Search Results (622)

Background/Objectives: Assessing treatment response in neuroendocrine tumors (NETs) remains challenging. The multifactorial mechanism of action of peptide receptor radionuclide therapy (PRRT) further complicates response evaluation, particularly in the absence of standardized criteria. This study aimed to compare different imaging-based response assessment methods after PRRT and to explore their relationship with clinical outcomes, particularly progression-free survival (PFS). Methods: In this single-center retrospective study, we analyzed NET patients treated with PRRT between 2020 and 2024 who underwent [⁶⁸Ga]Ga-DOTATOC PET/CT before and after therapy, with a minimum follow-up of 12 months. Five response criteria were evaluated: (a) Krenning Score changes; (b) adapted PERCIST criteria (MORE); (c) ZP-normalized parameter; (d) qualitative visual PET assessment; and (e) RECIST-based morphological response on contrast-enhanced CT. Imaging findings were correlated with clinical outcomes. Nonparametric analyses were performed using the MedCalc^® software. Results: Thirty-one patients (median age 63 years; 17 males) with NET were evaluated after PRRT. Post-PRRT PET/CT was performed at a median of 3 months. Response rates varied across methods, with higher rates noted using functional imaging (MORE 66%, Visual PET 68%, ZP 70%) compared to RECIST (40%) and Krenning score (21%). After a median follow-up of 37 months, 58% of patients experienced disease progression. Although no significant association was found between the response criteria and progression (p > 0.05), functional imaging showed a trend toward better correlation with longer progression-free survival. Conclusions: Functional PET-based responsecriteria suggest association with progression-free survival compared to RECIST criteria and Krenning score changes. However, given the exploratory nature of the study and its methodological limitations, these observations should be considered hypothesis-generating only. They do not provide definitive evidence of superiority over established assessment methods and therefore should not be interpreted as practice-changing. Full article

Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy. Next-generation sequencing (NGS) enables molecular characterization and may identify clinically actionable alterations; however, real-world multicenter data linking genomic subgroups to survival outcomes remain limited. We aimed to characterize the molecular landscape of NGS-tested PDAC in a Turkish multicenter cohort and evaluate the association of key molecular alterations, including KRAS status and KRAS variant subgroups, with survival outcomes. Methods: We conducted a multicenter retrospective cohort study including patients with pathologically diagnosed PDAC between 2017 and 2025 who underwent tumor-based NGS in routine clinical practice. Overall survival (OS) was calculated from the date of metastasis, defined as the date of diagnosis for de novo metastatic disease and the date of first documented distant recurrence for recurrent cases. Progression-free survival (PFS) was calculated from the initiation of first-line systemic therapy for metastatic disease to progression or death. Survival was estimated using the Kaplan–Meier method and compared using the log-rank test. Multivariable Cox proportional hazards models were constructed for OS and PFS using clinically relevant covariates selected a priori. Results: A total of 98 patients underwent molecular profiling, and survival analyses were performed in 92 patients with available OS/PFS data. KRAS mutations were detected in 83.7% (82/98) of patients, with predominant variants G12D (47.6%), G12V (30.5%), and G12R (12.2%). TP53 mutations were present in 59.2% (58/98) of tumors, and all tumors were microsatellite stable. Tumor mutational burden data were available for 72 patients; the median TMB was 3.83 mutations/Mb, and 15.3% of evaluable tumors had a TMB ≥ 10 mutations/Mb. Excluding KRAS, clinically actionable alterations were identified in 4.1% of patients, whereas an additional 32.7% harbored potentially actionable or investigational alterations. Median OS was 14.0 months (95% CI, 11.7–16.3), and median PFS was 6.0 months (95% CI, 4.3–7.7). In unadjusted analyses, OS and PFS did not differ significantly according to KRAS mutation status (OS, p = 0.967; PFS, p = 0.652), TP53 mutation status (OS, p = 0.404; PFS, p = 0.510), or KRAS variant subgroup (OS, p = 0.332; PFS, p = 0.194). In multivariable Cox analyses, KRAS mutation status was not independently associated with OS (aHR 1.13, 95% CI 0.56–2.28; p = 0.727) or PFS (aHR 1.09, 95% CI 0.59–2.01; p = 0.780), whereas ECOG performance status remained the strongest adverse clinical factor. Conclusions: In this multicenter real-world PDAC cohort, the molecular landscape was dominated by KRAS and TP53 alterations, whereas clinically actionable non-KRAS alterations were identified in only a minority of patients. After adjustment for major clinical covariates, KRAS mutation status was not independently associated with OS or PFS. Molecular profiling may still be useful for identifying uncommon potentially targetable alterations; however, larger clinically annotated multicenter studies are needed to better define its prognostic and treatment-directing value in routine practice. Full article

