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ABSTRACTIntroductionNeuroendocrine neoplasms (NENs) are a rare group of tumors originating from neuroendocrine cells in various organs. They include neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs), which differ in biological behavior and prognosis. NETs are usually well-differentiated and slow-growing, while NECs are poorly differentiated and more aggressive. Management of NETs often involves somatostatin analogs like octreotide and lanreotide to control tumor growth and alleviate symptoms, especially in well-differentiated NETs. Lanreotide is used to control tumor growth, and both lanreotide and octreotide alleviate symptoms. Treatment approaches may vary depending on the specific type and grade of the neuroendocrine neoplasm.Areas CoveredThis review provides an update on the safety of lanreotide autogel in treating patients with NETs, through a comprehensive review of clinical trials, post-marketing surveillance, real-world evidence, and its safety profile. Specific adverse events, side effects, and potential risks associated with lanreotide autogel are discussed, along with risk mitigation strategies and recommendations for patient monitoring.Expert OpinionThe findings highlight the overall safety of lanreotide autogel in managing NETs, focusing on its efficacy in controlling hormone secretion, tumor progression, and symptom management. New safety concerns and precautions are also addressed to help healthcare providers make informed decisions when prescribing lanreotide autogel.

AbstractRecent popular and scholarly work has drawn attention to the relationship between universities and urban housing markets. Universities play a critical role in the post-industrial urban economy and have many impacts beyond their campus. This paper focuses on the policy debates to expand housing for students with the intention of relieving pressure in the rental housing market in cities that are home to many higher education institutions and their students. Boston, for example, is home to one of the largest student populations enrolled in institutions of higher education in the United States. The city faces a tight rental market, in part, because of the high number of students who seek off-campus rental housing. This paper examines the evolution of a policy debate about universities and rental housing that led to the creation of the LightView housing project at Northeastern University. Drawing on archival analysis of public documents and key informant interviews with stakeholders, we identify the tensions of this housing project and the policy debate, in which universities need to confront how their housing projects impact neighborhoods and how the public and transparent nature of development shapes the policy debate.

The emerging moiré superstructure of twisted transition metal dichalcogenides (TMDs) leads to various correlated electronic and optical properties compared to those of twisted bilayer graphene. In such a versatile architecture, phonons can also be renormalized and evolve due to atomic reconstruction, which, in turn, depends on the twist angle. However, observing this reconstruction and its relationship to phonon behavior with conventional, cost-effective imaging methods remains challenging. Here, we used noninvasive Raman spectroscopy on twisted WSe2/WSe2(t-WSe2) homobilayers to examine the evolution of phonon modes due to interlayer coupling and atomic reconstruction. Unlike in the natural bilayer (NB), ∼0° as well as ∼60° t-WSe2samples, the nearly degenerate A1g/E2gmode in the twisted samples (1–7°) split into a doublet in addition to the nondegenerate B2gmode, and the maximum splitting is observed around 2–3°. Our detailed theoretical calculations qualitatively capture the splitting and its dependence as a function of the twist angle and highlight the role of the moiré potential in phonon hybridization. Additionally, we found that around the 2° twist angle, the anharmonic phonon–phonon interaction is higher than the natural bilayer and decreases for larger twist angles. Interestingly, we observed anomalous Raman frequency softening and line-width increase with the decreasing temperature below 50 K, pointing to the combined effect of enhanced electron–phonon coupling and cubic anharmonic interactions in moiré superlattice.

