Music Listening in Stem Cell Transplantation and Acute Myeloid Leukemia: A Randomized Clinical Trial.

CONTEXT: Music listening (ML) has been shown to have a beneficial effect on patients with cancer. However, novel intervention approaches are needed. OBJECTIVES: We aimed to determine whether ML based on the iso-principle, conducted using a mobile application (GloMus), improves symptom burden, quality of life (QoL), anxiety, and depression in patients undergoing stem cell transplantation (SCT) and intensive induction chemotherapy for acute myeloid leukemia (AML). METHODS: In this randomized controlled clinical trial, we assigned 71 patients to the ML or standard care (SC) groups, stratified by the reason for admission (AML, allogeneic-SCT, or inpatient/outpatient autologous-SCT). Upon admission, participants in the ML groups were invited to undergo daily ML sessions designed to change negative moods into positive ones (iso-principle). The intervention consisted of listening to pre-recorded classical music ordered by beats per minute and tonality. Symptom burden (Edmonton Symptom Assessment System-Revised) was assessed in the ML groups before and after each session. Anxiety, depression (Hospital Anxiety and Depression Scale), and QoL (Functional Assessment of Cancer Therapy-Bone Marrow Transplantation/Leukemia) were measured weekly in the ML and SC groups. RESULTS: Symptom burden in both allogeneic- and inpatient autologous-SCT ML groups reduced after the intervention. In all experimental groups, clinically important improvements were observed after ML sessions. No differences were found between the groups (ML vs. SC) at different weeks of admission regarding anxiety, depression, and QoL. CONCLUSIONS: ML based on our innovative iso-principle strategy, conducted using GloMus, reduced the symptom burden in patients undergoing allogeneic- and inpatient autologous-SCT (ClinicalTrials.gov number, NCT05696457).

Distributed Nonlinear Model and Fast Analysis for In-Band IMD3 Prediction of Surface Acoustic Wave Resonators.

The motivation of this work is to analyze the in-band intermodulation distortion (IMD) occurring in surface acoustic wave (SAW) devices, using a recently developed fast method based on the input-output equivalent sources (IOES). The method calculates the equivalent current sources of a given harmonic (H) or IMD, which when applied at the boundaries of any uniform nonlinear region produce the same nonlinearities as the full distributed circuit. The accuracy of the method is validated with a very simplified SAW resonator with ten digits, which is modeled by a discretized Mason-based circuit. The IOES method provides equal results to the ones obtained through harmonic balance (HB) simulations, performed by means of commercial software, being the first 1000 times faster. Once the accuracy of the method is guaranteed, it is used to analyze the measured in-band IMD3 of several lithium tantalite 42° cut leaky SAW (LSAW) resonators with different pitches and duty factors at the B66 long term evolution (LTE) frequency band. Those resonators are comprised of 100 and 20 electrode pairs for the active region and each of the reflectors, respectively, which implies the analysis of a very large distributed nonlinear problem with thousands of nonlinear local sources. The IOES method takes 35.4 s in simulating 51 frequency points, whereas this simulation is not possible using a commercial HB simulator on a general-purpose computer.

A journey through anticoagulant therapies in the treatment of left ventricular thrombus in post-COVID-19 heparin-induced thrombocytopenia: a case report.

BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug reaction associated with thrombosis. Clinical scoring systems and the presence of anti-platelet factor 4 (anti-PF4)/heparin antibodies determine the diagnosis. CASE PRESENTATION: A 57-year-old man who was treated with acenocoumarol due to a chronic left ventricular thrombus was admitted to the hospital for severe SARS-CoV-2 pneumonia and pulmonary embolism. The patient was started on bemiparin and discharged. Left lower limb acute arterial ischemia and thrombocytopenia were diagnosed 18 days later. Computed tomography angiography revealed a large left ventricular thrombus and multiple arterial thrombi. Left femoral-popliteal thromboembolectomy was performed. Anti-PF4/heparin antibodies confirmed an HIT diagnosis. Fondaparinux (7.5 mg/24 h) was initiated, but cardiac surgery was necessary. Bivalirudin was used during surgery, with an initial load (1.25 mg/kg) and maintenance infusion (2.5 mg/kg/h). The cardiac thrombus was extracted, but the patient experienced a postsurgical myocardial infarction. Percutaneous cardiovascular intervention (PCI) required a bivalirudin load (0.75 mg/kg) and maintenance infusion (1.75 mg/kg/h). No coronary lesions were detected, and argatroban was started afterwards (0.5 µg/kg/min). When the platelet count exceeded 100 × 109/L, acenocoumarol was initiated. Thereupon, acetylsalicylic acid (100 mg/24 h) was added. No other complications have been reported to date. CONCLUSION: The clinical presentation of intraventricular and multiple arterial thrombi is remarkable. SARS-CoV-2 infection likely contributed to a hypercoagulable state. The management of patients with HIT undergoing cardiac surgery is challenging. If surgery cannot be delayed, then treatment with bivalirudin is recommended. Additionally, this drug is recommended for PCI. Bivalirudin is safe and well-tolerated in both procedures.

The Input-Output Equivalent Sources Method for Fast Simulations of Distributed Nonlinearities in Bulk Acoustic Wave Resonators and Filters.

This work presents a new method to analyze weak distributed nonlinear (NL) effects, with a focus on the generation of harmonics (H) and intermodulation products (IMD) in bulk acoustic wave (BAW) resonators and filters composed of them. The method consists of finding equivalent current sources [input-output equivalent sources (IOES)] at the H or IMD frequencies of interest that are applied to the boundary nodes of any layer that can contribute to the nonlinearities according to its local NL constitutive equations. The new methodology is compared with the harmonic balance (HB) analysis, by means of a commercial tool, of a discretized NL Mason model, which is the most used model for NL BAW resonators. While the computation time is drastically reduced, the results are fully identical. For the simulation of a seventh-order filter, the IOES method is around 700 times faster than the HB simulations.

Targeting cytoskeletal phosphorylation in cancer.

Phosphorylation of cytoskeletal proteins regulates the dynamics of polymerization, stability, and disassembly of the different types of cytoskeletal polymers. These control the ability of cells to migrate and divide. Mutations and alterations of the expression levels of multiple protein kinases are hallmarks of most forms of cancer. Thus, altered phosphorylation of cytoskeletal proteins is observed in most cancer cells. These alterations potentially control the ability of cancer cells to divide, invade and form distal metastasis. This review highlights the emergent role of phosphorylation in the control of the function of the different cytoskeletal polymers in cancer cells. It also addresses the potential effect of targeted inhibitors in the normalization of cytoskeletal function.

Musculoskeletal ultrasound: an effective tool to help medical students improve joint inflammation detection?

AIM: The objective of this study was to evaluate whether musculoskeletal (MS) ultrasound (US) can be useful in helping medical students to detect joint inflammation through physical examination. MATERIAL AND METHODS: The study was performed by two groups of four 6th year medical students. None had received any previous training in the clinical examination of joints or the use of ultrasound. Students were put through a 5-session training programme on the clinical detection of either knee [group 1] or metacarpophalangeal (MCP) [group 2] inflammation. After an initial training session on physical examination of normal and inflamed joints, the students examined 170 joints from 41 patients attending the hospital outpatient clinic in 4 separate sessions. The same joints were assessed for synovitis with US with the ensuing data compared to that of the students and analyzed for concordance with Cohen's unweighted kappa. RESULTS: In total 60 knees [group 1] and 110 MCP [group 2] were evaluated. The agreement between the presence of arthritis detected by the students in the four sessions and the presence of synovitis detected by US improved from the session I to sessions III with a marked improvement in the last session. CONCLUSIONS: MSUS may be an effective technique for helping students to acquire the ability to detect joint inflammation.