Endometrial cancer (EC) is the sixth most common cancer in women. Its overall incidence has increased by 132% over the past 30 years, reflecting an increase in the prevalence of risk factors. The mortality rate decreased by 15% in the last 30 years, despite the high number of endometrial cancer-related deaths occurring world-wide. An inverse relationship has been observed between the incidence of EC, mortality and socio-economic status: more patients living in low-income countries die from EC because they do not have access to timely and effective treatment. About 80% of EC cases are diagnosed in an early stage and have a good prognosis. However, about 20% of cases present in advanced stages and are characterized by a poor prognosis. The molecular classification proposed by The Cancer Genome Atlas (TGCA) and its surrogate for clinical use allowed the adoption of personalized treatments. The assessment of the status of the MMR has revolutionized the treatment of advanced ECs, leading to significant results both in terms of PFS and OS. In this review we will focus on MMR deficiency (dMMR)/microsatellite instability-hypermutated (MSI-H) tumors, which globally account for 20–30% of ECs. The dMMR group encompasses multiple etiologies, including sporadic defects in MMR genes, germline mutations, and hypermethylation of the MLH1 promoter. Currently, the combination of immunotherapy (I-O) with standard chemotherapy has become the new standard first-line treatment for dMMR advanced or recurrent ECs. Although the main clinical trials involving patients with MMRd/MSI-H ECs treated with I-O and chemotherapy have demonstrated efficacy and long-term control of the disease, a significant number of patients do not respond to treatment (intrinsic or primary resistance) and others develop progression during treatment (acquired or secondary resistance). In this narrative approach the biological and molecular bases of these tumors have been integrated with recent advances involving diagnostic techniques, therapeutic opportunities and the genomic and phenotypical alterations underpinning the mechanisms of resistance. Special attention was given to the need for robust, clinically affordable biomarkers to promptly identify responders and non-responders to the current treatment regimens. Full article

Nai plum (Prunus salicina Lindl. var. cordata) is a high-value fruit crop in southern China, yet its post-harvest quality is often compromised by fruit browning, a major constraint to storage and marketability. Addressing this challenge requires a deeper understanding of the species’ reproductive biology, which underpins both fruit set and cultivar improvement. In this study, we characterized the flowering biological characteristics of Nai plum accessions introduced from Yanling and Liuyang (Hunan Province) and Shaoguan and Lechang (Guangdong Province). Using field observations combined with microscopic and submicroscopic techniques, we documented flowering phenology, flowering dynamics, floral organ traits, pollen viability and stigma receptivity. The flowering period was in March, lasting 26–28 d, and the group blooming period was divided into three stages: Initial opening stage, Full blooming stage, and Final flowering stage. The single-flower opening process was divided into eight stages. Pollen viability followed a unimodal curve, peaking at the petal flattening stage (PF) across all accessions, though peak values varied by provenances. Stigmas were of the wet type, with receptivity following a weak–strong–weak pattern; peak receptivity occurred at early flowering (EF) and PF in most accessions. The EF of Nai plum from Yangling (S1) lasted for 7 h, and PF lasts for 28 h. The EF of Nai plum from Yangling (S2) lasted for 3 h, and the PF lasted for 11 h. Both the EF and the PF of Nai plum from Shaoguan (S3) lasted for 14 h. The bud white stage (BW) of Nai plum from Lechang (S4) lasted for 6 h and the EF lasted for 7 h. The EF of Nai plum from Liuyang (S5) lasts for 7 h, and the PF lasted for 28 h. These findings clarify the reproductive phenology and floral biology of Nai plum, providing foundational knowledge that can inform breeding strategies and cultivation practices aimed at improving fruit set and, ultimately, post-harvest quality. Full article

