An artificial intelligence-driven predictive model for pediatric allogeneic hematopoietic stem cell transplantation using clinical variables.

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a procedure with high morbidity and mortality. Identifying patients for maximum benefit and risk assessment is crucial in the decision-making process. This has led to the development of predictive risk models for HSCT in adults, which have limitations when applied to pediatric population. Our goal was to develop an automatic learning algorithm to predict survival in children with malignant disorders undergoing HSCT. METHODS: We studied allogenic HSCTs performed on children with malignant disorders at a third-level hospital between 1991 and 2021. Survival was analyzed using the Kaplan-Meier method, log-rank test for the univariate analysis, and Cox regression for the multivariate analysis. A prognostic index was constructed based on these findings. Lastly, we constructed a predictive model using a random forest algorithm to forecast 1-year survival after HSCT. RESULTS: We analyzed 229 HSCTs in 201 patients with a median follow-up of 1.64 years. Variables that impacted on the multivariate analysis were older age (hazard ratio [HR] 1.40, 95% confidence interval [CI] 1.12-1.76, p = .003), oldest period of HSCT (HR 0.46, 95% CI 0.29-0.73, p < .001), and mismatched donor (HR 2.65, 95% CI 1.51-4.65, p = .001). Our prognostic index was associated with 3-year overall survival (OS; p < .001). A random forest was developed using as variables: diagnosis, age, year of HSCT, time from diagnosis to HSCT, disease stage, donor type, and conditioning. This achieved 72% accuracy in predicting 1-year OS. CONCLUSIONS: Our index and random forest was effective in predicting 1-year survival. However, further validation in diverse populations is necessary to establish their generalizability.

Cancer is not a risk factor for severe COVID-19 in children, except in patients with recent allogeneic hematopoietic stem cell transplantation or comorbidities.

The EPICO (Spanish general registry of COVID-19 in children)-SEHOP (Spanish Society of Pediatric Hematology and Oncology) platform gathers data from children with SARS-CoV-2 in Spain, allowing comparison between children with cancer or allogeneic hematopoietic stem cell transplantation (alloHSCT) and those without. The infection is milder in the cancer/alloHSCT group than in children without comorbidities (7.1% vs. 14.7%), except in children with recent alloHSCT (less than 300 days), of which 35.7% experienced severe COVID-19. These data have been shared with the SEHOP members to support treatment and isolation policies akin to those for children without cancer, except for those with recent alloHSCT or additional comorbidities. This highlights the collaborative registries potential in managing pandemic emergencies.

Exploring the Efficacy of Nonlinear Filters in CMOS for 2-D Signal Processing for Image Quality Enhancement.

This study rigorously investigates the effectiveness of nonlinear filters in CMOS for 2-D signal processing to enhance image quality. We comprehensively compare traditional linear filters' performance, which operate on the principle of linearity, with nonlinear filters, such as the median-median (Med-Med) approach, designed to handle nonlinear data. To ensure the validity of our findings, we use widely accepted metrics like normalized squared error (NSE), peak signal-to-noise ratio (PSNR), and structural similarity index (SSIM) to quantify the differences. Our simulations and experiments, conducted under controlled conditions, demonstrate that nonlinear filters in CMOS outperform linear filters in removing impulse noise and enhancing images. We also address the challenges of implementing these algorithms at the hardware level, focusing on power consumption and chip area optimization. Additionally, we propose a new architecture for the Med-Med filter and validate its functionality through experiments using a 9-pixel image sensor array. Our findings highlight the potential of nonlinear filters in CMOS for real-time image quality enhancement and their applicability in various real-world imaging applications. This research contributes to visual technology by combining theoretical insights with practical implementations, paving the way for more efficient and adaptable imaging systems.

Passive Electroluminescence and Photoluminescence Imaging Acquisition of Photovoltaic Modules.

In photovoltaic power plant inspections, techniques for module assessment play a crucial role as they enhance fault detection and module characterization. One valuable technique is luminescence. The present paper introduces a novel technique termed passive luminescence. It enhances both electroluminescence and photoluminescence imaging acquisition in photovoltaic power plants under normal operation in high irradiance conditions. This technique is based on the development of an electronic board, which allows the polarity of the module to be changed, enabling the current generated by the photovoltaic string to be injected into the module and producing electroluminescence effects. Additionally, the board can bypass the module and set an open circuit, inducing photoluminescence emission using sunlight as an excitation source. The proper coordination of the board and an InGaAs camera with a bandpass filter has allowed for the integration of a lock-in technique, which has produced electroluminescence and photoluminescence pictures that can be used for fault detection.

