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A proposed methodology for detecting the malignant potential of pulmonary nodules in sarcoma using computed tomographic imaging and artificial intelligence-based models
No full textThe presence of lung metastases in patients with primary malignancies is an important criterion for treatment management and prognostication. Computed tomography (CT) of the chest is the preferred method to detect lung metastasis. However, CT has limited efficacy in differentiating metastatic nodules from benign nodules (e.g., granulomas due to tuberculosis) especially at early stages (<5 mm). There is also a significant subjectivity associated in making this distinction, leading to frequent CT follow-ups and additional radiation exposure along with financial and emotional burden to the patients and family. Even 18F-fluoro-deoxyglucose positron emission technology-computed tomography (18F-FDG PET-CT) is not always confirmatory for this clinical problem. While pathological biopsy is the gold standard to demonstrate malignancy, invasive sampling of small lung nodules is often not clinically feasible. Currently, there is no non-invasive imaging technique that can reliably characterize lung metastases. The lung is one of the favored sites of metastasis in sarcomas. Hence, patients with sarcomas, especially from tuberculosis prevalent developing countries, can provide an ideal platform to develop a model to differentiate lung metastases from benign nodules. To overcome the lack of optimal specificity of CT scan in detecting pulmonary metastasis, a novel artificial intelligence (AI)-based protocol is proposed utilizing a combination of radiological and clinical biomarkers to identify lung nodules and characterize it as benign or metastasis. This protocol includes a retrospective cohort of nearly 2,000–2,250 sample nodules (from at least 450 patients) for training and testing and an ambispective cohort of nearly 500 nodules (from 100 patients; 50 patients each from the retrospective and prospective cohort) for validation. Ground-truth annotation of lung nodules will be performed using an in-house-built segmentation tool. Ground-truth labeling of lung nodules (metastatic/benign) will be performed based on histopathological results or baseline and/or follow-up radiological findings along with clinical outcome of the patient. Optimal methods for data handling and statistical analysis are included to develop a robust protocol for early detection and classification of pulmonary metastasis at baseline and at follow-up and identification of associated potential clinical and radiological markers
Follicular Helper T-Cell–derived Nodal Lymphomas: Study of Histomorphologic, Immunophenotypic, Clinical, and RHOA G17V Mutational Profile
No full textThe study was designed to review the demographic, clinical, and pathologic characteristics of follicular helper T cells (TFH)-derived nodal PTCL in India including angioimmunoblastic T-cell lymphoma (AITL), peripheral T-cell lymphoma (PTCL) with follicular helper T cell phenotype (P-TFH), and follicular T-cell lymphoma with additional immunohistochemistry (IHC) and RHOAG17V mutational analysis, as well as their impact on survival. This retrospective study included 88 cases of PTCL that were reclassified using IHC for TFH markers (PD1, ICOS, BCL6, and CD10) and dendritic-meshwork markers (CD21, CD23). Cases of TFH cell origin were evaluated for RHOAG17V mutation using Sanger sequencing and amplification-refractory mutation system–polymerase chain reaction (PCR) (validated using cloning and quantitative PCR) with detailed clinicopathologic correlation. Extensive re-evaluation with added IHC panel resulted in a total of 19 cases being reclassified, and the final subtypes were AITL (37 cases, 42%), PTCL—not otherwise specified (44, 50%), P-TFH (6, 7%), and follicular T-cell lymphoma (1, 1%). The presence of at least 2 TFH markers (>20% immunopositivity) determined the TFH origin. AITL patients tended to be male and showed increased presence of B-symptoms and hepatosplenomegaly. Histomorphology revealed that 92% of AITL cases had pattern 3 involvement. Sanger sequencing with conventional PCR did not yield any mutation, while RHOAG17V was detected by amplification-refractory mutation system–PCR in AITL (51%, P=0.027) and P-TFH (17%), which was validated with cloning followed by sequencing. Cases of RHOAG17V-mutant AITL had a worse Eastern Cooperative Oncology Group performance status initially but fared better in terms of overall outcome (P=0.029). Although not specific for AITL, RHOAG17V mutation shows an association with diagnosis and requires sensitive methods for detection due to low-tumor burden. The mutant status of AITL could have prognostic implications and translational relevance
Designing functionalized polymers through post-polymerization modification of side chain leucine-based polymer.