Research on cross-language adult speech perception shows that non-native speech sounds are interpreted through the listener’s L1 phonological system. According to the Perceptual Assimilation Model (PAM) and its extension, PAM-L2, discriminability of non-native/L2 speech contrasts is determined by how two phones are assimilated to L1 phonological categories. Specifically, discriminability varies depending on perceived overlap with L1 phonological categories. This study assessed the PAM/PAM-L2 account of the assimilation–discrimination relationship in discrimination of non-native/L2 stop–fricative contrasts, focusing on how discrimination varies with assimilation overlap. Chinese listeners completed assimilation and AXB discrimination tasks with six English (/p-f/, /b-v/, /t-θ/, /t-s/, /d-ð/, /d-z/) and two Persian (/k-x/, /g-ɣ/) stop–fricative contrasts. The contrasts were assimilated as four Uncategorized–Categorized (UC) contrasts, one with no overlap and three with partial overlap, and four Two-Category (TC) contrasts. The discrimination results showed that TC and non-overlapping UC contrasts were more accurately discriminated than partially overlapping UC contrasts, consistent with PAM/PAM-L2. Further analysis revealed that overlap scores were strongly negatively correlated with discrimination accuracy at the group level, and this correlation was also significant for most contrasts at the individual level. These findings suggest that exploring assimilation overlap may help clarify the assimilation–discrimination relationship in non-native/L2 stop–fricative contrast discrimination. Full article

Introduction: Inflammatory and immune-based prognostic markers such as the Lung Immune Prognostic Index (LIPI) and the Glasgow Prognostic Score (GPS) have gained increasing attention in ES-SCLC, particularly in patients receiving first-line chemoimmunotherapy. However, no prior study has explored a broader, integrated inflammatory framework that evaluates these parameters collectively. Methods: We retrospectively evaluated 166 patients with ES-SCLC treated with first-line platinum–etoposide plus atezolizumab or durvalumab between 2019 and 2025. LIPI could be calculated in 123 patients based on available dNLR and LDH values, while GPS and the Combined Inflammatory Prognostic Score (CIPS) could be assessed in 120 patients with accessible CRP and albumin data. Results: Median PFS and OS were 8.16 and 15.96 months, respectively. In univariate analyses, poor ECOG PS, liver and bone metastases, poor LIPI, poor GPS, and high-risk CIPS were associated with shorter PFS and OS. In multivariate analysis, only LIPI and GPS remained independent predictors of both PFS and OS, while ECOG PS was independently associated with OS. Although CIPS demonstrated clear prognostic separation in univariate analysis, it did not retain independent significance, likely due to sample size limitations and overlap with LIPI and GPS components. Conclusions: LIPI and GPS are strong independent prognostic markers in ES-SCLC receiving chemoimmunotherapy. While CIPS did not demonstrate independent prognostic value in multivariate analysis, its simplicity, balanced two-tier design, and use of routinely available biomarkers highlight its potential clinical utility. To our knowledge, this is the first study to assess a combined inflammatory prognostic model in this population. Prospective multicenter validation is warranted. Full article

