterioration of renal and cardiac function were diagnosed with cardiorenal syndrome (CRS) during the follow-up period. In addition, the serum Apela, as well as the difference in Apela between stable and worsening phases (ΔApela), was correlated with the estimated glomerular filtration rate (eGFR) and ΔeGFR in patients with CRS. Apela significantly inhibited the upregulated expression of MCP-1 and TNF-α induced by angiotensin II (AngII) in hRGEC, hMC, and HK-2 cells. Apela inhibited the adhesion of THP-1 cells to hRGEC and promoted the tubular formation of hRGEC. Moreover, Apela enhanced the expression of MMP-9 in hMC but inhibited the upregulated expression of α-SMA and vimentin in HK-2 cells by AngII. Conclusion: This study suggests that the level of Apela can be used to diagnose heart failure and assess the severity of cardiac dysfunction in patients with stable CHF, and its dynamic changes can be used to evaluate the damage to renal function in patients with CRS. Apela plays multiple protective effects on renal cells, highlighting its clinical application prospect in the prevention and treatment of CRS.
Resection of Renal Cell and Prostate Carcinoma Sternum Metastases with Long-Term Follow-Up: A Report of 2 Cases
Authors: Berdat Pascal A. , Vogt Paul R. , Schai Pascal A. , Kurrer Michael O. , Rüedi Christian , Brück Michael B. , Exner G. Ulrich
Published: February 2024

Introduction: Rarely solitary sternum metastases are addressed by resection. Two additional cases are presented as they are interesting because of their long-term follow-up. Case Presentation: Case 1: A renal cell carcinoma was treated by transabdominal nephrectomy at age 64. Right iliac bone and sternum metastases were diagnosed 7 months later and treated by internal hemipelvectomy followed by sternum metastasectomy 6 weeks after the internal hemipelvectomy. At 12-year follow-up, the patient appears disease free. Case 2: Prostate cancer was treated by prostatectomy at age 67. A subsequent solitary sternum metastasis was resected 10 years later for persistent PSA-activity despite repeated radiotherapy. The patient remains asymptomatic for 3 years now. Conclusion: Resection of sternum metastases may have curative potential and should be considered in tumours known to be rather resistant to chemo- and/or radiotherapy.
Lucio Phenomenon: An Unusual Case of Skin Necrosis
Authors: Rusia Kaveri , Saoji Vikrant , Madke Bhushan , Singh Adarshlata
Published: February 2024

Introduction: Lucio leprosy is a non-nodular diffuse type of lepromatous leprosy first described by Lucio and Alvarado. Lucio phenomenon is a rare vasculonecrotic reaction characterized by cutaneous necrosis with minimal constitutional features. Case Presentation: We describe an unusual case of a 53-year-old man from Central India who had blisters, ulcers, and widespread erosions on his foot, forearms, and arms. The diagnosis of lepromatous leprosy with the Lucio phenomenon was established after thorough evaluation by clinical findings, histopathological findings, and slit-skin smear examination. Conclusion: Lucio phenomenon is an uncommon cause of cutaneous infarction and necrosis. Primary care physicians should keep a high index of suspicion in patients with cutaneous necrosis and minimal constitution features. Since leprosy is a relatively curable disease, primary care physicians should think of a rare form of lepromatous leprosy presenting with cutaneous necrosis, especially in non-endemic zones.
New Karyotype Information for Ctenomys (Rodentia: Ctenomyidae) from Midwest and Northern Brazil
Authors: de Oliveira Thays Duarte , Bertocchi Natasha A. , Kubiak Bruno Busnello , Galiano Daniel , Althoff Sérgio Luiz , de Freitas Thales R.O.
Published: February 2024

