Background: The leading cause in COVID-19 patients is development of cytokine storm .    Material and Methods: This study was conducted in a tertiary center with diagnosis of COVID-19 patients. Clinical and laboratory features of patients were obtained from their medical cards and hospital software system and evaluated by retrospectively.                    Statistical analysis: In our study, 21.0 version (IBM, Armonk, NY, USA) of the SPSS (Statistical Package for the Social Sciences) program was used for statistical analysis of data. Descriptive statistics, discrete and continuous numerical variables were expressed as mean, ± standard deviation or median and interquartile range (IQR). Categorical variables were expressed as number of cases and (%). Cross table statistics were used to compare categorical variables (Chi-Square, Fisher exact test). Normally distributed parametric data were compared with Student’s t-test and Paired t-test; non-parametric data that did not meet normal distribution were compared with Mann Whitney U and Kruskal Wallis tests. Multiple intergroup comparisons were made by Post Hoc Tukey analysis. Kaplan-Meier and log-rank methods were used for survival analysis. Multivariable analysis was performed by using logistic regression. Correlation analysis was performed with Pearson or Spearman method according to normality distribution.  p<0.05 value was considered statistically significant.   Results: Data of 15 patients in combination group and 43 patients in control group were evaluated and included into the study. Of these patients 73.3% was male in combination arm and 72.1% in control group (p=0.9). Demographic findings and frequency of comorbidities were similar between two groups (table 1). Overall mortality was 46.7% (n=7) in combination arm and 69.8% (n=30) in control group although it was not statistically significant (p=0.1). Similarly, need of intubation was also lower in combination arm (46.7%) compared to control group (69.8%), it was not significantly different (p=0.1). ICU admission was significantly lower in combination (46.7%, n=7) arm than control group (76.7%, n=33) (p=0.03, Odds ratio [OR]:4.7). Development of severe infection (20%, n=3 vs 25%, n=9/36), pulmonary embolism (6.7%, n=1 vs 0), myocardial infarction (6.7%, n=1 vs 2.6%, n=1/38) and pneumothorax (13.3%, n=2 vs 2.6%, n=1/38) were not different between two groups (p=0.7, p=0.3, p=0.5 and p=0.2). In multivariable analysis only cHIS score was associated with high mortality (p=0.018, OR:2.8, [95% confidence interval: 1.2-6.6]). In survival analysis, mortality rate was significantly lower in combination arm than control group (Log-Rank:p=0.04;figure 1). In conclusion, combination therapy of high-dose anakinra and baricitinib may be an adequate treatment option in patients with COVID-19 who had critical disease and no additional safety signal.

IntroductionThe spinal cord is supplied by three longitudinal arteries: One anterior spinal artery and two posterior spinal arteries with an extensive collateral network making the spinal cord very resistant to ischemia. Hence spinal cord infarction is a rare occurrence, accounting for only approximately 1 % of alle strokes [1], and usually involves the anterior spinal artery [2]. Because of the paired blood supply from the posterior spinal arteries, infarction here is uncommon and estimated to be 11 % of spontaneous spinal cord infarctions [3]. The leading cause of spinal cord infarction is aortic surgery followed by aortic dissection and aneurism, but in 21 % no established etiology is found [4]. The clinical neurological deficits of the spinal cord is linked to the affected anatomical territory: For instance, the anterior spinal cord artery supplies the anterior two-thirds of the spinal cord, and anterior spinal cord infarction therefore results in palsy, deficit of thermal sensitivity with relative retained sense of position and vibration (due to sparing of the dorsal columns) [5].Brown-Sequard syndrome is a hemicord syndrome resulting in disruption of the:Corticospinal tract resulting in ipsilateral weaknessDorsal column resulting in ipsilateral loss of proprioceptionSpinothalamic tract resulting in contralateral loss of pain and temperature sensationThe leading cause of Brown-Sequard syndrome is traumatic, but other causes include vertebral disc herniation, tumors, radiation, hemorrhage, and cervical spondylosis [6].We report a case of spontaneous posterior cord infarction resulting in a Brown-Sequard syndrome.