Laparoscopic cholecystectomy: Histopathological analysis of metabolic associated fatty liver disease and fibrosis.

INTRODUCTION: Metabolic (dysfunction) associated fatty liver disease (MAFLD) and cholelithiasis are highly prevalent and are associated with common risk factors such as obesity, hypertriglyceridemia, and fasting glucose levels; however, it is not clear whether cholelithiasis is associated with MAFLD or fibrosis. OBJECTIVE: To determine MAFLD severity and associated risk factors in patients diagnosed with cholelithiasis. MATERIALS AND METHODS: Observational, cross-sectional and prolective study (from October 2018 to March 2020) of patients undergoing elective laparoscopic cholecystectomy with liver biopsy, excluding other causes of hepatic disease or significant alcohol consumption. MAFLD detection was based on histology using the Kleiner score and one of the following criteria: overweight/obesity, T2DM, or evidence of metabolic dysregulation. The AST to Platelet Ratio Index, the NAFLD Fibrosis Score, the fibrosis-4 index and the hepatic steatosis index were performed to assess the relationship of non-invasive hepatic scores with histopathology. RESULTS: 80 patients median age (interquartile range) was 42 (18) years, with a BMI of 27.9 (6.11) Kg/m2. Of all patients, 58.8% had MAFLD, 78.7% were women, and 13.8% had the severe form (formerly named NASH). No substantial correlation between biochemical parameters and histopathological analysis of MAFLD and fibrosis was observed. CONCLUSION: Because cholelithiasis and MAFLD are highly prevalent diseases, it is essential to conduct studies on the relationship between both pathologies. Currently, liver biopsy is the best diagnostic method since the predictive biochemical models did not show a substantial correlation to classify MAFLD. Its early detection is relevant since a considerable percentage of advanced fibrosis (8.7%) was found.

A Power-Line Communication System Governed by Loop Resonance for Photovoltaic Plant Monitoring.

Within this paper, a PLC system that takes advantage of the loop resonance of an entire DC-PV string configured as a circular signal path is developed and implemented. Low cost and extremely simple transceivers intended to be installed within each PV module of a string have been designed and successfully tested. In addition, an anti-saturation coil has been conceived to avoid saturation of the core when the entire DC current of the string flows through it. Bi-directional half-duplex communication was successfully executed with up to a 1 MHz carrier frequency (150 kbps bitrate), using a simple ASK modulation scheme. The transmission and reception performance are presented, along with the overall system cost in comparison to the previous literature.

Candelilla Wax Extracted by Traditional Method and an Ecofriendly Process: Assessment of Its Chemical, Structural and Thermal Properties.

A comparative study was carried out on the chemical, structural and thermal properties of candelilla wax from four wax-producing communities in Mexico, which was obtained by two extraction processes, the conventional one using sulfuric acid (SA) and an eco-friendly alternative process using citric acid (CA) as the extracting agent. The waxes were analyzed by basic chemistry (acidity, saponification, ester indexes, and others), color, Fourier transform infrared spectroscopy (FTIR), Raman micro-spectroscopy, X-ray diffraction (XRD), differential scanning calorimetry (DSC), and hardness and brittleness measurements. The waxes obtained by the environmentally friendly process showed differences in their physicochemical properties when compared to waxes from the conventional process. In addition, they showed some improvements, such as lighter shades and harder waxes, suggesting that the new environmentally friendly process is a viable option.

A collaborative, computer-assisted, psycho-educational intervention for depressed patients with chronic disease at primary care: protocol for a cluster randomized controlled trial.

