Search Results (64)

Background: Classical Hodgkin lymphoma (cHL) demonstrates high survival rates with the ABVD regimen (doxorubicin, bleomycin, vinblastine, dacarbazine); however, the use of bleomycin is associated with a significant risk of pulmonary toxicity. The Risk-Adapted Treatment of HL (RATHL) trial demonstrated that omitting bleomycin in patients with favorable interim Positron Emission Tomography (PET-CT) results did not adversely affect survival outcomes. In this study, we present real-world data from advanced-stage HL patients treated according to the RATHL protocol. Methods: This multicenter, retrospective study included newly diagnosed cHL patients with Ann Arbor stage IIB–IV disease or stage IIA disease with bulky disease or with involvement of three or more sites, enrolled from 29 centers across Türkiye. The analysis focused on patients whose initial treatment was de-escalated from ABVD to AVD (bleomycin was omitted). Data were collected on demographic and clinical prognostic characteristics, interim PET-CT findings (evaluated using the Deauville score), progression-free survival (PFS) and overall survival (OS). Survival outcomes were assessed using Kaplan–Meier analysis. Results: A total of 379 patients were included, with a median age of 34 years (range: 18–78). Following interim PET-CT assessments (After 2 cycles of ABVD), Deauville scores were 1 in 39.8% of patients, 2 in 39.1%, and 3 in 21.1%. Based on these results, bleomycin was omitted immediately after interim PET-CT in 73.9% of patients, after one additional ABVD cycle in 12.1%, and after two additional cycles in 14%. The median follow-up duration was 28 months (range: 6–96). The 3-year PFS and OS rates were 86.0% and 96.1%, respectively. Patients with Deauville scores of 1–2 had a 3-year PFS rate of 87.6%, compared to 79.8% in those with a score of 3 (p = 0.087). Increased age, poor Eastern Cooperative Oncology Group Scale (ECOG) performance status, bulky disease, and higher International Prognostic Scores (IPS) were significantly associated with inferior OS (p < 0.05). There were no significant differences in OS among patients who received 2, 3, or 4 cycles of ABVD. However, among patients treated with 2 cycles of ABVD, both extranodal involvement (p = 0.039) and higher IPS (p = 0.002) were significantly associated with decreased PFS. Conclusions: Our findings demonstrate that PET-guided de-escalation of bleomycin after two cycles of ABVD is feasible, effective, and safe in real-world multicenter practice in Türkiye. The survival outcomes are comparable to those reported in the RATHL study, reinforcing the role of interim PET-CT in guiding individualized therapy. However, patients with high IPS or extranodal involvement may require more tailored management strategies. Full article

Ion channels regulate ion transport across cell or organelle membranes, playing an important role in various biological processes. Sodium channel Nav1.4 is critical to initiating and propagating action potentials in skeletal muscles, and its dysfunction is associated with a variety of diseases, such as non-dystrophic myotonias. In this study, U-actitoxin-Avd3i (Avd3i), a Kunitz-type toxin derived from Anemonia viridis, was expressed in prokaryotic systems and was subsequently purified via high-pressure liquid chromatography. Patch clamp recording showed that Avd3i inhibited Nav1.4 in a concentration-dependent manner, with an IC₅₀ of 25.43 μM. However, the toxin exerted no inhibitory activity in Nav1.5/Nav1.7 channels or Kv1.1/Kv1.3/Kv1.4/Kv4.2 potassium channels. Our study found that the sea anemone-derived toxin Avd3i inhibited sodium channel Nav1.4, providing a novel molecule that can act on the channel. Full article

