bluuebunny/crossref_metadata_2025 huggingface dataset:
Decitabine-induced Sweet syndrome
Authors: Krishnasamy Suryashri , Paul Acsah Annie
Published: December 2024

Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory skin condition associated with the sudden onset of high-grade fever, painful rashes usually on the upper body, leukocytosis and neutrophilia. Approximately 21% of patients with Sweet syndrome have a concurrent malignancy, 80% of which are linked to haematological diseases, especially myelodysplastic syndrome and acute myeloid leukaemia. This is a case report of a woman in her 50s who was recently diagnosed with acute myeloid leukaemia and was started on decitabine 20 mg/m2(40 mg). She complained of fever, multiple hyperpigmented nodules over her limbs with pus, swelling with erythema over the right eye and erosion over the tongue 2 days after her first round of chemotherapy. The condition was diagnosed as Sweet syndrome owing to the presence of fever, leukocytosis, elevated erythrocyte sedimentation rate and neutrophil-dense infiltrates on skin biopsy. The patient was symptomatically treated, and decitabine was dechallenged. The patient started recovering after 4 days and was discharged. On follow-up, chemotherapy with other agents were not reinitiated because of the adverse reaction which ultimately led to the patient’s death.
Oesophageal pulmonary fistula secondary to oesophageal carcinoma
Authors: Elenjickal Vrinda Mariya , Sajikumar Keerthana , Magazine Rahul , Bhat Ganesh
Published: December 2024

A man in his early 60s presented with dysphagia and odynophagia. He was diagnosed with squamous cell carcinoma of the oesophagus. During his hospital stay, he developed a productive cough and experienced recurrent fever spikes. Chest radiograph revealed an abscess in the upper lobe segment of the right lung. The patient was treated with multiple antibiotics but there was no clinical–radiological improvement. Hence, CT of the thorax was performed which revealed an oesophageal pulmonary fistula. This was further confirmed by oesophagogastroduodenoscopy. We report a case of an oesophageal pulmonary fistula in a patient with oesophageal carcinoma complicated by a lung abscess, and its successful management by the placement of a self-expanding metallic stent and drainage of lung abscess via a Malecot catheter.
Scorpion sting-induced malignant middle cerebral artery infarction
Authors: Thangavelu Jaya Vigneish , Elambilakatt Raroth Srikanth , Varghese Dhanoop , Chacko Binila
Published: December 2024

A previously healthy middle-aged man in his 40s with a history of red scorpion envenomation presented to the emergency department for the management of an acute stroke syndrome, involving the left middle cerebral artery (MCA) territory, that developed 12 hours after the scorpion sting. He presented to the hospital 15 hours following the stroke. The activation of the autonomic nervous system by the Indian red scorpion venom is known to produce severe systemic manifestations, including cardiogenic shock and acute pulmonary oedema. Death is a rare consequence. Neurological complications resulting from red scorpion injuries are exceedingly uncommon and inadequately documented in the literature. The patient underwent an emergency decompressive craniectomy in view of neurological deterioration despite intracranial pressure-reducing agents. Thrombectomy could not be done in view of the malignant infarct (Alberta Stroke Program Early CT Score of 1) which involved over one-third of the MCA territory. Our patient has made a full recovery and at 6 months’ follow-up; he was capable of walking without assistance. It is essential to promptly identify and manage this under-recognised presentation in order to yield favourable functional outcomes for the patient.
Pancreaticopleural fistula: a rare aetiology of pleural effusion
Authors: Kabay Kenan , Bryce Gavin
Published: December 2024

Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis, which clinically presents as a pleural effusion and often with an absence of typical abdominal symptoms associated with pancreatic disease.

We describe a man in his early 50s who presented to the emergency department with pleuritic chest pain and progressive breathlessness with a history of alcohol excess. Chest X-ray demonstrated a bilateral pleural effusion with a dark red amylase-rich exudate on needle aspiration, necessitating a chest drain insertion. CT imaging then highlighted a left-sided PPF. Multiple chest drain insertions were required throughout the patient’s admission due to fluid reaccumulation.

Endoscopic retrograde cholangiopancreatography (ERCP) was conducted to stent the primary pancreatic duct to prevent fluid leakage—which was unsuccessful, resulting in post-ERCP acute-on-chronic pancreatitis. On recovery, the patient was discharged with a right-sided chest drain (following fluid re-accumulation) with adequate outpatient follow-up—illustrating no further fluid accumulation 6 months later.
IMPROVEMENT OF THE MECHANICAL PROPERTIES AND MICROSTRUCTURE OF AA3105/AZ31 WELD IN FSW PROCESS
Authors: KHOZANI ALIREZA KARIMIAN , ASVADI OMID , AFSHARI MAHMOUD , AFSHARI HOSSEIN , SAMADI MOHAMMAD REZA , NEMATZADEH FARDIN , BEYGI REZA
Published: December 2024

