基于Focal Loss改进LightGBM的供水管网毛刺数据检测

针对数据不平衡导致的管网毛刺数据检测召回率偏低问题,提出一种Focal Loss改进LightGBM的管网毛刺数据检测方法。首先,结合管网毛刺数据的特点,针对性构造邻域相关特征。其次,将Focal Loss函数引入LightGBM,提高模型对难以检测的毛刺样本的权重,并对Focal Loss不同的参数取值进行实验,以平衡精确率与召回率。最后,选择不同参数的Focal Loss进行模型融合,进一步提升模型对不平衡毛刺数据的检测性能。在某市供水管网的真实数据上进行实验,结果表明,对比基于交叉熵损失函数的单一模型,本文提出的Focal Loss改进后的融合模型在毛刺数据上召回率和F1值的提升幅度达33.3和18个百分点,但毛刺数据的精确率还有待进一步提升。本文所提方法从损失函数入手,动态调整难易样本的权重,有效地提升了不平衡数据下的毛刺数据的检测性能。

A crosstalk-free dual-mode sweat sensing system for naked-eye sweat loss quantification via changes in structural reflectance

Sweat loss monitoring is important for understanding the body’s thermoregulation and hydration status,as well as for comprehensive sweat analysis.Despite recent advances,developing a low-cost,scalable,and universal method for the fabrication of colorimetric microfluidics designed for sweat loss monitoring remains challenging.In this study,we propose a novel laserengraved surface roughening strategy for various flexible substrates.This process permits the construction of microchannels that show distinct structural reflectance changes before and after sweat filling.By leveraging these unique optical properties,we have developed a fully laser-engraved microfluidic device for the quantification of naked-eye sweat loss.This sweat loss sensor is capable of a volume resolution of 0.5µL and a total volume capacity of 11µL,and can be customized to meet different performance requirements.Moreover,we report the development of a crosstalk-free dual-mode sweat microfluidic system that integrates an Ag/AgCl chloride sensor and a matching wireless measurement flexible printed circuit board.This integrated system enables the real-time monitoring of colorimetric sweat loss signals and potential ion concentration signals without crosstalk.Finally,we demonstrate the potential practical use of this microfluidic sweat loss sensor and its integrated system for sports medicine via on-body studies.

Genetically modified pigs:Emerging animal models for hereditary hearing loss

Hereditary hearing loss(HHL),a genetic disorder that impairs auditory function,significantly affects quality of life and incurs substantial economic losses for society.To investigate the underlying causes of HHL and evaluate therapeutic outcomes,appropriate animal models are necessary.Pigs have been extensively used as valuable large animal models in biomedical research.In this review,we highlight the advantages of pig models in terms of ear anatomy,inner ear morphology,and electrophysiological characteristics,as well as recent advancements in the development of distinct genetically modified porcine models of hearing loss.Additionally,we discuss the prospects,challenges,and recommendations regarding the use pig models in HHL research.Overall,this review provides insights and perspectives for future studies on HHL using porcine models.

Relative Impacts of Sea Ice Loss and Atmospheric Internal Variability on the Winter Arctic to East Asian Surface Air Temperature Based on Large-Ensemble Simulations with NorESM2

To quantify the relative contributions of Arctic sea ice and unforced atmospheric internal variability to the “warm Arctic, cold East Asia”(WACE) teleconnection, this study analyses three sets of large-ensemble simulations carried out by the Norwegian Earth System Model with a coupled atmosphere–land surface model, forced by seasonal sea ice conditions from preindustrial, present-day, and future periods. Each ensemble member within the same set uses the same forcing but with small perturbations to the atmospheric initial state. Hence, the difference between the present-day(or future) ensemble mean and the preindustrial ensemble mean provides the ice-loss-induced response, while the difference of the individual members within the present-day(or future) set is the effect of atmospheric internal variability. Results indicate that both present-day and future sea ice loss can force a negative phase of the Arctic Oscillation with a WACE pattern in winter. The magnitude of ice-induced Arctic warming is over four(ten) times larger than the ice-induced East Asian cooling in the present-day(future) experiment;the latter having a magnitude that is about 30% of the observed cooling. Sea ice loss contributes about 60%(80%) to the Arctic winter warming in the present-day(future) experiment. Atmospheric internal variability can also induce a WACE pattern with comparable magnitudes between the Arctic and East Asia. Ice-lossinduced East Asian cooling can easily be masked by atmospheric internal variability effects because random atmospheric internal variability may induce a larger magnitude warming. The observed WACE pattern occurs as a result of both Arctic sea ice loss and atmospheric internal variability, with the former dominating Arctic warming and the latter dominating East Asian cooling.