Introduction:The term ”oxalosis” refers to the systemic buildup of calcium oxalate, the insoluble salt of oxalic acid, outside of the urinary system. Primary and secondary hyperoxalurias are the pathologic disease processes in charge of causing systemic oxalosis. The kidneys, bone, heart, blood arteries, and skin are major sites of oxalate accumulation that result in illness1. The primary hyperoxalurias are a class of uncommon autosomal recessive metabolic diseases characterised by abnormally excessive generation of serum oxalate and consequent tissue deposition. Most individuals first exhibit recurrent urolithiasis and renal failure when they are young. Primary hyperoxalurias are characterised by vascular deposition of skin manifestations that produce oxalate, such as livedo reticularis, acrocyanosis, peripheral gangrene, and ulcerations2. Skin symptoms, on the other hand, are uncommon in individuals who develop an oxalosis caused by renal insufficiency and, when they do, they are the consequence of extravascular deposition, resulting in calcified nodules and miliary papules3. Globally, it is estimated that 1 in 58,000 people suffer with primary hyperoxaluria. With Type 1 accounting for around 80% of cases, it is the most prevalent kind. Each of the two types accounts for around 10% of cases4. here we report a case of a 23 year-old female patient with a cutaneous oxalosis without livedo reticularis, acrocyanosis and ulceration, and it could be a very rare case in medical literature.

Research groups use the single motion stimulus design of Dr. D.Tadin ​(Tadin, Lappin, Gilroy & Blake, 2003) that allows to putatively assess spatio-contrast excitatory and inhibitory effects from duration threshold data of motion perception. The present work presents the correct neurocomputational model for this experimental design and analyses issues related to data and model comparisons, among which: (1) once the full computational model that predicts the psychophysical results is properly defined, it is shown that two low-level models of how inhibition acts on neuronal activity, i.e. “divisive inhibition” and “subtractive inhibition”, predict exactly the same thresholds and cannot arguably be claimed that one is better than another one, (2) it is excitatory and inhibitory processes that are the mechanisms shaping threshold changes, i.e. perceptual “facilitation” and “suppression” in the behavioural domain, (3) that this experimental design allows a quantitative comparison and usage of such “contrast–size tuning” data, (4) that such studies must be carefully designed once the model is correctly understood and applied, because of the rather large parameter space (~10-12 variables) necessary to explain the behavioural measures even in such simple experiments.

A document by Jennifer Cai. Click on the document to view its contents.

Cesarean scar choriocarcinoma following a cesarean scar molar pregnancy: A case reportAzadeh Tarafdari1, Sanaz Ghashghaee1, Zeinab Mansouri1, Mohammadamin Parsaei2,3*1. Department of Obstetrics and Gynecology, Imam Khomeini Hospital Complex, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran;2. Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran;3. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Azadeh Tarafdari: https://orcid.org/0000-0003-4591-9507Sanaz Ghashghaee: https://orcid.org/0009-0003-1770-8013Zeinab Mansouri: https://orcid.org/0000-0003-4920-2917Mohammadamin Parsaei: https://orcid.org/0000-0002-7764-0319* Address for correspondence: Mohammadamin Parsaei, Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Baqerkhan St, District 6, Tehran, Iran, Fax: +982166581658, Tel: +989113547074, Email: amin.parsaei890@gmail.com

Introduction:Edheim Chester Disease (ECD) is a rare disease of the non-Langerhans histiocytosis category involving organs such as the long bones, Central nervous system (CNS), skin, kidney, heart, arteries, and endocrinopathies.(1, 2) The disease is usually more common in the 50-60 years and men. Mutations that disrupt the cellular RAS-RAF-MEK-ERK signaling pathway play an essential role in the pathology of this disease.(3) Also, those diagnosed with the BRAF VR600E- mutation have more cardiac and CNS involvement.(4) Cardiac involvement in these patients can be seen as pseudo-tumor infiltrates of the right atrium (RA) in 36% of patients.(3)Diagnosis of the disease is based on histo-pathological, medical, and radiological findings, among which MRI is a key part of diagnosing the condition. (7, 8)In this clinical case, we present a challenging scenario involving a 42-year-old male patient who presented with shortness of breath and skeletal pain, in which a multi-disciplinary approach plan led to the diagnosis of ECD..