BACKGROUND: Depression and chronic diseases are frequently comorbid public health problems. However, clinical guidelines often fail to consider comorbidities. This study protocol describes a cluster randomized trial (CRT) aimed to compare the effectiveness of a collaborative, computer-assisted, psycho-educational intervention versus enhanced usual care (EUC) in the treatment of depressed patients with hypertension and/or diabetes in primary care clinics (PCC) in Santiago, Chile. METHODS: Two-arm, single-blind, CRT carried out at two municipalities in Santiago, Chile. Eight PCC will be randomly assigned (1:1 ratio within each municipality, 4 PCC in each municipality) to the INTERVENTION or EUC. A total of 360 depressed patients, aged at least 18 years, with Patient Health Questionnaire-9 Item [PHQ-9] scores ≥15, and enrolled in the Cardiovascular Health Program at the participating PCC. Patients with alcohol/substance abuse; current treatment for depression, bipolar disorder, or psychosis; illiteracy; severe impairment; and resident in long-term care facilities, will be excluded. Patients in both arms will be invited to use the Web page of the project, which includes basic health education information. Patients in the INTERVENTION will receive eight sessions of a computer-assisted, psycho-educational intervention delivered by trained therapists, a structured telephone calls to monitor progress, and usual medical care for chronic diseases. Therapists will receive biweekly and monthly supervision by psychologist and psychiatrist, respectively. A monthly meeting will be held between the PCC team and a member of the research team to ensure continuity of care. Patients in EUC will receive depression treatment according to clinical guidelines and usual medical care for chronic diseases. Outcome assessments will be conducted at 3, 6, and 12 months after enrollment. The primary outcome will be depression improvement at 6 months, defined as ≥50% reduction in baseline PHQ-9 scores. Intention-to-treat analyses will be performed. DISCUSSION: This study will be one of the first to provide evidence for the effectiveness of a collaborative, computer-assisted, psycho-educational intervention for depressed patients with chronic disease at primary care in a Latin American country. TRIAL REGISTRATION: retrospectively registered in ClinicalTrials.gov , first posted: November 3, 2020, under identifier: NCT04613076 .

Treatment of infantile fibrosarcoma associated to an abdominal aortic aneurysm with larotrectinib: a case report.

Infantile fibrosarcoma (IFS) is a rare pediatric tumor which often presents the ETV6-NTRK3 gene fusion. NTRK3 encodes the neurotrophin-3 growth factor receptor tyrosine kinase, a druggable therapeutic target. Selective tropomyosin receptor kinase (TRK) inhibitors, such as larotrectinib, have shown efficacy and safety in the treatment of IFS. We report a case of an abdominal IFS diagnosed in a newborn associated with an aortic aneurysm that was successfully treated with larotrectinib without relevant adverse effects.

Wafer-scale nanofabrication of sub-100 nm arrays by deep-UV displacement Talbot lithography.

In this manuscript, we demonstrate the potential of replacing the standard bottom anti-reflective coating (BARC) with a polymethylglutarimide (PMGI) layer for wafer-scale nanofabrication by means of deep-UV displacement talbot lithography (DTL). PMGI is functioning as a developable non-UV sensitive bottom anti-reflective coating (DBARC). After introducing the fabrication process using a standard BARC-based coating and the novel PMGI-based one, the DTL nanopatterning capabilities for both coatings are compared by means of the fabrication of etched nanoholes in a dielectric layer and metal nanodots made by lift-off. Improvement of DTL capabilities are attributed to a reduction of process complexity by avoiding the use of O2 plasma etching of the BARC layer. We show the capacity of this approach to produce nanoholes or nanodots with diameters ranging from 95 to 200 nm at a wafer-scale using only one mask and a proper exposing dose. The minimum diameter of the nanoholes is reduced from 118 to 95 nm when using the PMGI-based coating instead of the BARC-based one. The possibilities opened by the PMGI-based coating are illustrated by the successful fabrication of an array of nanoholes with sub-100 nm diameter for GaAs nanowire growth on a 2″ GaAs wafer, a 2″ nanoimprint lithography (NIL) master stamp, and an array of Au nanodots made by lift-off on a 4″ silica wafer. Therefore, DTL possess the potential for wafer-scale manufacturing of nano-engineered materials.

Renal Replacement Therapy Preferences Survey: Is Allo-Hemodialysis an Acceptable Option for Patient Caregivers and Health Care Professionals?

End-stage kidney disease (ESKD) is a worldwide unsolved problem. Access to renal replacement therapies (RRT) is still a challenge in some developed countries and even more so in developing countries. Allo-hemodialysis (alloHD) is a recently proposed, still hypothetical, alternative RRT where the blood of a healthy subject ("buddy") flows countercurrent to the patient's blood through the dialyzer. Solutes and fluid are transferred to the buddy and then cleared by his/her healthy kidneys, making alloHD essentially a procedure where the buddy "donates" kidney function intermittently to the patient. Its drastically reduced complexity makes -alloHD particularly attractive for low-resource settings. The acceptance of alloHD by patients, caregivers, and health care professionals (HCP) is unknown. In this cross-sectional study, we surveyed the preferences and acceptance of alloHD in 3 groups: caregivers related to ESKD patients, nonrelated caregivers (nrCG), and HCP. Four areas were explored: RRT preferences, kidney organ donation for transplant acceptance, -alloHD acceptance as a potential RRT, and alloHD technique acceptance. Hemodialysis was the preferred form of RRT. Kidney donation acceptance was similar in all groups. Intermittent kidney function donation (i.e., alloHD) was mainly accepted by related and nrCG but less accepted by HCP (87, 90, and 60% respectively, p < 0.01). New RRT alternatives such as alloHD are expected to be better received and accepted once animal, and clinical studies have demonstrated their feasibility, safety, and benefits. New RRT strategies are required primarily in most vulnerable populations and should be explored.