In this paper, the mechanical properties and microstructure of AZ31 and AA3105 joints obtained from single-pass friction stir welding are investigated. The microstructure of the weld has been analyzed by optical and scanning electron microscopy (SEM) to investigate the tunnel and volumetric (wormhole) defects, as well as the distribution of intermetallic phases. Moreover, the effect of different parameters of deviation angle, rotating velocity, linear velocity, and pin diameter on the tensile strength and Young’s modulus of the weld has been investigated. It was observed that increasing the rotating velocity from 900[Formula: see text]rpm to 1000[Formula: see text]rpm led to an improvement of about 8% in the Young modulus, while weld strength improved by 10% at a rotating velocity of 1100[Formula: see text]rpm. The optimization results showed that the Young modulus and weld strength can be improved simultaneously at a linear velocity of 30[Formula: see text]mm/min, deviation angle of [Formula: see text], rotating velocity of 1100[Formula: see text]rpm and a pin diameter of 3[Formula: see text]mm. Under the optimal conditions of the parameters, the values of tensile strength and Young’s modulus are improved up to 144[Formula: see text]MPa and 39[Formula: see text]GPa, respectively.
Advancements and Challenges in Additive Manufacturing: A Roadmap for Enhanced Finite Element Modeling and Process Optimization
Authors: Mehta Amrinder , Vasudev Hitesh , Balu Ranjith , Singh Gurbhej , Singh Suresh
Published: December 2024

Additive Manufacturing (AM) processes usually have nonlinearities like material properties, geometrical deformations, contact interactions and substantial displacements. These nonlinearities can make the problem-solving process more complicated and thus, it would be difficult to predict the consequences of the process. The finite element method, generally known as FEM, is a famous numerical technique that is applied to model complex physical phenomena and the materials’ behavior during the manufacturing process. This design supports the choice of manufacturing strategies that help a person avoid mistakes and hence save money. As for the computationally predicting of AM processes, PFEM is the most liked process in the computational world that brings about better accuracy, precision and shorter computing time. The future engineering problems which will be solved with AM in Finite Element Modeling (FEM) will be the result of the advancements in computational power, topology optimization, complex analyses, reliability and constraints, and new simulation methods. The main purpose of the roadmap for the evolution of AM technology will be to improve the capabilities and applications of AM technologies. This roadmap is geared toward the transition from digitalization to intellectualization, innovation and industrialization.
An IMEX Approach Assembled with Radial Basis Function-Finite Difference (RBF-FD) Method for Numerical Solution of Zakharov–Kuznetsov Modified Equal Width (ZKMEW) Equation with Power Law Nonlinearity Arising in Wave Phenomena
Authors: Oruç Ömer
Published: December 2024

This study deals with numerical solutions of Zakharov–Kuznetsov modified equal width (ZKMEW) equation with power law nonlinearity which is used in modeling of wave phenomena. The ZKMEW equation is a two-dimensional (2D) nonlinear partial differential equation and for numerical solution of it we first use an implicit–explicit (IMEX) backward differentiation formula for discretization of temporal variable and obtain a semi-discrete system. The IMEX approach treats nonlinear terms explicitly and linear terms implicitly. In this way, we avoid of solving nonlinear system of equations which is a big advantage in sense of computational load. Then space variables of the semi-discrete system are discretized via a local meshless radial basis function-finite difference (RBF-FD) method. For RBF-FD method we employ polyharmonic splines (PHS) which are free of shape parameters. One advantage of using RBF-FD method is its local property. Owing to the local property of the RBF-FD method sparse matrices are used which is an advantage in sense of execution time. Some numerical simulations are carried out and comparisons with the generalized finite difference method and space–time cloud method are performed. Stability of the proposed method is examined numerically. Obtained results verify efficiency and accuracy of the proposed method.
Effect of Double Microemulsion on the Aga/CMC/MoS2 Nano Composites for Drug Delivery: Green Synthesis and Physico-Chemical Characterization
Authors: Mohamadzadeh Fatemeh , Pourmadadi Mehrab , Mazinani Saeedeh , Abdouss Majid , Rahdar Abbas , Pandey Sadanand
Published: December 2024

In this work, the nanocarriers were synthesized utilizing the water/oil/water (W/O/W) emulsifying method to deliver Curcumin. A cutting-edge hydrogel nanocomposite, resulting from the fusion of Carboxymethyl cellulose (CMC), Agarose (Aga) and Molybdenum disulfide (MoS[Formula: see text], presents groundbreaking ph-responsive solutions for drug delivery, with a focus on the controlled release of Curcumin (Cur), a robust element demonstrating exceptional prowess in neutralizing malignant cells. Incorporating MoS2 into the CMC-modified Aga hydrogel introduces distinctive attributes that are amplified by the addition of Span 80 surfactant. This combination results in the creation of strong niosomal microemulsions, which helps Cur stay in the body longer. Adding hazelnut oil helps to make the microemulsion smaller without changing its round shape. FT-IR spectroscopy and XRD techniques were utilized in order to examine the microemulsions. Dynamic light scattering (DLS) tests showed that there are tiny particles in the nanocarriers. They are about 171.25 nm in size on average and have a PDI of 0.31. The round shape of the tiny particles was confirmed by looking at them with a special microscope called SEM. The zeta potential analysis showed that there is a positive charge on the surface, which is about 80.4 mV. Surprisingly, the drug was able to be loaded at 48% efficiency, with an entrapment efficiency of 86.75%, exceeding the previously reported values. Researchers tested how well Cur-loaded nanoparticles can kill cancer cells and also looked for any harmful effects on A549 and L929 cells. This discovery shows that using tiny carriers could be a good way to treat cancer.
Intel’s Fall from Grace
Authors: Cusumano Michael A.
Published: December 2024