Introduction: Its wide karyotypic variation characterizes the genus Ctenomys, and in Brazil, the genus is distributed in the country’s southern, Midwest, and northern regions. Recently, populations of Ctenomys have been found in the Midwest and northern Brazil, with two new lineages named C. sp. “xingu” and C. sp. “central.” Methods: This work combines classical cytogenetic and molecular analyses to provide new chromosomal information on the boliviensis group distributed in northern and Midwestern Brazil. This includes the validation of the karyotype of C. bicolor and C. nattereri and the description of the karyotype of C. sp. “xingu” and C. sp. “central.” Results: We found three different karyotypes: 2n = 40 for C. bicolor; 2n = 36 for C. nattereri, and specimens from a locality belonging to C. sp. “central”; 2n = 34 for the lineage C. sp. “xingu” and specimens from a locality belonging to C. sp. “central.” Furthermore, GTG banding revealed homologous chromosomes between species/lineages and allowed the identification of the rearrangements that occurred, which proved the occurrence of fissions. Conclusion: Considering our results on the variation of 2n in the boliviensis group, we found two possibilities: the first, deduced by parsimony, is that 2n = 36 appeared initially, and two fissions produced gave rise to 2n = 40, and an independent fusion gave rise to 2n = 34 from 2n = 36; moreover, the second explanation is that all karyotypes arose independently.
Safety and Efficacy of Bilateral Epiphysiodesis Surgery to Reduce Final Height in Extremely Tall Adolescents: A Follow-Up Study
Authors: Aeppli Tim R.J. , Benyi Emelie , Wehtje Henrik , Chrysis Dionisios , Sävendahl Lars
Published: February 2024

Introduction: Treatment options in patients with extreme tall stature are limited. Bilateral epiphysiodesis has emerged as a possible treatment method aiming to reduce final height. However, there is still insufficient data on long-term safety and final height outcome. Therefore, the aim of this study was to assess the efficacy and safety of bilateral epiphysiodesis to reduce final adult height in tall adolescents. Methods: The study population consisted of 72 patients with extreme tall stature who were followed at the Pediatric Endocrine Clinic at the Karolinska University Hospital, Stockholm (Sweden), and subsequently underwent bilateral epiphysiodesis around the knees (girls n = 45, boys n = 27). Results: When compared to the final height prediction at time of surgery, the procedure significantly reduced the achieved final height by a mean of 3.6 cm ± 0.4 cm in girls (p < 0.001; 26.0 ± 2.9% reduction) and 8.6 ± 0.9 cm in boys (p < 0.001; 40.5 ± 3.0% reduction). Furthermore, a negative correlation was observed between the absolute height reduction and the bone age at time of surgery, which was stronger in boys (r = −0.63, p < 0.001) than in girls (r = −0.44, p < 0.001). Besides reducing final height, body proportions were affected in all patients subjected to bilateral epiphysiodesis. However, as tall individuals typically have relatively long legs, body proportions were rather normalized after the surgery. There were no serious complications reported. Conclusion: This study suggests that bilateral epiphysiodesis is an efficient and safe method to reduce final height in extremely tall adolescent girls and boys. The achieved height reduction was higher in boys and when performed at an earlier bone age. Importantly, no serious side effects were reported. However, a continued follow-up is still warranted to detect any potential rare complications.
Design and implementation of pulse width modulation gate control signals for two-level three-phase inverters
Authors: Aboadla Ezzidin Hassan , Kadir Kushsairy , Khan Sheroz
Published: February 2024

The switching control circuit in a DC to AC inverter is the critical part that is applied to control the power transistors insulated-gate bipolar transistor (IGBTs) and metal-oxide semiconductor field-effect transistor (MOSFETs). This paper proposes a high-performance and low-cost pulse width modulation (PWM) control signal with a 120º phase shift circuit for a two-level three-phase inverter. Typically, a PWM signal with a 120º phase shift for three-phase inverters is generated with the help of analogue components with more complicated designs and power losses or by using a microcontroller with necessary programming or coding. The proposed solution is to design a 120° three-phase shift circuit based on D flip-flops and the 555-timer to generate the clock signal for the flip-flop input in addition to the dead-time control circuit. The proposed circuit is controlled by one square wave signal as an input signal to generate six output PWM control signals at 50 Hz to operate six MOSFETs in the three-phase inverter. Simulation results in power simulation software PSIM and PROTEUS simulation tools are used to verify the proposed circuit. Hardware implementation of the proposed circuit and three-phase inverter is carried out to validate the performance of the proposed design.
A survey to build framework for optimize and secure migration and transmission of cloud data
Authors: Bathini Ravinder , Vurukonda Naresh
Published: February 2024