Alpine meadows on the Tibetan Plateau experience chronic, fine-scale disturbances from the plateau zokor (Eospalax baileyi), a subterranean rodent that alters soil and vegetation structure through persistent burrowing and mounding. While classical theory predicts that plant community stability peaks at intermediate disturbance levels, this may not apply under spatially heterogeneous disturbance regimes. We assessed community stability across a five-level zokor disturbance gradient using a multi-indicator framework integrating compositional variability (average variation degree, AVD), co-occurrence-based cohesion, indicator species analysis, and boosted regression tree (BRT) modeling. Stability (1−AVD) peaked under extreme disturbance, alongside reduced indicator species richness and the dominance of disturbance-tolerant taxa. Increased cohesion suggested stronger species associations. Drivers of stability shifted from plant attributes under low disturbance to soil constraints (bulk density and moisture) under high disturbance. These results challenge the intermediate disturbance–stability paradigm and suggest that abiotic filtering can promote compositional convergence and structural stability. Our findings highlight the importance of spatial disturbance patterns in shaping community resilience and provide early warning indicators and targeted guidance for managing alpine grasslands under subterranean disturbance. Full article

Background: Diabetes insipidus (DI) in newborns is an extremely rare condition, with the age of presentation strongly suggesting a genetic background of the disease. The differential diagnosis should include arginine vasopressin deficiency (AVD) and arginine vasopressin resistance (AVR). Some novel diagnostic tools such as copeptin evaluation and genetic tests are vital for early diagnosis. Case report: We present the case of a 1-month-old boy with polyuria observed since birth. Laboratory tests showed persistent hypernatremia, elevated plasma and low urine osmolality. An attempt at oral administration of desmopressin had no effect; additionally the copeptin level was increased. A genetic study (NGS of the AVP, AVPR2 and AQP2 genes) was considered and a new pathogenic variant in the AVPR2 gene (hemizygous c.157del) was detected. After the genetic test result was obtained, treatment with hydrochlorothiazide was started. The patient is now 3 months old, developing normally, and the weight and height are normal. Conclusions: Newborns with DI should be subjected to extensive multidisciplinary diagnostics, including endocrine and renal causes. Copeptin evaluation and prompt genetic diagnosis allows for the early diagnosis and implementation of appropriate treatment. Full article

Hodgkin’s Lymphoma (HL) affects approximately 8500 individuals annually in the United States. The 5-year relative survival rate has improved to 88.5%, driven by transformative advances in immunotherapy and precision oncology. The integration of Brentuximab vedotin (BV) and immune checkpoint inhibitors (ICIs) has redefined treatment paradigms. The phase III SWOG S1826 trial established nivolumab plus doxorubicin, vinblastine, and dacarbazine (N + AVD) as an emerging new standard for advanced-stage HL, achieving a 2-year progression-free survival (PFS) of 92% compared to 83% for BV plus AVD (HR 0.48, 95% CI: 0.33–0.70), with superior safety, particularly in patients over 60. In relapsed/refractory HL, pembrolizumab outperforms BV, with a median PFS of 13.2 versus 8.3 months (HR 0.65, 95% CI: 0.48–0.88), as demonstrated in the KEYNOTE-204 trial. Emerging strategies, including novel ICI combinations, minimal residual disease (MRD) monitoring via circulating tumor DNA (ctDNA), and artificial intelligence (AI)-driven diagnostics, promise to further personalize therapy. This review synthesizes HL’s epidemiology, pathogenesis, diagnostic innovations, and therapeutic advances, highlighting the role of precision medicine in addressing unmet needs and disparities in HL care. Full article

Severe aortic valve diseases (AVD) cause changes in heart sounds, making phonocardiogram (PCG) analyses challenging. This study presents a novel method for segmenting heart sounds without relying on an electrocardiogram (ECG), specifically targeting patients with severe AVD. Our algorithm enhances traditional Hidden Semi-Markov Models by incorporating signal envelope calculations and statistical tests to improve the detection of the first and second heart sounds (S1 and S2). We evaluated the method on the PhysioNet/CinC 2016 Challenge dataset and a newly acquired AVD-specific dataset. The method was tested on a total of 27,400 cardiac cycles. The proposed approach outperformed the existing methods, achieving a higher sensitivity and positive predictive value for S2, especially in the presence of severe heart murmurs. Notably, in patients with severe aortic stenosis, our proposed ECG-free method improved S2 sensitivity from 41% to 70%. Full article