Meso-Rex bypass is the surgical intervention of choice for children with extrahepatic portal vein obstruction (EHPVO). Patency of Rex vein, umbilical recessus of the portal vein, is a prerequisite for this surgery. Conventional diagnostic modalities poorly detect patency, while transjugular wedged hepatic vein portography (WHVP) accurately detects patency in 90%. We aimed to assess Rex vein patency and portal vein branching pattern in children with EHPVO using transjugular WHVP and to identify factors associated with Rex vein patency. Transjugular WHVP was performed in 31 children with EHPVO by selective cannulation of left and right hepatic veins. Rex vein patency, type of intrahepatic portal venous anatomy (Types A–E), and factors associated with patency of Rex vein were studied. The patency of Rex recess on transjugular WHVP was 29%. Complete obliteration of intrahepatic portal venous radicles was the commonest pattern (Type E, 38.7%) while Type A, the favorable anatomy for meso-Rex bypass, was seen in only 12.9%. Patency of the Rex vein, but not the anatomical pattern, was associated with younger age at evaluation (patent Rex: 6.6?±?4.9 years vs. nonpatent Rex: 12.7?±?3.9 years, p?=?0.001). Under-5-year children had a 12 times greater chance of having a patent Rex vein (odds ratio: 12.22, 95% confidence interval: 1.65–90.40, p?=?0.004). Patency or pattern was unrelated to local factors like umbilical vein catheterization, systemic thrombophilia, or disease severity. Less than one-third of our pediatric EHPVO patients have a patent Rex vein. Younger age at evaluation is significantly associated with Rex vein patency. Meso-Rex bypass should be performed as early as the diagnosis of portal cavernoma is made in all children who are >8?kg and have a favorable anatomy.Conventional imaging (ultrasound Doppler and computerized tomography) poorly detects patency of Rex vein in extrahepatic portal vein obstruction.Transjugular wedged hepatic vein portography (WHVP) accurately detects patency in 90%. Meso-Rex bypass should be performed as early as the diagnosis of portal cavernoma is made in all children who are >8?kg and have a favorable anatomy. Conventional imaging (ultrasound Doppler and computerized tomography) poorly detects patency of Rex vein in extrahepatic portal vein obstruction. Transjugular wedged hepatic vein portography (WHVP) accurately detects patency in 90%. Patency of the Rex vein on WHVP decreases with increasing age.Under-5-year age children are 12 times more likely to have a patent Rex vein. Patency of the Rex vein on WHVP decreases with increasing age. Under-5-year age children are 12 times more likely to have a patent Rex vein.

The gastrointestinal (GI) manifestations in children with hypermobile Ehlers–Danlos syndrome/joint hypermobility syndrome (hEDS/JHS) are not well described. We investigated the prevalence of GI disorders in children and young adults with hEDS/JHS through a single‐center retrospective review. Demographic data, clinical history, symptoms, and diagnostic studies were reviewed. Of 435 patients with hEDS/JHS, 66% were females (age 5−28 years). We noted a high prevalence of constipation (61%), dysphagia (32%), dyspepsia and/or gastroparesis (25%), eosinophilic esophagitis (EoE) (21%), and celiac disease (4%) in our cohort. Upper endoscopy and gastric emptying scans had the highest yield to detect abnormalities. Motility studies were abnormal in 31% of the 80 patients who underwent them. Dysphagia symptoms are significantly associated with EoE. Thirty‐three percent of dysphagia patients had EoE, versus 16% of non‐dysphagia patients (p< 0.001). Screening hEDS/JHS patients for GI issues should be routine, with further investigations and referrals guided by identified symptoms. Structural and functional gastrointestinal (GI) disorders have been reported in adults with hypermobile Ehlers−Danlos syndrome/joint hypermobility syndrome (hEDS/JHS).Pediatric studies have explored the association of disorders of gut−brain interaction in hEDS/JHS.Data on GI and motility disorders in pediatric patients have not been fully established, and they may remain overlooked, misdiagnosed, and untreated. Structural and functional gastrointestinal (GI) disorders have been reported in adults with hypermobile Ehlers−Danlos syndrome/joint hypermobility syndrome (hEDS/JHS). Pediatric studies have explored the association of disorders of gut−brain interaction in hEDS/JHS. Data on GI and motility disorders in pediatric patients have not been fully established, and they may remain overlooked, misdiagnosed, and untreated. We found a higher prevalence of constipation (61%), dysphagia (32%), dyspepsia (25%), eosinophilic esophagitis (21%), and celiac disease (4%) in our cohort of patients with hEDS/JHS.Screening hEDS/JHS patients for GI issues should be routine, with further investigations and referrals guided by identified symptoms. We found a higher prevalence of constipation (61%), dysphagia (32%), dyspepsia (25%), eosinophilic esophagitis (21%), and celiac disease (4%) in our cohort of patients with hEDS/JHS. Screening hEDS/JHS patients for GI issues should be routine, with further investigations and referrals guided by identified symptoms.