Tracing the trajectories of several semiconductor manufacturers.
Design of Speed Bump Flow Field for Reducing Bubble Overpotential in Proton Exchange Membrane Water Electrolysis
Authors: Gong Myungkeun , Na Youngseung
Published: December 2024

The design of the bipolar plates is essential to ensure a uniform distribution of reactants in the active area. This study designed a flow field that can quickly discharge oxygen. The designed improved performance by up to 12.13% at over 0.15 A cm−2. With increasing voltage, the reactants supplied to the catalyst-coated membrane (CCM) increased in both flow fields. There was no significant difference in performance between the two flow fields at 2.25 V. This is because the oxygen residence time is long when the current density is low, blocking the water supply. As current density increased, oxygen residence time decreased. The performance of the designed flow field, where many reactants are supplied, was improved. This is because bubble overpotential decreased as more water was supplied to the CCM. However, a continuous increase in current density did not result in a further increase in performance. This is because oxygen coalescence occurs more frequently. Furthermore, it was observed that when the radius of the speed bumps is increased to 0.5 mm, water becomes trapped between them at 3.15 V, where the oxygen generation rate is high. This is because oxygen pushes water between the speed bumps.
Probiotics and Phytobiotics as Dietary and Water Supplements in Biofloc Aquaculture Systems
Authors: Khanjani Mohammad Hossein , Sharifinia Moslem , Akhavan-Bahabadi Mohammad , Emerenciano Maurício Gustavo Coelho
Published: December 2024

Biofloc technology (BFT) is a relatively new microbial‐based cultivation system that can be adopted to accomplish more sustainable aquaculture and circularity goals. This review explores aspects of BFT integrating the utilization of probiotics and phytobiotics as dietary and water supplements. This scientific‐based snapshot unpacks some physiological pathways and brings a literature review on how these supplements can boost water quality, as well as aquatic species’ growth, health, and survival. Probiotics, live microorganisms that confer health benefits on the host when administered in adequate dosage, are noted for their ability to bolster animal defenses and sustain water quality in farming conditions. Recent studies showcased that selected bacteria, yeast, and fungi, once added into biofloc‐based systems can enhance animal performance, act as a tool for water quality management and protect fish and crustaceans against diseases. On the other hand, phytobiotics are additives sourced from plants that normally are added into compounded feeds and are known for their health and growth benefits in aquatic animals. These additives contain plant‐based substances/extracts that play a key role to suppress inflammation, pathogens, and can also act as antioxidants. These selected ingredients can promote healthy gut microbiota, improve feed efficiency, and turn on genes responsible for immunity improving disease resistance of fish/shrimp. According to this review, the adoption of probiotics and phytobiotics in BFT can greatly increase farm outputs by producing healthier animals, as well as promoting growth and consistent yields. Lastly, this review showcases the importance of proper section of probiotics and phytobiotics in order to achieve a functioning BFT. Despite its numerous advantages, BFT faces several challenges, especially related to microbial management. Probiotics and phytobiotics are practical tools that can play a crucial role to obtain a more stable environment with a desirable microbial population in water and gut. Future directions in the field should focus on optimizing the utilization of these supplements for a more resilient and sustainable BFT aquaculture.
Figure 4 from Kinetics of Nirogacestat-Mediated Increases in B-cell Maturation Antigen on Plasma Cells Inform Therapeutic Combinations in Multiple Myeloma
Authors: Shearer Todd , Comstock Melissa , Williams Rex L. , Johnson Mark C. , Cendrowicz Ewa , Leonowens Cathrine , Smith Margaret , Baughman Todd M. , Breitbach Caroline J. , Cheng Shinta , Green Damian J.
Published: December 2024

Nirogacestat treatment increases mbBCMA density on PCs from whole blood and bone marrow. mbBCMA density on PCs isolated from (A) whole blood or (B) bone marrow after single doses of 50, 150, and 300 mg nirogacestat or 2 to 4 100 mg twice daily doses of nirogacestat. Fold change in mbBCMA density on PCs isolated from (C) whole blood or (D) bone marrow. Data points represent individual sample results, and dashed lines indicate the median for each sample time point; for time points with n = 1, the median value is represented by the single value. MESF, molecules of equivalent soluble fluorochrome.
Figure 1 from Kinetics of Nirogacestat-Mediated Increases in B-cell Maturation Antigen on Plasma Cells Inform Therapeutic Combinations in Multiple Myeloma
Authors: Shearer Todd , Comstock Melissa , Williams Rex L. , Johnson Mark C. , Cendrowicz Ewa , Leonowens Cathrine , Smith Margaret , Baughman Todd M. , Breitbach Caroline J. , Cheng Shinta , Green Damian J.
Published: December 2024

Nirogacestat dosing and sampling schedule. The solid arrow indicates nirogacestat single doses and the first dose of nirogacestat twice daily dosing; the dotted arrows indicate nirogacestat 100 mg twice daily doses. Baseline whole-blood and bone marrow samples were collected 1 day before dosing (predose). *Each dosed participant contributed one predose and one postdose bone marrow sample (n = 2 per posttreatment time point). Sampling times were based on the randomization/enrollment scheme shown. Rich PK sampling and all indicated whole-blood mbBCMA samples were collected from each participant through the assigned postdose time point.
Políticas públicas para la primera infancia en los países latinoamericanos
Authors: de Souza Della Barba Patricia , Cañadas-Pérez Margarita , Suárez-Lozano María Teresa , Chiappero Tatiana Ivonne
Published: December 2024