Understanding the contribution of macroinvertebrate diversity indices to community stability in urban rivers is critical for developing more effective strategies to manage and conserve the ecological health of urban rivers and to maintain sustainable regional economic and social development. However, knowledge regarding the relationship between environmental factors, multidimensional biodiversity, and community stability in urban rivers remains limited. In this study, we investigated the relationships among macroinvertebrate multidimensional diversity, secondary productivity-to-biomass ratio (SP/B), and average variation degree (AVD) in a typical urban river—the North Canal River basin in Beijing—to identify which biodiversity metric best indicates community stability. Macroinvertebrates were extensively sampled from September to October 2020 in the North Canal River basin (BYH), a typical urban river in Beijing. We comparatively analyzed the spatial variation in different types of diversity—species diversity (SD), functional diversity (FD), and phylogenetic diversity (PD)—as well as SP/B and AVD between the upstream and midstream–downstream reaches of the river under varying degrees of urbanization and human disturbance. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to assess the relationships among multidimensional diversity, SP/B, and AVD. The results showed that upstream environmental factors and diversity indices together explained 52.9% and 52.0% of the variance in SP/B and AVD, respectively, while midstream–downstream factors explained 65.9% and 84.2%, respectively. These findings suggest that both SP/B and AVD are suitable indicators for examining the relationships between macroinvertebrate community stability, diversity indices, and environmental factors in the BYH. In the upstream region, total phosphorus (TP), FD, and PD were more indicative of SP/B in the central urban area, while SD and PD were more indicative of AVD. In contrast, in the midstream–downstream suburban areas, dissolved oxygen (DO), SD, and PD were more indicative of SP/B, while FD and PD were more indicative of AVD. These findings demonstrate that PD is a stronger indicator of both SP/B and AVD under varying anthropogenic disturbances and environmental conditions. The PLS-SEM results also indicated differences in the specific effects of FD and SD on community stability across the upstream and midstream–downstream sections, as well as differences in the direct effects of environmental factors such as TP and DO. These results suggest that PD is more sensitive than FD and SD in detecting the impacts of anthropogenic disturbances and environmental fluctuations on macroinvertebrate community stability in urban rivers. Our study provides evidence that PD outperforms FD and SD in predicting macroinvertebrate community stability in urban river ecosystems and that the combined use of SP/B and AVD better reveals the complex interactions between biodiversity and environmental factors influencing community stability. This combination can thus enhance our understanding of how biodiversity affects macroinvertebrate community stability in urban rivers. Full article

Functional groups are an effective method for assessing water quality. From January 2020 to December 2023, the phytoplankton and environmental variables at five sites in Baihua Reservoir (BHR) were collected once a month. The succession rate (SR) and the average variation degree (AVD) of the functional groups were determined, and the corresponding driving factors were analyzed by using the Random Forest model, hierarchical partitioning, and Mantel test. A total of 95 phytoplankton species belonging to 7 taxonomic categories were identified, which can be divided into 27 functional groups and 8 dominant functional groups (B, D, L₀, P, S1, W1, W2, Y). B, L₀, and Y occupied dominant positions in spatiotemporal succession, indicating that the water body was in a mesotrophic to eutrophication state. Water temperature, total nitrogen, and transparency were the key factors driving the functional groups’ succession. Total nitrogen, total phosphorus, permanganate index, and dissolved oxygen were significantly positively correlated with AVD (n = 230; p < 0.01). SR not only directly positively affected AVD (n = 230; p < 0.05) but also indirectly affected AVD by affecting physicochemical factors. Understanding the relationship between the succession, stability, and environmental factors of functional groups is of great significance for algae management and the prevention of water bloom. Full article