Effect of foot reflexology on an infant with sensorineural hearing loss:A case report

BACKGROUND Our study contributes to the further understanding of the mechanism of foot reflexology.Foot reflexology has been reported to affect hearing recovery,but no physiological evidence has been provided.This lack of evidence hampers the acceptance of the technique in clinical practice.CASE SUMMARY A girl was taken to North Sichuan Medical University Affiliated Hospital for a hearing screen by her parents.Her parents reported that her hearing level was the same as when she was born.The girl was diagnosed with sensorineural hearing loss(SNHL)by a doctor in the otolaryngology department.After we introduced the foot reflexology project,the parents agreed to participate in the experiment.After 6 months of foot reflexology treatment,the hearing threshold of the girl recovered to a normal level,below 30 dB.CONCLUSION Foot reflexology should be encouraged in clinical practice and for families of infants with SNHL.

Acquired sensorineural hearing loss,oxidative stress,and microRNAs

Hearing loss is the third leading cause of human disability.Age-related hearing loss,one type of acquired sensorineural hearing loss,is largely responsible for this escalating global health burden.Noise-induced,ototoxic,and idiopathic sudden sensorineural are other less common types of acquired hearing loss.The etiology of these conditions is complex and multi-fa ctorial involving an interplay of genetic and environmental factors.Oxidative stress has recently been proposed as a likely linking cause in most types of acquired sensorineural hearing loss.Short non-coding RNA sequences known as microRNAs(miRNAs)have increasingly been shown to play a role in cellular hypoxia and oxidative stress responses including promoting an apoptotic response.Sensory hair cell death is a central histopathological finding in sensorineural hearing loss.As these cells do not regenerate in humans,it underlies the irreversibility of human age-related hearing loss.Ovid EMBASE,Ovid MEDLINE,Web of Science Core Collection,and ClinicalTrials.gov databases over the period August 1,2018 to July 31,2023 were searched with"hearing loss,""hypoxamiRs,""hypoxia,""microRNAs,""ischemia,"and"oxidative stress"text words for English language primary study publications or registered clinical trials.Registe red clinical trials known to the senior author we re also assessed.A total of 222studies were thus identified.After excluding duplicates,editorials,retra ctions,secondary research studies,and non-English language articles,39 primary studies and clinical trials underwent full-text screening.This resulted in 11 animal,in vitro,and/or human subject journal articles and 8 registered clinical trial database entries which form the basis of this narrative review.MiRNAs miR-34a and miR-29b levels increase with age in mice.These miRNAs were demonstrated in human neuroblastoma and murine cochlear cell lines to target Sirtuin 1/peroxisome proliferato r-activated receptor gamma coactivator-1-alpha(SIRT1/P GC-1α),SIRT1p53,and SIRT1/hypoxia-inducible factor 1-alpha signaling pathways resulting in increased apoptosis.Furthermore,hypoxia and oxidative stress had a similar adve rse apoptotic effect,which was inhibited by resve ratrol and a myocardial inhibitorassociated transcript,a miR-29b competing endogenous mRNA.Gentamicin reduced miR-182-5p levels and increased cochlear oxidative stress and cell death in mice-an effect that was corrected by inner ear stem cell-derived exosomes.There is ongoing work seeking to determine if these findings can be effectively translated to humans.