(analytical)The article analyzes the design of early childhood and early intervention public policies in Latin American countries, updating the legal framework and evaluating the effectiveness of existing programs. The article focuses on the relationship between the legislation that informs the design of public policies and the effectiveness of early intervention programs in the  countries that are members of the Ibero-American Early Childhood Care Network, with the authors identifying the perceived strengths and weaknesses of these initiatives according to its members. A total of eight members of this network participated in a descriptive and exploratory study that included semi-structured interviews and analysis of official documents. The results evidenced that while all of the countries have a regulatory framework for early childhood, there is no specificity regarding early intervention programs or the role of families in these policies. Chile, Mexico and Peru were notable for having the most comprehensive policies.
Keywords: Early intervention; public policy; child health.
Evaluación y asertividad: cohesión de grupo entre estudiantes con discapacidad intelectual
Authors: Bernal Andrea , Belmonte María Luisa , Bernárdez-Gómez Abraham
Published: December 2024

(analítico)Trabajar la resolución de conflictos con jóvenes con discapacidad intelectual favorece el desarrollo de habilidades sociales básicas que facilitan la igualdad de oportunidades dentro del mercado laboral. La muestra está constituida por estudiantes con discapacidad intelectual del programa formativo para la búsqueda de empleo, Todos somos campus, de la Universidad de Murcia. A través de un enfoque metodológico mixto, llevado a cabo mediante un test sociométrico y un cuestionario, se ha analizado la cohesión de grupo, el perfil estratégico y los medios de resolución de conflictos, el género y el nivel de asertividad. Este estudio ha supuesto la mejora de la competencia de la gestión del conflicto, al responder a la necesidad evaluada que mostraban los participantes.
Palabras clave:  Evaluación; resolución de conflictos; discapacidad intelectual; asertividad. Tesauro de Ciencias Sociales de la Unesco.
Voces de la infancia en situaciones de calle: aportes para la formación
Authors: Lopera-Álvarez Claudia Patricia , Alzate-Alzate Natalia Andrea , Londoño Vásquez David Alberto
Published: December 2024

(analytical)This article shares the results of a doctoral thesis that examines how educational activities are implementedwith children who were previously homeless and living on the street. An ethnography was conducted with participating children through techniques including focus groups and the construction of narratives with 5 boys and 6 girls who are supported by a non-profit in Antioquia (Colombia). Descriptive, axial and selective coding were developed for the analysis of the information, which led to the identification of three perspectives that can be used as part of their education: historical and emotional recognition, overcoming adult-centrism and learning in their own contexts. The authors conclude that a situated training perspective requires historical and emotional recognition of the participating children. This can be achieved through educational scenarios that allow them to expressthemselves and their feelings and talk about the sensitivity they have regarding their own experiences.
Keywords: Education; homeless children; context; participation; narratives.
Vascular Neurology Considerations for Antiamyloid Immunotherapy: A Science Advisory From the American Heart Association
Authors: Greenberg Steven M. , Aparicio Hugo J. , Furie Karen L. , Goyal Manu S. , Hinman Jason D. , Kozberg Mariel , Leonard Anne , Fisher Mark J. ,   on behalf of the American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology
Published: December 2024

Antibodies directed at the amyloid-β peptide offer the prospect of disease-modifying therapy for early-stage Alzheimer disease but also carry the risk of brain edema or bleeding events, collectively designated amyloid-related imaging abnormalities. Introduction of the antiamyloid immunotherapies into practice is therefore likely to present a new set of questions for clinicians treating patients with cerebrovascular disease: Which manifestations of cerebrovascular disease should preclude, or permit, antibody treatment? Is it safe to prescribe amyloid immunotherapies to individuals who require antithrombotic treatment, or to administer thrombolysis to antibody-treated individuals with acute stroke? How should severe amyloid-related imaging abnormalities be managed? This science advisory summarizes the data and key considerations to guide these challenging decisions as the medical community collects further data and experience with these groundbreaking agents.
Stigmagloia lobbanii gen. et sp. nov. (Bacillariophyceae, Mastogloiales), a new stigma-bearing diatom genus separated from Mastogloia
Authors: KEZLYA ELENA , GLUSHCHENKO ANTON , KAPUSTIN DMITRY , MALTSEV YEVHEN , DOAN-NHU HAI , KULIKOVSKIY MAXIM
Published: December 2024

The genus Mastogloia comprises mainly marine diatoms with a modified and specialized valvocopula called partecta. We isolated a new species, morphologically similar to M. cyclops, from the coastal waters of Viet Nam. A detailed study using light and scanning electron microscopy as well as molecular phylogenetic analysis based on SSU rDNA and rbcL sequences led us to describe a new genus and species, Stigmagloia lobbanii gen. et sp. nov. The main difference between Stigmagloia and Mastogloia is the presence of a stigma. The differences between S. lobbanii and M. danseyi, the type species of Mastogloia, are discussed. Mastogloia cyclops is transferred to Stigmagloia and a new combination, S. cyclops comb. nov., is proposed.
A new species of Croton (Euphorbiaceae) from the Espinhaço Mountain Range, Brazil
Authors: SILVA MARCOS JOSÉ DA , SODRÉ RODOLFO CARNEIRO
Published: December 2024