Introduction: Aortic valve disease (AVD) is an inflammatory, lipid infiltration and calcification disease that has been associated with changes in the conventional linear heart rate variability (HRV) indices showing a marked shift towards sympathetic predominance and a deterioration of the autonomic control. Objective: To explore the HRV dynamics in AVD patients through nonlinear methods by recurrence quantification analysis (RQA). Methods: In total, 127 subjects participated in a cross-sectional study categorized into three groups: healthy valve (HV), aortic valve sclerosis (AVSc), and aortic valve stenosis (AVS), as determined by echocardiographic assessment. HRV data were collected from five-minute ECG recordings at both a supine position and active standing. RQA indices were calculated using the Cross Recurrence Plot Toolbox. Results: In the supine position, patients with AVS exhibited larger determinism and trapping time than those with AVSc and HV. The analysis of these differences revealed that determinism and laminarity increased progressively from HV to AVS. In the same way, the magnitude of change (Δ) between positions decreased and presented the lowest values in AVS in most of the nonlinear indices. Conclusion: RQA indices of HRV in AVD patients indicate a rigidizing dynamic characterized by larger determinism and extended trapping times in fewer system states in relation to the severity of AVD. These findings establish a precedent for future perspective assessments for the implementation of these methods in medical software or devices. Full article

Aortic valve disease (AVD) is a highly prevalent condition worldwide. Aortic valve replacement (AVR) is the surgical treatment for those with severe disease. Common etiologies of AVD include aortic stenosis (AS), aortic insufficiency (AI), endocarditis, and congenital diseases. Shared decision-making plays a large role in the treatment methodology chosen for each patient. Selection of valve type and surgical intervention requires strong considerations of age and compatibility with vitamin K antagonists (VKAs) to ensure optimal post-operative outcomes. Due to the development of novel surgical techniques, including transcatheter AVR (TAVR) and placement of sutureless valves, patients who previously had limited access to AVD surgical options can now be considered for AVR. Further research into therapeutic development is imperative to improve patient short- and long-term outcomes as well as widen surgical candidacy for those seeking AVR for the management of AVD. Overall, AVR will continue to hold its prominent role in the treatment of AVD. Full article

Lithium-ion batteries (LIBs), valued for their high energy density, long lifespan, and low environmental impact, are widely used in electric vehicles (EVs) and energy storage. However, increased energy density has exacerbated thermal runaway (TR) issues, hindering large-scale applications. This paper systematically analyzes the mechanisms of TR and strategies for early warning and prevention to enhance battery safety. It begins by detailing TR mechanisms and their triggers, then reviews various TR early warning technologies, fire prevention methods, and the effectiveness and mechanisms of novel extinguishing agents such as hydrogels, perfluorohexanone, liquid nitrogen (LN), dry powder, and aqueous vermiculite dispersion (AVD). The study also explores advancements in new fire-retardant coatings for batteries. Finally, it summarizes current challenges and forecasts future research directions in battery technology. This review offers readers a clear, systematic overview of TR mechanisms, warning systems, and prevention technologies, providing comprehensive insights into TR management. Full article

In this study, a fish scale structure with low viscous drag was proposed and applied to the suction surface of a compressor cascade to reduce total pressure loss and suppress corner separation, a key source of compressor inefficiency. By using CFD simulations, the biomimetic structure was identified and integrated into the cascade design. To evaluate its effects, we analyzed secondary flow structures using 2D projected streamlines, axial velocity density (AVD), and vortex visualization techniques. The results show that the fish scale structure effectively reduces the volume of low-energy fluid by 18.36% and decreases total pressure loss at the outlet by 3.5%. Additionally, the AVD iso-surface proved instrumental in identifying low-energy fluid regions, which correlate closely with total pressure loss distribution. These findings highlight the potential of biomimetic-inspired designs to improve compressor performance by mitigating corner separation and reducing flow losses. Full article