Hydrogen bond cooperativity and anticooperativity within the water hexamer.

The hydrogen bond (HB), arguably the most important non-covalent interaction in chemistry, is getting renewed attention particularly in materials engineering. We address herein HB non-additive features by examining different structures of the water hexamer (cage, prism, book, bag and ring). To that end, we rely on the interacting quantum atoms (IQA) topological energy partition, an approach that has been successfully used to study similar effects in smaller water clusters (see Chem. - Eur. J., 19, 14304). Our IQA interaction energies, , are used to classify the strength of HBs in terms of the single/double character of the donor and acceptor H2O molecules involved in the interaction. The strongest hydrogen bonds on this new scale entail double donors and acceptors that show larger values of than those observed in homodromic cycles, paradigms of cooperative effects. Importantly, this means that besides the traditional HB anticooperativity ascribed to double acceptors and donors, the occurrence of these species is also related to HB strengthening. Overall, we hope that the results of this research will lead to a further understanding of the HB non-additivity in intramolecular and intermolecular interactions.

Arsenic and fluoride variations in groundwater of an endorheic basin undergoing land-use changes.

The salt content of soil and water in endorheic basins within arid areas greatly restrict agricultural activities. Despite this limitation, these lands are increasingly used to accommodate new settlements and/or agricultural practices. This study focuses on the Laguna El Cuervo closed basin of northern Mexico and its underlying aquifer, which has been found to contain high concentrations of arsenic (As) and fluoride (F). The spatial distribution of As and F, their variations with time, and the impact of drought conditions and land-use changes were investigated using well data collected from a total of 27 wells in 2007, 2010, and 2011 (As data also collected in 2005). Four of these wells were used as monitoring wells. Data also included the As content of 140 surface sediments. Results showed that 54.5 % of the wells surpassed the As limit for drinking water of 0.025 mg L(-1) and that 89.0 % surpassed he F limit of 1.5 mg L(-1). Spatial analyses identified the areas in the center of the basin with the highest content of contaminants. Principal component and correlation analyses showed a co-occurrence of As and F with r = 0.55 for the 2011 data and 0.59 for the combined data. In contrast, the relationship of As and F concentrations to droughts and changes in land use were not as clearly shown, possibly because of the short time this area has been monitored. The high As and F concentrations in the groundwater may be limiting the availability of water within this basin, especially considering the greater groundwater demand foreseen for the future. Water-conservation practices, such as drip irrigation and artificial groundwater recharge, should be considered to maintain groundwater levels supportive of agricultural practices.

Predictive factors of insulin resistance resolution with adjustable gastric band surgery.

INTRODUCTION: The aim of the study was to evaluate preoperative factors associated with remission of diabetes and weight loss after laparoscopic gastric band surgery. MATERIAL AND METHODS: A retrospective cohort of 95 patients who had an adjustable gastric band placed were included. A preliminary descriptive study of prognostic factors was performed using the logistic regression model with SPSS 17.0. The independent variables were age, sex, body mass index (BMI), diabetes status and degree of obesity; dependent variables were the proportion of weight loss, change in diabetes status score and percent changes in fasting sugar and glycosylated hemoglobin. RESULTS: The variables that were significantly associated with the percentage of changes in fasting blood sugar and glycated hemoglobin were: the degree of obesity in the first year; preoperative and diabetes status respectively. The analysis of the need for antidiabetic treatment using the modified diabetes status score showed preoperative BMI, age and gender as significant predictors. CONCLUSIONS: In patients undergoing gastric band surgery, weight loss is the fundamental mechanism by which insulin sensitivity increases. This improvement in glucose metabolism is influenced by factors such as sex, age, insulin treatment, duration of diabetes and degree of preoperative obesity.

Experimental realization of a multiscroll chaotic oscillator with optimal maximum Lyapunov exponent.