A micro-crosslinked amphoteric hydrophobic association copolymer as high temperature-and salt-resistance fluid loss reducer for water-based drilling fluids

During ultradeep oil and gas drilling,fluid loss reducers are highly important for water-based drilling fluids,while preparing high temperature-and salt-resistance fluid loss reducers with excellent rheology and filtration performance remains a challenge.Herein,a micro-crosslinked amphoteric hydrophobic association copolymer(i.e.,DADC)was synthesized using N,N-dimethyl acrylamide,diallyl dimethyl ammonium chloride,2-acrylamido-2-methylpropane sulfonic acid,hydrophobic monomer,and pentaerythritol triallyl ether crosslinker.Due to the synergistic effects of hydrogen bonds,electrostatic interaction,hydrophobic association,and micro-crosslinking,the DADC copolymer exhibited outstanding temperature-and salt-resistance.The rheological experiments have shown that the DADC copolymer had excellent shear dilution performance and a certain degree of salt-responsive viscosity-increasing performance.The DADC copolymer could effectively adsorb on the surface of bentonite particles through electrostatic interaction and hydrogen bonds,which bring more negative charge to the bentonite,thus improving the hydration and dispersion of bentonite particles as well as the colloidal stability of the drilling fluids.Moreover,the drilling fluids constructed based on the DADC copolymer exhibited satisfactory rheological and filtration properties(FLHTHP=12 m L)after aging at high temperatures(up to200℃)and high salinity(saturated salt)environments.Therefore,this work provided new insights into designing and fabricating high-performance drilling fluid treatment agents,demonstrating good potential applications in deep and ultradeep drilling engineering.

Numerical study of alpha particle loss with toroidal field ripple based on CFETR steady-state scenario

Effects of plasma equilibrium parameters on the alpha particle loss with the toroidal field ripple based on the CFETR steady-state scenario have been numerically investigated by the orbit-following code GYCAVA. It is found that alpha particle losses decrease and loss regions become narrower with the plasma current increasing or with the magnetic field decreasing. It is because the ripple stochastic transport and the ripple well loss of alpha particle are reduced with the safety factor decreasing. Decrease of the plasma density and temperature can reduce alpha particle losses due to enhancement of the slowing-down effect. The direction of the toroidal magnetic field can significantly affect heat loads induced by lost alpha particle. The vertical asymmetry of heat loads induced by the clockwise and counter-clockwise toroidal magnetic fields are due to the fact that the ripple distribution is asymmetric about the mid-plane, which can be explained by the typical orbits of alpha particle. The maximal heat load of alpha particle for the clockwise toroidal magnetic field is much smaller than that for the counter-clockwise one.

Insights into the mechanism of L-malic acid on drip loss of chicken meat under commercial conditions

Background A deterioration in the meat quality of broilers has attracted much more attention in recent years.L-malic acid(MA)is evidenced to decrease meat drip loss in broilers,but the underlying molecular mechanisms are still unclear.It’s also not sure whether the outputs obtained under experimental conditions can be obtained in a com-mercial condition.Here,we investigated the effects and mechanisms of dietary MA supplementation on chicken meat drip loss at large-scale rearing.Results Results showed that the growth performance and drip loss were improved by MA supplementation.Meat metabolome revealed that L-2-aminoadipic acid,β-aminoisobutyric acid,eicosapentaenoic acid,and nicotinamide,as well as amino acid metabolism pathways connected to the improvements of meat quality by MA addition.The transcriptome analysis further indicated that the effect of MA on drip loss was also related to the proper immune response,evidenced by the enhanced B cell receptor signaling pathway,NF-κB signaling pathway,TNF signaling pathway,and IL-17 signaling pathway.Conclusions We provided evidence that MA decreased chicken meat drip loss under commercial conditions.Metabolome and transcriptome revealed a comprehensive understanding of the underlying mechanisms.Together,MA could be used as a promising dietary supplement for enhancing the water-holding capacity of chicken meat.

Machine learning for carbonate formation drilling: Mud loss prediction using seismic attributes and mud loss records