This work introduces a trimming technique based on eTrim technology to minimize both the input-referred offset voltage and its temperature drift in the operational amplifiers. The proposed low-voltage op-amp utilizes the body effect to maintain a constant bandwidth across the rail-to-rail input common-mode range under low supply voltages. During input common-mode transitions, the current in the folded cascode stage remains stable, ensuring a robust output stage. Furthermore, a specialized gain-boosting structure enhances the low-frequency gain while preventing occasional latch-up during low-voltage power-up. A pin-multiplexing scheme is employed for trimming data input, thereby eliminating the need for dedicated trimming pins and mitigating post-package parameter variations. At room temperature, a constant-current injection mechanism reduces the DC offset to microvolt levels. At high temperature, temperature-compensated current injection cancels the first-order drift component. Implemented in a low-voltage operational amplifier, post-layout simulation results demonstrate that with a 100-pF capacitive load, the amplifier achieves a gain–bandwidth product exceeding 10 MHz, a low-frequency gain greater than 140 dB, and an input-referred noise of 2.54 µVp-p for the P-channel input and 3.95 µVp-p for the N-channel input. The trimming process reduces the residual offset to the microvolt range and effectively suppresses offset drift, ensuring accurate offset compensation across the specified temperature range. Full article

Background/Objectives: Cancer is the second leading cause of death globally, and resistance to immunotherapy requires new strategies. One promising approach is cross-line immunotherapy, defined as retreatment with the same or different immune checkpoint inhibitors after progression on prior immunotherapy. Understanding the efficacy and safety of this innovative treatment modality is critical for advancing cancer care. Methods: In this study, we evaluated outcomes of cross-line immunotherapy in a cohort of 105 patients with various malignant tumors at Beijing Friendship Hospital. The primary endpoints of the study included progression-free survival (PFS2) and overall survival (OS), measured from the initiation of cross-line immunotherapy. All patients received treatment regimens determined by their physicians. The study aimed to evaluate the efficacy of cross-line immunotherapy, with or without other therapies. Results: The study reported a median PFS2 of 6.9 months (95% CI: 4.7–8.1) and a median OS of 12.9 months (95% CI: 11.7–NA). The objective response rate (ORR) was 11%, while the disease control rate (DCR) was 77%. Although 35.2% of patients experienced grade 3 or higher immune-related adverse events, primarily hematological toxicities, no specific immune treatment-related hematological events were noted. Additionally, elevated D-dimer levels and hyponatremia emerged as prognostic factors associated with poorer outcomes, whereas hypertriglyceridemia correlated with enhanced survival. A nomogram developed for predicting PFS2 and OS demonstrated high discriminative capacity. Conclusions: These findings show that cross-line immunotherapy is safe and effective for patients with malignant tumors. It offers a viable option for patients who are progressing after initial treatments, which highlights the need for personalized strategies. Full article

Background: Immune checkpoint inhibitors (ICIs) have become a cornerstone in the treatment of advanced non-small cell lung cancer (NSCLC), yet substantial heterogeneity in clinical outcomes persists. Easily accessible biomarkers that can reliably stratify prognosis in real-world practice are still lacking. The Lung Immune Prognostic Index (LIPI), integrating lactate dehydrogenase (LDH) and the derived neutrophil-to-lymphocyte ratio (dNLR), has emerged as a promising candidate, yet its clinical relevance remains incompletely defined. Methods: We conducted a multicenter retrospective analysis of 211 patients with metastatic NSCLC treated with second-line nivolumab between 2017 and 2025. Patients were categorized into three groups (good, intermediate, and poor) according to their LIPI score, and the relationships between LIPI and objective response, disease control, progression-free survival (PFS), and overall survival (OS) were analyzed. Results: LIPI stratification effectively discriminated patients into prognostically distinct groups. Objective response rates were comparable across LIPI categories and did not differ significantly. In contrast, disease control declined progressively with worsening LIPI scores, reaching statistical significance (p < 0.001). Overall survival was significantly worse in patients with poor LIPI, demonstrating a clear stepwise reduction from good to poor LIPI groups (p = 0.007). Although progression-free survival showed a consistent numerical decrease across LIPI categories, this trend did not achieve statistical significance. Conclusions: In patients with metastatic NSCLC receiving second-line nivolumab in a real-world setting, LIPI reliably stratified overall survival and disease control outcomes, despite limited association with early response or progression-free survival. Its simplicity and reliance on routinely available laboratory parameters support its use as a clinically meaningful prognostic tool in everyday practice. Full article