Background & Aims: Intrahepatic cholangiocyte organoids (ICOs) model was evaluated for host differences in HBV infection, cellular responses, antiviral and immunomodulator responses. Methods: 12 ICOs generated from liver resections and biopsies were assessed for metabolic markers and functional HBV entry receptor expression throughout differentiation. Structural changes relevant to HBV infection were characterised using histology, confocal and electron microscopy examinations. Optimal ICO culture conditions for HBV infection using HepAD38 (genotype D) and plasma derived HBV (genotype B & C) were described. HBV infection was confirmed using HBcAg immunostaining, qRT-PCR (RNA, cccDNA, extracellular DNA) and ELISA (HBsAg and HBeAg). Drug response to antiviral and immunosuppressive agent, and cellular responses (interferon-stimulated genes (ISG)) to interferon-α and viral mimic (PolyI:C) were assessed. Results: ICOs underwent metabolic and structural remodeling following differentiation. Optimal HBV infection was achieved in well-differentiated ICOs using spinoculation, with time and donor dependent increase in HBV RNA, cccDNA, extracellular DNA, HBeAg and HBsAg. Donor dependent drug-responsiveness to entry inhibitor and JAK inhibitor was observed. Despite having a robust ISG response to interferon-α and PolyI:C, HBV infection in ICOs did not upregulate ISGs. Conclusions: Human ICOs support HBV infection and replication with donor dependent variation in viral dynamics and cellular responses. These features can be utilised for development of personalised drug testing platform for antivirals.

A document by Ashraf Ahmed . Click on the document to view its contents.

Case Report

Introduction: Exposure to respiratory viruses is a significant cause of morbidity and affects virus-specific antibody levels. Little is known about determinants associated with immune response to these viruses. We aimed to investigate the determinants of respiratory syncytial virus (RSV) and rhinovirus (RV) specific IgG responses in both children and adults. Methods: The study is based on the EGEA cohort, composed of 530 samples of children in EGEA1 (1991-95) and 1241 samples of adults in EGEA2 (2003-07). Cumulative RV-specific IgG responses (species A, B and C) and IgG responses to RSV-G protein were measured by micro-array technology. Multiple linear mixed models (random effect to account for familial dependence) were performed to assess associations between age, sex, body mass index (BMI), tobacco smoke exposure and season of blood sampling with RSV and RV-specific IgG levels. Results: In children (11.1±2.8 years old, 57% of boys), higher RV-specific IgG levels were associated with older age (only for RV-B), female sex and lower BMI, while only older age was associated with higher RSV-specific IgG levels. In adults (43.5±16.7 years old, 48% of men), younger age, female sex, lower BMI, active smoking and all seasons except summer were associated with higher RV-specific IgG levels. Older age, active smoking and all seasons except summer were associated with higher RSV-specific IgG levels. Conclusion: Personal and seasonal determinants of RSV- and RV-specific IgG levels seem to vary according to the respiratory virus type and between children and adults, suggesting different patterns of responses along the life course.

Background: mRNA-containing, PEGylated Covid-19 vaccines can cause hypersensitivity reactions (HSRs), or rarely, life-threatening anaphylaxis in a small fraction of immunized people. A causal role of anti-PEG antibodies (Abs) has been proposed but not yet proven in a large animal model. Methods: Domestic pigs (n=6) were immunized with 0.1 mg/kg PEGylated liposome (Doxebo) i.v., and the rise of anti-PEG IgG and IgM were measured in serial blood samples with ELISA. During the plateau of seroconversion, in the 1-3 weeks postvaccination period, the animals were injected i.v. with 1/3 human dose of the PEGylated mRNA vaccine, Comirnaty, and the hemodynamic (PAP, SAP, pulse pressure), cardiopulmonary (HR, EtCO2,), hematological (WBC, granulocyte, lymphocyte and platelet counts) parameters and blood immune mediators (anti-PEG IgM and IgG antibodies, thromboxane B2, C3a) were measured as endpoints of anaphylaxis. Results: In about a week, the level of anti-PEG IgM and IgG rose 5-10-thousand-fold in all of 6 pigs immunized with Doxebo, after which time all animals developed anaphylactic shock to i.v. injection of 1/3 human dose of Comirnaty. The reaction, starting within 1 min, involved maximal pulmonary hypertension, decreased systemic pulse amplitude, tachycardia, granulopenia and thrombocytopenia. These physiological changes were paralleled by C3a and TXB2 rises in blood and were absent in non-immunized pigs. Conclusions: Consistent with previous studies, these data show a causal role of anti-PEG Abs in the anaphylaxis to Comirnaty. Based on the involvement of C activation and identity of symptoms with those observed in pseudoallergy to PEGylated liposomes, the reaction represents C activation-related pseudoallergy (CARPA). The applied sensitization of the porcine CARPA model may help better understand these reactions, and, thus, make Comirnaty and other mRNA-LNP-based Vaccines and PEGylated Nanopharmaceuticals safer.