Due to the complexity and variability of carbonate formation leakage zones, lost circulation prediction and control is one of the major challenges of carbonate drilling. It raises well-control risks and production expenses. This research utilizes the H oilfield as an example, employs seismic features to analyze mud loss prediction, and produces a complete set of pre-drilling mud loss prediction solutions. Firstly, 16seismic attributes are calculated based on the post-stack seismic data, and the mud loss rate per unit footage is specified. The sample set is constructed by extracting each attribute from the seismic trace surrounding 15 typical wells, with a ratio of 8:2 between the training set and the test set. With the calibration results for mud loss rate per unit footage, the nonlinear mapping relationship between seismic attributes and mud loss rate per unit size is established using the mixed density network model.Then, the influence of the number of sub-Gausses and the uncertainty coefficient on the model's prediction is evaluated. Finally, the model is used in conjunction with downhole drilling conditions to assess the risk of mud loss in various layers and along the wellbore trajectory. The study demonstrates that the mean relative errors of the model for training data and test data are 6.9% and 7.5%, respectively, and that R2is 90% and 88%, respectively, for training data and test data. The accuracy and efficacy of mud loss prediction may be greatly enhanced by combining 16 seismic attributes with the mud loss rate per unit footage and applying machine learning methods. The mud loss prediction model based on the MDN model can not only predict the mud loss rate but also objectively evaluate the prediction based on the quality of the data and the model.

Ionically Imprinting-Based Copper(Ⅱ)Label-Free Detection for Preventing Hearing Loss

Copper is a microelement with important physiological functions in the body.However,the excess copper ion(Cu^(2+))may cause severe health problems,such as hair cell apoptosis and the resultant hearing loss.Therefore,the assay of Cu^(2+)is important.We integrate ionic imprinting technology(IIT)and structurally colored hydrogel beads to prepare chitosan-based ionically imprinted hydrogel beads(IIHBs)as a low-cost and high-specificity platform for Cu^(2+)detection.The IIHBs have a macroporous microstructure,uniform size,vivid structural color,and magnetic responsiveness.When incubated in solution,IIHBs recognize Cu^(2+)and exhibit a reflective peak change,thereby achieving label-free detection.In addition,benefiting from the IIT,the IIHBs display good specificity and selectivity and have an imprinting factor of 19.14 at 100μmol·L^(-1).These features indicated that the developed IIHBs are promising candidates for Cu^(2+)detection,particularly for the prevention of hearing loss.

Understanding the correlation between energy-state mismatching and open-circuit voltage loss in bulk heterojunction solar cells

Photoinduced intermolecular charge transfer(PICT)determines the voltage loss in bulk heterojunction(BHJ)organic photovoltaics(OPVs),and this voltage loss can be minimized by inducing efficient PICT,which requires energy-state matching between the donor and acceptor at the BHJ interfaces.Thus,both geometrically and energetically accessible delocalized state matching at the hot energy level is crucial for achieving efficient PICT.In this study,an effective method for quantifying the hot state matching of OPVs was developed.The degree of energy-state matching between the electron donor and acceptor at BHJ interfaces was quantified using a mismatching factor(MF)calculated from the modified optical density of the BHJ.Furthermore,the correlation between the open-circuit voltage(Voc)of the OPV device and energy-state matching at the BHJ interface was investigated using the calculated MF.The OPVs with small absolute MF values exhibited high Voc values.This result clearly indicates that the energy-state matching between the donor and acceptor is crucial for achieving a high Voc in OPVs.Because the MF indicates the degree of energy-state matching,which is a critical factor for suppressing energy loss,it can be used to estimate the Voc loss in OPVs.

Simulation of charge-exchange induced NBI losses on EAST

The neutral beam injection is widely adopted in tokamaks as a key heating tool,playing a crucial role in generating burning plasmas.However,the loss of beam ions can damage the first wall and reduce the heating efficiency,resulting in failure to maintain steady-state conditions.In this work,the effect of neutral particles in the edge on fast ions generated by NBI in the Experimental Advanced Superconducting Tokamak(EAST)device is studied using the particle tracer code(PTC).The poloidal distribution of neutral particles is calculated by edge plasma simulation code SOLPS-ITER.In this simulation,four beam lines in EAST are considered:co-current tangential(co-tang),co-current perpendicular(co-perp),counter-current tangential(ctr-tang)and counter-current perpendicular(ctr-perp).It is shown that,in the absence of neutral particles,the loss fraction of ctr-injection is considerably higher than that of the co-injection.When considering the neutral particles,it is found that the ctr-perp injection demonstrates a significant variation in particles loss fraction(ranging from 18.56%to 25.42%)compared to the other three injection configurations.In terms of the loss fraction induced by neutral particles,ctr-injection exceeds co-injection,and perpendicular configuration exceeds tangential configuration.Furthermore,the difference of charge exchange ratios of three different energy(full energy,half energy,one third energy)of the four injections can be attributed to variations in the poloidal trajectories associated with each of these injections.Moreover,approximately half of fast ions which undergo neutralization directly lose to the first wall while the rest re-enter the bulk plasma and re-ionize.Except for the ctr-tang injection,the reionization ions from the other three injections exhibit effective confinement.