The use of shotcrete is a critical support technique in ocean engineering structures. However, it often exhibits low chloride and salt erosion resistance under ocean environmental conditions and poor long-term durability. This study employed polypropylene fiber (PF) and basalt fiber (BF) to optimize the shotcrete mix design. Laboratory immersion and salt spray tests simulated chloride ion corrosion environments in the ocean’s underwater and atmospheric zones. The effects of different corrosion mechanisms and varying fiber volume fractions on shotcrete strength and durability were then analyzed. The results indicate that shotcrete demonstrates strong resistance to chloride-induced corrosion in both ocean underwater and atmospheric zones when the volume fractions of PF and BF are 0.2% and 0.1%, respectively. Based on test results from 3D digital microscopy (3D-DM), X-ray diffraction (XRD), and scanning electron microscopy (SEM), the chloride-induced degradation mechanism of hybrid fiber-reinforced shotcrete was analyzed from both mesoscopic and microscopic perspectives. This study offers theoretical support for applying hybrid fiber-reinforced shotcrete in ocean engineering environments. Full article

Background: Age- and cancer-related sarcopenia and malnutrition are common in older patients with colorectal cancer (CRC) and may negatively influence treatment tolerance and prognosis. However, the comparative prognostic value of post-chemotherapy changes in CT-based body composition parameters at the third lumbar vertebra (L3) and the twelfth thoracic vertebra (T12) levels, and their associations with nutritional indices, remain unclear. This study aimed to examine and compare the prognostic relevance of post-chemotherapy body composition changes at L3 and T12 and to assess their relationship with nutritional indices in older patients with metastatic CRC (mCRC). Methods: This retrospective study included 87 older patients with mCRC. Baseline and ~3-month follow-up CT scans were analyzed at L3 and T12 using 3D Slicer to quantify skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), visceral-to-subcutaneous fat ratio (VSR), and intramuscular adipose tissue index (IMATI). Changes (Δ) in CT-derived body composition after chemotherapy were calculated as percentage change using ((follow-up − baseline)/baseline) × 100. Prognostic Nutritional Index (PNI) and Geriatric Nutritional Index (GNRI), which are established nutritional assessment tools, were calculated from baseline laboratory/anthropometric data. Agreement between T12 and L3 was assessed, and associations with grade ≥ 3 toxicity, progression-free survival (PFS), and overall survival (OS) were evaluated using multivariable models and ROC analyses. Results: Mean age was 69.0 ± 4.5 years (59 male/28 female), and 26.4% developed grade ≥ 3 adverse events. Over 3 months, mean SMI declined significantly at both L3 (46.7 ± 8.8 → 42.8 ± 9.8 cm²/m²) and T12 (34.6 ± 8.2 → 31.6 ± 8.1 cm²/m²) (p < 0.001 for both), accompanied by decreases in VATI and VSR; T12-IMATI increased significantly. Baseline PNI showed a weak positive correlation with L3-SMI (r = 0.302, p = 0.033), whereas GNRI showed moderate correlations with SMI at L3 (r = 0.502, p < 0.001) and T12 (r = 0.317, p = 0.025) and was associated with longitudinal changes in muscle metrics. T12-SMI consistently yielded lower values than L3-SMI, and agreement varied by compartment (best for SATI; weakest for VSR). Lower GNRI and greater L3-SMI loss were independently associated with grade ≥ 3 toxicity; ΔL3-SMI showed the highest discrimination (AUC = 0.79, 95% CI = 0.69–0.87, p < 0.001; cut-off >5.1% loss). All patients progressed (median PFS 7.6 months); mortality was 82.8% (median follow-up: 25 months). In multivariable analysis, PFS, CRP, GNRI, and ΔL3-SMI remained independently associated with OS. ΔL3-SMI provided the strongest mortality discrimination (AUC = 0.85, 95% CI = 0.74–0.94, p < 0.001; cut-off >10.4% loss), while ΔIMATI was also informative (AUC = 0.71, 95% CI = 0.59–0.82, p = 0.023). Conclusions: In older patients with mCRC, early post-chemotherapy skeletal muscle loss—particularly at the L3 level—showed the strongest prognostic association with severe toxicity and mortality. GNRI provided complementary prognostic information as a marker of baseline immunonutritional reserve. Although T12-derived measurements were correlated with L3-derived values, systematic bias suggests that they should not be interpreted interchangeably for longitudinal risk stratification. Full article