No full textThe opportunity to modify the chemical functionality of the incorporated amino acid moiety in side chain amino acid-based polymers provides access to tailor their optical, mechanical, and biological properties. Methacrylate monomers from C-terminus modified amino acids and their subsequent polymerization leads to the formation of polymethacrylate polymers with pendant amine (-NH2) groups. To this end, the post-polymerization reactions on the amine groups offer a facile route to prepare functionalized side chain amino acid-based polymeric materials. Herein, we synthesized side chain L-leucine pendant homopolymer using reversible addition-fragmentation chain transfer (RAFT) polymerization of Boc-L-leucine methacryloyloxyethyl ester (Boc-leu-HEMA) and subsequently the Boc group is deprotected to prepare P(H3N+-leu-HEMA). Post-polymerization modifications on the pendant amine groups were performed to incorporate fluorescent probe, propargyl group, methacrylic moiety, hydrophobic fatty acid, anionic pendant, and hydrophilic polyethylene glycol (PEG) units; which demonstrates an efficient platform to build a library of functionalized polymers from a single polymeric backbone. We have studied the solvatochromic behavior of fluorescence probe bearing polymers using fluorescence spectroscopy. The ability of the pendent methacrylic unit containing polymers to undergo crosslinking and the mechanical properties of the synthesized gel are investigated by the rheological study
Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN):Multi-Center Collaboration and Global Registry Program
No full textBackground
BPDCN is a rare, aggressive hematologic malignancy derived from the precursors of plasmacytoid dendritic cells (pDC), typically presenting with primary cutaneous dissemination and involvement of bone marrow (BM) as well as extramedullary sites including central nervous system (CNS). In 2008, it was recognized by WHO as a distinct entity and is now recognized under Myeloid/Histiocytic/Dendritic neoplasms in the 2022 5th edition update of WHO Classification. Since the recognition of this unique entity, recent efforts have been put forward for greater understanding and international collaboration, however usually focused on North America and Europe(Pemmaraju at al and Pagano et al), with this current effort representing the largest known international efforts including more parts of the world, including Asia, Middle East and Africa.
Objective
Due to its historical rarity and heterogeneous presentation of disease, as well as differences in availability of therapies across geo-locations, at present there is no worldwide consensus on the management of BPDCN. The outcomes remain poor, and the optimal therapy of disease remains to be determined. Launched on July 1st, 2022, the aim of our global registry is through a multi-center international collaboration to build a large database of patients with BPDCN in order to generate data-driven diagnostic and treatment recommendations.
Materials and Methods
The registry collects retrospective and prospective data on clinical presentation, diagnostics, treatment regimens and outcomes of patients diagnosed with BPDCN after January 1st, 2010. The data is collected globally through eCRF and Excel form. The Registry is included in ClinicalTrials.gov database (NCT05430971).
Results
Through July 15 th, 2023, 15 centers from 11 countries (Armenia, Canada, Cyprus, Egypt, Georgia, India, Italy, Taiwan, Turkey, UK and USA) have joined the registry and another 13 centers from USA, UK, Egypt, Iraq, Canada, Netherlands, Tajikistan, Czech Republic, Guatemala, Brazil, Serbia, Germany are onboarding. 27 retrospective and 2 prospective pts are currently included in the registry. 76 % of pts are male, in keeping with historical expectation BPDCN. Median age at diagnosis was 62 years (4-97). In 90 % of patients the tumor cells were triple positive with CD4+, CD56+, CD123+ immunophenotype. 53.6% of patients presented with cutaneous manifestation. 21% of pts received the initial treatment with AML-based regimens, 66% with ALL-based and 7% with lymphoma-based regimens. 21% of pts underwent alloSCT. 35% of pts were diagnosed after 2018, only 1 patient has received tagraxofusp, a CD123-directed therapy that received FDA approval for previously untreated or relapsed/refractory BPDCN in 2018(Pemmaraju N et al NEJM 2019). 69 % of patients achieved complete response (CR), from which 90 % were treated with ALL-based regimens. 52% of patients experienced relapse.