We describe Croton espinhacensis, a new species collected in Bahia and Minas Gerais state, related specially to C. harleyi, a species in section C. sect. Geiseleria from the Caatinga Domain of Northeast Brazil by having the same habit and branching pattern of the stem, leaves grouped at the apex of the branches, bisexual thyrses with flowers continuous along the inflorescence axis, and staminate flowers with 11 stamens. Both species are differentiated mainly by the combination of leaf and floral characters, as well as types floral nectaries. The new species has been confused in herbarium collections with C. atrorufus, a species also found in the Espinhaço Moutain Range, probably due to its habit, colors of the branches and, in some cases, ovate leaves which is why we also compared them. Croton espinhacensis is the only one in sect. Geiseleria with indumented anthers, and one of the few species in the entire genus with this character state.
Pittosporum napoense (Pittosporaceae), a new species from limestone areas of Guangxi, China
Authors: HUANG YU-SONG , ZOU CHUN-YU , LIU YAN , DENG YUN-FEI
Published: December 2024

Pittosporum napoense, a new species of Pittosporaceae is described and illustrated from limestone areas of Guangxi, China. Morphologically, it is most similar to P. kerrii in paniculate inflorescences with many corymbs, inflorescence axis with ferruginous pubescence, and oblate capsule dehiscing by 2 valves, but it can be easily distinguished from the latter by the indumentum of leaf blade and calyx, the colour of petals, the quantity of ovules and the length of filament. Photographs of this new species, as well as a table to distinguish it from P. kerrii, are provided. The threatened status of the new species is also assessed.
EXPRESS: Multi-Segment and Single-Segment Sales Contests: Evidence of Their Effectiveness and the Underlying Mechanisms
Authors: Bommaraju Raghu , Arunachalam S. , Hohenberg Sebastian
Published: December 2024

Sales contests are vital motivational tools, yet their effectiveness remains unclear. This research provides valuable insights by examining two contest types: 1) single-segment contests, where a salesperson competes against all other salespeople, and 2) multi-segment contests, where salespeople are divided into homogeneous segments and compete only within their respective segments. The authors compare both contests using different theoretical lenses and integrate managerial insights. For the empirical assessment, the authors carried out a field experiment with two treatment groups, each group participated in a different contest type, and a control group that did not participate in any contest. To strengthen the internal and external validity of the findings, they conducted four supplementary studies, which comprised two additional field studies and two experimental studies. Findings reveal that, on average, single-segment contests do not outperform a no-contest situation, while multi-segment contests enhance not only the average performance but also the performance across the segments. This performance improvement is mediated by a higher perceived chance of winning and motivation. Additionally, the authors compare multi-segment contests with 'duel-style' contests, where a salesperson competes in one-on-one duels within the same segment. Results indicate that the former yields superior results.
EXPRESS: Does Featuring People with Disabilities Help or Hurt Fashion Marketing Effectiveness?
Authors: Wang Jiaqian , Wei Chuang
Published: December 2024

People with disabilities constitute 16% of the global population but seldom appear in fashion marketing communications. The limited campaigns featuring models with disabilities elicit mixed responses from consumers, and the extant literature also makes contradictory predictions about whether disability representation helps or hurts. Ten preregistered field and lab experiments (including four supplemental studies) examine the effect of disability representation on fashion marketing effectiveness. We find that featuring people with (vs. without) disabilities improves fashion marketing effectiveness (i.e., click-through rate of ads, brand attitudes, behavioral intent, brand choice) by boosting perceived brand warmth (i.e., worthy intentions) and coolness (i.e., appropriate deviation from norms). On top of mediation results, we provide process evidence by showing that the positive effect of featuring models with (vs. without) disabilities attenuates when disability representation is reactive (vs. proactive) or when the brand is a follower (vs. first mover) in adopting this practice. Additionally, we demonstrate that compared to plus-size representation, disability representation more effectively enhances marketing effectiveness, as well as brand warmth and coolness. This research offers theoretical and practical insights into disability representation and highlights the importance of nuanced investigations in understanding various diverse representations and diversity, equity, and inclusion (DEI) initiatives.
International Harmonization of Nomenclature and Diagnostic Criteria (INHAND): Nonproliferative and Proliferative Lesions of Nonrodent Ocular Tissues
Authors: Schafer K. A. , Atzpodien E. , Bach U. , Bartoe J. , Booler H. , Brassard J. , Farman C. , Kochi M. , Lejeune T. , Meseck E. , Nolte T. , Ramos M. , Short B. , Sorden S. , Teixeira L. , Turner O. , Walling B. , Yekkala K. , Yoshizawa K.
Published: December 2024

The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions) Project ( www.toxpath.org/ inhand.asp) is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP), and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying lesions observed in ocular tissues (eyes and glands and ocular adnexa) from laboratory nonrodent species (rabbits, dogs, minipigs, and nonhuman primates) used in nonclinical safety studies with an emphasis on ocular-targeted dosing. Some of the lesions are illustrated by color photomicrographs. The standardized nomenclature presented in this document is also available electronically on the Internet ( http://www.goreni.org/ ). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes descriptions and visual depictions of spontaneous lesions and lesions induced by exposure to various test materials. A widely accepted and utilized internationally harmonized nomenclature for lesions in laboratory animals will provide a common language among regulatory and scientific research organizations in different countries and increase and enrich international exchanges of information among toxicologists and pathologists.
Labial salivary gland biopsy: a crucial method for confirming seronegative Sjogren’s syndrome—a case report
Authors: Romala Satyasai S. G. , Moturi Kishore , Manyam Ravikanth , Vadupu Meghana , Lakshmi P. Divya Naga , Budumuru Anil , Shivajiraju U. , Hyma J. S. D. N. Sai , Ramachandrudu R. V. S. N. S.
Published: December 2024