Background/Objectives: Allogeneic hematopoietic stem cell transplantation is associated with increased cardiovascular risk driven by endothelial dysfunction, chronic inflammation, and treatment-related metabolic disturbances, including dyslipidemia. In the contemporary era of post-transplant cyclophosphamide-based prophylaxis, the prognostic significance of dyslipidemia—particularly as assessed by non-HDL cholesterol—remains unclear. In this study, we aimed to compare the engraftment days, graft-versus-host disease (GVHD) development, relapse, overall survival rates, and cardiovascular mortality in patients using myeloablative/reduced intensity conditioning regimens with post-transplant cyclophosphamide (PTCy) 50 mg/kg/day for 2 days in patients with acute leukemias. Methods: A total of 95 adult patients with acute leukemias were included in their first remission who underwent matched sibling donor transplantation with PTCy (50 mg/kg on days +3 and +4). Patients were stratified according to pre-transplant non-HDL-C levels (<160 mg/dL vs. ≥160 mg/dL). Matched related donors were selected for the patients. All patients received either myeloablative or reduced-intensity conditioning based on EBMT criteria, with fludarabine-based combinations including busulfan, treosulfan, or TBI, along with ATLG administered at a total dose of 15 mg/kg. Peripheral blood stem cells were used for all transplants, and GVHD prophylaxis consisted of cyclosporine. Results: Platelet (median 13 vs. 14 days) and neutrophil (median 14 vs. 15 days) engraftment times and veno-occlusive disease (VOD) rates were comparable across groups (all p > 0.05); cumulative incidences of grade II–IV aGVHD at +100 days, grade III–IV aGVHD at +100 days, and moderate-severe cGVHD at 1 year, relapse-free survival, and non-relapse mortality at 1 year were comparable in two cohorts (all p > 0.05). GVHD-free/relapse-free survival (GRFS) at 1 year was also comparable across groups (p = 0.15). Median GRFS was 150 (95% CI: 120–330) days and 270 (95% CI: 154-not reached) days, respectively [HR was 0.68 (0.40–1.15), p = 0.15; GRFS at 1 year was 66.6% vs. 52.0%, respectively]. The groups were also comparable in terms of overall survival (OS). Follow-up ranged from 0.5 to 108 months, and median follow-up was 60 months in two cohorts. Median OS was not reached in non-HDL-C < 160 (95% CI: 70 months–not reached) and 67 months in non-HDL-C ≥ 160 groups (95% CI: 13 months–not reached) (Log rank = 0.21). No cardiovascular death events occurred during the follow-up period. Conclusions: In this homogeneous matched sibling donor transplant cohort with extended follow-up and uniform administration of post-transplant cyclophosphamide, cyclosporine-based GVHD prophylaxis, and anti-thymocyte lymphoglobulin (ATLG), pre-existing dyslipidemia was not associated with an adverse impact on GRFS, NRM, PFS, CMV reactivation, OS or long-term cardiovascular mortality. Full article

The Sanjiang Plain is a key black soil agricultural zone in Northeast China. The conversion of dry-lands (DL) to paddy fields (PF) alters soil aggregate phosphorus (P) fractions and microbial diversity, yet the underlying mechanisms are unclear. This study compared DL and PF (converted from DL) soils. The results showed that electrical conductivity (EC) and soil organic carbon (SOC) increased significantly after the dryland-to-paddy conversion (p < 0.05). The proportions of macroaggregates and microaggregates increased, while the silt+clay fraction declined (p < 0.05), indicating enhanced aggregate stability. Soil total P increased by 16.04%, of which 83.81%, was attributed to macroaggregate-associated P. The dominant P fractions shifted from NaOH-Po to NaOH-Pi and HCl-Pi. The land-use change also markedly altered the soil microbial community structure, leading to increased abundances of Bradyrhizobium and Pseudomonas and decreased abundances of Streptomyces and Mesorhizobium, collectively driving the transformation of P fractions. The key functional genes identified were gcd, phoD, and phnA. However, this study did not capture the temporal dynamics of P forms and microbial community structure across different stages of land-use conversion. Future research should track these dynamics throughout the conversion process to clarify the mechanisms of P evolution. Full article