The polycyclic aromatic hydrocarbons (PAHs) are common constituents and pose significant influences on many separation and conversion processes. Herein, an efficient approach has been developed to fast and precisely reconstruct the molecular models for PAHs. The method involves stochastic reconstruction for a molecular library and artificial neural network (ANN) optimization for model refinement. Stochastic reconstruction, aided by modeling matrices, allows fast arrangement of benzene molecules, simplifying the construction of fused-ring cores. ANN analysis of multiple PAHs models reveals relationships between modeling parameters (MPs) and evaluation parameters (EPs). By optimizing hyper-parameters, a minimal loss function value of 0.085 is achieved, indicating the high precision of modeling. Case study on interfacially active asphaltene (IAA) shows successful reconstruction of its molecular structure, confirmed by experimental results (deviation error < 10%). These findings provide valuable insights into using an universal algorithm to fast and precisely reconstruct intricate natural PAHs and other natural chemical compounds

Melt electrowriting (MEW) is a solvent-free (i.e., no volatile chemicals), high-resolution 3D printing method that enables the fabrication of semi-flexible structures with rigid polymers. Despite its advantages, the MEW process is sensitive to changes in printing parameters (e.g., voltage, printing pressure, and temperature), which can cause fluid column breakage, jet lag, and/or fiber pulsing, ultimately deteriorating the resolution and printing quality. In spite of the commonly used error-and-trial method to determine the most suitable parameters, here, we present a machine learning (ML)-enabled image analysis-based method for determining the optimum MEW printing parameters through an easy-to-use graphical user interface (GUI). We trained 5 different ML algorithms using 168 MEW 3D print samples, among which the gaussian process regression ML model yielded 93% accuracy of the variability in the dependent variable, 0.12329 on root mean square error for the validation set and 0.015201 mean square error in predicting line thickness. Integration of ML with control feedback loop and MEW can reduce the error-and-trial steps prior to the 3D printing process, decreasing the printing time (i.e., increasing the overall throughput of MEW) and material waste (i.e., improving the cost-effectiveness of MEW). Moreover, embedding trained ML model with the feedback control system in a GUI facilitates a more straightforward use of ML-based optimization techniques in the industrial section (i.e., for users with no ML skills).

Recent years, the clusteroluminescence derived from through-space conjugation (TSC) is found in aromatic clusters. Diverging from the intensity enhancement or emission shift observed in aggregation-induced emission (AIE), clusteroluminescence imparts traditional aromatic compounds with new luminescence emission upon aggregation, opening a new chapter in the aggregate science. In this study, two phenothiazine derivatives with clusteroluminescence are synthesized, and their underlying mechanisms responsible for the emergence of new emission in aggregated state are explored through experimental and computational approaches. Additionally, a luminescent metal-organic framework (LMOF), Cd-MOF (Cd-PTZ-db) is fabricated from one phenothiazine derivative inheriting its clusteroluminescence prosperity, which exhibits great potential for the detection of hypochlorite (ClO-). Combining the clusteroluminescence with the traditional luminogens, this research provides insights into the role of through-space conjugation and intramolecular motion in clusteroluminescence. Furthermore, uniting the unique clusteroluminescent properties with the stable framework of MOFs helps to lay the ground for practical applications.

Chirality transfer for natural chiral biomolecules can reveal the indispensable role of chiral structures in life and can be used to develop the chirality-sensing biomolecular recognition. Here, we report the synthesis and characterization of a series of achiral supramolecular organic frameworks (SOF-1, SOF-2, and SOF-3), constructed from cucurbit[8]uril (CB[8]) and tetraphenylethene (TPE) derivatives (1, 2, and 3), respectively, as chirality-sensing platforms to explore their chirality transfer mechanism for peptides in water. Given the right-handed (P) and left-handed (M) rotational conformation of TPE units and the selective binding of CB[8] to aromatic amino acids, these achiral SOFs can be selectively triggered in water by peptides containing N-terminal tryptophan (W) and phenylalanine (F) residues into their P- or M-rotational conformation, exhibiting significantly different circular dichroism (CD) spectra. Although various peptides have the same L-type chiral configuration, they can induce positive CD signals of SOF-1 and negative CD signals of SOF-2 and SOF-3, respectively. Based on the structural analysis of the linkage units between CB[8] and TPE units in these SOFs, a “gear-driven”-type chirality transfer mechanism has been proposed to visually illustrate the multiple-step chirality transfer process from the recognition site in the CB[8]’s cavity to TPE units. Furthermore, by utilizing the characteristic CD signals generated through the “gear-driven”-type chirality transfer, a series of SOFs can serve as chiroptical sensor arrays to effectively recognize and distinguish various peptides based on their distinctive CD spectra.