Background: Social determinants of health are non-medical factors that impact health. For patients with chronic kidney disease (CKD) progressing to kidney failure, the influence of social determinants of health on dialysis modality selection (haemodialysis vs. peritoneal dialysis (PD)) is incompletely understood.Methods: Retrospective cohort study of 981 consecutive patients with advanced CKD referred to the Ottawa Hospital Multi-Care Kidney Clinic (Canada) who progressed to dialysis from 2010 to 2021. Multivariable logistic regression was used to measure odds ratios (OR) for the associations between social determinants of health (education, employment, marital status and residence) and modality of dialysis initiation.Results: The mean age and estimated glomerular filtration rate were 64 and 18 mL/min/1.73 m2, respectively. Not having a high school degree was associated with lower odds of initiating dialysis via PD compared to having a college degree (29% vs. 48%, OR 0.55 (95% confidence interval (CI) 0.34–0.88)). Unemployment was associated with lower odds of initiating dialysis via PD compared to active employment (38% vs. 62%, OR 0.40 (95% CI 0.27–0.60)). Being single was associated with lower odds of initiating dialysis via PD compared to being married (35% vs. 48%, adjusted OR 0.52 (95% CI 0.39–0.70)). Living alone at home was associated with lower odds of initiating dialysis via PD compared to living at home with family (33% vs. 47%, adjusted OR 0.55 (95% CI 0.39–0.78)).Conclusions: Social determinants of health including education, employment, marital status and residence are associated with dialysis modality selection. Addressing these ‘upstream’ social factors may allow for more equitable outcomes during the transition from advanced CKD to kidney failure.

Midodrine, an oral α‐1‐adrenergic receptor agonist, counters arterial hypovolemia and reduces complications in adult patients with cirrhosis. This randomized controlled trial (RCT) aimed to assess the efficacy and safety of midodrine in preventing complications and improving survival in children with cirrhosis and ascites who are awaiting liver transplantation (LT). This open‐label RCT conducted from January 2022 to May 2023 included children under 18 years with cirrhosis and ascites. Patients were randomized to receive either midodrine plus standard medical therapies (SMTs) or SMT alone. The primary outcome measure was the incidence of cirrhosis‐related complications within 6 months. Thirty‐five subjects were enrolled and randomized. Patients in the midodrine arm had a lower incidence of new‐onset acute kidney injury (AKI) compared with the SMT arm (11.1% vs. 41.2%). Patients in the midodrine arm showed a decline in serum creatinine and improvement in glomerular filtration rate, whereas no changes were observed in the SMT arm. There was a lower incidence of new‐onset hyponatremia in the midodrine arm (20% vs. 56%). Midodrine led to reduction in plasma rennin activity (PRA) and improvement in systemic hemodynamics. There was no difference in the rate of resolution of ascites, recurrence of ascites, requirement of therapeutic paracentesis, cumulative albumin infusion requirement, episodes of spontaneous bacterial peritonitis, and hepatic encephalopathy between the two arms. Midodrine, when added to SMT, was effective in reducing the incidence of new‐onset AKI and hyponatremia in pediatric cirrhotics awaiting LT. It also improved systemic hemodynamics and showed a trend towards reducing PRA. Midodrine inhibits renin–angiotensin–aldosterone system (RAAS) and is used to control refractory ascites in cirrhotic adultsMidodrine is safe in children as evidenced by its usage in orthostatic hypotension/vasovagal syncope Midodrine inhibits renin–angiotensin–aldosterone system (RAAS) and is used to control refractory ascites in cirrhotic adults Midodrine is safe in children as evidenced by its usage in orthostatic hypotension/vasovagal syncope Midodrine prevents acute kidney injury (AKI) and hyponatremia in children with end‐stage liver disease on waitlist for liver transplantationMidodrine usage did not result in control of ascites or native liver survival Midodrine prevents acute kidney injury (AKI) and hyponatremia in children with end‐stage liver disease on waitlist for liver transplantation Midodrine usage did not result in control of ascites or native liver survival

Individuals with eating disorders are at a higher risk of electrolyte abnormalities than the general population. We conducted the first representative cohort study assessing whether electrolyte abnormalities in people with eating disorders were associated with mortality and physical health outcomes.

Prostate cancer commonly metastasizes to lymphatic and skeletal systems with lesser frequency to visceral organs; however, uncommon visceral sites have also been found and reported as case reports. We present a series of uncommon metastatic visceral spread in prostate cancer on prostate-specific membrane antigen–based diagnostic and posttherapeutic imaging modalities.