Background

Sjogren’s syndrome is an autoimmune disease that affects exocrine glands like sweat glands, salivary glands, and lacrimal glands. Dentists frequently encounter these patients and have an important role in establishing the diagnosis. It is mainly diagnosed by clinical features like xerostomia and xerophthalmia, along with anti-Sjögren’s syndrome-related antigen A (anti-SSA/also called Ro antigen) and anti-Sjögren’s syndrome-related antigen B (anti-SSB/ also called La antigen) antibodies in the patients. However, there is a subset of the population where autonuclear antibodies cannot be detected but are still present with all clinical features of Sjogren’s syndrome. Such patients usually remain undiagnosed, and only symptomatic treatment is given in spite of repeated consultation with various medical specialists. Only after establishing a proper diagnosis can we initiate definitive treatment.

Case presentation

Here, we report a case of seronegative Sjogren’s syndrome in a patient with severe xerostomia without anti-SSA and anti-SSB antibodies. The focus score from the labial biopsy, co-relating with clinical presentation, helped us in establishing the diagnosis. After a definitive diagnosis, our patient is put on cholinergic therapy, which greatly reduced the symptoms of xerostomia.

Conclusions

Physicians and dentists should refer such patients to an oral and maxillofacial surgeon for a labial biopsy to consider “seronegative Sjogren’s syndrome." The “focus score” evaluation by the pathologist helps in establishing the diagnosis of “seronegative Sjogren’s syndrome”.
Assessing Large Language Models for Oncology Data Inference From Radiology Reports
Authors: Chen Li-Ching , Zack Travis , Demirci Arda , Sushil Madhumita , Miao Brenda , Kasap Corynn , Butte Atul , Collisson Eric A. , Hong Julian C.
Published: December 2024

PURPOSE

We examined the effectiveness of proprietary and open large language models (LLMs) in detecting disease presence, location, and treatment response in pancreatic cancer from radiology reports.

METHODS

We analyzed 203 deidentified radiology reports, manually annotated for disease status, location, and indeterminate nodules needing follow-up. Using generative pre-trained transformer (GPT)-4, GPT-3.5-turbo, and open models such as Gemma-7B and Llama3-8B, we employed strategies such as ablation and prompt engineering to boost accuracy. Discrepancies between human and model interpretations were reviewed by a secondary oncologist.

RESULTS

Among 164 patients with pancreatic tumor, GPT-4 showed the highest accuracy in inferring disease status, achieving a 75.5% correctness (F1-micro). Open models Mistral-7B and Llama3-8B performed comparably, with accuracies of 68.6% and 61.4%, respectively. Mistral-7B excelled in deriving correct inferences from objective findings directly. Most tested models demonstrated proficiency in identifying disease containing anatomic locations from a list of choices, with GPT-4 and Llama3-8B showing near-parity in precision and recall for disease site identification. However, open models struggled with differentiating benign from malignant postsurgical changes, affecting their precision in identifying findings indeterminate for cancer. A secondary review occasionally favored GPT-3.5's interpretations, indicating the variability in human judgment.

CONCLUSION

LLMs, especially GPT-4, are proficient in deriving oncologic insights from radiology reports. Their performance is enhanced by effective summarization strategies, demonstrating their potential in clinical support and health care analytics. This study also underscores the possibility of zero-shot open model utility in environments where proprietary models are restricted. Finally, by providing a set of annotated radiology reports, this paper presents a valuable data set for further LLM research in oncology.
Phase II Trial of Nivolumab Plus Doxorubicin, Vinblastine, Dacarbazine as Frontline Therapy in Older Adults With Hodgkin Lymphoma
Authors: Torka Pallawi , Feldman Tatyana , Savage Kerry J. , Ganesan Nivetha , Drill Esther , Hancock Helen , Davey Theresa , Perez Leslie , Capadona Charisse , Subzwari Sarima , Galasso Natasha , Yang Jinshu , Post Michelle , Boardman Alexander , Caron Philip , David Kevin , Epstein-Peterson Zachary , Falchi Lorenzo , Ghione Paola , Hamlin Paul , Horwitz Steven M. , Intlekofer Andrew M. , Johnson William , Kumar Anita , Lue Jennifer , Noy Ariela , Owens Colette , Palomba M. Lia , Salles Gilles A. , Steiner Raphael , Stuver Robert , Vardhana Santosha , Yahalom Joachim , Dogan Ahmet , Zelenetz Andrew D. , Schöder Heiko , Moskowitz Alison J.
Published: December 2024

PURPOSE

We conducted a phase I/II study evaluating nivolumab plus doxorubicin, vinblastine, dacarbazine (N-AVD) as frontline therapy for treatment-naïve older adults (OA) with classical Hodgkin lymphoma (cHL; ClinicalTrials.gov identifier:
NCT03033914
).

METHODS

Patients age ≥60 years with newly diagnosed, any stage, cHL were treated with six cycles of AVD at standard doses plus nivolumab 240 mg intravenously once every 2 weeks (on days 1 and 15) of each cycle. A geriatric assessment was performed before therapy initiation. The primary end point was progression-free survival (PFS).