A multi-inverter-fed power system is susceptible to small-signal instability owing to weak grid influence. Using the impedance-frequency (IF) method to analyse system stability at engineering sites has the following limitations: 1) The internal information of a grid-connected inverter is unknown because of technical confidentiality. Thus, its impedance model should fit in a grey box. 2) The IF method defaults to the subsystem aggregation impedance without right-half-plane (RHP) poles, which may result in incorrect stability analysis. 3) The data used for drawing the IF curve should be calculated per frequency, which is time-consuming. To address these limitations, this study proposes a grey box method for small-signal stability analysis of a multi-inverter-fed power system based on Bode diagrams. First, grey box impedance fitting for a single grid-connected inverter and impedance aggregation for a multi-inverter-fed power system are discussed. Second, the principle of the proposed method is elaborated. Using the Bode diagram, the number of RHP poles of the aggregated impedance and actual number of circles for Nyquist curves are identified. Third, a multi-inverter-fed power system is constructed, and the effectiveness of the proposed method is verified using case analysis and hardware-in-the-loop real-time experiments based on RT-LAB. Finally, the advantages of the proposed method are revealed by comparing it to the IF method.

Reliability is a fundamental requirement of wide-area backup protection (WABP) systems, and it is one of the most crucial performance indicators for such a WABP system. Two definitions are introduced: the reliability of WABP systems and the undetectable probability of a power line. They are determined by the specific placement of communication links (CLs) and phasor measurement units (PMUs). A simultaneous optimization model is formulated to minimize the construction cost of WABP systems by optimizing the partitioning and placement of PMUs, protection centers (PCs), and CLs. The model takes into account several constraints, including latency, regional balance, and system reliability. To reduce computational complexity, a cluster-based genetic algorithm is developed to determine the optimal solution. Finally, numerical simulations are conducted using IEEE test cases. Results demonstrate that the proposed method can minimize the construction costs of WABP systems while increasing their reliability.

One of the challenges of fossil fuel power plants is CO2 emissions. By implementing a tax, the utilization of non-fossil resources can be increased, leading to a reduction in CO2. However, an incorrect tax policy can negatively impact the social welfare index. This paper encompasses the social welfare Index, which incorporates economic, social, and environmental aspects. Furthermore, tax revenue has been allocated as a subsidy to non-fossil producers. The mutual effects of taxation, prices, and subsidies create a loop, wherein the amount paid as a subsidy and received as tax converge in an optimized cycle. Thus, the tax formula presented in this article exhibits two key characteristics: optimality in increasing social welfare and equivalence between the amounts paid and received through its application. The results indicate that an optimized tax formula leads to an increased social welfare index. Additionally, the findings demonstrate that with the increase in the capacity of non-fossil resources, the effect of the tax in improving the social welfare index becomes more significant. However, with continued growth, the impact on social welfare gradually diminishes until the point where further capacity expansion beyond a specific limit will have no effect.

Introduction: Temporal lobe epilepsy (TLE) can affect eloquent areas, affecting language. We applied the Translingual Lexical Decision Task (TLDT), a tongue independent behavioral screening tool to measure language dominance in drug resistant TLE. Method: Patients with left TLE (LTLE) (n=26), right TLE (RTLE) (n=28) and Controls (n=30) were evaluated using TLDT. We performed two repeated measures ANOVAs for accuracy and response time, with Visual half-field as intra-subject factor (left visual-field, LVF; right visual-field, RVF), and Group as inter-subject factor (RTLE, LTLE, Controls). Result: A main effect of visual half-field was found, showing RVF (left hemisphere) advantage. A main effect of Group was found in accuracy, and pairwise comparisons showed that both patient groups performed less accurately compared to Controls, and LTLE performed significantly lower than RTLE. Also, the Group by Visual half-field interaction was significant. Post hoc t-tests indicated the Controls and RTLE performed better in RVF than in LVF whereas no visual half-field effect was found in LTLE. For response times, the interaction was also significant. Post hoc t-tests showed a significant RVF advantage for Controls only, which was present for RTLE when tested one-tailed. LTLE group did not show an RVF advantage. Conclusion: Overall, the results demonstrated that TLDT is a non-invasive method to investigate language lateralization in drug-resistant TLE patients, and can efficiently distinguish between LTLE and RTLE. Compared to RTLE and Controls, language lateralization is diminished in LTLE. The current findings highlight the potential use of TLDT as an effective presurgical language lateralization screening tool.