Long‐term D‐penicillamine (D‐pen) therapy in Wilson disease (WD) has numerous adverse effects which advocates its withdrawal, but with an inherent risk of relapse. This prospective observational study was conducted with the objective of evaluating incidence of relapse following withdrawal of D‐pen from combination (D‐pen + zinc) therapy in maintenance phase of previously symptomatic hepatic WD. Hepatic WD patients <18 years of age and on combination therapy for >2 years with 6 months of biochemical remission were included. Biochemical remission was defined as achievement of (i) aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤1.5 times upper limit of normal (ULN), (ii) serum albumin >3.5 g/dL, international normalized ratio (INR) <1.5 and (iii) 24‐h urinary copper excretion (UCE) <500 mcg/day, nonceruloplasmin‐bound‐copper (NCC) <15 mcg/dL. After D‐pen withdrawal, monthly liver function test (LFT) and INR and 3 monthly UCE and NCC were done till 1 year or relapse (elevation of AST/ALT/both >2 times ULN or total bilirubin >2 mg/dL), whichever occurred earlier. Forty‐five patients enrolled with median combination therapy duration of 36 months. Sixty percent of them had their index presentation as decompensated cirrhosis. Fourteen patients (31.8%) relapsed (cumulative incidence: 4 at 3 months, 11 at 6 months, and 14 at 12 months after D‐pen discontinuation). All relapsers had index presentation as decompensated cirrhosis. On Cox‐regression, ALT at D‐pen withdrawal was an independent predictor of relapse (hazard ratio [HR]: 1.077, 95% confidence interval [CI]: 1.014–1.145, p= 0.017) with area under the receiver operating characteristic (AUROC) of 0.860. ALT ≥40 U/L predicted risk of relapse with 85.7% sensitivity, 70.9% specificity. Incidence of relapse after withdrawal of D‐pen from combination therapy is 31.8% in hepatic WD. ALT ≥40 U/L, at the time of D‐pen stoppage, predicts future relapse. Nearly 32% of hepatic WD children relapse after withdrawal of D‐pen from combination therapy. Majority of relapses occur within 6 months of D‐pen discontinuation.WD patients with index presentation as decompensated cirrhosis are at risk for relapse.Alanine aminotransferase (ALT) ≥40 U/L at the time of D‐pen withdrawal is a predictor for future relapse. Nearly 32% of hepatic WD children relapse after withdrawal of D‐pen from combination therapy. Majority of relapses occur within 6 months of D‐pen discontinuation. WD patients with index presentation as decompensated cirrhosis are at risk for relapse. Alanine aminotransferase (ALT) ≥40 U/L at the time of D‐pen withdrawal is a predictor for future relapse. Long‐term D‐penicillamine (D‐pen) therapy in Wilson disease (WD) has serious side effects which advocates its withdrawal, but with an inherent risk of relapse.Relapse rate after withdrawal of D‐pen from combination (D‐pen + zinc) therapy in maintenance phase of symptomatic hepatic WD has not been studied previously. Long‐term D‐penicillamine (D‐pen) therapy in Wilson disease (WD) has serious side effects which advocates its withdrawal, but with an inherent risk of relapse. Relapse rate after withdrawal of D‐pen from combination (D‐pen + zinc) therapy in maintenance phase of symptomatic hepatic WD has not been studied previously.