Acute coronary syndrome (ACS), driven by inflammation and thrombosis, remains a leading cause of morbidity globally. While traditional risk scores are useful, the prognostic value of combining inflammatory and autoimmune biomarkers remains understudied. This study aimed to evaluate the predictive role of high-sensitivity C-reactive protein (hs-CRP), platelet factor 4 (PF4), D-dimer, and antiphospholipid antibodies (anticardiolipin and anti-β2-glycoprotein I) for the development of major adverse cardiovascular events (MACE) in patients with ACS. We conducted a prospective cohort study at a tertiary referral center in Mexico. A total of 103 patients admitted with confirmed ACS were included. Blood samples were collected upon admission to measure biomarker levels. Participants were followed for 30 days. The primary outcome was the occurrence of MACE, defined as reinfarction, death, percutaneous coronary intervention, or bypass surgery. Multivariate logistic regression analysis was performed to identify independent predictors, adjusting for age, smoking, and comorbidities. MACE occurred in 51.4% of participants. Patients with adverse outcomes were significantly older and had longer hospital stays (p < 0.05). In the biomarker analysis, PF4 and hs-CRP demonstrated high sensitivity (98%) but low specificity. In the multivariate analysis, IgG anti-β2-glycoprotein I (p < 0.001) and D-dimer (p = 0.024) emerged as significant independent predictors of MACE. Conversely, IgM isotypes did not show independent predictive value. Beyond traditional risk factors, markers of coagulation (D-dimer) and autoimmunity (IgG anti-β2-glycoprotein I) are independent predictors of short-term adverse events in ACS patients. Integrating these multidomain biomarkers into clinical assessment may enhance risk stratification and prognostic accuracy. Full article

Solid-state lighting, especially light-emitting diodes (LEDs), is revolutionizing indoor lighting due to its energy efficiency, long lifespan, low heat output, and enhanced color rendering. LEDs can quickly adjust light intensity, enabling the development of visible light communication (VLC) technology. However, the modulation bandwidth of phosphor-converted white LEDs commonly used for illumination is limited, potentially affecting the speed of the VLC links. This paper presents a receiver-side equalization technique to overcome bandwidth limitations in VLC links due to LEDs. The proposed approach utilizes a novel transimpedance amplifier with an embedded T-network shunt-feedback equalizer (TIA-TE) to introduce adjustable high-frequency peaking in the TIA’s frequency response. By incorporating this peaking, the system’s bandwidth is extended without sacrificing important performance parameters like gain, noise, or power dissipation. The TIA-TE is followed by a main amplifier and a standalone continuous-time linear equalizer (CTLE) for further signal conditioning, while a 50 Ω buffer interfaces the receiver with measurement equipment. Post-layout simulations in a 0.35 µm CMOS process validate the approach. Using a 4 pF photodiode, the system bandwidth was initially limited by the LED’s 3 MHz modulation bandwidth. The proposed TIA-TE extends the bandwidth to 8.4 GHz without sacrificing the gain or power dissipation. The subsequent CTLE further extends the bandwidth to 14 MHz. The receiver front end achieves a mid-band transimpedance of 110 dBΩ and an input-referred noise current of 7.2 nA_rms, while dissipating 2.48 mW (excluding the 50 Ω buffer). Simulated 28 Mb/s NRZ eye diagrams demonstrate the feasibility of the proposed TIA-TE architecture for LED-limited VLC links. Full article