Facial expression is an important way to reflect human emotions. Analyzing facial movements is an effective means of understanding expressions. In this paper, a classic optical measuring method called stereo digital image correlation (stereo-DIC or 3D-DIC) is employed to analyze the deformation of facial expressions. The forming processes of six basic facial expressions of certain experimental subject are analyzed through the strain calculated by 3D-DIC. Based on the calculated results, a novel deformation analysis strategy is introduced to dissect the details of facial expressions. The observations especially deal with the areas that deform first and the strain variation of the most active areas on the human face in the expressions. The presented investigations demonstrate the superior performance of 3D-DIC in the quantitative analysis of facial expressions. Such measuring method and analytical strategy might have potential value to further reveal the underlying human emotional fluctuation.

EEG microstates provides a unique perspective on the dynamic functional organization of the brain, has attracted considerable attention. This study conducted a bibliometric analysis of 441 articles retrieved from the Web of Science database using CiteSpace. The analysis focused on four key areas of EEG microstates: The academic network, classification and function, reliability of parameter, and primary research topics. Results revealed a steady increase in annual publications within this field. The academic network was dominated by the countries (including Switzerland, the United States, and China), the journal NeuroImage, and prominent researchers such as Koenig, Michel, and Lehmann. Determining the optimal number and the functions of EEG microstate classes were attributed to the clustering algorithms and validation criteria. The reliability of EEG microstate parameters varied, with mean duration demonstrating high reliability while the lower reliability was observed for transition probabilities (TP). Primary research topics encompassed cognitive function exploration, developmental changes, psychiatric disorder diagnosis, and emotion recognition. Future research should prioritize developing standardized labeling criteria for EEG microstate classes. Additionally, caution should be exercised when using TP. Moreover, integrating EEG microstate analysis with machine learning techniques provides significant advantages for the advancement and execution of related research endeavors.

Background Multiple Myeloma (MM) is more often characterized by clonal plasma cell proliferation restricted to the bone marrow. However, a small percentage of patients with MM develops extramedullary disease (EMD): this type of localization is found in 1.7-4.5% of the newly diagnosed MM (ND/MM) and in 3.4-10% of patients with relapsed or refractory disease (RR/MM) and seems to have a bad prognostic impact. In the present report, we describe a very rare case of splenic involvement in a patient with ND/MM. Case A 72 years old female was referred in June 2022 with asthenia and abdominal pain. At physical examination, spleen enlargement was detected, with anemia (Hb 10.5 g/dL) and thrombocythopenia (48 x 109/L). Abdominal echography confirmed spleen enlargement (20 cm of longitudinal diameter). Blood tests showed free light chain alteration with a λ/κ ratio of 800. Marrow aspiration showed 60% of λ-restricted immature plasma cells: p53 expression was present in 91% of elements. PET CT scan revealed multiple focal areas of bone increased metabolic activity and a widespread positivity of the spleen with focal areas of higher uptake. Diagnosis of MM with splenic EMD was done and Dara-VMP regimen was started. After the first cycle of therapy, a marked reduction of the spleen size was observed with increase of both Hb level and platelet count. After the 2nd cycle of therapy, however, there was evolution in plasma cells leukemia: Vd-PACE regimen was thus started, but after the 2nd cycle she died in October 2022 from septic shock and multiorgan failure. Conclusions Our very rare case of ND/MM with spleen involvement confirms the aggressive behaviour of EMD, with negative prognostic factors (p53 mutation) and failure to frontline highly effective therapy. In the other few cases of spleen involvement reported, however, there were only scarce details about response: as a consequence, collection of similar cases is warranted to fully understand clinical features and possible alternative approaches for these extremely rare patients.

Satellite SAR provides ocean surface wind fields at 10 m above sea level. The objective is to investigate the capability of Synthetic Aperture Radar (SAR) satellite StriX observations for mapping offshore wind farm wakes. The focus is on the conditions under which an apparent wind speed surplus is generated, measured in 48% of the 67 images available. The results compare well to Sentinel-1 observations, showing a 34% surplus rate during several years based on 1171 images. Three wind speed surplus cases have been studied in detail using the mesoscale Weather, Research, and Forecasting model (WRF) model with two wind farm parametrizations. The SAR-based observations and WRF model compare for most cases, though only when Turbulent Kinetic Energy (TKE) is included in the wind farm parametrization. The TKE mixes higher momentum downwards in a stable atmosphere, causing surface wind speed surplus near the surface.