‘CP 10‐1620’ (Reg. no. CV‐216, PI 693837) sugarcane (a complex hybrid of Saccharumspp.) was developed through cooperative research conducted by the USDA–ARS, the University of Florida, and the Florida Sugar Cane League, Inc. At the June 7, 2018, Florida Sugarcane Variety Committee Meeting, CP 10‐1620 was released to growers for mineral (sand) soils in Florida, and seed was available in September 2018. CP 10‐1620 was selected from a polycross of ‘CP 00‐1100’ × ‘CP 05‐1740’ (Cross no. X07‐1225) made at Canal Point, FL, in December 2007. Neither the female parent, CP 00‐1100, nor the male parent, CP 05‐1740, is a commercial cultivar. Cane yield of CP 10‐1620 on sand soils, averaged across 12 harvests through three crop cycles (plant cane, first ratoon, and second ratoon), was 11.0% higher (P <0.05) than the combined mean of three checks, ‘CL 88‐4730’, ‘CP 96‐1252’, and ‘CPCL 97‐2730’, which are commercial checks for sand soils. The commercial recoverable sucrose for CP 10‐1620 was not significantly lower than the combined mean of the checks but the higher cane yield resulted in 8.4% higher (P< 0.05) sucrose yield than the combined mean of the checks. CP 10‐1620 was released because of its high cane yields on sand soils, and its acceptable levels of resistance to brown rust (caused by Puccinia melanocephalaH. & P. Sydow), leaf scald (caused by Xanthomonas albilineansAshby, Dowson), Sugarcane mosaic virusstrain E (mosaic), smut (caused by Sporisorium scitamineum), Sugarcane yellow leaf virus, and ratoon stunt [caused by Leifsonia xylisubsp. xyli(Davis et al.) Evtushenko]. CP 10‐1620 was moderately susceptible to orange rust (caused by Puccinia kuehniiE. J. Butler), and it has high freeze tolerance. CP 10‐1620 tested positive for the Bru1 locus, which is an indicator of brown rust resistance. CP 10‐1620 is a new sugarcane cultivar in Florida.CP 10‐1620 has high yields of cane and sucrose in Florida.CP 10‐1620 is resistant or moderately resistant to the typical diseases found in Florida.CP 10‐1620 is the result of a cooperative effort between the USDA, UF IFAS, and the Florida Sugar Cane League.CP 10‐1620 has high cold tolerance.

‘CP 13‐1954’ (Reg. no. CV‐218, PI 704104) sugarcane (Saccharumspp. hybrid) was developed through cooperative research conducted by the USDA–ARS, the University of Florida, and the Florida Sugar Cane League, Inc., and released to growers for organic (muck) soils in Florida in June 2020. The parentage of CP 13‐1954 is ‘CP 85‐1491’ × Poly 09‐24. Based on the results of three crops (plant cane, first ratoon, and second ratoon) in field trials conducted at five locations, CP 13‐1954 had higher cane yield (16.2%), sucrose yield (15.6%), and economic index (29.7%) at P< .05 compared with the reference cultivar, ‘CP 96‐1252’. CP 13‐1954 stalks are usually taller than the reference cultivar, ‘CP 00‐1101’, with small‐to‐medium diameter, and exhibits resistance to ratoon stunting disease, Sugarcane mosaic virusstrain E, brown rust, orange rust, and smut and moderate resistance to leaf scald on muck soils in Florida. CP 13‐1954 has Bru1 locus that provides resistance against brown rust. CP 13‐1954 showed moderate cold tolerance among all the tested cultivars. CP 13‐1954 is a new sugarcane cultivar released for organic soils in Florida.CP 13‐1954 yields higher than commercial checks in organic soils in Florida.CP 13‐1954 is resistant to most of the common sugarcane diseases in Florida.CP 13‐1954 has moderate level of freeze tolerance.

The complex hybrid sugarcane (Saccharumspp.) cultivar ‘CP 15‐1407’ (Reg. no. CV‐217; PI 704105) was made available to growers in June 2022 for cultivation on muck soils in Florida. This development took 10 years thanks to collaborative research by the USDA–ARS, the Florida Sugar Cane League Inc., and the University of Florida. It started at Canal Point (CP) as a bi‐parental cross between ‘CP 08‐1110’ (female) and CP 05‐1616 (male). Due to its high stalk weight, adequate disease resistance, higher recoverable sugar, and equivalent cane yield to best check ‘CP 96‐1252’ on muck soils, the Florida Sugarcane Variety Committee recommended releasing CP 15‐1407. It has demonstrated resistance to brown rust, orange rust, sugarcane mosaic, smut, leaf scald, and ratoon stunt and is moderately susceptible to yellow leaf. In late‐stage, on‐farm yield trials, CP 15‐1407 stalk weights were 27.8% heavier than that of CP 96‐1252, while cane yields and economic index (EI) did not differ from CP 96‐1252. Florida sugarcane output and crop sustainability are predicted to benefit from CP 15‐1407's sustained cane production capacity and proven disease resistance. Sugarcane cultivar CP 15‐1407 was recommended for release for cultivation on muck soils in Florida.The new cultivar has an excellent package of disease resistance.CP 15‐1407 is expected to maintain crop sustainability in Florida.