The geographic distribution patterns of soil microbial communities associated with cultivated Acanthopanax senticosus plants in Northeast China were investigated. High-throughput sequencing revealed that the diversity and community assembly of bacterial and fungal communities in the inter-root soil varied significantly with geographic location. The study found that bacterial communities were predominantly assembled through stochastic processes at most sites, while fungal communities showed greater variation, with both stochastic and deterministic processes involved. The complexity of bacterial–fungal co-occurrence networks also varied with longitude and latitude, demonstrating both positive and negative interactions. PICRUSt 2.0 and FUNGuild were used to predict the potential functions of soil bacterial and fungal microbiota, respectively, during different land use patterns. The average taxonomic distinctness (AVD) index indicated varying degrees of community stability across sites. Key microbial taxa contributing to community variability were identified through Random Forest modeling, with Bacteriap25 and Sutterellaceae standing out among bacteria, and Archaeorhizomyces and Clavaria among fungi. Soil chemical properties, including pH, TN, TP, EC, and SOC, significantly correlated with microbial diversity, composition, and co-occurrence networks. Structural equation modeling revealed that geographic distribution patterns directly and indirectly influenced soil chemical properties and microbial communities. Overall, the study provides insights into the geographic distribution patterns of soil microbial communities associated with A. senticosus and highlights the need for further research into the underlying mechanisms shaping these patterns. Full article

Background/Objectives: Perineal injuries, including episiotomies and spontaneous tears, are common complications during childbirth, often leading to significant discomfort and prolonged recovery for women. This retrospective observational cohort study aimed to explore the relationship between antenatal anovaginal distance (AVD) and the incidence of perineal injuries in a cohort of pregnant women evaluated for pelvic floor health at 28 to 32 weeks of gestation. Methods: Conducted at the University Hospital of Padua over 18 months, the study included 416 women who underwent vaginal delivery at term. Based on AVD, the study participants were divided into two groups: AVD-N group, which included 252 patients with AVD ≥ 2 cm, and the AVD-R group, which included 164 with AVD < 2 cm. The results of the pelvic floor assessment and those related to childbirth were then examined in relation to AVD (reduced vs. normal). Results: The study found that women with reduced AVD were more likely to experience perineal injuries. Specifically, the incidence of episiotomy and severe perineal tears (3rd and 4th degree) was significantly higher in the reduced AVD group (p < 0.05). Furthermore, a lower AVD was associated with increased perineal muscle hypertonicity and a higher likelihood of operative delivery with episiotomy. Logistic regression analysis confirmed that reduced AVD was an independent risk factor for perineal injuries, regardless of other maternal or neonatal characteristics. Conclusions: These results suggest that AVD measurement during pregnancy may help identify women at higher risk of perineal trauma, enabling more personalized obstetric care to mitigate these outcomes. Full article

We present the case of a 43-year-old Caucasian man who developed visceral leishmaniasis (VL) following treatment with a combination of brentuximab vedotin and doxorubicin, vinblastine, and dacarbazine (A+AVD) for advanced-stage classical Hodgkin’s lymphoma (cHL). The patient initially showed a favorable response to the treatment, but shortly after completing six cycles, he experienced recurrent fever, splenomegaly, and severe anemia. Extensive infectious disease evaluations led to a diagnosis of VL, confirmed by PCR testing. The patient was treated with amphotericin B, resulting in full clinical recovery. In addition to presenting this rare case, we conducted a full review of the literature on VL in the context of hematological disorders, including non-Hodgkin’s lymphoma, splenic marginal zone lymphoma, and other lymphoproliferative diseases. This review highlights the increasing prevalence of VL in immunocompromised individuals, particularly those undergoing treatments like chemotherapy or immunotherapy, and underscores the importance of considering VL in differential diagnoses when such patients present with persistent fever and splenomegaly. Full article