Cinobufotalin prevents bone loss induced by ovariectomy in mice through the BMPs/SMAD and Wnt/β-catenin signaling pathways

Background:Osteoporosis is a chronic bone disease characterized by bone loss and decreased bone strength.However,current anti-resorptive drugs carry a risk of various complications.The deep learning-based efficacy prediction system(DLEPS)is a forecasting tool that can effectively compete in drug screening and prediction based on gene expression changes.This study aimed to explore the protective effect and potential mechanisms of cinobufotalin(CB),a traditional Chinese medicine(TCM),on bone loss.Methods:DLEPS was employed for screening anti-osteoporotic agents according to gene profile changes in primary osteoporosis.Micro-CT,histological and morphological analysis were applied for the bone protective detection of CB,and the osteogenic differentiation/function in human bone marrow mesenchymal stem cells(hBMMSCs)were also investigated.The underlying mechanism was verified using qRT-PCR,Western blot(WB),immunofluorescence(IF),etc.Results:A safe concentration(0.25mg/kg in vivo,0.05μM in vitro)of CB could effectively preserve bone mass in estrogen deficiency-induced bone loss and promote osteogenic differentiation/function of hBMMSCs.Both BMPs/SMAD and Wnt/β-catenin signaling pathways participated in CB-induced osteogenic differentiation,further regulating the expression of osteogenesis-associated factors,and ultimately promoting osteogenesis.Conclusion:Our study demonstrated that CB could significantly reverse estrogen deficiency-induced bone loss,further promoting osteogenic differentiation/function of hBMMSCs,with BMPs/SMAD and Wnt/β-catenin signaling pathways involved.

An Improved Solov2 Based on Attention Mechanism and Weighted Loss Function for Electrical Equipment Instance Segmentation

The current existing problem of deep learning framework for the detection and segmentation of electrical equipment is dominantly related to low precision.Because of the reliable,safe and easy-to-operate technology provided by deep learning-based video surveillance for unmanned inspection of electrical equipment,this paper uses the bottleneck attention module(BAM)attention mechanism to improve the Solov2 model and proposes a new electrical equipment segmentation mode.Firstly,the BAM attention mechanism is integrated into the feature extraction network to adaptively learn the correlation between feature channels,thereby improving the expression ability of the feature map;secondly,the weighted sum of CrossEntropy Loss and Dice loss is designed as the mask loss to improve the segmentation accuracy and robustness of the model;finally,the non-maximal suppression(NMS)algorithm to better handle the overlap problem in instance segmentation.Experimental results show that the proposed method achieves an average segmentation accuracy of mAP of 80.4% on three types of electrical equipment datasets,including transformers,insulators and voltage transformers,which improve the detection accuracy by more than 5.7% compared with the original Solov2 model.The segmentation model proposed can provide a focusing technical means for the intelligent management of power systems.

Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.

Hemoglobin loss method calculates blood loss during pancreaticoduodenectomy and predicts bleeding-related risk factors