RESULTS

Patient characteristics (N = 40) included median age of 66 years (range, 60-78 years) with 38% ≥70 years, 78% with stage III/IV disease, 68% with International Prognostic Score of ≥3, 82% dependent in ≥1 activities of daily living, 23% dependent in ≥1 instrumental activities of daily living, 50% with impaired timed up and go test, and 40% with polypharmacy. Among 37 response-evaluable patients, the median follow-up was 49 months and 3-year PFS and overall survival (OS) were 79% and 97%, respectively. Overall, 50% patients experienced grade 3/4 treatment-related adverse events (TRAEs), including febrile neutropenia in 8%. Four (10%) patients stopped therapy due to TRAEs. There was no correlation between baseline geriatric impairments and survival outcomes or toxicities. Positron emission tomography-2 was not predictive of PFS or OS.

CONCLUSION

N-AVD is a highly effective and well-tolerated frontline regimen in OA with cHL across a wide range of geriatric impairments.
Cost-Effectiveness of Remote Tailored Risk Communication and Navigation for Hereditary Genetic Risk Assessment Uptake: Economic Evaluation From the Genetic Risk Assessment for Cancer Education and Empowerment Trial
Authors: Handorf Elizabeth A. , McDougall Jean A. , Heidt Emily , An Jinghua , Walters Scott T. , Toppmeyer Deborah L. , Kinney Anita Y.
Published: December 2024

PURPOSE

The Genetic Risk Assessment for Cancer Education and Empowerment Project demonstrated that tailored counseling and navigation (TCN) substantially increased the rate of genetic evaluation (GE) in women with high-risk breast or ovarian cancer (odds ratio, 8.9 [95% CI, 3.4 to 23.5] for TCN
v
usual care [UC]). This study sought to estimate the cost and cost-effectiveness of TCN in a clinic setting from a societal perspective.

METHODS

We identified the components of the intervention and downstream outcomes which would result in resource use. We assessed time spent by staff, cost of mailings, cost of patient time, and cost of testing and counseling in 6 months. Incremental cost-effectiveness ratios were calculated for outcomes of interest. We assessed the sensitivity of our results to assumptions via one-way sensitivity analyses. In addition, we assessed how results would change if a higher volume of patients was given TCN, with a health coach working full-time.

RESULTS

TCN costs $68,924 in US dollars (USD) to deliver per 212 patients, or $325 USD per patient. The intervention cost was $2,154 USD per record-verified GE. Much of this was attributed to training costs for health coaches ($50,223 USD). When including testing and counseling, the incremental cost effectiveness ratio (ICER) of TCN versus UC was $3,250 USD per additional GE. This was most sensitive to TCN effectiveness (ie, GE rate in TCN patients) and cost of testing. Cost-effectiveness would be more favorable with higher coaching volume (ICER of $1,730 USD/GE).

CONCLUSION

Implementing TCN in a clinic setting would come with notable costs, and current reimbursement policies for telemedicine may not be sufficient. Cost-effectiveness of TCN can be improved if subsequent interventions are more efficacious or are delivered to greater patient volumes.
Financial Toxicity Among Patients With Advanced Solid Tumors Participating in Early-Phase Clinical Trials
Authors: Blanter Julia , Van Hyfte Grace , Ahmad Maham , Xu Suzanne , Hapanowicz Olivia , Fazilov Gabriela , Lu Ashley , Lucas Natalie , Wu Kathy , Shelton Gary , DeMerchant Mandy , Lachowicz Michael , Kier Melanie , Werner Michael , Eder Joseph P. , Galsky Matthew D. , Marron Thomas U. , Smith Cardinale B. , LoRusso Patricia M. , Hofstatter Erin , Doroshow Deborah B.
Published: December 2024

PURPOSE

Financial toxicity (FT) adversely influences patient quality of life and is a barrier to clinical trial enrollment. Early-phase clinical trials (EPCTs) recruit patients who may have high baseline FT and require additional visits and procedures, potentially increasing FT.

METHODS

In this prospective survey study, we sought to assess FT at baseline and after 2 months among patients with advanced solid malignancies participating in EPCTs. Participants were age 18 years and older, were English-speaking, and were treated at the Yale Cancer Center (Yale) and the Tisch Cancer Institute at Mount Sinai (Mount Sinai). At the time of consent and 2 months later, patients completed a sociodemographic questionnaire as well as the 11-item validated Comprehensive Score for Financial Toxicity (COST) instrument. Primary outcomes were baseline COST score and change in COST score from baseline to 2 months. Lower score is associated with higher FT.

RESULTS

One hundred forty-six patients completed survey 1. Mean age was 61.5 years and 50.7% were male. The most common histologies were lung (17.8%), colorectal (16.4%), and breast (12.3%) cancers. Mean baseline COST score was 22.12 (standard deviation, 8.01). FT was associated with being a primary wage earner (
P
= .044) and inversely associated with age (
P
= .025). Seventy-one patients completed survey 2. Among 71 patients who completed both surveys, there was no significant difference in COST score between surveys 1 and 2 (
P
= .28). Race, ethnicity, education, and household income were not associated with baseline COST score or change in FT.