In the recent era of computational technologies, the internet is needed daily. The data generated is enormous and primarily stored on dedicated servers or clouds. Data migration and transfer are significant tasks for maintaining consistency and updating data. The data is the most critical component in any cloud service. There are various methods to protect data, like secure transfer, encryption, and authentication. These techniques are used as per need and transmission of the data. As data grows on a server or cloud, it must be migrated securely. Here, the exhaustive survey is provided for building a framework for migrating and transmitting cloud data. The framework should be sustainable and adaptable for load-balancing recovery and secure transmission. Various security load balancing parameters must be considered to obtain these state-of-the-art functionalities in the framework. The existing similar frameworks are studied, and findings are proposed in the paper to develop the framework.
IoT-based health information system using MitApp for abnormal electrocardiogram signal monitoring
Authors: Utomo Bedjo , Triwiyanto Triwiyanto , Luthfiyah Sari , Caesarendra Wahyu , Anant Athavale Vijay
Published: February 2024

Information systems are currently developing very rapidly, and this is inseparable from the role of internet of things (IoT) technology, especially in the world of telemedicine. MitApp is an open-source application that can be used to monitor electrocardiogram (ECG) signals in real-time. The aim of this study is to develop an IoT-based ECG signal monitoring system that utilizes the MitApp application to detect abnormal ECG signals that are characterized by symptoms of cardiac arrhythmias. To process ECG signal data obtained from lead electrode results, the research method utilizes Arduino Uno as a microcontroller. The result is then displayed on the thin film transistor (TFT) layer using the Nextion module. The ESP32 module is used as a Wi-Fi module to send data to the MitApp app on a smartphone. The results showed that the results of the comparison test of ECG signal module data with ECG simulator tools with beats per minute values of 60, 80, 100, 120, and 140 obtained an error rate of 0.05. Based on these results, there is potential to develop this feature and integrate the system with the patient management system to improve the effectiveness of remote monitoring.
On the use of historical data in context-aware multimedia documents adaptation processes
Authors: Smaala Aziz , Laboudi Zakaria , Saighi Asma , Moudjari Abdelkader
Published: February 2024

Playing multimedia documents in ubiquitous systems may require content adaptation based on gathered context information and accumulated historical data. Several approaches have already been proposed, in which adaptation actions are performed to provide adapted documents. Nevertheless, these approaches focus mainly on efficient use of context information without involving historical users data to improve the adaptation process. Thus, this paper allows for consideration of historical users data during the execution of the adaptation process. To do so, the context elements and the adaptation actions are first modeled using the oriented-object approach and then converted into relational and NoSQL databases schemes. Finally, algorithms for storing, retrieving and analysing data are designed. The proposal is validated by implementing scenarios through a real prototype. At a first step, the performances are measured to estimate the cost of data processing. The experiments show that NoSQL databases excel in data storage and ease of implementation, while relational databases perform well in data retrieve. At a second step, the proposal usefulness is highlighted by showing how historical data contribute to adaptation rules personalization using datadriven rule learning mechanisms rather than defining them explicitly. The analysis algorithm could retain personalized adaptation rules with confidence degree greater than 90%. Overall, the results are satisfactory.
Hybrid Wi-Fi and PLC network for efficient e-health communication in hospitals: a prototype
Authors: Khan Shafi Ullah , Ullah Jan Sana , Hwang Taewoong , Koo In-Soo
Published: February 2024

E-health is being adapted in modern hospitals as a significant addition to the existing healthcare services. To this end, modern hospitals urgently require a mobile, high-capacity, secure, and cost-effective communication infrastructure. In this paper, we explore potential applications of a hybrid broadband power line communication (PLC) and Wi-Fi in an indoor hospital scenario. It utilizes the existing power line cables and Wi-Fi plug-and-play devices for indoor broadband communication. Broadband power line (BPL) adaptors with Wi-Fi outputs are used to build an access network in hospitals, particularly in areas where the wireless router signal is poor. The Tenda PH10 AV1,000 AC Wi-Fi power line adapter is a set of BPL adapters that offer operational bandwidth of up to 1,000 Mbps. These adapters are based on the HomePlug AV2 protocol and can provide a data rate up to 200 Mbps on the physical layer. An experiment using the PLC Wi-Fi kit is carried out to show that a Wi-Fi and PLC hybrid network is the best candidate to provide wide range of practical applications in a hospital including, but not limited to, telemedicine, electronic medical records, early-stage disease diagnosis, health management, real-time monitoring, and remote surgeries.
Multiple-node model of wind turbine generating system for unbalanced distribution system load flow analysis
Authors: Gianto Rudy , Khwee Kho Hie
Published: February 2024