BACKGROUND The common clinical method to evaluate blood loss during pancreaticoduoden-ectomy(PD)is visual inspection,but most scholars believe that this method is extremely subjective and inaccurate.Currently,there is no accurate,objective me-thod to evaluate the amount of blood loss in PD patients.We retrospectively analyzed the clinical data of 341 patients who underwent PD in Shandong Provincial Hospital from March 2017 to February 2019.According to different surgical methods,they were divided into an open PD(OPD)group and a laparoscopic PD(LPD)group.The differences and correlations between the in-traoperative estimation of blood loss(IEBL)obtained by visual inspection and the intraoperative calculation of blood loss(ICBL)obtained using the Hb loss method were analyzed.ICBL,IEBL and perioperative calculation of blood loss(PCBL)were compared between the two groups,and single-factor regression analysis was performed.RESULTS There was no statistically significant difference in the preoperative general patient information between the two groups(P>0.05).PD had an ICBL of 743.2(393.0,1173.1)mL and an IEBL of 100.0(50.0,300.0)mL(P<0.001).There was also a certain correlation between the two(r=0.312,P<0.001).Single-factor analysis of ICBL showed that a history of diabetes[95%confidence interval(CI):53.82-549.62;P=0.017]was an independent risk factor for ICBL.In addition,the single-factor analysis of PCBL showed that body mass index(BMI)(95%CI:0.62-76.75;P=0.046)and preoperative total bilirubin>200μmol/L(95%CI:7.09-644.26;P=0.045)were independent risk factors for PCBL.The ICBLs of the LPD group and OPD group were 767.7(435.4,1249.0)mL and 663.8(347.7,1138.2)mL,respectively(P>0.05).The IEBL of the LPD group 200.0(50.0,200.0)mL was slightly greater than that of the OPD group 100.0(50.0,300.0)mL(P>0.05).PCBL was greater in the LPD group than the OPD group[1061.6(612.3,1632.3)mL vs 806.1(375.9,1347.6)mL](P<0.05).CONCLUSION The ICBL in patients who underwent PD was greater than the IEBL,but there is a certain correlation between the two.The Hb loss method can be used to evaluate intraoperative blood loss.A history of diabetes,preoperative bilirubin>200μmol/L and high BMI increase the patient's risk of bleeding.

A Loss-model-based Efficiency Optimization Control Method for Induction Traction System of High-speed Train under Emergency Self-propelled Mode

Increasing attention has been paid to the efficiency improvement of the induction traction system of high-speed trains due to the high demand for energy saving. In emergency self-propelled mode, however, the dc-link voltage and the traction power of the motor are significantly reduced, resulting in decreased traction efficiency due to the low load and low speed operations. Aiming to tackle this problem, a novel efficiency improved control method is introduced to the emergency mode of high-speed train traction system in this paper. In the proposed method, a total loss model of induction motor considering the behaviors of both iron and copper loss is established. An improved iterative algorithm with decreased computational burden is then introduced, resulting in a fast solving of the optimal flux reference for loss minimization at each control period. In addition, considering the parameter variation problem due to the low load and low speed operations, a parameter estimation method is integrated to improve the controller's robustness. The effectiveness of the proposed method on efficiency improvement at low voltage and low load conditions is demonstrated by simulated and experimental results.

Repeated pregnancy losses with multiple aneuploidies and major genomic imbalance:A case report

Rationale:If one of the partners is having balanced autosomal translocation,it is usually observed that the offspring inherit either normal chromosomes,balanced translocation identical to one of the parent or unbalanced chromosomal rearrangements of the same parental chromosome having translocation.Concern:A unique case presented with history of 8 miscarriages for genetic counseling.The last abortus material evaluation showed monosomy of chromosome X(Turner syndrome)in all the analyzed cells.There was a history of infertility and also repeated second trimester abortions on the paternal side.On the maternal side,there was a history of intellectual disability.Diagnose:History of repeated abnormal pregnancy outcomes.Wife’s karyotype is normal;however,husband shows translocation between chromosome 4 and 22.Intervention:Peripheral blood sample around 3 mL was collected for karyotype.Embryo biopsy was done and DNA was extracted and processed for whole exome sequencing.Outcomes:Wife’s karyotype is normal and husband has translocation between chromosome 4 and 22.Surprisingly,the entire pregnancy outcome including embryo screening has different,complete or partial aneuploidies of chromosomes other than chromosome 4 and 22.Main lesson:Though the translocation in one of the parent is balanced,we have to think beyond traditional ways for evaluating a couple with repeated pregnancy loss as we cannot predict the errors at cell division.Option of in vitro fertilization and preimplantation genetic diagnosis in couples having balanced translocations should be discussed so that early intervention can prevent the agony of pregnancy loss.

Systemic Inflammation Response Index and weight loss as prognostic factors in metastatic pancreatic cancer: A concept study from the PANTHEIA-SEOM trial

BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.