I read with a great interest a recently published clinical study of Takala et al 1 on metaplastic carcinoma of the breast. The authors explored 78 patients with the diagnosis of metaplastic carcinoma in the period 2002‐2016. In line with previous studies, the authors confirmed predominantly triple‐negative phenotype of metaplastic carcinomas (85%) exhibiting a poor therapeutic response with an ag‐ gressive clinical course and poor outcome. Two things are worthy of further discussion: First, 12% of the pa‐ tients were estrogen receptor (ER)‐positive, eight of which received adjuvant endocrine therapy. I would appreciate more information from the authors regarding the percentage of ER positivity in these metaplastic carcinomas and a potential response to endocrine treat‐ ment. It is well known that most metaplastic carcinomas are ER‐neg‐ ative and if ER‐positive, the percentage of positive cancer cells is usually low (range, 1%‐10%). This fact may substantially affect the response to endocrine therapy, as the patients with lower ER posi‐ tivity in their breast cancers are less responsive to anti‐ER treatment modalities. Another important issue is a targeted therapy of metaplastic carcinomas that has recently come into focus. Multiple molecular studies have revealed potentially targetable biomarkers in met‐ aplastic carcinomas of the breast. These include PI3K (PIK3CA, PTEN, PIK3R1), MAPK (NF1, KRAS, NRAS), RB1, and Wnt path‐ ways.2‐9 Of these, PI3K pathway alterations are of particular im‐ portance in metaplastic carcinoma given that several studies have shown their relevance in predicting the response to mTOR/PIK3CA inhibitors.6,10‐13 In addition, programmed death‐ligand 1 (PD‐L1) expression in cancer and/or inflammatory cells, as a predictor of response to immune checkpoint inhibitors, has also been described in a substantial proportion of metaplastic carcinomas.3,14‐16 A pecu‐ liar case report of Adams et al revealed an impressive therapeutic response of the PD‐L1‐positive metaplastic carcinoma to the com‐ bined treatment with pembrolizumab (anti‐PD‐1 drug) and nab‐ paclitaxel therapy.16 Of note, the Food and Drug Administration (FDA) has recently approved atezolizumab, an anti‐PD‐L1 drug, for the treatment of PD‐L1‐positive triple‐negative breast cancers.17,18 Given the period of your cohort, I was wondering if any of the pa‐ tients were profiled for the aforementioned targetable biomarkers and treated accordingly? Semir Vranic MD, PhD

The goal of this research is to determine the differences between spinal deformities of students in urban and rural areas with regard to the initial and final measurements. This research was conducted on a sample of 1105 students. This research program includes students from the first to the fifth grade in the following 11 elementary schools in Sarajevo. Method of measuring the curvature of the spine based on Napoleon Wolanski ’ s criteria from 1975 entitled D-5 spine posture (ESP). The analysis of spinal deformity of students in urban and rural classrooms was done by using the descriptive chi-square statistics. It has been determined that in the initial measurement, a greater number of examinees with no spinal deformity came from the rural schools. The examinees from the urban schools displayed first- and second-degree spinal deformity. In the final measurement, a greater number of examinees without spinal deformity came from rural schools, 28 (2%) to be precise. There was also a greater representation of first-degree spinal deformity in the examinees from urban schools, 49 (8%) to be precise. However, the representation of second-degree spinal deformity was not present in either of the examinees from rural or urban schools.

Permanent grasslands provide a wide array of ecosystem services. Despite this, few studies have investigated grassland carbon (C) dynamics, and especially those related to the effects of land-use changes. This study aimed to determine whether the land-use change from permanent grassland to arable lands resulted in variations in the soil C stock, and whether such variations were due to increased soil respiration or to management practices. To address this, seasonal variations of soil respiration, sensitivity of soil respiration to soil temperature (Q10), and soil C stock variations generated by land-use changes were analyzed in a temperate mountain area of central Italy. The comparisons were performed for a permanent grassland and two adjacent fields, one cultivated with lentil and the other with emmer, during the 2015 crop year. Soil respiration and its heterotrophic component showed different spatial and temporal dynamics. Annual cumulative soil respiration rates were 6.05, 5.05 and 3.99 t C ha−1 year−1 for grassland, lentil and emmer, respectively. Both soil respiration and heterotrophic soil respiration were positively correlated with soil temperature at 10 cm depth. Derived Q10 values were from 2.23 to 6.05 for soil respiration, and from 1.82 to 4.06 for heterotrophic respiration. Soil C stock at over 0.2 m in depth was 93.56, 48.74 and 46.80 t C ha−1 for grassland, lentil and emmer, respectively. The land-use changes from permanent grassland to arable land lead to depletion in terms of the soil C stock due to water soil erosion. A more general evaluation appears necessary to determine the multiple effects of this land-use change at the landscape scale.