Conclusion
Current analysis of a 29-patient worldwide cohort of BPDCN demonstrates a high degree of heterogeneity in treatment regimens based on a multitude of considerations including geographic, socio-economic, drug availability, and varied clinical preferences. The outcome of ALL-based treatment was superior as compared to AML-based, but relapse rate remained high. Further global collaboration is needed to collect additional data and to identify the best diagnostic and therapeutic approaches for this challenging disease
Looking Beyond Toxicities Other Health-Related Morbidities Noted in Childhood Solid Tumor Survivors
No full textAim:
In addition to the well-known toxicities of treatment, survivors of pediatric solid tumors can also develop other health-related conditions. They may either be an indirect consequence of therapy or could be unrelated to their prior history of malignancy. We aim to evaluate the nontoxicity related health conditions in survivors of pediatric solid tumors.
Materials and Methods:
The study included a cohort of hepatoblastoma (HB), Wilm's tumor (WT), and malignant germ cell tumors (MGCT) survivors registered at pediatric surgical-oncology clinic from 1994 to 2016. Follow-up was done according to standard protocols and children were evaluated at each visit for any health-related conditions.
Results:
Of the survivors, 318 survivors, comprising of 48, 81, and 189 survivors of HB, MGCT, and WT, respectively, were included in the analysis. We found 20.8% of patients with HB, 11.1% of patients with MGCT, and 16.4% of patients with WT to report nontoxicity-related health issues. A high prevalence of surgical conditions (3.4%), secondary malignancies (1.2%), gynecological conditions in girls (16.9%), tuberculosis (1.2%), gallstone disease (0.9%), pelvi-ureteral junction obstruction (0.9%), and neurological issues (0.9%) was noted. Two presumed survivors had died, one due to a late recurrence and the other due to a secondary malignancy.
Conclusions:
A high prevalence of medically or surgically manageable conditions makes it imperative to keep these children under follow-up to address any health-related conditions they may subsequently develop
Multi-omics studies in interpreting the evolving standard model for immune functions.
No full textA standard model that is able to generalize data on myriad involvement of the immune system in organismal physio-pathology and to provide a unified evolutionary teleology for immune functions in multicellular organisms remains elusive. A number of such ‘general theories of immunity’ have been proposed based on contemporaneously available data, starting with the usual description of self–nonself discrimination, followed by the ‘danger model’ and the more recent 'discontinuity theory'. More recent data deluge on involvement of immune mechanisms in a wide variety of clinical contexts, a number of which fail to get readily accommodated into the available teleologic standard models, makes deriving a standard model of immunity more challenging. But technological advances enabling multi-omics investigations into an ongoing immune response, covering genome, epigenome, coding and regulatory transcriptome, proteome, metabolome and tissue-resident microbiome, bring newer opportunities for developing a more integrative insight into immunocellular mechanisms within different clinical contexts. The new ability to map the heterogeneity of composition, trajectory and endpoints of immune responses, in both health and disease, also necessitates incorporation into the potential standard model of immune functions, which again can only be achieved through multi-omics probing of immune responses and integrated analyses of the multi-dimensional data
Mitigating hERG liability of toll‐like receptor 9 and 7 antagonists through structure‐based design.