Nowadays, different kinds of experimental realizations of chaotic oscillators have been already presented in the literature. However, those realizations do not consider the value of the maximum Lyapunov exponent, which gives a quantitative measure of the grade of unpredictability of chaotic systems. That way, this paper shows the experimental realization of an optimized multiscroll chaotic oscillator based on saturated function series. First, from the mathematical description having four coefficients (a, b, c, d1 ), an optimization evolutionary algorithm varies them to maximize the value of the positive Lyapunov exponent. Second, a realization of those optimized coefficients using operational amplifiers is given. Herein a, b, c, d1 are implemented with precision potentiometers to tune up to four decimals of the coefficients having the range between 0.0001 and 1.0000. Finally, experimental results of the phase-space portraits for generating from 2 to 10 scrolls are listed to show that their associated value for the optimal maximum Lyapunov exponent increases by increasing the number of scrolls, thus guaranteeing a more complex chaotic behavior.

Successful Reversal of Late, Severe Thrombotic Bioprosthetic Mitral Valve Stenosis With Anticoagulation Therapy.

Late bioprosthetic valve thrombosis (bPVT) is a rare and potentially life-threatening complication following valve replacement with thrombus formation leading mostly to valvular stenosis or embolic phenomena. Clinically, it manifests as symptoms of fatigue, dyspnea, or reduced exercise capacity. The existing treatment guidelines lack clear recommendations for managing this specific presentation. In this case study, we present a distinct clinical scenario wherein the use of anticoagulation, specifically apixaban, successfully reversed very late, severe thrombotic stenosis in a 78-year-old woman with a Medtronic Hancock II porcine mitral valve (Dublin, Ireland). This case highlights the need to consider bPVT as an alternative etiology to valve degeneration in the setting of late bioprosthetic valve stenosis. Additionally, it demonstrates how apixaban therapy may serve as a viable treatment modality in these scenarios.

Detecting partial premature ovulation during follicular aspiration compromises the quantity, but not the quality, of the oocytes retrieved in stimulated in vitro fertilization (IVF) cycles.

OBJECTIVE: To analyze if partial premature ovulation (PPO) detection during oocyte pick-up (OPU) impairs the quality of the retrieved oocyte cohort. METHODS: The PPO concept refers to the situation when premature ovulation happens only in some of the follicles and it is detected during OPU. This study constitutes a retrospective analysis performed in an infertility clinic (Spain) during 2016-2021 with patients undergoing OPU after controlled ovarian hyperstimulation for an in vitro fertilization (IVF) treatment. Study code: 2110-VLC-091- VG, registered on December 9 2021. Data from women with PPO (n=111) were compared to a matched control sample of cycles without PPO (n=333) at a proportion of 1:3. RESULTS: Cycles were matched for age, body mass index (BMI), treatment year, embryo genetic analysis and stimulation protocol type. The mean numbers of oocytes (6.1 vs. 11.2), mature oocytes (4.7 vs. 8.8), correctly fertilized oocytes (3.6 vs. 6.6) and top-quality blastocysts (0.9 vs. 1.8) were significantly lower in the PPO group than the nonPPO group (p<0.05). However, maturation, fertilization, top-quality blastocyst and pregnancy rates were statistically comparable among groups (p>0.05). CONCLUSIONS: Cycles with PPO have fewer available oocytes and, thus, fewer available embryos for transfer, al though their quality is intact, and still offer chances of pregnancy in these cases. Hence cycle cancellation may not be worth associated money, time and morale losses once PPO is detected.

Trade impacts of external border measures under the European Union's plant health legislation.

BACKGROUND: This article assesses whether the European Union's (EU's) plant health regulations have had an impact on imports. A dynamic modelling approach was applied, using a two-step generalized method of moments estimator for panel data, and covering an 8-year period (2013-2020). The estimated equation includes volumes of trade, economic drivers, the trading partner, and variables capturing categories of import requirements (phytosanitary certificates, exemptions, restrictions) with regards to external border measures for enhanced biosecurity. RESULTS: From the analysis we can conclude that the import regime and its recent changes have had a limited impact, if any, on trade flows of the affected products. The most significant impact is found for products classified as high-risk plants, while the extension of the phytosanitary certificate requirement to new products seems to have had negligible effects on trade. CONCLUSION: Therefore, the plant protection regime for extra-EU trade seems to be not trade distorting while supplying a framework to enhance plant health in the EU. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.