This study aims to characterize traumatic spinal cord injury (TSCI) neurophysiologically using an intramuscular fine-wire electromyography (EMG) electrode pair. EMG data were collected from an agonist-antagonist pair of tail muscles of Macaca fasicularis, pre- and post-lesion, and for a treatment and control group. The EMG signals were decomposed into multi-resolution subsets using wavelet transforms (WT), then the relative power (RP) was calculated for each individual reconstructed EMG sub-band. Linear mixed models were developed to test three hypotheses: (i) asymmetrical volitional activity of left and right side tail muscles (ii) the effect of the experimental TSCI on the frequency content of the EMG signal, (iii) and the effect of an experimental treatment. The results from the electrode pair data suggested that there is asymmetry in the EMG response of the left and right side muscles (p-value < 0.001). This is consistent with the construct of limb dominance. The results also suggest that the lesion resulted in clear changes in the EMG frequency distribution in the post-lesion period with a significant increment in the low-frequency sub-bands (D4, D6, and A6) of the left and right side, also a significant reduction in the high-frequency sub-bands (D1 and D2) of the right side (p-value < 0.001). The preliminary results suggest that using the RP of the EMG data, the fine-wire intramuscular EMG electrode pair are a suitable method of monitoring and measuring treatment effects of experimental treatments for spinal cord injury (SCI).

We introduce a new dissimilarity measure between a pair of “clonal trees”, each representing the progression and mutational heterogeneity of a tumor sample, constructed by the use of single cell or bulk high throughput sequencing data. In a clonal tree, each vertex represents a specific tumor clone, and is labeled with one or more mutations in a way that each mutation is assigned to the oldest clone that harbors it. Given two clonal trees, our multi-labeled tree dissimilarity (MLTD) measure is defined as the minimum number of mutation/label deletions, (empty) leaf deletions, and vertex (clonal) expansions, applied in any order, to convert each of the two trees to the maximum common tree. We show that the MLTD measure can be computed efficiently in polynomial time and it captures the similarity between trees of different clonal granularity well.

The main purpose of this study is to provide conceptual theoretical framework with purpose to investigate effects of quality and brand image on brand loyalty of smartphone consumers in Bosnia and Herzegovina. Hypothesized relationships are to be investigated as this represents scientifically unexplored aspect of our daily lives. The methodology suggested to be used for data analysis is descriptive statistics and regression analysis in a case of quantitative approach whereby structured survey may be used as main data collection instrument. It is expected that results of this study will confirm hypothesized relationships. It is recommended for researchers to provide validation of the proposed model and investigate hypothesized relationships not only in Bosnia and Herzegovina, but also in other Western Balkan countries. The findings of this study will have implications for both scientists regarding their future scientific work, but also for practitioners in smartphones business regarding their marketing strategies.

The future of biomedical engineering is exciting, and prospects for biomedical engineering journals are rapidly growing. In this editorial, a brief history of Biomedical Engineering Online is outlined, along with our plans for future directions of the journal.

The state estimation algorithm estimates the values of the state variables based on the measurement model described as the system of equations. Prior to applying the state estimation algorithm, the existence and uniqueness of the solution of the underlying system of equations is determined through the observability analysis. If a unique solution does not exist, the observability analysis defines observable islands and further defines an additional set of equations (measurements) needed to determine a unique solution. For the first time, we utilise factor graphs and Gaussian belief propagation algorithm to define a novel observability analysis approach. The observable islands and placement of measurements to restore observability are identified by following the evolution of variances across the iterations of the Gaussian belief propagation algorithm over the factor graph. Due to sparsity of the underlying power network, the resulting method has the linear computational complexity (assuming a constant number of iterations) making it particularly suitable for solving large-scale systems. The method can be flexibly matched to distributed computational resources, allowing for determination of observable islands and observability restoration in a distributed fashion. Finally, we discuss performances of the proposed observability analysis using power systems whose size ranges between 1354 and 70 000 buses.