No full texthERG is considered to be a primary anti-target in the drug development process, as the K+ channel encoded by hERG plays an important role in cardiac re-polarization. It is desirable to address the hERG safety liability during early-stage development to avoid the expenses of validating leads that will eventually fail at a later stage. We have previously reported the development of highly potent quinazoline-based TLR7 and TLR9 antagonists for possible application against autoimmune disease. Initial experimental hERG assessment showed that most of the lead TLR7 and TLR9 antagonists suffer from hERG liability rendering them ineffective for further development. The present study herein describes a coordinated strategy to integrate the understanding from structure-based protein-ligand interaction to develop non- hERG binders with IC50 >30 μM with retention of TLR7/9 antagonism through a single point change in the scaffold. This structure-guided strategy can serve as a prototype for abolishing hERG liability during lead optimization
Structural ordering enhances highly selective production of acetic acid from CO<sub>2</sub> at ultra-low potential
No full textElectrochemical reduction of CO2 to value-added chemicals and fuels using renewable energy technologies is known to facilitate the creation of an artificial carbon cycle. Although the practical use of most conventional electrocatalysts is curbed by the low efficiency and poor stability of the catalyst there is also the need of large input energy in the form of potential. In this work, a family of bismuth-based transition metal chalcogenides was designed to enable multi-electron transfer for selectively reducing CO2 to acetic acid at ultra-low potential of −0.1 V (vs. RHE). The structural design in AgBiS2, CuBiS2 and AgBiSe2 facilitated an optimized CO adsorption accounting for the production of acetic acid at low potential. The disordered arrangement of Ag and Bi in AgBiS2 also favors CO hydrogenation, which leads to the formation of a large amount of methanol in addition to acetic acid. However, an induced structural ordering of these atoms upon selected substitution enhanced the lattice strain in CuBiS2 and AgBiSe2 favoring only C–C coupling and 100% acetic acid is produced at lower potential with stability up to 100 hours. The origin of the CO2 reduced product has been validated by 13CO2 isotopic experiments and the mechanistic pathway has been proposed with the support of in situ IR experiments. Finally, a 4 times improvement in the current density of the best catalyst, AgBiSe2, was achieved in a flow cell configuration, which produced the highest ever acetic acid yield at lower potential with a faradaic efficiency of 49.81%. This work provides a novel strategy to improve electrochemical performance towards the formation of high value-added chemicals selectively at ultra-low potential
Nitrogen electrocatalysis: Electrolyte engineering strategies to boost faradaic efficiency
No full textThe electrochemical activation of dinitrogen at ambient temperature and pressure for the synthesis of ammonia has drawn increasing attention. The faradaic efficiency (FE) as well as ammonia yield in the electrochemical synthesis is far from reaching the requirement of industrial-scale production. In aqueous electrolytes, the competing electron-consuming hydrogen evolution reaction (HER) and poor solubility of nitrogen are the two major bottlenecks. As the electrochemical reduction of nitrogen involves proton-coupled electron transfer reaction, rationally engineered electrolytes are required to boost FE and ammonia yield. In this Review, we comprehensively summarize various electrolyte engineering strategies to boost the FE in aqueous and non-aqueous medium and suggest possible approaches to further improve the performance. In aqueous medium, the performance can be improved by altering the electrolyte pH, transport velocity of protons, and water activity. Other strategies involve the use of hybrid and water-in-salt electrolytes, ionic liquids, and non-aqueous electrolytes. Existing aqueous electrolytes are not ideal for industrial-scale production. Suppression of HER and enhanced nitrogen solubility have been observed with hybrid and non-aqueous electrolytes. The engineered electrolytes are very promising though the electrochemical activation has several challenges. The outcome of lithium-mediated nitrogen reduction reaction with engineered non-aqueous electrolyte is highly encouraging
High-Performance Digital Signal Processing Circuit Design and Analysis for Wireless Communication Systems
No full textDSP circuits are used to perform various signal processing tasks, such as filtering, modulation, demodulation, and encoding. The demand for high-performance DSP circuits is increasing as wireless communication systems continue to evolve into a faster and more efficient signal processing. One of the challenges in designing high-performance DSP circuits is to balance the trade-offs between power consumption, performance, and area utilization. Here, this study proposes a novel algorithmic approach, which is a combination of Support Vector Machine (SVM) and Convolutional Neural Network (CNN). Novel algorithms can be used to improve the efficiency and speed of DSP circuits. These algorithms can be implemented by using various hardware architectures, such as Digital Signal Processors (DSPs), Application-Specific Integrated Circuits (ASICs), and Field Programmable Gate Arrays (FPGAs). Hardware implementation involves designing and optimizing the circuitry to implement the selected architecture. This involves optimizing the layout, routing, and placement of the components to minimize the area and power consumption. Performance evaluation involves testing and measuring a circuit's performance to ensure that it meets the design specifications. In conclusion, high-performance DSP circuit design and analysis for wireless communication systems using novel algorithms is essential for meeting the ever-increasing demand for faster and more efficient signal processing. The design process involves several stages, including algorithm design, architectural selection, hardware implementation, and performance evaluation, and requires a deep understanding of both DSP theory and hardware design