CONCLUSION

Moderate FT was reported at baseline and on trial among EPCT participants. No change in FT was observed between time points. Additional efforts should be made to decrease FT associated with EPCT participation to maximize access to novel therapies.
Neuroendocrine and Developmental Impacts of Early Life Exposure to EDCs
Authors: Streifer Madeline , Thompson Lindsay M , Mendez Skylar A , Gore Andrea C
Published: December 2024

Polychlorinated biphenyls (PCBs) pose a global challenge to environmental and human health. Although toxic and carcinogenic at higher exposure levels, at lower concentrations they can act as endocrine-disrupting chemicals. Individuals are more vulnerable to endocrine-disrupting effects of PCB exposures during the perinatal period, when the neuroendocrine system is developing, although assessing the full impact of PCB exposure is difficult because of the often-latent onset of adverse effects. The goal of this study was to determine developmental effects of an estrogenic PCB mixture, Aroclor 1221 (A1221), on KNDy and kisspeptin neuron numbers in the hypothalamic arcuate nucleus and anteroventral periventricular nucleus (AVPV), together with measures of hypothalamic-pituitary-gonadal hormones and postnatal development. We conducted RNAscope of kisspeptin, prodynorphin, neurokinin B, and estrogen receptor alpha genes in the P30 hypothalamus. Early-life PCBs caused small but significant changes in development (body weight and anogenital index) but had no effect on puberty. We found sex-specific effects of treatment on serum LH, FSH, and estradiol in a sex- and developmental age-dependent manner. RNAscope results revealed increased prodynorphin in the AVPV of male rats, but no effects on kisspeptin or neurokinin B in AVPV or arcuate nucleus. An unexpected species difference was found: we were unable to detect prodynorphin coexpression with kisspeptin within KNDy neurons in rats, unlike mice, sheep, and primates. These data show that early-life PCBs can induce developmental and hormonal changes that together with other reports showing latent effects on behavior and the hypothalamic-pituitary-gonadal axis, indicate adverse endocrine and neurobehavioral outcomes.
Giving an Account: When, Where, for Whom, and Why?
Authors: Butler Judith
Published: December 2024

In this essay, Judith Butler considers a series of critical engagements with their work, examining not only what it means to give an account of oneself but to whom and about what. Several of the authors in the collection Unaccountably Queer draw attention to how the generalized philosophical problem, can I give an account of myself ?, changes once we ask what prompts the question, to whom the answer is addressed, and in what time and space the “account” becomes an instrument or illumination of power. If any such account assumes a language saturated with social norms, then how is it possible to avoid becoming trapped in categories, or effaced by them, if they function to discredit the speaking I? Considering the racial politics of account giving, transphobic and diasporic narratives, complaints, colonial trajectories, and humanitarian whiteness, the question takes on new dimensions by virtue of its specific conditions of enunciation. Along the way, giving an account of oneself is distinguished from memoir and autobiography, and the existential stakes of theoretical reflection are defended.
High-Intensity Intervallic Exercise (HIIE) Is Superior to Isocaloric Moderate-Intensity Continuous Exercise (MICE) at Reducing Postprandial Hyperglycemia
Authors: Mora-Rodriguez Ricardo , Moreno-Cabañas Alfonso , Alvarez-Jimenez Laura , Mora-Gonzalez Diego , Morales-Palomo Felix
Published: December 2024

Purpose

We investigated if a bout of HIIE is more efficacious at reducing postprandial hyperglycemia than an isocaloric bout of MICE.

Methods

Nineteen healthy physically active individuals (21% women) completed three trials in a randomized order: i) HIIE cycling consisting of 5 bouts of 4 min at 83 ± 9% of subjects’ maximal oxygen consumption (V˙O2 MAX) with active recoveries at 53 ± 8% for a total of 50 min; ii) MICE cycling at 65 ± 8% of V˙O2 MAX for 50 min, and iii) CONTROL no exercise. All trials were followed by a standard oral glucose tolerance test (OGTT) ingesting 74 grams of glucose traced with 1 gram of uniformly labeled [13C]-glucose. Plasma glucose and insulin concentrations, and plasma glucose kinetics ([6,6 2H2] glucose infusion) were measured before, during exercise, and during the OGTT. Insulin sensitivity was estimated by the Matsuda index (ISI). Energy expenditure and carbohydrate oxidation (CHOxid) were monitored.

Results

At rest, blood glucose, insulin concentrations, and CHOxid were similar in all three trials. During exercise, energy expenditure was similar in HIIE vs MICE (548 ± 131 vs 560 ± 125 kcals; p = 0.340). However, CHOxid, plasma glucose concentration, and its rates of appearance in plasma (Ra) were higher in HIIE vs MICE (Ra glucose 34.3 ± 9.8 vs 28.9 ± 6.8 μmol·kg-1·min-1; p = 0.021). During the OGTT, plasma glucose and insulin concentrations were lower, and insulin sensitivity higher in HIIE vs CONTROL (ISI MATSUDA; 12.4 ± 4.7 vs 10.8 ± 4.7 au; p = 0.007). Exercise delayed blood incorporation of [13C]-glucose into blood (p = 0.023). Early during the OGTT, glucose clearance rates were higher in HIIE vs CONTROL (7.1 ± 3.1 vs 5.5 ± 3.0 mL·kg-1·min-1; p = 0.015).

Conclusions

HIIE is more effective than MICE to reduce hyperglycemia and hyperinsulinemia after glucose ingestion. HIIE improves glycemic control by increasing splanchnic glucose retention and glucose clearance rates.