‘CP 15‐2516’ (Reg. no. CV‐215, PI 703029) sugarcane cultivar, a complex hybrid of Saccharumspp., was developed jointly by USDA‐ARS, the University of Florida, and the Florida Sugar Cane League. CP 15‐2516 was released in June 2022 for commercial cultivation on the Florida organic (muck) soils due to its high cane and sucrose yields, commercial recoverable sucrose (CRS), and economic index (EI). CP 15‐2516 originated from CPX13‐1630, a cross between a female parent (CP 95‐1039) and a male parent (‘CP 06‐2400’). CP 15‐2516 is resistant to brown rust, orange rust, and Sugarcane mosaic virusstrain E. CP 15‐2516 harbors the Bru1 marker associated with brown rust resistance. CP 15‐2516 is moderately resistant to leaf scald and ratoon stunt disease, smut, and yellow leaf. Based on the results of three harvest cycles over five locations in Stage 4 on muck soils, cane and sucrose yields of CP 15‐2516 were 10.48% (181.31 Mg ha−1) and 11.49% (18.62 Mg ha−1) respectively, higher (P< .05) than those of the reference cultivar ‘CP 96‐1252’. Compared with CP 96‐1252, the EI of CP 15‐2516 was significantly (P< .05) higher by 15% (3233 ha−1). The mean cane fiber content of CP 15‐2516 was 138.7 kg Mg−1and was 1% to 8% higher than the reference cultivars (‘CP 00‐1101’, CP 96‐1252, and ‘CPCL 05‐1201’). CP 15‐2516 flowers intermittently during January in Florida's climate. CP 15‐2516 has a better freeze tolerance than commercial reference cultivars CP 00‐1101 and CP 96‐1252. CP 15‐2516 is expected to positively contribute to the profitability and sustainability of the Florida sugarcane industry. CP 15‐2516 sugarcane cultivar was released for commercial production on organic soils in Florida.Sucrose and cane yields of CP 15‐2516 were equivalent to or higher than those of reference cultivars.CP 15‐2516 was resistant and moderately resistant to economically significant diseases.CP 15‐2516 showed better cold tolerance than reference cultivars.

A series of activators of GCN2 (general control nonderepressible 2) kinase have been developed, leading to HC-7366, which has entered the clinic as an antitumor therapy. Optimization resulted in improved permeability compared to that of the original indazole hinge binding scaffold, while maintaining potency at GCN2 and selectivity over PERK (protein kinase RNA-like endoplasmic reticulum kinase). The improved ADME properties of this series led to robust in vivocompound exposure in both rats and mice, allowing HC-7366 to be dosed in xenograft models, demonstrating that activation of the GCN2 pathway by this compound leads to tumor growth inhibition.

Hypodontia of a maxillary central incisor is infrequent and can indicate Solitary median maxillary central incisor syndrome. We report on an 11-year-old child with medical comorbidities who presented with hypodontia of a maxillary central incisor, buccally impacted maxillary canines and root resorption of the maxillary lateral incisors. She had previously had dental extractions. Joint orthodontic–paediatric–oral surgery treatment included loss of the maxillary lateral incisors and fixed orthodontic appliances to idealize space for prosthetic replacement of a central incisor. The value of multidisciplinary planning is emphasized and the dental considerations for patients with complex medical histories explored.CPD/Clinical Relevance:The reader should have an understanding of the importance of a joint orthodontic-paediatric-oral surgery approach when managing complex paediatric dental patients.

The faults in high voltage direct current (HVDC) transmission lines cause a sudden rise in DC, resulting in over-stressing of converter valves and transformer windings. DC line faults of longer duration, or permanent nature, will lead to a severe disturbance in the associated AC network as well. Thus, the HVDC line faults must be detected immediately to interrupt the fault current by initiating proper actions of control and protection. This paper implements a new method to detect the asymmetrical (pole-to-ground) faults in the conventional bipolar LCC-HVDC transmission system. The proposed method defines a Fault Indicating Parameter (FIP) based on the transient voltage and current elements of each pole. The transient elements are obtained based on single-end measurements. Single-end or non-unit measurements lead to the development of simple, cost-effective and fast protection criteria. Also, the method is applicable to faults close to the line boundary and of high resistivity. A two-terminal bipolar LCC-HVDC transmission system, based on ±500 kV, 1000 MW and 900 km length, is used to evaluate the performance of the proposed technique in offline mode, using MATLAB/Simulink software. Also, the results are validated using an OPAL-RT real-time simulator under divergent fault conditions. The simulation results prove the robustness, selectiveness and accuracy of the proposed scheme.