This paper discusses a method to integrate a wind turbine generating system (WTGS) into a three-phase unbalanced distribution system load flow (DSLF) analysis. The proposed method is based on the single-phase multiple-node model. In the present work, the single-phase multiple-node model is extended to a three-phase multiple-node model to facilitate the load flow analysis of a three-phase unbalanced power system network. The multiple-node model (i.e., three-node model) will only modify the load flow analysis by introducing two lines and two load buses to the distribution system network where the WTGS is installed. Thus, a standard three-phase load flow program can be employed to compute the unknown quantities in the DSLF problem formulation. The proposed method is verified by incorporating the model into the load flow analysis of three-phase distribution networks. The investigation uses two representative distribution networks (i.e., 19-bus and 25-bus networks). The results of the study confirm the validity of the proposed method.
Design and implementation of energy-efficient hybrid data aggregation in heterogeneous wireless sensor network
Authors: Al-Heeti Mohamed Muthanna , Hammad Jamal A. , Mustafa Ahmed Shamil
Published: February 2024

Heterogeneous wireless sensor network (HWSN) is a trending technology in both the industrial and academic sectors, consisting of a large number of interconnected sensors. However, higher energy consumption and delay are significant drawbacks of this technology in applications such as military, healthcare, and industrial automation. The main objective of this research is to enhance the energy efficiency of HWSN using a clustering technique. In this article, a novel approach, namely power optimization and hybrid data aggregation (POHDA), is proposed to address these challenges in HWSN. POHDA-HWSN focuses on power optimization and congestion avoidance through effective CH selection using hybrid data aggregation based on parameters such as residual energy, distance, mobility, threshold value of the node, and latency. By weight-based effective cluster head (CH) selection, the energy consumption, end-to-end delay, and overhead during communication are reduced in this network. The POHDA-HWSN approach considers specific parameters to compare the results and outcomes with earlier research such as HCCS-WSN, FMCA-WSN, and APCC-WSN. The results prove that the proposed POHDA-HWSN approach achieves higher energy efficiency and delivery ratio.
Bidirectional recommendation in HR analytics through text summarization
Authors: Arandi Channabasamma , Yeresime Suresh
Published: February 2024

For over a decade, online job portals have been providing their services to both job seekers and employers in search of hiring opportunities. Because of the high demand for recruitment, it is insufficient to use conventional hiring methods to find a suitable candidate to fill the position. Validating resumes online is challenging due to the potential for manual errors, making the process inherently risky. The bidirectional method comprises named entity recognition (NER) for extracting the required resumes for recruiters. Cosine similarity shows the match percentage of resumes for the job requirements and vice versa. In an attempt to tackle an issue of unregistered words, a solution called decoder attention with pointer network (DA-PN) has been introduced. This method incorporates the use of coverage mechanism to prevent word repetition through generated text summary. DA-PN+Cover method with mixed learning objective (MLO) (DA-PN+Cover+MLO) is utilized for protecting grow of increasing faults in generated text summary. Performance of proposed method is estimated using evaluation indicator recall oriented understudy for gisting evaluation (ROUGE) and attains an average of 27.47 which is comparatively higher than existing methods.
An enhanced control scheme for multifunctional grid connected PV system using fuzzy and predictive direct power control
Authors: Boukezata Boualem , Chaoui Abdelmadjid , Gaubert Jean Paul , Boutalbi Oussama
Published: February 2024

This paper presents a combination between a fuzzy logic control (FLC) and a predictive direct power control for multifunctional grid connected photovoltaic (PV) system, to solve the oscillation problem in the DC link voltage of the in-verter caused by the fast irradiation changing. The whole system consists of a PV system which interface a DC-AC inverter, a FLC maximum power point tracking (MPPT) algorithm has been adopted to operate the DC-DC converter at the MPP. The predictive control strategy is applied to the DC-AC inverter with FLC in its voltage control loop to improve the power exchange between the grid and the PV system. Simulation results have been verified through MATLAB/Simulink software for the purpose of giving the effectiveness of the suggested control against existed controllers.